Lansing's Dental Discussion
By Holly Scott-Hetchler DDS
March 18, 2019
Category: Dental Procedures
Tags: gummy smile  
YouDontHavetoLivewithaGummySmileHeresHowWeCanChangeit

A beautiful smile is a balanced smile, especially in regard to your gums. A normal smile usually shows 4 mm or less of gum tissue along with about 10 mm of tooth length. But if your gums show more than that, your smile may seem too gummy. In terms of perceived balance, this could detract from your smile's attractiveness.

Fortunately, you don't have to live with a gummy smile—there are various ways to correct or minimize its effect. First, though, we'll need to determine the underlying cause before deciding on the best treatment. And, there are several possible causes, the obvious being too much gum tissue present. Teeth that appear shorter due to wear or incomplete eruption could also make the gums appear larger.

We may be able to correct these size problems by surgically removing and reshaping excess gum tissues and possibly the underlying bone to reveal more of the teeth. We can also bond composite resins or porcelain veneers to shorter teeth to make them appear larger.

But not all gummy smile problems pertain directly to the teeth and gums; instead, it could be your upper lip moves too far up as you smile (hypermobility). Or, your upper jaw may be too long for your face, which can also cause too much of the gums to show during smiling.

With upper lip hypermobility, we may be able to inhibit the lip muscles' movement temporarily with Botox injections that partially paralyze the muscles (the effect eventually wears off, so this treatment will need to be repeated). A periodontist, an oral surgeon, or a plastic surgeon could also permanently alter the upper lip movement through a surgical procedure. Surgery may also be necessary for an abnormally long upper jaw: orthognathic surgery re-positions the jaw to the skull, which can lessen the amount of gums showing.

If your smile is too gummy, we can transform it. But first, let's find out what the real cause is with a comprehensive dental examination. Once we know, we can better advise you on the best way to bring beautiful balance to your smile.

If you would like more information on improving a gummy smile, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Gummy Smiles.”

JanetJacksonEvenpopstarsgetinsecureabouttheirsmiles

Multi-platinum recording artist Janet Jackson has long been known for her dazzling smile. And yet, Jackson admitted to InStyle Magazine that her trademark smile was once a major source of insecurity. The entertainer said, “To me, I looked like the Joker!” It was only after age 30 that the pop icon came to accept her unique look.

Jackson is not alone. A study commissioned by the American Association of Orthodontists found that more than one third of U.S. adults are dissatisfied with their smile. But there’s good news—modern dentistry can correct many flaws that can keep you from loving your smile, whether you’re unhappy with the color, size, or shape of your teeth. Here are some popular treatments:

Professional teeth whitening: Sometimes a professional teeth whitening will give you the boost you need. In-office whitening can dramatically brighten your smile in just one visit.

Tooth-colored fillings: If you have silver-colored fillings on teeth that show when you smile, consider replacing them with unnoticeable tooth-colored fillings.

Dental bonding: If you have chipped, cracked, or misshapen teeth, cosmetic bonding may be the fix you’re looking for. In this procedure, tooth colored material is applied to the tooth’s surface, sculpted into the desired shape, hardened with a special light, and polished for a smooth finish.

Porcelain veneers: Dental veneers provide a natural-looking, long-lasting solution to many dental problems. These very thin shells fit over your teeth, essentially replacing your tooth enamel to give you the smile you desire.

Replacement teeth: Is a missing tooth affecting your self-confidence? There are several options for replacing missing teeth, from a removable partial denture to a traditional fixed bridge to a state-of-the-art implant-supported replacement tooth. Removable partial dentures are an inexpensive way to replace one or more missing teeth, but they are less stable than non-removable options. Dental bridges, as the name implies, span the gap where a tooth is missing by attaching an artificial tooth to the teeth on either side of the space. In this procedure, the teeth on both sides of the gap must be filed down in order to support the bridgework. Dental implants, considered the gold standard in tooth replacement technology, anchor long-lasting, lifelike replacements that function like natural teeth.

After coming to embrace her smile, Jackson asserted, “Beautiful comes in all shapes, sizes, and colors." If you don’t feel that your smile expresses the beauty you have inside, call our office to schedule a consultation. It’s possible to love your smile. We can help.

For more information, read Dear Doctor magazine article “How Your Dentist Can Help You Look Younger.”

By Holly Scott-Hetchler DDS
February 26, 2019
Category: Oral Health
Tags: oral health   gum disease  
TakeCareofYourGumsTakeCareofYourHeart

At this time of year, hearts are everywhere you look, so it's fitting that February is American Heart Month, a time to focus on cardiovascular health. Cardiovascular disease, which includes heart disease and stroke, is the number one cause of death around the world. But did you know that there's a link between the health of your heart and the health of your mouth?

People with advanced gum disease have a higher risk of having a heart attack, stroke or other cardiovascular event, but what is the connection? For one, oral bacteria found in gum disease can enter the bloodstream, where it has been found in artery-clogging plaque. In addition, untreated gum disease has been determined to worsen high blood pressure, a major contributor to heart attack, stroke and heart failure. One study reported that when gum disease was treated, high blood pressure fell by up to 13 points. But perhaps the most significant common denominator between gum disease and heart disease is inflammation, according to many researchers.

Gum disease is the most common inflammatory disease, affecting nearly 50% of US adults over 30, and 70% of those aged 65 and older, according to the U.S. Centers for Disease Control. The body's inflammation response is a key weapon in fighting infection. However, when there is chronic low-level inflammation such as occurs with untreated periodontal (gum) disease, many adverse health effects can result. In one Harvard University study, chronic inflammation was found to triple the risk of heart attack and double the risk of stroke.

The relationship between gum disease and heart disease is still not completely understood, but there's no denying that a connection exists between the two, so it's worth doing what you can to take care of both your gums and your cardiovascular health. Here are some tips:

  • Eat a heart-healthy—and gum-healthy—diet. A diet low in refined carbohydrates, high in fiber, vitamins C and D, antioxidants and Omega-3s has been shown to lower inflammation, benefitting your gums and your heart.
  • Quit smoking. Using tobacco in any form is a risk factor for developing both gum disease and heart disease.
  • Take care of your oral health. Gum disease can often be prevented—and reversed if caught early—simply with good oral hygiene, so be diligent about brushing your teeth twice a day and flossing once a day.
  • Come in for regular cleanings and checkups. Regular cleanings can help keep your gums healthy, and an examination can determine if you have gum disease. Be sure to tell us about any medical conditions or medications.

As you think about what you can do to take care of your heart health and overall health, don't forget your gums. If you have questions about how to improve your oral health, call us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Good Oral Health Leads to Better Health Overall” and “Carbohydrates Linked to Gum Disease.”

RemovableDenturesRemainaViableOptionforPeoplewithTotalToothLoss

Although highly preventable, total tooth loss continues to affect millions of people worldwide, harming their nutrition, health and social standing. In the United States alone, a quarter of adults between 65 and 74 suffer from total tooth loss.

Fortunately, there are a number of ways to restore lost teeth, including fixed bridgework and dental implants. These fixed solutions, though, can put a strain on finances; implants in particular require a minimum amount of bone in the jaw, which may not be present in people with extensive tooth loss. In these cases, removable dentures, time-tested and affordable, are a viable option.

While the technology is simple, adaptable and effective, creating custom-fitted dentures is a painstaking process. It begins with an impression mold of the patient’s jaw ridges that once supported the natural teeth. A dental lab technician uses the impression to fashion a life-like plastic resin base, making sure the final dimensions won’t interfere with the patient’s cheeks, lips, and jaw movement.

The prosthetic (artificial) teeth, each chosen to match the patient’s facial structure and past appearance, are then carefully positioned on the base. Teeth positioning on each denture arch must also balance with the opposing arch to assure a good bite. Once delivered, the dentist may make other adjustments to assure they fit comfortably within the patient’s mouth.

Dentures also require regular care and maintenance to ensure a continuing good fit and an overall healthy mouth. Your gums will still be susceptible to disease, so cleaning and maintaining both your dentures and the mouth’s soft tissues is an ongoing necessity.

The lack of natural teeth can also lead to more bone loss, which can cause the dentures to lose their accurate fit and make them uncomfortable to wear. To remedy this, we can add more resin material to the dentures to refit them or, in extreme cases of poor fit, create a new denture to match current gum contours. Alternatively, we can install a few dental implants that will support the denture instead of the gum ridges, which would inhibit further bone loss.

To learn whether dentures could be a good option for you, we’ll first need to conduct a thorough examination of your mouth. It could be this original tooth replacement system will bring back the teeth and smile you’ve lost.

If you would like more information on dentures, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Removable Full Dentures.”

By Holly Scott-Hetchler DDS
February 06, 2019
Category: Oral Health
Tags: oral health  
GetRelieffromCrackedCornersoftheMouth

If you’ve noticed redness or small skin cracks at the corners of your mouth, you may have a common infection known as perleche or angular cheilitis. Depending on its cause, there are ways to treat the redness and skin cracking to lessen your discomfort.

The term perleche comes from the French word “lecher,” meaning to lick. This is derived from the tendency of perleche patients to constantly lick the area to ease irritation; unfortunately, this also helps perpetuate the inflammation. Once the skin is broken the area is commonly infected by yeast called candida albicans.

Initially, perleche may arise from a variety of sources, most of them locally from either inside or around the mouth, although it can be triggered by a general body infection or disease like diabetes or cancer, or vitamin or iron deficiencies. Inside the mouth reduced saliva flow, tissue inflammation under a rarely cleaned denture (denture stomatitis), pressure on the mouth corners caused by a collapsed bite due to missing teeth and similar conditions can elevate the risks for infection. Around the mouth wrinkling or “marionette lines,” deep lines that extend from the mouth to the chin due to aging or environmental exposure, can contribute to crack formation. Drooling during sleep or as a result of orthodontic treatment is also a contributing cause.

The main focus of treatment for perleche is to bring any infection under control. This can be accomplished with a course of oral or topical antifungal (yeast-attacking) medication. If the infection has spread into the mouth or throat we might then prescribe a troche, a small lozenge designed to dissolve, which you would rinse with and then swallow to affect other portions of the mouth. Steroid or zinc oxide ointments applied directly to the skin can control inflammation and serve as a barrier agent with antifungal properties to promote healing.

If the cause is more related to dental problems (ill-fitting dentures or missing teeth), then it’s important to have these addressed and treated. You may also consult a dermatologist for treatments to lessen wrinkling around the mouth that might also contribute to chronic cases of perleche.

If you would like more information on cracked mouth corners, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Cracked Corners of the Mouth.”

By Holly Scott-Hetchler DDS
January 27, 2019
Category: Dental Procedures
CrazyLittleThingCalledHyperdontia

The movie Bohemian Rhapsody celebrates the iconic rock band Queen and its legendary lead vocalist, Freddie Mercury. But when we see pictures of the flamboyant singer, many fans both old and new may wonder—what made Freddie’s toothy smile look the way it did? Here’s the answer: The singer was born with four extra teeth at the back of his mouth, which caused his front teeth to be pushed forward, giving him a noticeable overbite.

The presence of extra teeth—more than 20 primary (baby) teeth or 32 adult teeth—is a relatively rare condition called hyperdontia. Sometimes this condition causes no trouble, and an extra tooth (or two) isn’t even recognized until the person has an oral examination. In other situations, hyperdontia can create problems in the mouth such as crowding, malocclusion (bad bite) and periodontal disease. That’s when treatment may be recommended.

Exactly what kind of treatment is needed? There’s a different answer for each individual, but in many cases the problem can be successfully resolved with tooth extraction (removal) and orthodontic treatment (such as braces). Some people may be concerned about having teeth removed, whether it’s for this problem or another issue. But in skilled hands, this procedure is routine and relatively painless.

Teeth aren’t set rigidly in the jawbone like posts in cement—they are actually held in place dynamically by a fibrous membrane called the periodontal ligament. With careful manipulation of the tooth, these fibers can be dislodged and the tooth can be easily extracted. Of course, you won’t feel this happening because extraction is done under anesthesia (often via a numbing shot). In addition, you may be given a sedative or anti-anxiety medication to help you relax during the procedure.

After extraction, some bone grafting material may be placed in the tooth socket and gauze may be applied to control bleeding; sutures (stitches) are sometimes used as well. You’ll receive instructions on medication and post-extraction care before you go home. While you will probably feel discomfort in the area right after the procedure, in a week or so the healing process will be well underway.

Sometimes, dental problems like hyperdontia need immediate treatment because they can negatively affect your overall health; at other times, the issue may be mainly cosmetic. Freddie Mercury declined treatment because he was afraid dental work might interfere with his vocal range. But the decision to change the way your smile looks is up to you; after an examination, we can help you determine what treatment options are appropriate for your own situation.

If you have questions about tooth extraction or orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Simple Tooth Extraction” and “The Magic of Orthodontics.”

By Holly Scott-Hetchler DDS
January 17, 2019
Category: Dental Procedures
AMouthguardforNBAStarIsaiahThomas

Even after losing a tooth in an on-court collision with an opposing player, Isaiah Thomas didn’t slow down. The Boston Celtics point guard completed the play…and the rest of the game. Unfortunately, that wasn’t the end of his dental problems — it was just the beginning.

Over the next few days, Thomas had a total of ten hours of oral surgery to treat problems with multiple teeth. He got a temporary bridge, and will receive a permanent one at a later date. He also got fitted for a custom-made mouthguard to prevent re-injury.

We’re pleased to see that Thomas is getting appropriate dental treatment. But it’s unfortunate that he didn’t get the mouthguard sooner; this one piece of inexpensive safety gear could have saved him a lot of pain and trouble. If you think mouthguards are strictly for full-contact sports, Thomas’ troubles should make you think again. In fact, according to a 2015 study in the journal Sports Health, the five sports with the highest overall risk of tooth loss are basketball, football, hockey, martial arts, and boxing. Plenty of other also involve the risk of dental injury.

The study also notes that some 5 million teeth are avulsed (knocked out) each year in the U.S. alone. Countless others are loosened, fractured or chipped. What’s more, it is estimated that the lifetime cost of treating an avulsed tooth is between $5,000 and $20,000. The cost of a custom-made mouthguard is just a small fraction of that.

Where can you or your child get a custom-made mouthguard? Right here at the dental office! These high-quality items are professionally fabricated from a model of your actual teeth, so they fit much better than an off-the-shelf one ever could. They offer superior protection, durability and comfort — because, after all, no mouthguard can protect you if it’s too uncomfortable to wear.

Thomas’ season is now over due to a hip injury, but at least he will now have time to rest and get his dental problems taken care of. Let’s hope his story will inspire more athletes — both professional and amateur — to prevent similar problems by wearing custom-made mouthguards. Whether you compete on a school team, enjoy a pick-up game after work, or play in the big leagues, a dental injury is one problem that you don’t need.

If you have questions about custom-made mouthguards, please contact us or schedule an appointment for a consultation.

By Holly Scott-Hetchler DDS
January 07, 2019
Category: Oral Health
Tags: oral hygiene  
ANewResolution-Floss

Now that we’re into the New Year, it’s a good time to look over your list of resolutions. Did you remember to include dental health on your list? Here’s one simple resolution that can help keep your smile bright and healthy through the New Year and beyond: Floss every day!

Your oral hygiene routine at home is your first line of defense against tooth decay and gum disease. While brushing your teeth twice a day effectively removes much of the food debris and dental plaque from your teeth, brushing alone is not sufficient to remove all the plaque that forms on your teeth and around your gums. For optimal oral health, flossing once a day is also necessary.

Which teeth do you need to floss? Any dentist will tell you, “Only the ones you want to keep!” And yet according to a national survey of over 9,000 U.S. adults age 30 and older, nearly 70% don’t floss every day, and nearly one third admit that they don’t floss their teeth at all. Unfortunately, if you don’t floss, you’ll miss cleaning about a third of your tooth surfaces. When plaque is not removed, this sticky film of bacteria releases acids that cause cavities and gum disease. With dental floss, however, you can clean between the teeth and around the gums where a toothbrush can’t reach.

Flossing is an essential component of good oral hygiene. Still, daily flossing seems to be a harder habit to get into than brushing. Some people tense up their cheek muscles while flossing, making it harder to comfortably reach the back teeth, so remember to relax as you floss. If unwaxed floss doesn’t glide easily between teeth, try waxed floss. If you have trouble using traditional dental floss, you can try threader floss, which has a rigid tip, interdental brushes, floss picks, or a water flosser, which cleans by way of pressurized water.

It’s not too late to add one more resolution to your list, and flossing is a habit that will go a long way toward keeping you in the best oral health. And along with good dental hygiene at home, regular professional dental cleanings and checkups are key to a healthy smile. If you would like more information about maintaining excellent dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Daily Oral Hygiene” and “Flossing—A New Technique.”

PracticeDailyOralHygienetoPreventCalcifiedPlaqueFormation

If you’ve ever heard your dentist or hygienist talk about “calculus,” they’re not referring to a higher branch of mathematics. The calculus on your teeth is something altogether different.

Calculus, also called tartar, is dental plaque that’s become hardened or “calcified” on tooth surfaces. Plaque begins as soft food particles and bacteria that accumulate on the teeth, and more so if you don’t properly clean your teeth every day. This built-up plaque becomes both home and food source for bacteria that can cause tooth decay or periodontal (gum) disease.

Because of this direct link between plaque and/or calculus and dental disease, we encourage everyone to perform two important oral hygiene tasks every day. The first is to floss between your teeth to remove plaque as you are unable to effectively reach those areas with a toothbrush.  Once you loosen all the plaque, the other really important task is a thorough brushing of all of the tooth surfaces to remove any plaque that may have accumulated since the last brushing. Doing so every day will catch most of the softer plaque before it becomes calcified.

Once it forms, calculus is impossible to remove by brushing and flossing alone. That’s why you should have regular cleanings performed by a dental professional. Dentists and hygienists have special tools called scalers that allow them to manually remove plaque and calculus, as well as ultrasonic equipment that can vibrate it loose to be flushed away with water.

In fact, you should undergo dental cleanings at least twice a year (or as often as your dentist recommends) even if you religiously brush and floss daily. Calculus forms so easily that it’s nearly inevitable you’ll accumulate some even if you have an effective hygiene regimen. Your dental team can remove hardened deposits of calculus that may have gotten past your own hygiene efforts.

If you haven’t been consistently practicing this kind of daily hygiene, see your dentist to get a fresh start. Not only will they be able to check for any emerging problems, they can clean your teeth of any plaque and calculus buildup so that you’ll be able to start with a “clean” slate.

Calculus can be tenacious, but it not impossible to remove. Don’t let it set you up for an unhealthy experience with your teeth and gums.

If you would like more information on reducing plaque buildup, please contact us or schedule an appointment for a consultation.





This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.

Contact Us

Please do not submit any Protected Health Information (PHI).

Our Location

Holly A. Scott-Hetchler DDS, PC 919 Chester RdLansing, MI 48912