Why Gum Health Is Assessed Before Cosmetic Dental Work

This clinic works within periodontology and oral surgery, along with pink esthetics — the gum side of a smile. Zirconia and veneer crowns, esthetic fillings and whitening belong to the restorative and prosthetic field and are not carried out here.

Even so, the gum side is often the first stage in planning such work. That is the subject here: why gum health is assessed before smile esthetics is planned. What follows is general information.

White and Pink Esthetics: Two Layers of One Smile

A smile has two layers: the tooth itself, and the gum tissue that frames it. Dentistry calls these white esthetics and pink esthetics, and they are not considered separately.

Veneers, zirconia crowns, laminates and what people describe as a "Hollywood smile" all sit in the white layer. Material questions, such as ceramic versus zirconia, belong to that layer too.

How the Restoration Margin Relates to the Gum Line

Between the gum margin and the bone beneath it, the tissue occupies a dimension of its own. A crown or filling margin that encroaches on it can set the stage for a continuing inflammatory response.

Where a margin ends is therefore decided together with the gum level. Where the distance is insufficient, steps such as crown lengthening may come into question after examination and imaging.

Gum Findings Often Seen Before Esthetic Planning

Common findings include inflamed gums that bleed on brushing, a gum line running asymmetrically between the two sides, and teeth that look shorter than they are.

Root surfaces exposed by recession, and loss of the papilla between teeth — often called a black triangle — are frequent too. These are assessed within gum treatment, and each approach may differ.

If Whitening Is Considered, What Is Checked on the Gum Side?

For anyone considering whitening, the first question is whether root surfaces are exposed; these are not covered by enamel, so sensitivity can occur, as set out in causes of tooth sensitivity.

The second is separating the tooth's own shade from staining caused by deposits. Appearance may change after tartar cleaning; where tissue is inflamed, timing is decided by the clinician.

Preparation Steps That May Arise Before Crowns or Veneers

The first step is usually settling the inflammation, since an impression or a margin set on bleeding, swollen tissue may not be reliable. Adjusting the gum level or crown lengthening may be planned first.

After a surgical step, tissue needs time to settle into its own contour. Waiting for healing before the impression stage may be advised; how long that takes varies from person to person.

Which Steps Are Carried Out Here, and Which Are Referred?

The steps carried out here are: periodontal assessment, tartar cleaning and gum treatment, gum level adjustments, crown lengthening, root coverage surgery and implant surgery.

Zirconia and veneer crowns, esthetic fillings and whitening fall outside this clinic's scope. For those, patients are referred to clinicians working in restorative dentistry or prosthodontics.

How the Sequence Is Built

The general order is: clinical and radiographic assessment, then establishing gum health, then waiting for the tissue to become stable, and finally planning the esthetic stage with the relevant clinician.

This content is for general information and does not replace an examination. To learn which steps might be needed on the gum side in your own case, a clinical examination is recommended.