Gum recession

Gum recession is a problem that affects many adults, especially over 40, and can be unsightly if it shows on smiling. In some cases it can be a sign of gum disease (periodontitis) but for others it can be a result over-zealous brushing, thin gums (a thin tissue biotype), tooth grinding (bruxism) and it can also be related to small areas of missing bone (dehiscence). I often look out for these areas of dehiscence on skulls in museums and my next article about the MARY ROSE will demonstrate this.

This lady clearly showed gum recession on the two front teeth when she smiled. One tooth also has a very dark root (dead tooth). We decided to extract the dark tooth and move the canine tooth, behind it, into its position. Often this type of recession that shows on smiling needs a gum transplant from the back of the mouth (free gingival graft) to repair it

There was almost total resolution of the recession on the other affected front tooth (see blue arrow) which is great news as it saved her from an operation with my Periodontist friend.

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Impacted canine teeth

Impacted canine teeth

The canine is the longest tooth in our mouths, and is critical for guiding the lower jaw into the proper bite.

It starts to form at 4-5 months of age, almost 11 years before it is due. At first it is just under the eye socket yet it is one of the last teeth to come in.

The Upper canines ,like wisdom teeth, have a tendency to go off course (probably because they are the last ones in). Impacted teeth are ones that cannot fit in. 2/3rds of impacted canines are in the roof of the mouth (see photo) and unfairly this happens more often to girls.

If we catch these ‘off course’ teeth early enough (normally at 10ish), then some can be encouraged into the mouth by extracting the overlying baby canines. In extreme cases (like above) the impacted canine may need removing surgically as some can damage the neighbouring teeth.

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Diastemas

A “diastema” is a dental term referring to a space or gap between two teeth, often the two upper central incisor teeth (upper front teeth). There are several causes including small teeth and a prominent lip attachment (fraenum), but they can occur as part of a disease process like gum disease.

Famous diastemas can be seen on Jade Jagger, Vanessa Paradis and Madonna.

They can actually be healthy as they are brush-able and for children they may not qualify for NHS treatment.

They can be treated with orthodontics, though if it is due to small teeth, then adding some white filling OR placing veneers can either reduce or eliminate them.

Diastema at the start of treatment with Invisalign

Diastema at the start of treatment with Invisalign

Diastema half way through Invisalign treatment

Diastema half way through Invisalign treatment

Diastema Mythology

In the Canterbury Tales, the “gap-toothed wife of Bath” the diastema was associated with lustful characteristics.

In some African countries it is considered a sign of fertility. In France, they are called “dents du bonheur” (“lucky teeth”), and in Australia, they are said to be a predictor of future wealth

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Mouth Cancer awareness

Mouth Cancer awareness

In Britain, the incidence of mouth cancer has increased faster than any other cancer in the past 25 years. Alarmingly, the rate of mouth cancer in women has increased significantly at a rate of 3% per year since 1994.

At Lakeside Orthodontics we regularly screen adults for mouth cancer and signs of secondary cancer in neck nodes.

One in 3 people diagnosed with oro-pharyngeal cancers are infected with a form of Human Papilloma virus (HPV), the simple wart.

Although most people will be infected with HPV at some point of their lives, two particular strains HPV16 and HPV18 are most likely to cause cancer. The % of patients with HPV16 was 35 times greater in those with throat cancer compared with the cancer free population.

Early detection of mouth cancer greatly improves the chances of survival. A simple mnemonic is the RULE for suspecting oral cancer:

  • Red and/or white lesion
  • Ulcer
  • Lump
  • Exceeding THREE weeks duration.

Other common causes of mouth cancer are alcohol and Tobacco

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Tooth wear - a silent risk to the modern generation

Tooth wear – a silent risk to the modern generation

Severe tooth wear is becoming more prevalent. Some of this is because people are living longer and tooth wear naturally progresses over the years.

The 2009 Adult Dental Health Surveys highlighted a trend toward increasing tooth-wear which has got 10% worse over the last 11 years.

Of particular concern are the 16-34 year olds. Much of the increase here seems to be related to poor drink choice (carbonated/fruit juices) and eating healthy food too frequently (!) (such as a lot of citrus fruit), Eating disorders and stress-related bruxism (tooth grinding). Citric acid in fruit and fizzy drinks is very good at loosening enamel.

Once the enamel (outer coat of the tooth) is breached, the dentine wears SEVEN times faster!

To help reduce the rate of tooth wear consider the following:

  1. Avoid fizzy drinks – it is alright to make your own with fizzy water and sugar-free squash (e.g. tooth-kind Ribena)
  2. Try to avoid citrus fruits and eat them with food (not between meals)
  3. Consider a night guard if you grind your teeth
  4. Consider getting any exposed dentine covered over by your dentist
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What do swimming pools and tooth whitening have in common?

The answer should be nothing, but a lot of beauty salons who offer tooth whitening are using Chlorine Dioxide which is better known as a pool cleaner. It can be very acidic, as in the story below, and can lead to irreversible loss of enamel and sensitivity. Under General Dental Council regulations tooth bleaching is an act of dentistry and it is illegal for anyone who is not on the Dental register to prescribe/perform. They also do not carry any indemnity insurance. If you value your teeth make sure you see a professional and that the agent is pH balanced and certainly not Chlorine Dioxide.

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