All Posts tagged long in the tooth

Gum Disease: The Real Problem of Being ‘Long in the Tooth’

"long in the tooth" walrus - dental condition

You look a bit ‘long in the tooth’!

Typically, If you describe someone as being ‘long in the tooth’, you are saying derisively or humorously that they are old or aging.

However, there may be more at stake than hurt feelings.

Clinically speaking, having an unusually long tooth or teeth can be symptomatic of a much bigger problem. Gum disease.

My Tooth Became Really Big. Can You Help Me?

I saw this new patient last week, and she was correct. When you looked at her, all that you saw was one tooth. I don’t mean that one tooth was all that was present. She has many teeth that show when she smiles and talks. What I am referring to is one tooth that stands out more prominently than all of those around it. She was literally ‘long in the tooth’.

How did it stand out? First of all, it was much longer than the teeth on either side. It was her cuspid, or “eye tooth” as people commonly refer to it. The tooth is a large tooth, to begin with, but this was even larger and more prominent than we usually see.

The tooth was also pushed forward. When a front tooth is pushed forward, two things can result. First of all, the tooth may bite on the lower lip and therefore feel strange. It also causes a protrusion of the upper lip.

To top off these calls to attention by the tooth, the color of this tooth was whiter than the rest.

Gum Disease Spreading to the Bone

I recently wrote about shorter teeth.
Shorter teeth come as the result of years and decades of wear of the biting surface as we get older.
I also mentioned some teeth could do just the opposite. They appear to get longer as the gum and bone shrink a little away from the tooth.

My new patient was not an example of either scenario. Her tooth got much “longer” because of gum disease.

Gum disease starts in the gums and then spreads to the bone. This condition is a bacterial infection that will destroy the bone in which the tooth rests. If the disease damages all of the bone, then the tooth will become loose.
If you are lucky enough, you won’t experience any pain, and one day, the tooth will fall out of your head.
More likely than not, you will have swelling and discomfort requiring help from a professional to either save the tooth or remove it, depending on the severity of the situation.

A Good Analogy

Once the bone is attacked and slowly is destroyed, the tooth loses its primary stability.
Let me give you an analogy.
Think of a post implanted in the ground.
If the earth is covering a good portion of the post, then the post remains stable.
If the ground erodes away from the post and more post is above the surface than in the earth, instability will appear. The post will become movable, and if pressure is applied, it will no longer stand perfectly straight. It will start to lean to one side or the other.

The same thing happens to a tooth with gum disease, and this is what I saw in the mouth in question. Fortunately for her, the bone destruction did not extend significantly to the adjacent teeth.  I recommended removing the tooth and replacing it.

As for the fact that this tooth was also whiter than the rest is because she had an old crown on the tooth. That crown matched her teeth years ago and was thus whiter.
No matter how I replace the tooth, I would correct the color and make it match its neighbors.

Building Bridges

So how did I plan on replacing the tooth after removal?
Our choices were either a single implant or a permanent bridge which can’t come out.

After an evaluation, I recommended a bridge for two main reasons.

1. The first reason centers on the fact that the bone loss was resulting in the bone moving upwards. If I placed an implant, the resultant tooth would be very long.

Remember that was one of her initial concerns. A permanent bridge would deal with this long tooth issue better.

2. Secondly, I would utilize my “Same Day-Immediate Bridge” technique that I developed. It allows me to remove a tooth and provide a replacement in usually less than an hour. We did that, and she left with a stunning and much-improved smile.

Taking Advantage of Our “Better Than Insurance” Program

Best of all, she took advantage of our “Better than Insurance” program that I mentioned in the last couple of columns. Rules do apply, but she met all of the criteria and saved 20% of the fee.
She looked terrific, and we saved her money! Another happy customer and a healthy smile!

Call Megan today at 440.951.7856 and find out about our “Better Than Insurance” initiative to save you money and preserve your smile for a lifetime.

 

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

 

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Tooth Size – The Long and the Short of it

 

Tooth Size The long and the short of it

Does it ever seem that your tooth size is longer or shorter than it was when you were younger? In this article, we explore the various reasons and causes of the changes in our tooth size.

Do our teeth get longer as we age?

There is an expression that I don’t hear that often anymore. The idiom is “long in the tooth.” This phrase is usually referring to someone getting older. It is based on the thought that teeth grow longer as we age.

Well, this is true when we are children and teens. As teeth start to come in or erupt, as we term it in dentistry, they appear to be growing.

They are not growing. In fact, when teeth are developing in the gums as children, they are adult size. As we get into our teen years, the teeth grow into the mouth. It appears that they are growing bigger, but in reality, they are just uncovering themselves from the gum tissue from which they were buried.

Less gum tissue = longer teeth

Teeth, for the most part, do not grow or move anymore once we reach our late teens. However, with time, gum tissues may shrink away from the tooth.
Sometimes, we become very hard brushers and wear away our gum tissue. Gum tissue is fragile right around the tooth and can be easily brushed away. Now we see more enamel than we saw previously.

Other times, due to gum disease, a shrinkage of gum tissue may occur. This reduction happens as bacteria destroy the underlying bone and there is nothing to support the gum tissue.

In any of these cases, we see more tooth enamel. Making it appear that our teeth are longer than before. This condition occurs because more tooth is exposed above the gum line than what we may have observed in previous years.

Okay, I get it. As we get older, and our gums shrink, our teeth “appear” to get longer than they were in our youth. That’s what the idiom, “long in the tooth” means.

Why Are My Teeth So Short?

But wait! As we age, many of us see our teeth shorten. This phenomenon isn’t supposed to happen, is it? Well if the gum does not shrink away from the tooth, then the pseudo-growing phenomenon will not occur. That explains lack of getting bigger, but where does the shortness come from?
Are the teeth shorter or do they just appear that way?
Does it fool us as the tooth growing act fools us?

Our teeth DO shrink!

In reality, the teeth get shorter. It is not an optical illusion. The more we chew, the more our teeth wear.

Teeth are the hardest tissue in the body. They are denser than bone. It needs to be this hard as it is the first tissue encountered during the eating process. It needs to be very dense as it tears and grinds at food.

Ah, there is the answer to your question. We use our teeth to grind.

With modern dental care and a better understanding of what causes disease, we can keep our teeth for many years longer than previous generations. Because of this, we grind more food for more years. Over time, our teeth slowly wear away. If we are missing teeth, then the remaining ones work harder, grind more and end up wearing away more. This is how we get short teeth.

This condition is even more noticeable in the front of our mouths. Let me explain why this is so. The patient who asked me that question had their upper front teeth meet their lower front teeth. The teeth touched each other tip to tip. In dentistry, we call it “edge to edge.” Every time they chewed their food, not only did their back teeth grind, but their front teeth were grinding too.

Sounds great. After all, more teeth grinding is more efficient -right?  Wrong!

The problem stems from the fact that the front teeth are narrow-edged. They are designed to tear, not to crush. When we use them to grind, they wear away very quickly. Grinding with our incisors creates short teeth and a loss of healthy cosmetics.

We identified the problems. Any solutions?

How do we fix this issue? I will give you some answers in our next column. Until then, if things are starting to change in your mouth and just don’t look right, please give me a call and ask me a question. I will do my best to help you. You can reach me at 440.951.7856

 

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

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