Cosmetic Gum Surgery

Your child won't keep his or her first teeth forever, but that doesn't mean those tiny pearly whites don't need conscientious care. Maintaining your child's dental health now will provide health benefits well into adulthood, as primary (baby) teeth serve some extremely important functions.

Kids developing jaws and teeth.

For one thing, primary teeth serve as guides for the eruption of permanent (adult) teeth, holding the space into which these new teeth will erupt. The crowns (tops) of the permanent teeth actually push against the roots of the baby teeth, causing them to resorb, or melt away. In this way, the adult teeth can take their proper place.

What's more, your child's primary teeth will be there for most of childhood, helping your child to bite, chew and speak. For the first six or so years, he or she will be relying on primary teeth exclusively to perform these important functions. Until around age 12, your child will have a mix of primary and permanent teeth. You will want to make sure those teeth stay healthy and are lost naturally — when it's time.

Your Child's First Teeth

Kids mouth anatomy.

Your child's 20 baby teeth will begin to appear usually between six and nine months, though in some cases it may start as early as three months or as late as twelve months. The two lower front teeth tend to erupt first, followed by the two upper ones, these teeth are called the central incisors. Then the neighboring teeth called lateral incisors will erupt too. The first molars come in next, followed by the canines (eyeteeth). And finally, the last teeth to erupt are the two-year molars. Sometimes your baby can experience teething discomfort during this process. If so, there are courses of action to help make your child more comfortable.

Your infant's gums should be gently wiped after each feeding with a water-soaked gauze pad or damp washcloth. As soon as the first tooth erupts, establish a daily brushing routine with a small, soft-bristled toothbrush and no more than a thin smear of fluoridated toothpaste. Your child may need your help with this important task until about the age of 6.

Your Child's First Dental Appointment

Age one dental visit

The American Academy of Pediatric Dentistry recommends that your child see a dentist by his/her first birthday, or as early as the first tooth erupts. Though this may sound early, learning proper pediatric oral hygiene techniques, checking for cavities, and watching for developmental problems is extremely important.

There are a number of forms of tooth decay that can affect babies and small children. Early Childhood Caries (tooth decay) can develop rapidly, progressing from the hard, outer enamel layer of a tooth into the softer, inner dentin in six months or less.

Most of all, it's important for your child to have a positive experience at the dental office as he/she will be a regular visitor for years to come.

Pediatric Dental Treatments

There are a variety of dental treatments offered to prevent tooth decay in children, or to save or repair teeth when necessary. They include:

Topical Fluoride — Fluoride incorporates into the enamel of teeth, making it harder and more resistant to decay. Although there is a small amount of fluoride in toothpastes and in some drinking water supplies, a higher concentration can be applied professionally to your child's teeth for maximum protection.

Dental Sealants — A plastic coating can be applied at the dental office to prevent cavities by sealing the little grooves on the chewing surfaces of back teeth known as “pits and fissures.” These little crevices become the perfect environments for decay-causing bacteria. Immature tooth enamel is more permeable and therefore less resistant to tooth decay. Dental sealants are easy to apply and provide years of protection (Watch Dental Sealant Video).

Root Canal Treatment — Perhaps you have had a root canal treatment yourself, to save an injured or severely decayed tooth. Well, sometimes children need root canals, too. In children these are called pulpotomies or pulpectomies. As mentioned above, baby teeth are important guides to the permanent teeth that are already forming beneath your child's gums. Therefore, saving them from premature loss can help prevent a malocclusion (“mal” – bad; “occlusion” – bite) that requires orthodontic treatment.

Bonding — Chips and minor fractures to front teeth — common childhood occurrences — can be repaired with tooth-colored bonding materials. These lifelike resins made of plastic and glass can be used on baby teeth as well as permanent teeth and last until the youngster has completed facial growth (Watch Bonding Video).

Orthodontic Concerns

Orthodontic Problems.

By around age 7, most malocclusions have become evident. Interceptive orthodontic treatment around this time can help direct proper tooth positioning and/or jaw growth, eliminating or simplifying the need for later treatment. There are many orthodontic problems that can be detected early and are examples of why a trained professional should evaluate your child during his/her growth and development.

Sports & Your Child's Teeth

If your child is active in sports, a custom-made mouthguard is a highly recommended safeguard. According to the American Dental Association, an athlete is 60 times more likely to suffer dental harm when not wearing one of these protective devices. A custom mouthguard is made specifically for your child using a model of his or her teeth. This will offer greater protection than an off-the-shelf model. It's an investment that pays off highly in the form of reduced pain, suffering — and dental expenses down the road!

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Cosmetic gum surgery.There are many elements that make up an ideal smile; bright, healthy-looking teeth immediately come to mind. But the gum tissue that surrounds and supports those teeth also plays a big role in how appealing your smile will look.

There are various cosmetic issues involving gum (gingival) tissue. For example, your smile may look “gummy” — meaning you seem to display too much gum tissue when you smile, or your teeth appear too short. Sometimes it's the opposite problem — your teeth appear too long because your gum tissue has receded (pulled back), exposing tooth-root surfaces that were covered at one time. Or, you may have an uneven gum line, meaning gum tissue covers some of your teeth more than others. All of these cosmetic gum problems can be successfully treated with cosmetic procedures performed in the dental office.

Cosmetic Gum Problems

Excess Tissue. A gummy smile can be caused by excessive gum tissue covering more enamel surface of a tooth's crown (upper portion) than normal. If that is the case, a procedure known as “crown lengthening” can be performed, in which gum tissue (and sometimes a small amount of bone tissue) is removed to expose more tooth surface.

Receding Gums. Sometimes your gums can shrink down (recede), exposing a portion of your tooth roots. This causes a cosmetic problem because root surfaces, which have no enamel covering, tend to appear more yellow than the crowns of your teeth. Also, exposed roots can be more sensitive to cold or touch, and can be at greater risk of decay. There are various gum-grafting procedures that can cover exposed roots, all of which involve moving gingival (gum) tissue from one site in the mouth to another. For example, roots can be covered with tissue from the roof of your mouth, which is of the same type; or adjacent (nearby) tissue can be moved over to cover an exposed root. Sometimes laboratory-processed tissue from another donor can even be used. All of these options can be discussed with you in more detail.

Uneven Gum Line. If you have an uneven gum line where some teeth are covered by more tissue than others, it is often possible to recontour (reshape) the tissue for a very pleasing effect. This can be done conventionally with a surgical scalpel or with newer dental laser technology. The advantage of a laser is that it seals the tissue as it sculpts it, making the procedure more comfortable and requiring a shorter healing time.

What to Expect

All cosmetic gum surgery can be performed at the dental office — and it usually requires only a local anesthetic (numbing shot). In fact, for laser surgery you may need only a topical anesthetic applied in gel form. If you would like a deeper level of relaxation, you can have oral or possibly even an IV sedative; but if this is required, you will need a ride home. Laser surgery leaves no open wounds and causes minimal, if any, discomfort, though the anatomy of the area may preclude laser use. An examination is required to determine whether conventional or laser treatment is in your best interests.

Grafts may take longer to heal, particularly if tissue is taken from the roof of your mouth. If that's the case, you will have two sites that need to heal: the donor site from which the tissue was taken, and the recipient site where the tissue was attached. Both of these sites will require stitches, usually of the dissolving type. You will need to eat a softer diet and avoid chewing on that side of your mouth for a few days. Though full healing may take a few weeks, you will be able to resume your normal activities the very next day. Whichever kind of cosmetic gum surgery you may need, the procedures are routine and predictable — and they can do wonders for your smile!

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