DiMariano Family Dentistry Blog

Posts for: March, 2019

By Drs. Jeff DiMariano & Shaina DiMariano
March 16, 2019
Category: Oral Health
DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”


By Drs. Jeff DiMariano & Shaina DiMariano
March 06, 2019
Category: Dental Procedures
Tags: gummy smile  
YouDontHavetoLivewithaGummySmileHeresHowWeCanChangeit

A beautiful smile is a balanced smile, especially in regard to your gums. A normal smile usually shows 4 mm or less of gum tissue along with about 10 mm of tooth length. But if your gums show more than that, your smile may seem too gummy. In terms of perceived balance, this could detract from your smile's attractiveness.

Fortunately, you don't have to live with a gummy smile—there are various ways to correct or minimize its effect. First, though, we'll need to determine the underlying cause before deciding on the best treatment. And, there are several possible causes, the obvious being too much gum tissue present. Teeth that appear shorter due to wear or incomplete eruption could also make the gums appear larger.

We may be able to correct these size problems by surgically removing and reshaping excess gum tissues and possibly the underlying bone to reveal more of the teeth. We can also bond composite resins or porcelain veneers to shorter teeth to make them appear larger.

But not all gummy smile problems pertain directly to the teeth and gums; instead, it could be your upper lip moves too far up as you smile (hypermobility). Or, your upper jaw may be too long for your face, which can also cause too much of the gums to show during smiling.

With upper lip hypermobility, we may be able to inhibit the lip muscles' movement temporarily with Botox injections that partially paralyze the muscles (the effect eventually wears off, so this treatment will need to be repeated). A periodontist, an oral surgeon, or a plastic surgeon could also permanently alter the upper lip movement through a surgical procedure. Surgery may also be necessary for an abnormally long upper jaw: orthognathic surgery re-positions the jaw to the skull, which can lessen the amount of gums showing.

If your smile is too gummy, we can transform it. But first, let's find out what the real cause is with a comprehensive dental examination. Once we know, we can better advise you on the best way to bring beautiful balance to your smile.

If you would like more information on improving a gummy smile, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Gummy Smiles.”