Bulimia’s Effect on Teeth

A life of bingeing and purging

Bulimia is an eating disorder in which people binge-eat large amounts of food. Then they purge — throw up, fast, or engage in some other “purging” behavior such as using laxatives or exercising to excess — in an attempt to rid their bodies of all the extra calories.

Constant cycles of bingeing and purging are hard on the heart, kidneys, and other organs. But bulimia can be especially damaging to the teeth.

The Best Eating Disorder Videos of 2016 »

Purging and your teeth and mouth

Repeated vomiting can cause serious damage to the teeth. Vomit is especially toxic because it contains stomach acids. These acids break down food in your stomach so your body can digest it.

But in the mouth, these acids are corrosive, enough to wear away at the enamel that covers and protects your teeth. Brushing your teeth too hard after you vomit can also contribute to tooth decay.

Cavities

Cavities

The acids from frequent vomiting can wear away so much tooth enamel that they leave a hole, or cavity. Bingeing on sugary foods and sodas can also contribute to tooth decay.

When you have dental decay, you may notice that your gums bleed when you brush them. If you don’t get a cavity filled, the hole will eventually become so big that you can lose the tooth.

Yellow, brittle teeth

yellow brittle teeth

As the erosion gets worse, you may also notice the color and texture of your teeth change. Your teeth may be weaker and more brittle than usual.

They can chip easily and may look ragged at the bottom. Sometimes they’ll turn a yellowish color or take on a glassy appearance. Bulimia can also change the shape and length of your teeth.

Swollen salivary glands

Swollen salivary glands

The acids in vomit can irritate the glands on the sides of each cheek. These glands produce saliva, the fluid that helps you swallow. It also protects your teeth against decay. You’ll notice a swelling around your jaw if your salivary glands are affected.

Although most changes in your teeth from bulimia aren’t reversible, salivary gland swelling should go down once you get treated and stop bingeing and purging.

Mouth sores

Mouth sores

Just as stomach acid wears away at the enamel on your teeth, it can also wear away at the skin on the roof and sides of your mouth. It can also damage your throat.

This can leave painful sores inside your mouth and throat. The sores can swell up and even become infected. Some people feel like they have a constant sore throat.

Dry mouth

A lack of saliva can also lead to the constant feeling that your mouth is parched. Also known as dry mouth, this condition is more than just a minor annoyance. It can affect the way you eat by changing the flavor of food.

Dry mouth can also damage the teeth because saliva washes the away bacteria that cause tooth decay. Having dry mouth can make existing tooth decay from bulimia even worse.

Pain

As your tooth enamel wears away, it leaves the sensitive inner part of your teeth exposed. You may start to notice that your teeth hurt.

Some people have pain and sensitivity whenever they eat hot or cold food. They may feel discomfort when they bite into an ice cream cone or eat something hot such as soup.

Damage to your gums and soft palate can cause additional pain when chewing or swallowing.

How to Get Rid of Cavities

What causes cavities?

Dental cavities, or caries, are tiny holes in the hard surface of the teeth. They are caused by bacteria on the surface of teeth creating acid out of sugar. The most common culprit is a bacterium known as Streptococcus mutans.

The bacteria form a sticky film known as plaque. The acids in plaque remove minerals from (demineralize) your enamel — a coating of the teeth made mostly of calcium and phosphate. This erosion causes tiny holes in the enamel. Once the acid damage spreads into the dentin layer underneath the enamel, a cavity forms.

Getting rid of cavities at home

Many home treatments are based off of a study from the 1930s that suggested that cavities are caused by lack of vitamin D in the diet. In this study, kids who added vitamin D to their diets showed a reduction in cavities. However, those who added vitamin D while also removing grain products from their diets had the best results. This is possibly because grains can stick to the teeth.

Not getting enough vitamin D may make teeth more susceptible to cavities, but we now understand that this is only a part of the puzzle. Other risk factors for cavities include:

  • dry mouth or having a medical condition that reduces the amount of saliva in the mouth
  • eating foods that cling to teeth, like candy and sticky foods
  • frequent snacking on sugary foods or drinks, like soda, cereals, and ice cream
  • heartburn (due to acid)
  • inadequate cleaning of teeth
  • bedtime infant feeding

Once a cavity has penetrated the dentin, you won’t be able to get rid of it at home. The following home remedies might help prevent cavities or treat “pre-cavities” by remineralizing weakened areas of your enamel before a cavity develops:

1. Sugar-free gum

Chewing sugar-free gum after meals has been shown in clinical trials to help remineralize enamel. Gum containing xylitol has been researched extensively for its ability to stimulate saliva flow, raise the pH of plaque, and reduce S. mutans, but long-term studies are needed.

Sugar-free gum containing a compound called casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) has been shown to reduce S. mutans even more than xylitol-containing chewing gum. You can find this type of gum in stores.

Shop online for sugar-free gun.

2. Vitamin D

Vitamin D is important to help absorb calcium and phosphate from the food you eat. Studiesshow an inverse relationship between eating foods high in vitamin D and calcium, like yogurt, and cavities in young children. You can get vitamin D from dairy products, like milk and yogurt. You can also get vitamin D from the sun.

More recent research has challenged how vitamin D can affect dental health.

Shop online for vitamin D supplements.

3. Brush with fluoride toothpaste

Fluoride plays an important role in preventing cavities and remineralizing enamel. Extensive research has been done to show that regularly brushing your teeth with a fluoride toothpaste prevents cavities.

Most studies have been conducted either in children or adolescents, so more research is needed in adults and the elderly.

Shop online for fluoride toothpaste.

4. Cut out sugary foods

This is the cavity remedy that no one likes to hear — stop eating so much sugar. The World Health Organization says that eating sugar is the most important risk factor for cavities. They recommend reducing your sugar intake to less than 10 percent of your total caloric intake for the day.

If you’re going to eat sugar, try not to snack on sugary foods throughout the day. Once the sugar is gone, your enamel has a chance to remineralize. But if you are constantly eating sugar, your teeth don’t get the chance to remineralize.

5. Oil pulling

Oil pulling is an ancient practice that involves swishing around an oil, like sesame or coconut, in your mouth for about 20 minutes, then spitting it out. Claims that oil pulling “removes toxins” from the body aren’t backed up by evidence. But a small, triple-blind, placebo-controlled clinical trial showed that oil pulling with sesame oil reduces plaque, gingivitis, and the number of bacteria in the mouth just as effectively as chlorhexidine mouthwash. Larger studies are needed to confirm these effects.

Shop online for coconut oil.

6. Licorice root

Extracts from the Chinese licorice plant (Glycyrrhiza uralensis) can combat the bacteria responsible for dental cavities, according to at least one study.

One researcher has taken this to the next level and created a licorice lollipop to help fight tooth decay. Pilot studies using licorice extract in a lollipop showed they were effective in significantly reducing S. mutans in the mouth and preventing cavities. Larger and more long-term studies are needed.

Shop online for licorice root tea.

Chipped Tooth

Overview

Enamel — or the tough, outer covering of your teeth — is one of the strongest substances in your body. But it does have it limits. A forceful blow or excessive wear and tear can cause teeth to chip. The result is a jagged tooth surface that can be sharp, tender, and disfiguring.

Causes of chipped teeth

Teeth can chip for any number of reasons. Common causes include:

  • biting down on hard substances, like ice or hard candy
  • falls or car accidents
  • playing contact sports without a mouth guard
  • grinding your teeth when you sleep
Risk factors for chipped teeth

It makes sense that weakened teeth are more likely to chip than strong teeth. Some things that reduce the strength of a tooth include:

  • Tooth decay and cavities eat away at enamel. Large fillings also tend to weaken teeth.
  • Teeth grinding can wear down enamel.
  • Eating a lot of acid-producing foods, such as fruit juices, coffee, and spicy foods can break down enamel and leave the surface of teeth exposed.
  • Acid reflux or heartburn, two digestive conditions, can bring stomach acid up into your mouth, where they can damage tooth enamel.
  • Eating disorders or excessive alcohol use can cause frequent vomiting, which in turn can produce enamel-eating acid.
  • Sugar produces bacteria in your mouth, and that bacteria can attack enamel.
  • Tooth enamel wears down over time, so if you’re 50 years or older, your risk of having weakened enamel increases. In one study published in the Journal of Endodontics, nearly two-thirds of those with cracked teeth were over 50.

Which teeth are at risk?

Any weakened tooth is at risk. But one study shows that the second lower molar — possibly because it takes a fair amount of pressure when chewing — and teeth with fillings are most prone to chipping. That being said, intact teeth are also subject to chipping.

Chipped tooth treatment options

Treatment of a chipped tooth generally depends on its location, severity, and symptoms. Unless it’s causing severe pain and significantly interfering with eating and sleeping, it’s not a medical emergency.

Still, you should make an appointment with your doctor as soon as possible to avoid infection or further damage to the tooth. A minor chip can usually be treated by simply smoothing and polishing the tooth.

For more extensive chips your doctor may recommend the following:

Tooth reattachment

If you still have the tooth fragment that broke off, place it in a glass of milk to keep it moist. The calcium will help keep it alive. If you don’t have milk tuck it into your gum, making sure not to swallow it.

Then get to your dentist immediately. They may be able to cement the fragment back onto your tooth.

Bonding

A composite resin (plastic) material or porcelain (layers of ceramic) is cemented to the surface of your tooth and shaped to its form. Ultraviolet lights are used to harden and dry the material. After drying, more shaping is done until the material fits your tooth exactly.

Bonds can last up to 10 years.

Porcelain veneer

Before attaching a veneer, your dentist will smooth away some of the tooth’s enamel to make room for the veneer. Usually, they’ll shave away less than a millimeter.

Your dentist will make an impression of your tooth and send it to a lab to create the veneer. (A temporary veneer may be used in the meantime.) When the permanent veneer is ready, your dentist will bond it to your tooth.

Thanks to the durable materials, the veneer could last about 30 years.

Dental onlays

If the chip only affects a part of your tooth, your dentist may suggest a dental onlay, which is often applied to the surface of molars. (If damage to your tooth is significant, your dentist might recommend a full dental crown.) You may receive anesthesia so the dentist can work on your teeth to make sure there is room for an onlay.

In many cases, your doctor will take a mold of your tooth and send it to a dental lab to create the onlay. Once they have the onlay, they will fit it onto your tooth and then cemented it on.

With advances in technology, some dentists can mill porcelain onlays right in the office and place them that day.

Dental onlays can last for decades, but a lot depends on whether you eat a lot of foods that put wear and tear on the onlay and what tooth was affected. For example, one that gets a lot of pressure when you chew, such as a molar, will wear more easily.

Dental costs

Costs vary greatly by what part of the country you live in. Other factors are what tooth is involved, the extent of the chip, and whether the pulp of the tooth (where the nerves are) is affected. In general, though, here’s what you might expect to pay:

  • Tooth planing or smoothing. About $100.
  • Tooth reattachment. You’ll have to pay for the dental exam, which is usually between $50 to $350. However, because tooth reattachment doesn’t require much in the way of materials, the charge should be minimal.
  • Bonding. $100 to $1,000, depending on the complexity involved.
  • Veneers or onlays. $500 to $2,000, but this will depend on the material used and how much the tooth has to be prepared before affixing the veneer/crown.
Self-care for a chipped tooth

While you most likely will need a dentist to repair a chipped tooth, there are steps you can take to reduce injury to the tooth until you see your doctor.

  • Place temporary dental filling material, a teabag, sugar-free gum, or dental wax over the jagged edge of the tooth to protect your tongue and gums.
  • Take an anti-inflammatory painkiller such as ibuprofen (Advil, Motrin IB) if you have pain.
  • Place ice on the outside of your cheek if the chipped tooth is causing irritation to the area.
  • Floss to remove food caught between your teeth, which can cause even more pressure on your chipped tooth when you chew.
  • Avoid chewing using the chipped tooth.
  • Swipe clove oil around any painful gums to numb the area.
  • Wear a protective mouth guard when you play sports or at night if you grind your teeth.
Complications of chipped teeth

When the chip is so extensive that it starts to affect the root of your tooth, infection can ensue. Treatment usually is a root canal. Here, some symptoms of such an infection:

  • pain when eating
  • sensitivity to hot and cold
  • fever
  • bad breath or sour taste in your mouth
  • swollen glands in your neck or jaw area

Identifying and Treating a Dead Tooth

Overview

Teeth are made up of a combination of hard and soft tissue. You may not think of teeth as living, but healthy teeth are alive. When the nerves in the pulp of the tooth, which is the inner layer, become damaged, such as by injury or decay, they can stop providing blood to the tooth. That can cause an infection and cause the nerve to die. This is also sometimes known as a non-vital tooth.

Read on to learn how to identify a dead tooth and what you should do if you see signs that your tooth is injured.

What are the signs of a dead tooth?

A dead tooth is a tooth that’s no longer receiving a fresh supply of blood. For many people, discoloration may be one of the first signs of a dying tooth. You may also experience pain in the tooth or gums.

Healthy teeth are usually a shade of white, though the color can vary depending on your diet and oral hygiene. For example, if you regularly consume foods that are staining, like coffee, blueberries, or red wine, or smoke, your smile may appear off-white or light yellow. This discoloration will likely be uniform, however.

If you have a tooth that’s discolored because it’s dying, it will be a different color than the rest of your teeth. A dying tooth may appear yellow, light brown, gray, or even black. It may look almost as if the tooth is bruised. The discoloration will increase over time as the tooth continues to decay and the nerve dies.

Pain is another possible symptom. Some people don’t feel any pain. Others feel mild pain, and still other people will feel intense pain. The pain is often caused by the dying nerve. It can also be caused by infection. Other signs of infection may include:

  • bad breath
  • bad taste in your mouth
  • swelling around your gum line

If you experience any symptoms of a dying tooth, it’s important to see your dentist right away.

What causes a tooth to die?

Trauma or injury to your tooth is one possible cause for a tooth to die. For example, getting hit in the mouth with a soccer ball or tripping and hitting your mouth against something can cause your tooth to die. A tooth may die quickly, in a matter of days, or slowly, over several months or years.

A tooth can also die as the result of poor dental hygiene. That can lead to cavities, which when left untreated can slowly destroy your tooth. Cavities begin on the enamel, which is the outer protective layer of your tooth. Left untreated, they can slowly eat away at the enamel and eventually reach the pulp. That causes the pulp to become infected, which cuts off blood to the pulp and, eventually, causes it to die. You’ll likely experience intense pain once the decay has reached the pulp.

Diagnosis

A dying tooth may be identified during a routine dental appointment that includes X-rays. It may also be identified if you see your dentist because of pain or concerns over discoloration.

You should always see your dentist following any tooth injury, or if you have any signs of a dying tooth. That way your dentist can begin treatment as soon as possible.

Treatment

It’s important to treat a dying or dead tooth as soon as possible. That’s because left untreated, the bacteria from the dead tooth can spread and lead to the loss of additional teeth. It could also affect your jawbone and gums.

Your dentist may treat a dead or dying tooth with a procedure known as a root canal. Alternatively, they may remove the entire tooth.

Root canal

With a root canal, you may be able to keep your tooth intact. During the procedure, the dentist makes an opening into the tooth and then uses small instruments to remove the pulp and clean out the infection. Once all of the infection has been removed, your dentist will fill and seal the roots and place a permanent filling in the small opening.

In many cases, you may need to have a crown following a root canal. This may be a good option if the enamel was damaged or if the tooth had a large filling. With time, a tooth that had a root canal can become brittle. That’s why crowns are usually recommended for posterior teeth (due to grinding and chewing). A crown is a covering that’s specifically molded to your tooth. Your dentist will file away part of your existing tooth and then permanently fit the crown over the tooth. A crown can be made to match the color of your surrounding teeth so that it’s not noticeable.

If your doctor determines that you don’t need a crown, you may be able to use tooth bleaching to treat any discoloration to the affected tooth. This is usually seen on anterior teeth only. Alternatively, your dentist may recommend covering the tooth with a porcelain veneer. Talk to your doctor about the different aesthetic treatments available.

Removal or extraction

If your tooth is severely damaged and unable to be restored, your dentist may recommend completely removing the dead tooth. During the procedure, the dentist will completely remove the tooth. Following the extraction, you can replace the tooth with an implant, denture, or bridge. Talk to your dentist about your options. Some questions you should ask are:

  • Will it need to be replaced over time?
  • How much will it cost? Will my dental insurance cover it?
  • What’s recovery like?
  • Will I need to do anything different to take care of the replacement tooth?

Pain management

If your tooth is causing lot of pain, there are somethings you can do at home while you wait for treatment:

  • Avoid hot beverages. They can increase inflammation, which can make your pain worse.
  • Take an over-the-counter anti-inflammatory medication, like ibuprofen (Advil, Motrin).
  • Avoid eating hard things. The force of biting down on them may aggravate the damaged nerves.

It’s important to see your dentist right away. Home treatment should not be used in place of professional medical treatment. Instead, you should use these methods while you wait for your appointment.

Tips for prevention

Preventing a dead tooth isn’t always possible, but there are some things you can do to reduce your risk.

  • Practice good oral hygiene. Brush your teeth twice a day, and floss at least once a day.
  • See your dentist every six months. Preventative dental care can help stop problems before they start. Your dentist can also identify early signs of tooth decay and treat them before the decay reaches your pulp.
  • Wear a mouth guard. If you’re participating in contact sports, like hockey or boxing, always wear a mouth guard to protect your teeth from trauma.
  • Maintain a healthy diet. Avoid eating a lot of sugary foods, which can increase your risk for tooth decay.
  • Drink water, especially after eating. Water can help wash away bacteria from your teeth between brushings.

What does a physician have to say about teeth? Lots!

Our friends at The Mighty Mouth have done a fantastic job using video to promote good oral health. Some of our favorites are those featuring Dr. Ben Danielson, a pediatrician in Seattle, Washington with lots to say about the oral health of kids and expectant mothers.

Dr. Ben Danielson reviews smart snacks for a healthy mouth: Choosing healthy snacks can lead to healthy teeth! Watch Dr. Ben Danielson – with a really big carrot – talk about smart snacks!

Dr. Ben Danielson shares best brushing practices: Children with healthy baby teeth are more likely to have good oral health for life. Watch Dr. Ben Danielson – with an enormous tooth brush – talk about best brushing practices!

Dr. Ben Danielson discusses child’s first dental screening: Did you know? It’s important to take care of baby’s teeth starting with their very first tooth! Learn why.

Dr. Ben Danielson shares how to keep your child’s mouth healthy: Cavities are preventable – and prevention saves you money. Learn more about helping your child have a healthy mouth.

Dr. Ben Danielson discusses importance of prenatal dental care: Know anyone who is getting ready to have a baby? Good oral health during pregnancy is important for mom and baby.

Dr. Ben Danielson explains why baby teeth matter: Keeping baby teeth healthy will help your child enjoy a lifetime of better teeth.

We hope you enjoy these brief, informative videos as much as we do. Oh. While you’re on YouTube, check out Lou the Toothfairy. He’s a hoot!

Exploring a 2Gen Approach to Improve Dental Health

When children struggle to get the dental care they need, the obstacle often can be traced to challenges being faced by their parents or caregivers. The Children’s Dental Health Project (CDHP), a nonprofit policy institute, has launched an initiative to examine these connections and explore whether multi-generational policy solutions can improve oral health.

In a new video, CDHP Executive Director Meg Booth explains why the initiative — sometimes called a 2Gen approach — is needed. Although the percentage of kids with dental coverage has steadily risen in recent decades, Booth points out that many adults “don’t have the same access (to care) they had as children.” Although children enrolled in Medicaid or CHIP are eligible for a comprehensive set of dental services, adults face a different reality when it comes to oral health coverage. In most states, Medicaid offers adults only limited or emergency dental services.

Research has revealed a variety of links between children and parents when it comes to getting dental services. For example, an analysis of Connecticut’s Medicaid dental program showed that children were much more likely to receive dental services during a year when their parents or caregivers also had seen a dentist. In fact, 81 percent of children whose parents had obtained dental care also received dental care. By contrast, only 52 percent of kids whose parents had no dental visit received oral health services themselves.

At this stage, CDHP’s research will focus on how oral health intersects with the economic stability of families, children’s educational outcomes and other areas. Their hope is to uncover policy solutions that could support the integration of oral health into models, communities, and programs that put all families on the path to well-being and success.

 

Pediatricians Prefer Prevention

Guest Blog Post by Lori Byron, MD, FAAP, Member Executive Committee, Council on Environmental Health, American Academy of Pediatrics

Good overall health includes good oral health! Fortunately, dental health has improved radically in the past century. Unfortunately, Black, Latinx, and Native American children, and those from families with low incomes, continue to experience health disparities, oral health disparities among them.

Father and ChildFluoride, a naturally occurring element found in varying levels in all water sources, has played a large role in the progress we have made to date. Pediatricians acknowledge the conclusions of health experts that fluoridation of community water supplies is the single most effective public health measure to prevent dental decay.

Fluoride in recommended amounts has been deemed safe and effective by the American Academy of Pediatrics (AAP), the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and many other science-based organizations. Fluoride strengthens the teeth and helps prevent decay. As a pediatrician, I always prefer prevention measures for health rather than treatment.

Many of us live where fluoride in sufficient amount is not available in our water. If this is the case for your children, be sure you are using fluoride toothpaste and ask your dentist or pediatrician about fluoride varnish. Most pediatric offices are equipped to apply fluoride varnish to your child’s teeth during a routine visit. The treatment can be repeated two to four times a year and is performed with your child leaning back in your lap. It takes only a few minutes, and the taste is acceptable to most children.

Just like immunizations, iodine in our salt, Vitamin D in our milk, and well child care, fluoride treatments are a way to help prevent disease and keep your child healthier. Drinking plenty of water, avoiding sugary drinks, limiting candy, and brushing every day with fluoridated toothpaste also helps! Please ask your pediatrician or your dentist if you have questions.

New Resources: Common Questions About Fluorosis and Fluoride

Parents have questions, and we have answers. The Campaign for Dental Health has just released new, simpler versions of two of our handouts for parents and caregivers, in both Spanish and English. Enhanced graphics, bold formatting, and a reduction in the amount of text makes these quicker and easier to read.

These resources and more are available on several different pages of our website. Look for them on the Learn and Share page under Fluoride and Children. They top the list of many resources and infographics of interest to parents, decision-makers, and advocates alike.

As companions to Fluorosis Facts: A Guide for Health Professionals and Fluoride Safety: A Guide for Health Professionals, these handouts let parents and caregivers leave the office with helpful information in hand. They are all housed together and available on the Health Professionals page.

We encourage you to download, print, and share these handouts with others.

Breaking News! Water Fluoridation Helps Reduce Decay in U.S. Kids and Teens

A new analysis has found that community water fluoridation (CWF) reduces decay by as much as 30-39% in children’s baby teeth (primary dentition) and by 12-24% in permanent teeth. The analysis was complex. It merged National Health and Nutrition Examination Survey (NHANES) results with Water Fluoridation Reporting System (WFRS) data and ran multivariate analyses with binary and continuous fluoridation variables. Here’s a link so you can read all about it: Water Fluoridation and Dental Caries in U.S. Children and Adolescents.

Young AdultsBreaking news? Well, not really. After all, we have known that fluoride prevents tooth decay since it was discovered by Frederick McKay over 100 years ago. Yes, 100 years ago. And since that time, as cities and towns have adopted the practice of adjusting the level of fluoride in the water system, we have seen significant, measurable decreases in both childhood and adult dental disease.

Some people question whether fluoridation is still needed given the increasing availability of dental products with added fluoride and preventive clinical services like sealants. Yet, the findings of this study are consistent with those of earlier studies, demonstrating that community water fluoridation has continued to provide a benefit on top of other preventive measures.

Dental decay is unfortunately still very common. Children and adolescents do not learn and thrive when dental pain prevents them from eating and sleeping well. (That’s not breaking news either.) And, although it’s easy to forget, for some children, especially young children, fluoridated water is the only available prevention.

Good oral health is essential to children’s overall health and well-being. That’s why the American Academy of Pediatrics and the Campaign for Dental Health work hard to promote and defend this important public health measure. And that’s also why we continue to share the evidence that water fluoridation helps reduce decay in kids, teens and adults.

Great Expectations — Perceptions in Smile Design

The Patient’s Perspective

an analysis by Dear Doctor magazine

Does your dentist see what you see — and vice versa? Can you really communicate how you want to change your smile?

Perceptions in smile design.

While beauty is definitely in the eye of the beholder, a person’s own perception of what looks good is an important factor in achieving a satisfying result when enhancing someone’s smile. Most of us understand that we want our teeth to look wonderfully bright and natural, but not like ultra-white “Chiclets” all in a row.

While there are several ways modern dentistry can alter the appearance of a smile by changing teeth, ranging from composite resins to porcelain veneers and crowns, this article discusses how you as an individual perceive what looks natural and what doesn’t — and how to go about communicating with your dentist what you want to change in your teeth and smile.

Perceptions and the Art of Dentistry

Does your dentist see what you see — and vice versa? Can you really communicate how you want to change your smile? These are important questions — so let’s start by examining what information is available to us from research on this important issue. Recent studies address this critical subject regarding communication between the public at large as a non-professional group and dental professionals, who may or may not “get” what you are trying to say about what you see and want to change in your smile.

One study set out to determine the differences in perceptions of lay persons and dental professionals. The study looked at variations in tooth size and alignment and their relation to surrounding gums and other facial features that make up a smile. The results are very enlightening because they show that there are varying levels of differences, which can actually aid the dentist artistically when making specific treatment recommendations.

There is no doubt that dentists look at smiles differently than non-professionals — which actually makes perfect sense. Dentists as a group are (and should be) more discerning of issues such as crown (tooth) length, midlines (how the teeth line up with other facial features) and gum-to-lip distance, to name a few.

According to the same study, lay persons place more importance on other features of facial aesthetics. For example, individuals rated mouth expression and lip shape as more noticeable than other “strictly dental” characteristics.

Vive La Difference

The art of “making smiles” lies in the dentist’s ability to integrate the individual’s personal perceptions of what is important and what he or she considers necessary to be aesthetically pleasing. It is the dentist as artist who must incorporate natural elements of dental anatomy and scientific knowledge into smile design. You must have confidence and trust that your dentist hears what you’re saying and that you are able to communicate what you want to look like. Indeed, trust is critical in this relationship with something as important as your smile, which is now in the hands of a dental professional.

Part of building the necessary trust is to accept that there will always be differing levels of perception between patient and dentist; minor variations in areas of smile analysis and design need not be an important concern to you. What is important, though, is for you and your dentist to understand what gets communicated in this encounter.

With a professionally trained and experienced eye, your dentist will actually see more dental possibilities than you do. It is therefore the responsibility of the dentist to inform and educate you so that you’re better able to make your own personal choices.

On the other hand, the old axiom “If it ain’t broke don’t fix it” is also a good principle to follow, at least aesthetically speaking. In other words, if you’re happy with certain characteristics of your smile, leave well enough alone.