Daniel Kelly

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Dentist - Charlottesville
905 Rio East Ct., Suite B,
Charlottesville, VA 22901
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By Daniel and Ellen Kelly, DMD
June 15, 2015
Category: Dental Procedures
Tags: gummy smile  
ImprovingaGummySmileDependsonitsCause

A “gummy” smile, in which the upper gums are too prominent, is a common condition. There are several causes for gummy smiles — determining which one is the first step to having your appearance changed.

Although perceptions vary from person to person, most dentists agree a gummy smile shows 4 mm or more of gum tissue, and the amount is out of proportion with the length of the crown (the visible tooth). Teeth normally erupt through the gums during childhood and continue development until early adulthood, shrinking back from the tooth until stabilizing in place.

This typically produces a crown length of about 10 mm, with a “width to length” ratio of about 75-85%. But variations can produce differences in the relationship between teeth and gums and the width to length ratio of the teeth. The teeth may appear shorter and the gums more prominent. Worn teeth, caused by aging or grinding habits, may also appear shorter.

If tooth to gum proportionality is normal, then the cause may be upper lip movement. When we smile, muscles cause our lips to retract 6-8 mm from the lip’s resting position. If the amount of movement is greater (meaning the lip is hypermobile), it may show too much of the gums. The upper jaw can also extend too far forward and cause the gums to appear too prominent.

There are a number of ways to improve gummy smiles, depending on the cause. Periodontal plastic surgery known as crown lengthening removes and reshapes excess gum tissue to reveal more of the tooth. Lip hypermobility can be reduced with Botox injections (to paralyze the muscles) or in some cases with surgery to reposition the muscle attachments. Orthognathic surgery can be used to surgically reposition an overextended upper jaw. Other cosmetic enhancements such as orthodontics, bonding or porcelain restorations can also prove effective.

The first step is to obtain an accurate diagnosis for your gummy smile. From there, we can devise the best treatment approach to bring your smile back into a more attractive proportion.

If you would like more information on minimizing 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.”

By Daniel and Ellen Kelly, DMD
May 29, 2015
Category: Oral Health
BeyonceMakesFlossingaFamilyAffair

As is the case with most celebs today, Beyonce is no stranger to sharing on social media… but she really got our attention with a video she recently posted on instagram. The clip shows the superstar songstress — along with her adorable three-year old daughter Blue Ivy — flossing their teeth! In the background, a vocalist (sounding remarkably like her husband Jay-Z) repeats the phrase “flossin’…flossin’…” as mom and daughter appear to take care of their dental hygiene in time with the beat: https://instagram.com/p/073CF1vw07/?taken-by=beyonce

We’re happy that this clip highlights the importance of helping kids get an early start on good oral hygiene. And, according to authorities like the American Dental Association and the American Academy of Pediatric Dentistry, age 3 is about the right time for kids to begin getting involved in the care of their own teeth.

Of course, parents should start paying attention to their kids’ oral hygiene long before age three. In fact, as soon as baby’s tiny teeth make their first appearance, the teeth and gums can be cleaned with a soft brush or cloth and a smear of fluoride toothpaste, about the size of a grain of rice. Around age 3, kids will develop the ability to spit out toothpaste. That’s when you can increase the amount of toothpaste a little, and start explaining to them how you clean all around the teeth on the top and bottom of the mouth. Depending on your child’s dexterity, age 3 might be a good time to let them have a try at brushing by themselves.

Ready to help your kids take the first steps to a lifetime of good dental checkups? Place a pea-sized dab of fluoride toothpaste on a soft-bristled brush, and gently guide them as they clean in front, in back, on all surfaces of each tooth. At first, it’s a good idea to take turns brushing. That way, you can be sure they’re learning the right techniques and keeping their teeth plaque-free, while making the experience challenging and fun.

Most kids will need parental supervision and help with brushing until around age 6. As they develop better hand-eye coordination and the ability to follow through with the cleaning regimen, they can be left on their own more. But even the best may need some “brushing up” on their tooth-cleaning techniques from time to time.

What about flossing? While it’s an essential part of good oral hygiene, it does take a little more dexterity to do it properly. Flossing the gaps between teeth should be started when the teeth begin growing close to one another. Depending on how a child’s teeth are spaced, perhaps only the back ones will need to be flossed at first. Even after they learn to brush, kids may still need help flossing — but a floss holder (like the one Beyonce is using in the clip) can make the job a lot easier.

If you would like more information about maintaining your children’s oral hygiene, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Top 10 Oral Health Tips For Children” and “How to Help Your Child Develop the Best Habits for Oral Health.”

By Daniel and Ellen Kelly, DMD
May 14, 2015
Category: Oral Health
Tags: bad breath  
BanishBadBreath

Treating bad breath is big business. Just check your local drug store or supermarket and you'll find a mind-numbing array of mints, gums, mouthwashes, sprays, strips and other products that promise to sweeten your breath and make you (or your mouth at least) irresistible. But most of these products only mask halitosis (from the Latin “halitus” – exhalation, and Greek “osis” – disease) and some even contain ingredients, like sugar, that contribute to tooth decay and gum disease. In most cases, for enduring, healthful results, nothing beats a trusty toothbrush, toothpaste and floss, used faithfully and correctly, along with periodic dental checks and cleanings.

Oral bacteria are the number one reason for noxious breath. More than 600 types inhabit our mouth, and some of them emit awful odors — predominantly volatile sulfur compounds characterized by a “rotten egg” smell) — as they consume remnants of food trapped in our mouth. Brushing and flossing regularly, especially after eating, can dislodge food trapped between teeth (interdental) and under the gums (subgingival), depriving microbes of a ready-made meal. It also disrupts the buildup of sticky plaque (microbial “biofilms”) where odor-causing germs can flourish.

When cleaning your mouth, pay special attention to the back of the tongue. It is the primary location for generating halitosis because it is drier and less efficiently cleansed by saliva and normal oral activity than the front. Our office can instruct you on proper oral hygiene including the gentle use of a tongue scraper or brush.

Sometimes more involved periodontal techniques such as scaling and root planing (deep cleaning) are called for; antibiotics may be useful in targeting the offending microbes. If tooth decay and/or periodontal (or gum) disease is contributing to halitosis appropriate treatment is necessary.

Remember that foul breath is just a symptom of some underlying condition. If diligent oral care at home doesn't do the trick, our office can help you get to the root of the problem and determine the appropriate therapy.

If you would like more information about halitosis and ways to prevent or treat it, 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 “Bad Breath.”

By Daniel and Ellen Kelly, DMD
April 29, 2015
Category: Dental Procedures
TomHanksAbscessedToothGetsCastAway

Did you see the move Cast Away starring Tom Hanks? If so, you probably remember the scene where Hanks, stranded on a remote island, knocks out his own abscessed tooth — with an ice skate, no less — to stop the pain. Recently, Dear Doctor TV interviewed Gary Archer, the dental technician who created that special effect and many others.

“They wanted to have an abscess above the tooth with all sorts of gunk and pus and stuff coming out of it,” Archer explained. “I met with Tom and I took impressions [of his mouth] and we came up with this wonderful little piece. It just slipped over his own natural teeth.” The actor could flick it out with his lower tooth when the time was right during the scene. It ended up looking so real that, as Archer said, “it was not for the easily squeamish!”

That’s for sure. But neither is a real abscess, which is an infection that becomes sealed off beneath the gum line. An abscess may result from a trapped piece of food, uncontrolled periodontal (gum) disease, or even an infection deep inside a tooth that has spread to adjacent periodontal tissues. In any case, the condition can cause intense pain due to the pressure that builds up in the pus-filled sac. Prompt treatment is required to relieve the pain, keep the infection from spreading to other areas of the face (or even elsewhere in the body), and prevent tooth loss.

Treatment involves draining the abscess, which usually stops the pain immediately, and then controlling the infection and removing its cause. This may require antibiotics and any of several in-office dental procedures, including gum surgery, a root canal, or a tooth extraction. But if you do have a tooth that can’t be saved, we promise we won’t remove it with an ice skate!

The best way to prevent an abscess from forming in the first place is to practice conscientious oral hygiene. By brushing your teeth twice each day for two minutes, and flossing at least once a day, you will go a long way towards keeping harmful oral bacteria from thriving in your mouth.

If you have any questions about gum disease or abscesses, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Periodontal (Gum) Abscesses” and “Confusing Tooth Pain.”

By Daniel and Ellen Kelly, DMD
April 14, 2015
Category: Oral Health
DentalErosionmdashIsYourFavoriteDrinkTheCause

Your teeth were designed to last you a lifetime, so you should do everything you can to protect them. This includes guarding them against dental erosion. However, many people may not know for sure what dental erosion is, much less how or why they need to guard against it.

Dental or tooth erosion is the irreversible loss of tooth enamel from chemical attack by acids. Eating or sucking acidic foods such as lemons is a good example. But most people are shocked to discover that it can also be caused by their favorite sodas (carbonated beverages), natural fruit juices, energy and sports drinks — especially with excessive consumption. It takes the saliva, nature's protection, at least 30 to 60 minutes to neutralize the effects of acid, so only one acidic drink an hour causes your teeth to be continually bathed in acid. And this is an important fact to know, because if your mouth is acidic all the time, this will promote tooth decay.

Will brushing help out with prevention?

When it comes to dental erosion, brushing immediately after acid consumption can actually make it worse by accelerating the erosion process. This is because the acids in these drinks (and some foods) actually dissolves tooth enamel and softens the tooth surface. These newly softened surfaces can literally be brushed away if you brush before your saliva has a chance to try to reverse the process. If done often, you could even brush away your enamel! For this reason, you should wait at least 30 to 60 minutes before you brush your teeth after consuming any of these products.

So what can you do to prevent dental erosion?

One important step that you (and your family) can do to help prevent dental erosion is to limit the amount of these beverages you drink. Instead, try drinking calcium-rich milk or water and saving your favorite acidic beverage for a special treat that you consume preferably with a meal. Try reducing the number of these drinks you consume over a period of time. If you must drink an acidic beverage avoid swishing it in the mouth and use a straw to reduce the contact between the acid and your teeth.

Just remember that once your dental enamel has eroded, it is gone forever. So you should follow these simple tips now to protect your smile and future.





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