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Julie M. Gillis, DDS, PC Blog

Should Gingival Recession Be Treated?

August 21, 2017

Filed under: Gum Recession — Tags: — Dr Gillis @ 6:53 am

Should Gingival Recession Be Treated?

Please see our previous blog on what IS gingival recession.

Should gingival recession be treated?  The answer is, it depends!  This blog will explore some of the reasons to treat or not to treat gingival recession.  We hope you enjoy it!

We care about gingival recession for many reasons.  Mostly because we want you to save your teeth for a lifetime and gingival recession is not a normal process of aging.  Most importantly your dentist should help you determine the cause of your gingival recession and then tell you the things you can do to prevent it from continuing.

Gingival Recession

Several areas of gingival or gum recession noted

The gingival recession pictured here is severe.  The patient has been informed as to the likely causes of his recession (Orthodontic movement of the teeth combined with excessive and hard tooth brushing) and instructed in how to prevent it from getting worse.  Our patient really wants to have a better looking smile!  The following are the patient’s main concerns:

  • Dark colored front teeth
  • Short side teeth (lateral incisors)
  • Poor alignment of the front teeth
  • Gingival recession is only a minor concern

Now, please look at the photo of our patient’s smile.  Even with a wide smile, the gingival recession cannot be seen.  The most noticeable things about the smile are the discolored or dark front teeth and the short side teeth that seem to stick out.

The patient's concerns are apparent in this smile photo.

The patient’s concerns are apparent in this smile photo.

Our office decided to start with study models to show the patient what could be done to improve his smile.  Conservative treatment including four porcelain veneers on his front teeth would take care of his esthetic concerns.  We elected not to treat the gingival recession for these reasons:

  1. The gingival recession was not visible in his smile
  2. Gingival recession is very difficult to treat successfully
  3. We can monitor the recession over time and assure that it is not getting worse
  4. The patient has been instructed in the things he can do to prevent further gingival recession. This includes proper brushing and a gentle or no tooth paste.
  5. The gentlest thing next to gums is healthy tooth structure – not dental restorations
  6. Even with the recession, there is still adequate healthy gums around each tooth.

Stubler-10 G.Stubler6

When you look at our result compared to the before treatment photo, you can see how well the gum tissue is responding to the new porcelain veneers.  The improvement in the smile was perfect for our patient and addressed his cosmetic concerns while conserving healthy tooth structure and minimizing unnecessary surgery.

 

Our office would be happy to help you take the best care possible of your teeth.  You can reach our Grand Junction, Colorado office at (970) 242-3635.  Or visit our website at www.juliegillisdds.com for more information.  We would love to have you visit and like us on Facebook or Instagram.  Find us at Julie Gillis DDS on Facebook or DDSJulie on Instagram

Yours for better dental health,

Julie Gillis DDS, AAACD

Restoring Teeth/Restoring Smiles

 

 

What is Gingival or Gum Recession?

August 16, 2017

Filed under: Gum Recession — Tags: — Dr Gillis @ 6:48 pm

What is Gingival Recession?

This blog reviews what gingival recession is and the typical causes of gingival recession.  Photos display gingival recession on both front and back teeth.  By reading this blog is is hoped that you will become more aware of this problem and the ways that gingival recession can be prevented.  If gingival recession is already present, you will read how you can help prevent it from progressing.

Gingival Recession

Several areas of gingival or gum recession noted

What is gingival recession?  See the photo above.  Gingival recession happens when the gums recede or move away from their normal position near the edge of the tooth’s enamel and move toward the tip of the tooth’s root exposing the root surface of the tooth.  Once gingival recession has occurred, it will not go away on its own.  Typical causes of gingival recession are as follows:

  1. Overly aggressive tooth brushing
  2. Brushing the teeth with a hard-bristled toothbrush
  3. Brushing the teeth with an abrasive toothpaste
  4. A gum infection, periodontitis or gingivitis may cause attachment loss especially if not treated early
  5. Orthodontic movement of the teeth into an area of very thin bone so that the bone resorbs and the gums move down the roots of the teeth
  6. Trauma
  7. An ill-fitting appliance that presses on the gums
  8. Clenching and grinding of the teeth alone or combined with any of the above

We care about gingival recession for many reasons.  Mostly because we want you to save your teeth for a lifetime and gingival recession is not a normal process of aging.  Most importantly your dentist should help you determine the cause of your gingival recession and then tell you the things you can do to prevent it from continuing!

G.Stubler6

In the photo shown here, the gingival recession is present in most areas of the mouth.  As you can see, the front teeth have been beautifully restored with porcelain veneers.  The likely causes of the gingival recession is Orthodontic movement of the teeth combined with excessive and hard tooth brushing.  Look closely at the gingival recession present on the back teeth.  The exposed root is much softer than the adjacent enamel on the crown of the tooth and because this exposed part is softer, the root is more likely to be damaged or worn away by excessive tooth brushing.

So, what should you do?  If you believe that you have gingival recession you should talk about this with your dentist.  We recommend the following:

  • Use a soft toothbrush and a very mild or no toothpaste.
  • Your teeth will get clean if you dip your toothbrush in a mouth rinse for brushing. This eliminates the problem of the paste wearing away your tooth.
  • Review your brushing techniques with your dentist or dental hygienist.
  • Have photos taken of your teeth that show the recession and then compart the amount of recession over time. It should not get worse if you are doing the right things!

Our office would be happy to help you take the best care possible of your teeth.  You can reach our Grand Junction, Colorado office at (970) 242-3635.  Or visit our website at www.juliegillisdds.com for more information.  We would love to have you visit and like us on Facebook or Instagram.  Find us at Julie Gillis DDS on Facebook or Julie Gillis DDS on Instagram

 

 

Preventing Tooth Erosion or Tooth Attrition

July 1, 2017

Filed under: Tooth Erosion,Tooth Reshaping/Bite Adjustment — Tags: — Dr Gillis @ 8:00 am

Is tooth erosion or attrition part of the normal aging process?  Yes and NO!

Severe wear into the softer dentin of both upper and lower teeth.

Severe tooth erosion into the softer dentin of both upper and lower teeth.

Tooth erosion is not from normal aging, tooth attrition is.  See below for definitions.

Is it natural for our teeth to wear down and become shorter as we age?  Yes, your teeth will wear from chewing food, but not very much!  Normal chewing  should only cause you to lose about 1 mm of tooth length over a lifetime of 100 years!  The type of food eaten will make a difference in the amount of wear as well.  Ages ago when people ground grains between stones to make their breads and other foods, some bits of stone would be in the resulting flour or meal and eating foods prepared with this would, over years of time, cause excessive wear of tooth structure.

Severe erosion into the softer dentin of the lower teeth. Note the 'cupped' shape of the top or chewing surface of the tooth.

Severe erosion into the softer dentin of the lower teeth. Note the ‘cupped’ shape of the top or chewing surface of the tooth.

The more severe wear we are talking about in this blog is preventable tooth wear from tooth erosion.  Think of the ways that people use their teeth as tools (trimming nails, breaking string, cracking nuts, holding tools) and you can imagine that this causes way more wear than any type of natural chewing.    Sometimes, even your occupation will make your teeth more likely to undergo heavy wear.  If you work in an area of heavy dust and grit this gritty film will often be present on your teeth and if this is combined with any type of clenching and grinding, the wear can be severe over a short time.

Why do some people’s teeth look old and worn while they are still young?  This is most likely due to tooth or dental erosion or attrition.

Tooth Erosion  results in the loss of tooth structure due to softening of the tooth surface from an acidic diet. the softened tooth wears away more easily during chewing and is especially prone to more severe wear if you clench or grind your teeth.   Tooth attrition  is a type of irreversible wear caused by the contact of the upper and lower teeth resulting in loss of tooth structure.  This type of wear starts in the areas where the teeth contact during normal chewing.  Tooth wear is a physiological process and is commonly seen as a normal part of aging.

Note that the upper teeth are almost see-thorough at the edge. Severe erosion into the inner layer of the teeth (the dentin) on both upper and lower teeth.

Note that the upper teeth are almost see-thorough at the edge. Severe erosion into the inner layer of the teeth (the dentin) on both upper and lower teeth.

Our friends at Wikipedia note that, “Advanced and excessive wear and tooth surface loss can be defined as pathological in nature, requiring intervention by a dental practitioner. The pathological wear of the tooth surface can be caused by bruxism, which is clenching and grinding of the teeth. If the attrition is severe, the enamel can be completely worn away leaving underlying dentin exposed, resulting in an increased risk of dental caries and dentin hypersensitivity. It is best to identify pathological attrition at an early stage to prevent unnecessary loss of tooth structure as enamel does not regenerate.”

Our office would be happy to answer your questions about tooth erosion. We will let you know your options!

Yours for better dental health,

Julie Gillis DDS

Restoring Smiles/Restoring Health

 

 

Perio Breath – It’s Real, It’s Nasty, and It’s Treatable!

June 26, 2017

Filed under: Perio Breath & Bad Breath,Uncategorized — Tags: — Dr Gillis @ 12:16 pm

Perio Breath – It’s Real, It’s Nasty, and It’s Treatable!

Perio breath can be so distracting that your message may not get across!

Perio breath can be so distracting that your message may not get across!

Perio breath is probably equal across men and women. This treatable condition deserves more press!

Perio breath is probably equal across men and women. This treatable condition deserves more press!

Perio breath – by this I mean the breath of someone who has active and probably untreated periodontal disease is unmistakeable and I wish I could just guide any person with this condition into prompt treatment!  Just do it!  Do this for you, for your improved health, for improved taste, and for improved interpersonal conversations!

Using a hand actually does help direct your breath downward and away form your listener! There are more permanent solutions however.

Using a hand actually does help direct your breath downward and away form your listener! There are more permanent solutions however.

Everyone has bad breath on occasion! Perio breath is an especially bad form of this and won't go away with better eating and brushing. It takes the intervention of dentists and dental hygienists to cure!

Everyone has bad breath on occasion! Perio breath is an especially bad form of this and won’t go away with better eating and brushing. It takes the intervention of dentists and dental hygienists to cure!

I can smell periodontal breath across the room.  And I know our office could make such a difference in improved health for whichever person has this! It is the smell of deep infection and rot.  For patient’s with this condition, they may even be unaware that they have this problem.  And if they are aware, they may try to cover up the        condition with gum or breath mints or toothbrushing.  These may help a little but if your bad breath is due to active periodontal disease, treatment with your dentist and dental hygienist is the only way to cure this problem.

A spritz can help common bad breath. Perio breath needs treatment!

A spritz can help common bad breath. Perio breath needs treatment!

If bad breath was visible maybe we would do more to prevent it!

If bad breath was visible maybe we would do more to prevent it!

Let me take you to why I am blogging about this now.  I just got off an airplane and no, I did not have to sit directly beside someone with perio breath.  This has happened to me and it is not pretty!  But periodically the smell would blow over us from the vents where we passengers are all exchanging air and it got me wondering who was the breather causing this and do they even know there is fairly simple treatment?  Granted, it could have been something else (standard bad breath, medical issue related bad breath etc.,) but I am pretty sensitized to the real perio breath.  If you or someone you know and love has this problem, kindly and sweetly suggest that they or you should have a consult with their dentist.  Periodontal disease causing bad breath is not painful but the stigma of having bad breath may be!  We can help!

Straighten Teeth with Porcelain Veneers and Braces or Just Veneers?

June 20, 2017

Filed under: Porcelain Veneers — Tags: , — Dr Gillis @ 7:15 am

Straighten Teeth with Porcelain Veneers and Braces or Just Veneers?

Severe crowding, flaring and tipping of teeth - corrected in one month with porcelain veneers.

Severe crowding, flaring and tipping of teeth – corrected in one month with porcelain veneers.

Severe crowding, flaring and tipping of teeth - corrected in one month with porcelain veneers.

Severe crowding, flaring and tipping of teeth – corrected in two visits with porcelain veneers.

 

Should you straighten your teeth with Porcelain veneers and braces or just veneers?

 

 

The answer is not easy!  Braces are certainly not always needed.  See the photos here that show what is possible with porcelain veneers in our office!

There may be benefits depending on your choice of using porcelain veneers only or porcelain veneers and braces.  In general, if you choose to straighten your teeth with veneers without doing braces you can expect the following: (I will explain all in more detail below)

  1. Considerably shorter treatment time
  2. More shaping of your teeth
  3. There may need to be compromises in the result
  4. May or may not be longer treatment time in the dentist’s chair
  5. Treatment will probably be more expensive
  6. More of your teeth may need veneers than if you were to complete braces before your veneer treatment

Item (1) above:  Treatment that includes veneers and braces will often add 6 months or more to the overall treatment time)

Item (2) above:  When using veneers alone, your dentist will need to adjust just enough on your teeth to achieve your desired cosmetic result.  Your dentist should be able to review the pros and cons of this.  Ask a lot of questions so that you understand the treatment that is proposed.

Item (3) above:  Your dentist should be able to explain to you and/or show you photos and models that describe the result that you should achieve.  If may be that a slight compromise in the alignment of the teeth will still be wonderful for you and will save you months of treatment time and possibly a considerable amount of money.

Item (4) above:  If your dentist recommends veneers and braces it may be because just completing braces will decrease the number of veneers needed to achieve an ideal result.  Veneers and braces may both be recommended to achieve your goals as either one alone may not be enough.  Chipped or discolored teeth will still be chipped and discolored after braces.

Item (5) above:  The combination of veneers and braces will almost always be more expensive but the end result may be worth it!  Talk to your dentist to understand the recommendations.

Item (6) above:  This may or may not be true and will depend on your specific treatment!

Severe crowding, flaring and tipping of teeth - corrected in one month with porcelain veneers.

Severe crowding, flaring and tipping of teeth – corrected in one month with porcelain veneers.

Severe crowding, flaring and tipping of teeth - corrected in one month with porcelain veneers.

Severe crowding, flaring and tipping of teeth – corrected in one month with porcelain veneers.

Our office will often recommend the combination of veneers and braces to achieve a specific result but as you can see here, we can also make it look like you have been through several years of braces and yet your treatment time was only a month or so!  It is extremely important to select a dentist who excels at this type of treatment and who has your best interests at heart.  Please visit our web site at www.juiegillisdds.com for more information about our office.  Dr. Julie Gillis is an accredited member of the American Academy of Cosmetic Dentistry and was the very first dentist in Colorado to achieve this honor.  She now serves as an accreditation examiner for the AACD as well as on the American Board of Cosmetic Dentistry.

 

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