The Importance of ‘Near Me’ Mobile Searches for Periodontists

When you are marketing as a periodontist, it is vital to have your site optimized for mobile - especially since it is more common for your future patients to be searching for dental specialties using their smartphones rather than a computer. And, since mobile devices take the user’s location into account with each search - for example, Google Map results - “near me” searches looking for hyperlocal results happen all the time.

“Near Me” Searches are Common for Periodontists

Adding the qualifier “near me” to local searches has grown exponentially according to Think With Google in 2017. This rate of growth is much higher than those without the phrase. What does this tell us? When people are searching for periodontists, they want to see periodontists that are nearby their location.

Taking this a step further, Think With Google also has data suggesting that searches are getting even more specific, including “where to buy” and “on sale” in addition to “near me.” This sort of knowledge can be applied to your business, shaping how you handle local SEO for your practice.

Getting Hyperlocal with “Near Me”

There was a time when local results with a search would have left searchers with periodontists in their city or town. Now, the “near me” qualifier is getting hyperlocal – presenting results down to the neighborhood where the search is conducted.

For instance, the Nextdoor app has users enter their home addresses in order to gain access to the site. They are then connected with their neighborhood and everything in it. Users are asked to leave a recommendation and, when they search for a service, such as a periodontist, or ask for a recommendation, they are provided results that include hyperlocal businesses.

AdviceLocal set up a test account to search for a business located outside of the set neighborhood. Can you guess what happened? That’s right - they could not see the business, rather only businesses within the neighborhood.

It is anticipated that this is the direction hyperlocal searches are headed over the next several years. The news, food delivery apps, and more are set up in this manner - which is further evidence of the direction local SEO efforts need to be going. If you haven’t claimed your periodontist practice on Nextdoor yet, now is the time to do so. And, of course, stay in touch with new hyperlocal opportunities as they present themselves.

Hyperlocal with Facebook Neighborhoods

Facebook made an announcement in May 2021 that it is testing its new concept, Facebook Neighborhoods, in Canada.

The Facebook Neighborhoods idea seems rather similar to that of Nextdoor, allowing neighbors to connect and integrate popular features in their communities. For instance, residents will be able to vote for their favorite hyperlocal businesses, services, and places - and this includes periodontists.

It is likely that Facebook Neighborhoods will make its way into the U.S. And when it does, you will want to claim your business listing so that you may take advantage of all it has to offer you.

To learn more about the future of hyperlocal searches and how they relate to your periodontal practice, visit

Call 212-751-8530 today to schedule a consultation with Dr. Froum or request an appointment.

Excess Sugar Consumption: Effect on the Body

While sugar may seem like a substance that is harmful only to your teeth, causing cavities and gum disease, excessive consumption can cause severe damage to both physical and mental health. What is less well known are the systemic effects of sugar and that excess consumption is one of the leading causes of rising obesity, cardiovascular disease, type 2 diabetes and other chronic disease with addiction rates similar to narcotics. Because addition of sugar to food substances are often unregulated, the amount of sugar intake can remain largely unknown.

Sugar addiction or sugar craving?

Studies suggest sugar addiction or ‘cravings’ are similar to those of cocaine as it can increase energy and result in a short-term euphoric feeling. Sugar addiction has been shown to have withdrawal and relapse rates comparable to those associated with narcotics and other illicit drugs. One difference between narcotics and sugars is that unlike narcotics, sugar can be ‘added’ and hidden in foods, even foods considered healthy. Processed foods like protein bars, sweetened beverages like energy drinks, ‘healthy’ cereals, juices, and yogurts can be loaded with sugars. According to the American Heart Association, the average recommended sugar intake for men is 36 grams/day for men and 25 grams/day for women. One cup of Dannon low fat yogurt, a food substance deemed ‘healthy’, has 34 grams of sugar alone. Because of these hidden sugars and a lack of nutrition education, it is estimated the average American consumes 71.14 grams of sugar a day accounting for up to 17% of total adult calorie intake.

What does excess sugar consumption do to the body?

  • Obesity: fat diets trended in the early 2000’s but those diets replaced fat with sugar and sugar has been labeled as the number one reason why obesity rates have increased. Fat around organs have been associated with organ damage and failure.
  • Diabetes: Sugar overconsumption can spike insulin levels and drive insulin resistance. The risk for diabetes grows approximately 1.1% for every 150 calories of sugar consumed in 1 day. Diabetes is a risk factor for many diseases including periodontal disease.
  • Inflammation: high sugar consumption significantly increases pro-inflammatory cytokines and increases adipose tissue which further increases levels of inflammation.
  • Gut Dysbiosis: Studies have shown that diets high in sugar can trigger changes in gut microbiome favoring those associated with obese body types.
  • Depression: diets high in sugars and processed foods can cause neurotransmitter dysregulation increasing the risk of depression. Research has also found a correlation between excessive high fructose corn syrup consumption and an increased risk for Alzheimer’s disease and dementia.
  • Premature Aging: The shortening of telomeres is a natural process in aging which can be accelerated by a high intake of sugar. One study with 5,309 adult subjects showed that regular drinking of sugar-sweetened beverages was associated with shortened telomere length and premature cellular aging.

Curbing the Sugar Addiction/Craving

Dietary changes that directly limit sugar consumption and replace processed products with whole foods or ‘the single ingredient method’ is the best method.  Eating whole fruits, vegetables, high fiber foods, and grains instead of processed snacks with added sugars will help keep blood glucose levels stable throughout the day. Avoiding high-fructose corn syrup-containing items, added sugars & dyes, and cutting out refined carbohydrates can help decrease inflammation and balance hormone levels. Additionally, mindfulness techniques can be incorporated as a supportive measure; these can include post-meal walks, meditation, and non-distracted eating practices to slow down the speed of food consumption.

For more information on how sugar affects the oral cavity and the body, call 212-751-8530 today to schedule a consultation with Dr. Froum or request an appointment.

How a Periodontist Can Help Treat Halitosis

Bad breath, also commonly known as “halitosis” is an odor that is associated with the mouth that 50% of Americans suffer from and increase in intensity as a person gets older. There are many causes of bad breath and the treatment for it depends upon the reason for the bad breath. A periodontist is a specialist in bone and gum disease and can help you treat your bad breath with a variety of treatments.

What are the current treatments available for bad breath?

The available methods of halitosis treatment can be divided into a physical reduction of bacteria, a chemical reduction of bacteria, masking the odor of bad breath, and chemical neutralization of bacterial odor. Determining the cause of bad breath is extremely important to determine if a dentist can treat your bad breath or a medical doctor referral is needed to treat medical issues which are causing your halitosis.

What are the dental treatments available to treat bad breath?

Fix all cavities, broken crowns, broken teeth, crowded teeth, partially impacted teeth, and/or other food trap areas.

Professional cleanings to remove bacteria and a consultation with a periodontist to see if deep cleanings are necessary.

Cleanings done between the teeth with piks, water piks, inter-dental flossers, floss and/or any other tool used to get between the teeth. Specialized anti-bacterial cream specific to the bacteria in your mouth can be used as well.

Customized anti-bacterial mouth rinse specific to the bacteria in your mouth can be used for 2-3 weeks to reduce bad bacteria. This is followed by another probiotic rinse for two weeks to rebuild the good bacteria in the mouth.

What can I do at home to treat bad breath?

Use Triclosan toothpaste, use of essential oils, consumption of probiotics with Lactobacillus salivarius.

Use take home trays to decrease bacteria and volatile sulfa-compounds that are the source of malodor. These customized trays are combined with hydrogen peroxide gel can be used 2-3 times a day and have the added side effect of tooth whitening.

Use Xylitol agents, Biotene rinses, and systemic drugs such as Evoxac/Sialagen to increase salivation if you have dry mouth.

Decrease the consumption of odorous foods such as garlic, onions, and other spices that embed themselves in the tongue and can have long lasting bad breath effects.

Quit smoking, avoid tobacco products and the usage of heavy alcohol.

What medical options treat bad breath?

Medications to reduce bad breath can include broad spectrum antibiotic coverage for pharyngitis and/or drugs such as proton pump inhibitors for GERD.  When H. pylori infections are observed, the therapy consists of the intake of omeprazole, amoxicillin and clarithromycin. Surgical intervention can include tonsillectomy/adenotonsillectomy, Sinus surgery, or liver/kidney transplantation.  In the endocrinological and metabolic disorders (Diabetes/Amino Acid disorders), the underlying diseases should be treated. 

What psychological options treat bad breath?

Patients suffering from perceived bad breath can have significantly elevated scores for obsessive-compulsive symptoms, depression, anxiety, phobic anxiety, and paranoid ideation compared with similar patients without halitosis. To treat delusional halitosis a multidisciplinary approach of health care practitioner, psychologists and psychiatrist are required.

Call 212-751-8530 today to schedule a consultation with Dr. Froum or request an appointment.

What Causes Gum Recession?

Gum recession, loss of gum tissue around the root surface, is a disease that can be caused by many different factors. 84% of teenagers & adults suffer from gum recession which can result in long and ugly teeth, sensitive roots and ultimately tooth loss. Gum recession can be both an esthetic (cosmetic) problem as well as a functional problem. Without the good thick tissue protecting our teeth, the teeth can develop cavities and bone loss, ultimately leading to larger problems. When treated early gum recession can be an easy fix but if treated late, treatment can become much more complex and costly. The most common causes of gum recession are as follows.

Gum Infections

Oral bacteria can cause gum infections including gum diseases like gingivitis and periodontal disease. During these diseases, the gum and bone tissue can be lost which cause the gums around the teeth to recede. Patients can develop long looking teeth that can become loose. Common signs of gum disease include bleeding gums, loose teeth, increased spaces between teeth, gum loss around the teeth, bad breath, and red swollen gums.

Aggressive Oral hygiene (Tooth Brushing)

Gum tissue can be lost by an oral home care routine that is too aggressive. Most commonly, people will brush their gums and teeth with a toothbrush in a manner that is either too hard and/or with a toothbrush that is too hard. When the gums are over brushed or flossed, they can be traumatized, and the gum tissue can recede around the teeth.

How does genetics cause gum recession?

People can be born with thin gum tissue that is more likely to recede than other people with thicker gum tissue. There are two types of tissue in the mouth. One tissue called keratinized tissue which is hard and protective and not likely to recede. The other tissue is called non-keratinized tissue and this is the tissue that allows for movement and flexibility but is more likely to recede when traumatized. The less keratinized tissue volume and thickness an individual has, the more prone they are to recession. Gum grafting is a technique that increases the amount of keratinized tissue around teeth with recession or prevent recession from occurring in people with thin gum tissue.

How does orthodontic Movement (Braces) cause recession?

When a person gets either braces or clear aligners like Invisalign, teeth are moved into different positions in the jaw. Teeth are often moved in a direction to lessen the teeth crowding in the jaw. Teeth moved in this direction, which increases the room in the jaw for crowded teeth, may result in thinning of the bone around the teeth resulting in gum tooth recession. This recession can happen during the orthodontic movement or many years after completion. An Orthodontist will often send people with thin tissue to a Periodontist to evaluate the gum and bone around the teeth to be moved and see if gum grafting is needed to build up the gum tissue before orthodontics begin.

How does smoking & tobacco products cause gum recession?

Smoking, vaping, and chewing tobacco products can cause gum recession around teeth because of the chemicals in the tobacco products. The hot smoke from smoking can traumatize the tissue leading to gum tissue loss. Chewed tobacco can harm the gum tissue from both the chemicals in the tobacco as well as the friction from the material against the gums.

Bad Bite

Many dental studies have shown that people who have bad bites with teeth banging against each other can develop recession around their teeth. Typically, bad bites will quicken the amount of recession someone can develop, especially if they already have bacteria in their mouth that cause bone and gum tissue loss.

Teeth Grinding & Teeth Clenching

Like a bad bite, grinding your teeth or clenching them together can quicken the recession you can get when you have bacteria that causes gum and bone tissue loss in your mouth. People who grind their teeth can find ways to prevent damage to their teeth by using a night guard and/or botox treatment in the jaw.

Mouth Trauma

Trauma or a direct blow to the gums can cause recession by ulcerating the gum tissue or having the gum tissue peel away from the tooth. If the tooth is healthy and is not suffering from gum disease already, the gum tissue can grow back to normal levels after it heals from the trauma. If the gums do not grow back in 3-6 months, the gums may need to have soft tissue grafting to bring them back to normal levels.

Call 212-751-8530 today to schedule a consultation with Dr. Froum or request an appointment.

How to Choose the Best Periodontist in NYC

Are you searching for a periodontist in New York, NY?

While dentists provide general care for the whole mouth, a periodontist focuses specifically on gum and bone health, the tissues that hold the teeth in the jaw. Your dentist can help monitor your gum health and even treat many gum conditions, but may recommend that you see a periodontist if you have any severe or chronic issues with your gums and teeth, such as bleeding gums, gum recession, bad breath, loose teeth, gum disease, or other gum issues. When it comes time to see a periodontist, how will you know which one to choose? With so many in NYC, you need to look for certain qualities that make the best periodontist stand out from the rest.

Qualities to Look For in a Periodontist

  1. Education. Of course you’ll want to be sure the periodontist you choose has not only completed the necessary undergraduate and dental degrees, but has also completed a residency in periodontology at an American Dental Association-accredited institution. Periodontology is a concentration within the medical dentistry or dental surgery field. A periodontist must complete all of the above to earn that title.
  2. Experience. In addition to education, you should look for a periodontist with plenty of experience in the field of periodontology, not just in dentistry alone. If a periodontist is new to the field, they should be working alongside a more experienced periodontist in order to learn and gain quality experience.
  3. Membership with Dental Associations and Societies. While it is not a requirement for a periodontist to be a member of any associations and societies, one who is a member of organizations such as the American Academy of Periodontology has proven that they are willing to go above and beyond with their practice and their professional development. Certifications such as this require extra written and oral exams and must be renewed periodically, which ensures that all qualifying periodontists are keeping up to date with current best practices.
  4. Handles Complex Cases. Not all periodontists offer the same services. Look for a periodontist who routinely handles complex conditions and procedures. Even if your current needs are relatively simple, you could experience changes that require more in-depth procedures. If this occurs, you will be glad you chose a periodontist from the beginning who could handle all periodontal conditions, no matter their complexity.
  5. Teaches. A truly excellent periodontist is also a teacher. Experience and knowledge should be used to the fullest to educate other periodontists and dentists on best practices and techniques. There’s no greater vote of confidence than when someone excels at their field to the extent that they are asked to teach others how to do the same.
  6. Uses Cutting Edge Technology. Advancements in technology have revolutionized periodontology, making procedures faster and less invasive for the comfort and convenience of the patient. Look for a periodontist who uses the latest technology in their practice for diagnosis and treatment.
  7. Has published in Dental Journals- Top periodontists in their field publish in journals and have performed research that is shared with other colleagues. When your periodontist not only is in clinical practice but academic research, they stand out from the rest of the field.

Dr. Scott H. Froum Embodies All of These Qualities and More

When it comes to excellence in the field of periodontology, Dr. Scott Froum checks all of these boxes and more. He completed his Bachelor of Arts at Amherst College and received his Dental Doctorate and Periodontal Certificate from the SUNY Stony Brook Dental School. Dr. Froum has multiple decades of experience in the dental and periodontal fields, specializing in periodontology and implant dentistry. He is currently a clinical professor in the post-graduate department of Periodontics at SUNY Stony Brook School of Dental Medicine.

In addition to being a diplomate of the American Academy of Periodontology, he serves as the chief editor of the Perio-Implant Advisory Journal and has been written in numerous textbooks on Periodontics and Implantology.  He lectures extensively on the national and international level.

Dr. Froum has handled and continues to handle many complex cases ranging from bone regeneration procedures to save teeth, to treating Implant Complications to gum grafting to crown lengthening and many other services. A complete range of periodontal, implant, and cosmetic procedures as well as preventive dentistry are all offered through Dr. Froum’s practice. State-of-the-art technology is implemented in every aspect of patient care to provide the highest quality service.

To choose one of the best periodontists in the field. Call 212-751-8530 today to schedule a consultation with Dr. Froum or request an appointment.

What Causes a Gummy Smile

The gummy smile is when the gums enlarge and can be caused by three main reasons (1) bacteria causing inflammation, (2) medication, and (3) systemic disease. Most of the treatment involves either gum cleanings or surgical intervention in the form of crown lengthening.

How does bacteria cause a gummy smile?

One reason by people develop gummy smiles is inflammation and bleeding of the gums caused by bacteria. Gum disease (gingivitis and periodontitis) can result in gum tissue swelling, overgrowing, and starting to bleed. Braces and other orthodontic appliances can trap food and if proper oral hygiene is not done, can result in gum overgrowth (Figure 1). The first step is to start performing good oral hygiene and get dental cleanings. In many instances, surgical removal of excess gingival tissue may be needed which can be accomplished quickly and efficiently with a dental laser (figure 2).


Gummy smile caused by a combination of poor oral hygiene and orthodontics increasing bacterial accumulation leading to gum overgrowth

Picture of a gummy smile correction after removal of excess gum tissue with a dental laser

What medications cause a gummy smile?

The following classes of drugs have been associated with gum overgrowth and a gummy smile.

  • Antiseizure (phenytoin, phenobarbital, lamotrigine, vigabatrin, ethosuximide, topiramate, and primidone)
  • Blood pressure (calcium channel blockers such as nifedipine, amlodipine, and verapamil)
  • Immunosuppressant (cyclosporine)
  • Amphetamines (cocaine, Ritalin, methamphetamine)

Treatment may not be needed, and this condition may resolve by itself if the drug causing the problem is discontinued or another drug is substituted. Bacteria caused by poor oral hygiene can make drug induced gummy smiles worse so frequent dental cleanings may be needed.  If these methods do not work surgical treatment may be necessary.

What conditions or diseases cause a gummy smile?

  • Hormonal changes associated with pregnancy or puberty
  • Diseases requiring hormone replacement therapy
  • Vitamin deficiencies (mostly vitamin C and vitamin Bs)
  • Benign neoplasms
  • Leukemias, malignant neoplasms/carcinomas, as well as many forms of granulomatous diseases

Treatment of gingival enlargement

Correction of the gummy smile is dependent on the reason for the gum overgrowth. If the gummy smile is caused by medication, stopping the drug and proper home care will usually resolve the problem. When caused by a disease, treatment of the disease usually will result in resolution. Hormonal fluctuations caused by pregnancy and puberty are often unavoidable, and gum overgrowth can often be minimized with excellent home care and dental cleaning visits. When these noninvasive modalities do not result in resolution of the gummy smile surgical treatment can remove the excess gum tissue.

Call 212-751-8530 today to schedule a consultation with Dr. Froum or request an appointment.

Diseases That Affect the Tongue

How does the healthy tongue look?

The tongue should be a pinkish to reddish in color on the top of the tongue and should be pink with bluish hue on the underside as some veins may be seen.  The tongue should have a rough top surface due to the taste buds and the underside of the tongue should be smooth.  There should be no hairs, furrows, or ulcerations.  The tongue should fit comfortably in the mouth with the tip against the teeth.

What can cause a tongue to look smooth and shiny?

If the tongue is not smooth because of rubbing against the teeth, crowns, implants or a denture than nutritional deficiency may be the culprit. Vitamin deficiency, especially vitamin B12 deficiency (pernicious anemia), can be the cause. Other deficiencies that can contribute include vitamin B3, B6, B9, and iron.

What causes the tongue to look white?

  • Oral candidiasis (thrush), is an infection of a fungus called Candida albicans that can make the tooth look white and furry. Immunosuppression such as (HIV), diabetes, denture use without teeth cleaning, and/or antibiotic use (usually over long-term periods).
  • Oral lichen planus is an autoimmune disease that has a white lace-like pattern called reticular lichen planus.
  • Geographic tongue is a non-cancerous problem with painless patches on the tongue that can appear, disappear, and then reappear in a different area. This is seen in 1%–3% of the population. Recent evidence, however, suggests that geographic tongue may be linked with a Vitamin B3 deficiency and inflammation of the intestine or leaky gut.
  • Vitamin Deficiency in Vitamin A, Vitamin B2, B3, B6, B9, and B12


White tongue: Candida albicans fungal infection sometimes referred to as thrush

What causes the tongue to look red?

A red tongue can be a sign of a vitamin deficiency (B2, B6, B9, B12) Iron deficiency, protein deficiency such as Kawasaki disease, or a strep infection (scarlet fever). Red ulcerations of the tongue can be signs of cell changes and red ulcerations lasting more than 2 weeks should be biopsied.

What causes the tongue to look black?

A black tongue is usually a harmless condition that can be caused by chlorohexidine rinses (Peridex), medications, smoking, antibiotic use, poor oral hygiene, soft diet, or dry mouth. The cause of black tongue is thought to be a change in the normal bacteria in the mouth after antibiotic treatment or use of products that contain bismuth (sulfa), such as Pepto-Bismol.


Black, hairy tongue from poor oral hygiene and smoking

What causes a change in taste?

  • Medications usually cause a metallic taste, and these are associated with some forms of antibiotics; chlorhexidine rinses; antihistamines; antifungals; antipsychotics; blood pressure, diabetes, seizure, and Parkinson’s disease medications; among others.
  • Covid-19 has been associated with changes in taste because due to the SARS CoV-2 virus affects the ACE-2 receptors in the tongue and nose.
  • Dry Mouth caused by colds or flu, smoking, and nutritional deficiencies (Vitamin B12, Vitamin C, and Zinc).

What causes the tongue to have ulcers?

Tongue ulcers that do not heal or regress in 10–14 days should be of concern and either biopsied or referred to a specialist.

  • Canker sores (aphthous ulcer)is a painful form of ulceration frequently encountered. The ulcer appears in one of several patterns: minor (small that heal within 14 days), major (large and may scar when they heal), or herpetiform (multiple pinpoints that can combined into 1 large ulcer).
  • Recurrent canker sores occur in some systemic illnesses, including Crohn’s disease, celiac disease, Behcet’s syndrome, pemphigus, herpes simplex, histoplasmosis, and reactive arthritis (Reiter’s syndrome).

Minor canker sore white in appearance with a red border frequently found on the lateral border of the tongue

Call 212-751-8530 today to schedule a consultation with Dr. Froum or request an appointment.

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Saving a Tooth with a Maxillary Root Amputation

What is maxillary molar root amputation?

Maxillary root amputation is a surgical treatment that removes one of the roots of a maxillary tooth while leaving the crown and remaining roots intact.  Root amputation treatment is used to save teeth with bone loss, have failing or failed root canals, or have a root that is fractured and are supposed to be taken out. Using this technique to save compromised upper molar teeth with root amputation can often be successful but the technique is sensitive and complex.

When is a maxillary molar root amputation a good idea?

  1. There is enough bone support around the remaining roots
  2. The periodontist performing the procedure is experienced in this specific type of treatment
  3. The root canal on the tooth (if the tooth has a root canal) is in good shape
  4. A tooth crown can be placed on the tooth in proper function and bite
  5. Routine dental cleanings and good home hygiene can be performed

X-ray of a upper molar tooth with a root amputation that allowed the patient to keep the tooth and avoid a sinus lift and dental implant

What is the success rate of maxillary molar root amputation?

Prognosis for molar teeth with root amputation is good, provided case selection and treatment is performed properly as stated above. One 15-year study showed long term success rates to be the same between molars with maxillary root amputation as compared with dental implants. Another 10 year long term study showed that teeth that had bone loss and were planned to be extracted, showed excellent success and function over the time period of the entire study. In addition, patients were able to avoid taking out the teeth, having to perform sinus lifts, and place dental implants when maxillary molar root resection was performed. Finally, this treatment on average is about 25% of the cost when comparing the alternative of taking out the tooth, placing a bone graft, performing a sinus lift, and placing dental implants to replace the teeth that were extracted.

Who is a candidate for maxillary molar root amputation?

Patients that are not eligible for dental implant therapy due to medical history, smoking, financial limitations, and/or who do not want dental implants or sinus lifts may be eligible for this type of procedure. Long term success rates are similar when comparing this type of tooth saving procedure to dental implant therapy.

To find out more about maxillary molar root resection and if it is the right treatment for you, call 212-751-8530 to schedule a consultation with Dr. Froum or contact us today.

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What is Crown Lengthening and When Do I Need It?

 If you have been told by your dentist that in order to complete your crown or filling you need crown lengthening, you may have questions as to what it is and why you need it. This quick article will address those questions.

What Is Crown Lengthening?

Crown lengthening is a procedure that is designed to be either what in dental terms is known as functional or esthetic.

Functional crown lengthening is a surgical procedure used to create space between the end of the crown or filling and the bone holding your tooth in the mouth. This surgical procedure can be performed with dental instruments or dental lasers which make it fast and painless. This space is necessary for the gums to ‘breathe’ and be healthy. This space, which is about 2-3millimeters in length, can’t have dental filling material or the tooth crown placed into it or the body will react to it. The body may ‘reject’ the dental filling or crown by the gums becoming inflamed, swollen, red, and start to bleed. Functional crown lengthening is also needed when the tooth is broken down or has cavities in it or near the gum line. There must be enough tooth left above the gums to put a crown or dental filling into the tooth. If the tooth is broken down, functional crown lengthening is a surgical procedure that will remove enough of the bone and gum to allow for a long-lasting tooth crown or filling.

What is Esthetic Crown Lengthening?

Esthetic crown lengthening is a surgical procedure used to reshape the gums or remove excess tissue to correct a gummy smile. When you grow, the jaw can grow and the gums can move around the teeth unevenly. This can lead to some of the gums being asymmetrical and look uneven. Esthetic crown lengthening often uses a dental laser to shape the gum tissue around the teeth in a non-invasive manner that makes them look even. Esthetic crown lengthening is also used to remove excess gum in cases when patients smile and show too much gum (figure 1). Lasers can be used to reduce the gum tissue and make the teeth look longer so more teeth show when you smile (figure 2). Esthetic crown lengthening is also used before someone gets veneers or crowns so these restorations appear more cosmetic and natural.

Crown Lengthening - Excess Gum Tissue and Uneven Gums

Figure 1. Patient with excess gum tissue and uneven gums before esthetic crown lengthening

Figure 2. Patient after esthetic crown lengthening and cosmetic dentistry

Crown lengthening Procedure Explained

Crown lengthening is a very common procedure and is usually quick and painless. The procedure can be performed with local anesthesia and when using a laser, often does not require stitches. In cases of functional crown lengthening, the dentist can put a temporary crown on the teeth and then the periodontist will use that as a marker for how much bone and/or gum tissue needs to be removed to make the tooth crown long-lasting. In cases of esthetic crown lengthening, a wax model or digital model can be used to guide the periodontist on how to shape the gums or correct the gummy smile. In many instances the time of the procedure can be 30-60 minutes and the healing time is usually a few days. Over the counter pain relief is usually sufficient to control any discomfort and the periodontist may give you a prescribed mouth rinse to keep the area clean.  In some instances, glue stitches can be used, or a surgical dressing can be applied.  You may feel tooth sensitivity after the procedure and a desensitizing gel or toothpaste can be used.

The gums usually take 4-6 weeks to fully heal before the tooth crowns, veneers, or dental fillings can be done. If you are not getting any dental restoration on the teeth and the procedure was performed to correct a gummy smile or reshape the gums, full healing should be around 2-3 months for the gums to fully settle into position.  Crown lengthening is one of the quickest and painless surgical procedures that can be performed with great results and success. Contact your periodontist today to find out more about this treatment.

Why Am I Bleeding After My Tooth Was Removed?

How much bleeding is normal after tooth extraction?

A little oozing is normal after a tooth is removed and this can happen for 24-48 hours, especially if the tooth was difficult to remove and the tooth had to be removed in pieces. Broken down teeth, broken down root canal teeth, teeth with multiple roots on them, teeth that are fused to the bone, and teeth that are underneath the gums can typically require surgery to take them out and the bleeding can be more due to the increased difficulty in tooth extraction. A call to the dentist office that performed the tooth removal should be made if the bleeding you have is filling your mouth with blood, lasts more than 3 days, or is causing you to become faint.

What causes excessive bleeding after tooth extraction?

Certain types of medical problems can cause clotting disorders and make someone prone to bleeding issues. Diseases like Hemophilia, von Willebrand’s disease, liver dysfunction, certain types of cancer, and other disorders involving the blood clotting cascade can cause someone to be more likely to bleed after tooth extraction. People on aspirin, Coumadin, Xarelto, Plavix, Lixiana, Pradaxa, and Eliquis are also more likely to bleed after tooth removal. Other medications that can cause bleeding are antidepressants, antipsychotics, corticosteroids, oral contraceptives, and tamoxifen. Supplements known to cause bleeding include garlic, ginseng, ginger, ginko biloba, donq qua, and feverfew. Other things that can cause bleeding after tooth removal include smoking, drinking alcohol, strenuous exercise, vigorous rinsing, and eating hard foods.

What can someone do to try and stop the bleeding after tooth removal?

If you are experiencing heavier than normal bleeding the first step to try and stop the bleeding is put gauze in your mouth and bite down on it for an extended period of time (20-30 minutes). If the bleeding continues wrap a warm tea bag around gauze and bite down on it in the same fashion as the tannic acid in the tea have clotting properties.  Do not smoke, drink alcohol, rinse for 24 hours after tooth removal, eat hard foods, or perform vigorous exercise to prevent the blood clot from dissolving and bleeding to occur. Bleeding can also occur the following morning after extraction as your tongue can disturb the clot and you can wake up in the morning with blood in your mouth. It is not uncommon for people who take anticoagulation medication to wake up with a jelly clot or a ‘liver clot’ in their mouth in the area of the removed tooth. This jelly clot needs to be wiped away and the whole process of biting down on gauze to stop the new bleeding will have to begin.

What can be done in the dental office to try and stop the bleeding?

If the bleeding after tooth removal is uncontrolled and filling your mouth with blood or it has lasted for more than 48 hours, a return to the dental office may be advised. Procedures that can be performed are removal of the bad clot by suction and saline irrigation of the tooth extraction area. The area can be cleaned and then packed with material that help stop bleeding. The area will then be stitched in a way that can assist gum tissue closure and stop bleeding. There are also ‘glue stitches’ available that can further help bleeding to stop. Lasers can also be used to cauterize the area and stop the bleeding.