Periodontal Specialists – Dr. Herbert Veisman
Many people suffer with a gummy smile because most don’t think that there is anything that they can do about it. The reasons some people have a gummy smile are as follows:
1. The teeth never fully erupted and they are still partially tucked away under the gum line (Altered Passive Eruption)
2. The upper jaw is considerably larger in proportion to the upper lip and there isn’t enough lip to cover the gums when smiling, hence, revealing a large proportion of gum as compared to tooth size (Vertical Maxillary Excess)
The first problem can be easily treated with a simple gum procedure called a “gum lift”. The second problem is more complex and may require complex jaw surgery. Generally speaking, in both cases, we would likely start with a gum lift and see if the patient is satisfied with the result. Usually people are happy with the results if they fall in the Altered Passive Eruption category. The results are immediate and you look like a new person right after the procedure. If someone has Vertical Maxillary Excess, then there is still a chance that a gum lift would lead to a satisfactory result. However, in some cases, jaw surgery (upper jaw) is necessary.
The way a gum lift works is that the upper (and sometimes lower) gums are scalloped and removed away from the tooth surface thereby revealing more pearly white tooth structure. As mentioned earlier, Altered Passive Eruption means the teeth never fully erupted and there is a LARGER PROPORTION OF GUM as you smile when compared to tooth structure (could be a ratio of, say, 2:1 of visible gum compared to visible tooth structure. After a gum lift, the PROPORTION of visible gum to tooth is corrected such that the ratio is more like 1:1 or even 1:2 (reversed) as compared to before the gum lift procedure. See some of our success stories on this website for examples.
Call us today for your GUMMY SMILE consultation at 416-225-GUMS (4867).
People lose teeth for all sorts of reasons: tooth decay, gum disease, accidents/trauma, or simply just wear down over time. Losing a tooth at the front of the mouth could impact your appearance. It will also impact your ability to bite into food properly. Losing a tooth at the back of the mouth will impact your bite and ability to chew your food properly. But if you lose many, most, or ALL of your teeth, this could affect your ability to live a long and healthy life. As our mothers used to tell us, “your health starts with your mouth”. Just as your eyes are the “windows to your soul”, your mouth is the “window to your health”. It’s been demonstrated in one university-based study after another that people who lose their teeth have a higher rate of heart disease and live shorter, less fulfilling and less fulfilled lives. Imagine not having most or all of your teeth. Imagine your life is based on loose and ill-fitting dentures. No matter how tight your new dentures will fit, they will loosen over time because your underlying jawbone resorbs over time. As the bone resorbs, there is less for your dentures to grab on to. Then, your dentures (especially the lower ones) will begin to slide around in your mouth like a hockey puck on ice. That’s a terrible feeling-not being about to close your teeth properly or chew your food. Most people who don’t have teeth or have ill-fitted dentures also suffer from poor nutrition. Let’s face it, as we get older, eating food becomes one of the few pleasures we have left. By not having solid teeth, our lives become dreary. We end up eating foods we CAN eat rather than foods we WANT to eat. That’s where dental implants come into the picture. Dental implants can replace that missing tooth in the front of the mouth or the one that got away in the back. It can replace one, two, four or up to 28 teeth. We live in an age of no limits. If we can put a man on the moon, we can certainly replace all the missing teeth in your mouth. Regardless if you lose one, a few, or all of your teeth, you can have a Hollywood smile with the miracle of dental implants. Call us today at 416-225-9910 for your consultation and let’s turn your life around.
As a periodontist, I have three more years of extra training above and beyond what a General Dentist has. A general dentist has 4 years of dental school training. There is MINIMAL time spent on dental implants because it is a specialized procedure taught in either Periodontics or Oral surgery training for 3-4 years following a year of hospital based residency AND specialty school training.
General Dentists who do implants learn the procedure on weekend courses and NOT in a specialty training program requiring literature review of thousands of peer-reviewed articles as well as a licensing examination at completion of the training as would a Periodontist.
Furthermore, as a periodontist, we have training specialized in dealing with the gums and tissues surrounding the implants so that the final surgical results are more aesthetically pleasing.
Finally, periodontists are trained to deal with all the varying complications and post-operative sequelae that could occur after implant surgery.
Would you go to your family doctor for open heart surgery? Would you take your new Mercedes for repairs at a local no-name dealer for complicated engine work?
The best way to find a good periodontist is to start with the reviews online. You can check RateMDs and Google. You can enter keywords or phrases like “Best Periodontist Toronto”, “Best Dental implant surgeon Toronto”. This will at least give you a good start.
Once you’ve narrowed down your search, you can look up the websites of those on your shortlist. Your search should consist of looking for important aspects about the doctor such as:
- Schools attended
- Years of experience
Also see if you can identify an area of the specialty field that the doctor seems to focus on. For example, someone could have a YouTube channel with surgeries related to dental implants and bone regeneration. Others might seem more focused on gum grafts and gum procedures.
A good periodontist is easy to reach online and you should get a reply within 24 hours of initial contact. This simply demonstrates that their office is on top of things and responsive to your needs. Imagine if you have treatment with a periodontist and you have an emergency. You need someone who will return your calls immediately.
Once you go for your initial consultation, you should look around the office, see how much attention and care is given to cleanliness and professional decorum. The devil is usually in the detail. A specialist with an old and antiquated waiting room and unfriendly staff likely reflects his or her values.
- Also don’t be afraid to ask questions such as: how many years of experience do you have?
- How many dental implants have you done?
- Have you ever published articles in peer-reviewed journals?
- Are you Canadian and US Board certified?
- Have you ever lectured and taught at dental colleges?
- What if I have an emergency at 3am on a Sunday….will you come and see me ASAP?
These questions probe a doctor’s engagement with their profession as well as with his/her patients. You want a specialist who is approachable, affable, and accessible! Always trust your gut instinct. If you feel you are being pressured to accept one treatment over another, run! The choice is always up to you to decide on the final treatment. The doctor is only there to present you with all the viable treatment options and perhaps go as far as to tell you which is the BEST option and WHY. That is as far as it should go. Don’t be afraid to ask many questions. After you’ve researched their website, write down all your questions so that you don’t forget the you are there for your consultation. It’s your money and time so get the most out of it.
10 common and serious health problems caused by bad oral health:
1. Cardiovascular Disease
Having poor oral health puts a person at risk for heart disease. If the gums are inflamed due to the bacteria that causes periodontal disease, that same bacteria can actually get into the bloodstream causing the arteries to build up plaque and harden. This hardening of the arteries is called atherosclerosis, and it is very serious. It leads to blood flow problems and heart blockages, and it increases the likelihood of having a heart attack. The damaging impact on the arteries and blood vessels can lead to hypertension and increase the risk for strokes. Endocarditis can also develop, which is an often fatal condition that occurs when the lining of the heart becomes infected.
Poor oral health can affect the brain. Substances that are released from gums inflamed by infection can actually kill brain cells and lead to memory loss. Dementia and possibly even Alzheimer’s disease can result from gingivitis when the bacteria in the mouth spreads to the nerve channels or enters the bloodstream.
3. Respiratory Infections
The respiratory system can suffer as a result of poor oral health. Bacteria in the mouth from infected teeth and swollen gums can be breathed into the lungs or travel there through the bloodstream. Once there the bacteria can lead to respiratory infections, pneumonia, acute bronchitis, and even COPD.
Not only are diabetics already more susceptible to infection such as infected gums that lead to periodontal disease, but periodontal disease can in turn make diabetes more difficult to control. Symptoms can worsen as blood sugar levels go haywire because of gum disease. It is especially important for diabetics to take good care of their oral health to prevent complications with their disease. Because gum disease can lead to higher than normal blood sugar levels, a person with poor oral health is at an increased risk of developing diabetes.
5. Pregnancy Complications
It is imperative for expectant mothers to practice good oral hygiene. Hormonal changes in the body during pregnancy can cause a woman to develop oral infections much more easily. Any infection in the mother’s body increases her risk of experiencing pregnancy complications. Oral health problems in the mother such as periodontitis and gingivitis have been known to lead to premature birth and low birth weight in infants. Gum disease puts both mother and baby at risk for experiencing serious health issues.
There is a link between poor oral health and problems with infertility in women. Gum disease can lead to various overall health issues that can make it more difficult for a woman to conceive and sustain a healthy pregnancy. It can actually take longer for a woman with poor oral health to get pregnant than it would for a woman who has good dental health.
7. Erectile Dysfunction
Having poor oral hygiene puts a man at an increased risk for suffering from erectile dysfunction. Chronic periodontal disease is known to be related with ED. CPD is an infection that occurs when gums pull away from teeth, which creates pockets that carry bacteria and allows the bug to spread to the bone surrounding teeth. Bacteria from diseased gums can get into the bloodstream and cause blood vessels to become inflamed. This inflammation can block the flow of blood to the genitals, making erections more difficult or even impossible to achieve.
Obviously, poor oral health practices such as smoking or using tobacco products can lead to oral and throat cancers, but other types of cancer have also been linked to gum disease. Risk for kidney cancer, pancreatic cancer, and blood cancers is much higher for people who have poor oral health.
9. Kidney Disease
Chronic kidney disease is a serious health problem that affects the kidneys, heart, bones, and blood pressure. Infections in the body such as periodontal disease can lead to kidney disease. People with gum disease generally have weaker immune systems and are more likely to acquire infections. Many people who suffer from very poor oral health also suffer from kidney disease. Kidney disease can be fatal if it leads to kidney failure or cardiovascular disease.
10. Rheumatoid Arthritis
According to the National Rheumatoid Arthritis Society, people with gum disease were four times more likely to have Rheumatoid Arthritis. Both diseases have inflammation in common. The oral bacteria from gingivitis can increase inflammation throughout the body. This makes the risk for developing rheumatoid arthritis, a painful and debilitating inflammatory disease, much higher.
How do I Prevent Bad Oral Health?
The best way to prevent serious health issues caused by bad oral health is to practice good oral hygiene and schedule regular visits with your dentist.
How do I practice good oral hygiene?
- Brush the teeth and gums for two minutes at least twice a day.
- Floss the teeth daily.
- Avoid smoking cigarettes or chewing tobacco products.
- Use toothpaste and mouthwash products that contain fluoride.
- Limit sugary foods and drinks.
- Eat a well-balanced diet for optimum nutrition.
How can I tell if my teeth are healthy?
Healthy teeth are clean and free of pain caused by cavities and disease. Healthy gums are pink and do not bleed when brushed or flossed.
Oral health is an indicator of overall health. Taking care to prevent oral health problems like gingivitis and periodontal disease can go a long way toward decreasing the risk for more serious health problems throughout the body.
During the week of March 15, 2020, The Royal College of Dentists of Ontario and the Ministery of Health for the province of Ontario have effectively shut down the practices of 7000 dentists in Ontario. The only services which are considered acceptable are emergencies, such as broken teeth or attending to someone with facial injury. However, because of the shortage of personal protective equipment (PPE), most dentists are not in a position to treat patients even for such emergencies. Only a handful of clinics such as the Emergency Dental Services has been seeing some patients and even they are running out of PPEs if they haven’t done so already. PPE’s have been in short supply from various distribution centres all over the country because the COVID19 pandemic caught everyone off guard.
Once the isolation/quarantine curtain lifts in the next couple of months, many people who didn’t sustain any serious injuries or suffer through any emergencies will still be in need of considerable dental care. Whether you haven’t had your teeth cleaned for several months or you’ve had fillings, crowns or other dental work crack or fall out of your mouth during the quarantine, you’ll need to see a dentist soon.
We encourage you to give us a call at 416-225-9910 and let us assess your post-COVID19 treatment needs so that you continue to maintain the highest level of oral health possible.
We wish everyone the best of health and stay safe during this challenging time.
Dr Veisman and team
If you have a gummy smile, there are two reasons for it. Either your teeth never fully erupted through the gums or your jaw bone is too long, or a combination of both. If your teeth never fully erupted, then we can help encourage that to happen by simply trimming some of the gum away. If your jaw bone is too long, then this would require consultation with an oral surgeon for more extensive treatment. However, we start with the gum trimming procedure first (as it is more conservative and simpler) and then decide later if you still require other interventions. Usually, 90%+ of patients are happy with the results from the gum trimming, called CROWN LENGTHENING, and do not proceed with more surgery. The most amazing aspect of this procedure is the fact that each patient experiences instant gratification. The results are INSTANT. You wake up from your procedure and you see the changes right away. It’s a NEW YOU.
Are your gums sore? Do your gums bleed when you eat, brush or floss your teeth? Many think that treating gum disease is painful and requires surgery. This is simply NOT the case. In fact, with most patients, simple root planing and scaling with local anesthetic and some antibiotics is all it takes. Once the disease is under control after a few weeks, it is recommended to return to the office for cleanings every 3 months. Why every three months? Because that is how long it takes bacteria to set up a new niche of colonies in the gums and that’s when their colonies must be destroyed. So don’t be afraid of gum surgery because chances are, you will only need deep cleanings.
Imagine you can’t go out with your friends, you can’t eat a good steak, corn on the cob, bite into a chocolate bar or an apple because your teeth are loose or you are wearing dentures and afraid they’ll get stuck in the food. It’s a pretty difficult and unhappy life. Dental implants will allow you to look your best, eat ANYTHING that you want, speak properly, and live your life with confidence. You won’t have to put your food through a blender first and you can get your dignity back. If this sounds like you, the call Dr Veisman at 416-225-9910 and tell us how we can help you get your life back.
You don’t need to sit white knuckled throughout your dental procedures any longer. Now you can sleep through the entire procedure and awaken refreshed and rested. Perio Asleep is a safe and comfortable way to have any type of gum or implant surgery with the use of analgesics and sedatives. You are monitored the entire time so it is the safest way to have any type of surgical intervention. Call us at 416-225-9910 for any further information