Possible Problems with a Dental Crown

Crowns aren't placed on perfect teeth. They're generally only required after a tooth has experienced some type of catastrophic event, such as fracture, tooth decay or a lost filling.
These same events can have a detrimental effect on other aspects of the tooth, like its nerve. It may, however, take time for these problems to develop. And for this reason, a tooth that previously seemed just fine, either before the crowning process was begun or even many years after, may suddenly begin to hurt.

• Discomfort or sensitivity - Patients may experience sensitivity immediately after the procedure as the anesthesia begins to wear off. If the tooth that has been crowned still has a nerve in it, you may experience some hot and cold sensitivity. Your dentist may recommend that you brush your teeth with a tooth paste designed for sensitive teeth. Pain or sensitivity that occurs when you bite down may mean that the crown is too high on the tooth. If this is the case, call your dentist. He or she can adjust the bite on the crown.
• Chipped crown - Dental crowns made of all porcelain can sometimes chip. If the chip is small, a composite resin can be used to repair the chip with the crown remaining in your mouth. If the chipping is extensive, the crown may need to be replaced.
• Loose crown - Sometimes the cement washes out from under the crown. Not only does this allow the crown to become loose, it allows bacteria to leak in and cause decay to the tooth that remains. If your crown feels loose, contact your dentist.
• Crown falls off - Sometimes crowns fall off. This can due to an improper fit or a lack of cement. If this happens, call your dentist. He or she will give you specific instructions on how to care for your tooth and crown for the day or so until you can be seen for an evaluation. Your dentist may be able to re-cement your crown in place; if not, a new crown will need to be made.
• Allergic reactions - Because the metals used to make crowns are usually a mixture of metals, a rare allergic reaction may occur. Let your dentist know about all allergies or sensitivities.
• Tooth pain - Ache, throbbing, pain when biting.
• “Bite” issues - Irregular bite, tenderness when biting.

When Do I Need a Dental Crown?

A crown is a restoration that covers, or “caps,” a tooth to restore it to its normal shape and size. A crown can also strengthen and improve the appearance of your tooth. Crowns are necessary when a tooth is generally broken down and a filling won’t solve the problem. If your tooth is cracked, a crown holds your tooth together to seal the cracks so the damage doesn’t get worse. Crowns are also used to support a large filling when there isn’t enough of the tooth remaining.

Functions of a crown:

1. Restore the form, function and esthetics of a tooth - Because a dental crown encases the entire visible portion of a tooth, porcelain crowns can be used to enhance or idealize the cosmetic appearance of teeth.
2. Improve the strength of a tooth - Dental crowns are routinely placed on teeth that have broken, have had large portions destroyed by tooth decay or have had root canal treatment. That's because beyond just restoring a tooth's shape, a crown can provide a reinforcing and strengthening effect too.
3. Protect the underlying tooth from any mechanical, chemical, or thermal injury.

Your dentist may also recommend a crown in order to protect weak teeth from fracturing (like after a root canal), restore already fractured teeth, or cover badly shaped or discolored teeth.

Teeth Wearing Away?

Your teeth are built to last. They can even last a lifetime with regular teeth cleanings and dental care. However, the daily grind of chewing, brushing, and grinding, along with accidental injuries, can take a toll.

Reasons for tooth erosion:

• Chipped, fractured or broken teeth - Things such as chewing ice, hard candy, popcorn kernels and opening nuts with your teeth can lead to chipping and breakage of natural teeth and restorations. Teeth that have fillings or root canals are at highest risk, because they aren't as strong as intact teeth. Most frequently, teeth are damaged as a result of an accident or sports-related injury. Although a chipped tooth can be repaired, a fracture is more difficult to fix especially if the crack extends below your gum line.
• Teeth grinding - Unconscious grinding or clenching of teeth, over time, can damage the chewing surfaces. In many cases, people don't realize they have a problem until a dentist notices signs on their tooth surfaces.
• Acid and tooth enamel erosion - Teeth become vulnerable when acid levels in the mouth are too high. Acid erodes enamel, making teeth more susceptible to decay. Acidic foods and drinks, and acid-producing bacteria in the mouth are prime culprits.
• Excessive consumption of alcohol - Alcoholics and binge drinkers can have the same wear on their teeth because of too much alcohol. Not only do teeth become thin and almost transparent in these extremes, but the body also loses needed vitamins and minerals, depriving teeth of some needed nutrients, too.
• Other physical conditions – Conditions such as cancer or even pregnancy show their presence on teeth, and individuals are advised to combine medical care with regular preventative dental care and maintenance.
• Medications - Many medications cause dry mouth. Saliva is necessary for keeping the mouth clean. Keeping a wash of saliva around the teeth keeps decay from forming as rapidly and provides needed moisture for gum tissue. Certain medications suck the saliva out of your mouth. Syrupy medicines also harm teeth by coating them with sticky sugar. Rinsing after taking cough, cold or allergy syrups, or having children rinse after taking them, will help keep residue from building up and attacking enamel.
• Brushing right after meals - If you have the habit of brushing right after dinner, stop doing so. Acids weaken tooth enamel and leave it more prone to erosion during brushing. Wait about 20 to 30 minutes before brushing your teeth.
• Brushing hard - Some people like to brush very hard. They want to keep their teeth very clean so they will scrub very hard, but that will traumatize the gums. Over time, it will cause the gums to recede. Brush gently and spend at least three minutes brushing and flossing your teeth each time. Always use a soft or ultrasoft toothbrush.

Mouth Cancer Causes, Diagnosis And Treatments

A cancerous (malignant) tumor starts from one abnormal cell. The exact reason why a cell becomes cancerous is unclear. Some people develop mouth cancer for no apparent reason. However, certain risk factors increase the chance that mouth cancer may develop. These include:

• Smoking - Mouth cancer is just one cancer which has a much higher incidence in smokers than in non-smokers.
• Alcohol - Drinking a lot of alcohol can increase your risk of developing mouth cancer.
• Chewing tobacco or the betel leaf.
• Poor dental hygiene.

Symptoms:

The most common symptoms of mouth cancer are a sore or ulcer in the mouth that does not heal and pain in the mouth that does not go away. In many cases, changes are seen in the mouth before the cancer develops. This means that early treatment of these changes may prevent progression. Other symptoms include:

• White patches anywhere in your mouth
• Red patches anywhere in your mouth
• A lump on the lip, tongue or in the mouth or throat
• Unusual bleeding or numbness in the mouth.
• Pain when chewing or swallowing
• A feeling that something is caught in the throat
• A change in your voice, or speech problems.
• A lump in the neck.

Diagnosis:

To confirm diagnosis, a patient needs a biopsy. A small sample of tissue is removed from a part of the patient’s body and is looked under the microscope to look for abnormal cells. If the doctors have confirmed mouth cancer, further tests are done such as, CT scan or MRI scan to see if the cancer has spread to other parts of the body. These tests reveal how much the tumor has grown in mouth and whether cancer has spread to local nymph nodes or to other areas of body.

Treatment:

Treatment options which may be considered include radiotherapy, surgery and chemotherapy. The treatment advised for each case usually depends on various factors such as the exact site and extent of the cancer and your general health. In many cases, treatment aims to cure the cancer. There is a good chance of a cure if it is treated in the early stages. Many cases are diagnosed at an early stage. This is because early mouth cancers are more easily detected than cancers deeper inside the body. In some cases, treatment aims to control the cancer. If a cure is not realistic, with treatment it is often possible to limit the growth or spread of the cancer so that it progresses less rapidly.

The most common treatment is surgery. The type of operation depends on the size of the cancer and its site. The operation may be to remove the cancer and some of the surrounding normal tissue. Radiotherapy is a treatment which uses high-energy beams of radiation which are focused on malignant (cancerous) tissue. This kills cancer cells, or stops cancer cells from multiplying. Chemotherapy is a treatment which uses anti-cancer medicines to kill cancer cells, or to stop them from multiplying.

It is important to have regular dental checkups to screen for oral cancer.

Tooth Discoloration

In today’s self-conscious society, the dull, stained effects of tooth discoloration represent a common dental complaint. Beyond the professionally managed teeth whitening options, people are employing new, everyday products in their ongoing struggle against yellow teeth and other forms of tooth discoloration. From whitening strips and take-home trays to whitening toothpaste and chewing gum, people are going to various lengths to achieve and maintain a white, attractive smile.

Tooth discoloration could be extrinsic or intrinsic. Extrinsic discoloration occurs in the outer layer of the tooth, called the enamel. Enamel stains can range from white streaks to yellow tints or brown spots and pits. Intrinsic discoloration occurs in the inner structure of the tooth, called the dentin, when the dentin darkens or displays a yellow (or gray) tint. Extrinsic staining can be effectively treated using various whitening techniques, intrinsic staining may be more stubborn, potentially requiring alternative cosmetic treatment such as veneers.

Causes:

• Foods/drinks - Coffee, tea, colas, wines and certain foods (e.g., tomatoes, cherries, blueberries etc.) can cause extrinsic tooth stains.     
• Tobacco use - Smoking or chewing tobacco can result in discolored teeth
• Poor dental hygiene - Inadequate brushing and flossing to remove plaque and stain-producing substances can cause tooth stains.
• Disease - Diseases affecting enamel and dentin can lead to tooth discoloration. Certain infections in pregnant mothers can cause tooth discoloration in the baby by affecting enamel development.
• Medications - Antihistamines, antidepressants and high blood pressure drugs can discolor teeth. Maternal use of tetracycline antibiotics during the second half of pregnancy may result in discoloration of the baby's tooth enamel.
• Ageing - As you age, the outer layer of enamel on your teeth wears away, revealing the dentin's natural, yellow color. Additionally, over the years your teeth accumulate more stains and tartars, causing them to darken and discolor.
• Dental work - Procedures requiring certain dental materials, such as silver amalgam restorations, can produce a grayish-black cast to teeth

Treatments: 

• Good hygiene - Practice proper dental hygiene by brushing and flossing daily, and getting professional teeth cleanings every six months or more frequently, depending on your dentist's recommendation 
• Whitening procedures
• In-office tooth whitening - Dentist can easily remove extrinsic and some intrinsic tooth discoloration caused by foods/drinks and other causes by applying a bleaching peroxide gel to the tooth enamel.
• At-home bleaching - Many dentists believe that professionally dispensed take-home whitening kits may produce the best results over time. More suitable for extrinsic tooth discoloration, home whitening usually is done with teeth whitening kits, gels or strips.
• Over-the-counter at home whitening products – These are convenient and low-cost alternative to bleaching discolored teeth without dentist supervision.
• Composite bonding, crowns and veneers - For teeth severely discolored by excessive fluoride, root canal treatment, or consumption of certain drugs, your dentist may recommend covering the tooth's outer surface with a color-matched composite bonding material, porcelain veneers or porcelain crowns instead of bleaching.

Consult with your dentist for the best tooth discoloration treatment options for your individual case.

How to Prevent Enamel Loss

Tooth enamel is the hardest tissue in the human body. It protects your teeth when you chew on crunchy foods and consume acidic beverages. But over time the enamel can chip, scrape, and wear away. And once it is gone, the body can’t replace it, making your teeth vulnerable and putting your oral health at risk. That’s why it’s so important to prevent tooth enamel loss starting at an early age and throughout your whole life.

Here are tips to prevent enamel loss:

• Limit your consumption of highly acidic foods like soda and citrus fruits. When you do consume them, rinse your mouth out with clean water immediately afterward. 
• Don’t swish, swirl or hold acidic drinks in your mouth for too long
• Make use of a straw when you consume acidic drinks. The straw helps the liquids to bypass the teeth and travel directly to your throat.
• Cut down on the amount you snack. No matter what you eat, the acidity level in your mouth is elevated for a few hours after your finish. Only snack when you are truly hungry, and try to brush your teeth or at least rinse your mouth afterward.
• Chew sugar-free gum for a few minutes during the time between meals. Gum increases your saliva production which in turn enhances the teeth with minerals
• Drink more water, and drink water more frequently
• Always use fluoride toothpaste. Fluoride strengthens the teeth but it is not in all toothpastes, so be sure to ready the label carefully.
• Consider using a mouthwash along with a fluoride paste to give you extra protection from the effects of everyday acids.
• Make sure you’re using a soft-bristled brush.

Talk to your dentist to learn other ways to prevent enamel loss. Take care of the strongest substance in your body and your enamel will take care of you!

Tooth Cavities

Dental cavities are holes in teeth caused by tooth decay. Cavities are caused by tooth decay - a process that occurs over time. Here's how tooth decay develops:

• Formation of plaque - Your mouth naturally contains many types of bacteria. Some thrive on food and drinks that contain certain forms of sugar. When these sugars aren't cleaned off your teeth, the bacteria quickly begin feeding on them and producing acids. The bacteria, form bacterial plaque — a sticky film that coats your teeth. If the plaque is not removed while it's soft, it becomes hard and difficult to remove — a good place for bacteria to hide.
• Plaque attacks - The acids in plaque remove minerals in your tooth's hard, outer enamel. This erosion causes tiny openings or holes in the enamel — the first stage of cavities. Once areas of enamel are worn away, the bacteria and acid can reach the next layer of your teeth, called dentin. This layer is softer than enamel and less resistant to acid.
• Destruction - As tooth decay develops, the bacteria and acid continue their march through your teeth, moving next to the inner tooth material (pulp) that contains nerves and blood vessels. The pulp becomes swollen and irritated from the bacteria. When decay advances to this extent, you may have a severe toothache, sensitivity, pain when biting or other symptoms. Your body also may respond to these bacterial invaders by sending white blood cells to fight the infection. This may result in a tooth abscess — a pocket of pus that's caused by a bacterial infection.

Prevention:
There are two main factors to preventing them: oral hygiene and diet change. Good oral hygiene includes brushing your teeth at least twice a day and flossing at least once, having a professional teeth-cleaning every six months, and having X-rays and a dental exam annually to detect cavity development (depending on your risk factors, your dentist may prescribe X-rays more or less frequently).

Reducing the amount of sugar — especially sugary drinks and juices — can help prevent cavities. You may consider brushing your teeth or rinsing your mouth after eating sticky foods.

Dental sealants may help prevent cavities and are most frequently applied to the teeth of children after their molars come in. Sealants are thin, plastic-like coatings on the surface of the molars that prevent the accumulation of plaque.
Fluoride is another cavity-prevention strategy. It can be consumed in drinking water or as a supplement. Topical fluoride is frequently applied as part of routine dentist visits.

Most importantly, visit your dentist regularly. The dentist can find decay early, when it can be treated.

What is Underbite, Overbite and Crossbite?

The correlation between your overall health and your bite is a direct one because if your jaws and teeth are misplaced or not properly aligned then this affects your physical health negatively. You may find it difficult to breathe, speak, and eat and your facial appearance as well as smile can also change. Underbite, overbite and crossbite are considered as malocclusion.

Underbite:
Ideally, the upper teeth are supposed to be slightly above the lower front teeth and the lower front teeth should lie slightly behind the upper ones. Underbite occurs due to the overgrowth of your lower jaw and/or undergrowth of upper jaw, or it could be a mixture of both. When a person suffers from underbite, the lower teeth hang past the upper front teeth. As a result, tooth wear happens and the patient may feel pain in jaws and joints. Underbite doesn’t only affect the upper incisor teeth but also the molars and the patient’s lower jaw becomes much more prominent.

It is important to have the underbite assessed as soon as it gets detected. The condition may worsen if not treated timely and if it becomes a skeletal issue from a dental one then surgery may be required to correct it.

Overbite:
Overbite is a condition in which the upper teeth overlap the lower teeth. Normally, our upper teeth slightly overlap the lower ones and it occurs naturally. However, the normal range of this gap is between 3 to 5 millimeters. If the gap is greater than 5mm then this condition will be characterized as an overbite.

Extensive and prolonged use of a pacifier worsens the condition and so do habits like thumb sucking, tongue thrusting and/or breathing from the mouth.

Crossbite:
Crossbite is a condition that may involve a single tooth or multiple teeth. A crossbite is when a lower tooth overlaps the upper tooth. Usually, crossbites are directly related to the narrowness of upper jaw and it can occur in the front or any of the other sides of the mouth.

When crossbite happens, one or more teeth may start tilting either toward the cheek or towards the tongue. Either way, this tilting affects the alignment of other teeth and paves way for different oral health issues such as teeth wear, bone loss and gum diseases. It must be noted that crossbite may occur on one or both sides of the jaw. Due to this condition, the jaw bone becomes excessively burdened and comes under stress.

Crossbites are also hereditary in nature because the tooth and jaw bone shapes are governed by genes. However, crossbite may develop if the baby teeth loss is delayed or new teeth emerge abnormally. Habits like careless chewing style and thumb sucking worsen the condition.

Treatment: Early orthodontic intervention may be required to shift teeth into an ideal position or to guide the growth of the jawbone. If the condition is ignored then surgery may be required. So, you must consult your dentist to consider the appropriate treatment and correct the abnormal growth or tilting of teeth.

Is Deep Cleaning Good or Bad for Gum Disease?

"Deep cleaning" often means scaling and root planing to a dentist or periodontist. Scaling is the process by which plaque (bacteria and food mixture) and calculus (tartar or mineralized plaque deposits) are removed from both supragingival (above the gum) and subgingival (below the gum) tooth surfaces.

Root planing involves removing plaque, calculus and smoothing rough root surfaces with fine scalers and ultrasonic instruments. This "planes" the roots under the gum to provide a smooth, clean surface to which the gums can reattach. After treatment, the goal is for the gingival (gum) tissue to become tight, pink, and healthy, with no bleeding or redness. Hopefully, the pockets that have formed between the teeth and the gums will shrink, reducing the need for surgical intervention.

Root planing is a treatment approach for gum and periodontal disease. However, the patient must be aware of certain issues:

• After root planing, teeth can become temporarily sensitive to cold air or cold liquids.
• After treatment, the gums will shrink as they get healthy and spaces between the teeth may develop. You may also experience gum recession on the outside surfaces of some of your teeth, but either situation is better than leaving gum disease insufficiently treated.

Does Teeth Whitening Cause Teeth Sensitivity?

Teeth whitening is one way to brighten your smile. It is a procedure that can be accomplished either at the dental office or in your own home. The downside to whitening your teeth is the sensitivity that sometimes develops. The properties of hydrogen peroxide - one of the main ingredients in most tooth whitening products may irritate the tooth nerve.

Tooth sensitivity is experienced as a rush or wave of pain usually as a response to cold air or water. If you suffer from tooth sensitivity then you may want to re-consider a whitening regime. However, there may be ways to combat this issue and still allow yourself to whiten your teeth.

• Follow the instructions of your dentist when using a professional product or the manufacturer's instructions for the over the counter products. Never whiten your teeth for longer than recommended.
• Sometimes just giving your teeth a short break between treatments can help to alleviate the symptoms.
• Taking pain killers can help reduce the symptoms if taken before applying the whitening product. Taking it ahead of time may prevent the symptoms from surfacing.
• See if you are using a product with a lower peroxide level.
• Limit the cold drinks and foods while you are whitening.
• Overuse of whitening products can also cause sensitivity. When used to excess, they have the potential to make your teeth very sensitive or even damage them.

If you tend to have teeth sensitive to whitening, talk with your dentist about the options available to you. If you try a product and experience painful sensitivity, stop using it immediately and consult with a dental professional. You and your dentist can decide together what product would be best for you.

Connection between Oral and Overall Health?

Although seeing a dentist is no substitute for a visit to a physician, regular dental checkups can reveal much about your overall health. If a dentist finds a potential health issue, he or she can refer you to a physician for follow-up.

Studies have shown that people with moderate or advanced gum (periodontal) disease are more likely to have cardiovascular disease (CVD) or heart disease than those with healthy gums. Although gum disease seems to be associated with heart disease, more studies are needed. But we do know that regular dental checkups, professional cleanings and good oral hygiene practices can improve oral health and that good oral health contributes to good overall health.

Studies show that people with diabetes are more susceptible to tooth loss and the development of gum (periodontal) disease and other oral health problems. Diabetes can slow the healing process and lower resistance to infections, including oral infections. Maintenance of good oral health through regular dental visits and appropriate treatment of gum problems is critical for people with diabetes.

Dentists also screen for oral cancer and other cancers of the head and neck, including skin cancer, cancer of the jaw bone and thyroid cancer, during routine checkups. Survival rates greatly increase if oral cancer is discovered earlier and treated. During your dental visit, you can ask your dentist to do an oral cancer screening. Also, periodic self-examinations can increase your chances of detecting oral cancer, so be sure to examine your face, cheeks, jaw and neck regularly for any changes or lumps.

Several studies have shown an association between periodontal disease and an adverse outcomes in pregnancy such as premature deliveries, fetal growth restrictions, and other complications.
The oral cavity may serve as a source for early detection for other medical concerns. For example, lesions in the mouth may be the first indication of HIV infection and may be used to determine the staging and progression of AIDS.

Visiting a dentist regularly can help you maintain your oral health. A dentist’s exam may detect poor nutrition and hygiene and oral cancer, as well as provide clues to your overall health and well-being. Also, brush and floss every day.

It is important for you and your family to provide your dentist with complete medical and dental histories and to inform your dentist of any recent health developments, including the use of over-the-counter medications and diet supplements, even if they seem unrelated to oral health. Why? Because some health conditions can even affect how dental care is provided.

References:

1. Stewart R, West M. Increasing Evidence for an Association between Periodontitis and Cardiovascular Disease. Circulation 2016.
2. Luo H, Pan W, Sloan F, Feinglos M, Wu B. Forty-Year trends in Tooth Loss Among American Adults with and without Diabetes Mellitus: An Age-Period Cohort Analysis. Prev Chronic Dis 2015;12:150309
3. Paquette D. Periodontal Disease and the Risk for Adverse pregnancy outcomes. Grand Rounds in Oral-Sys Med 2006; 4:14-24.

Is There a Way to Change the Shape of my Teeth?

Keeping your teeth clean and cavity free is indeed important, but the fact your teeth are healthy doesn’t automatically mean you’ll be ecstatic with their appearance. Genetics may provide you with teeth that are crooked, oddly shaped or that have large gaps between them. Or perhaps the appearance of your teeth has been altered from physical trauma or as a result of teeth grinding.

Whatever the reason, some people want to change the shape of their teeth. Maybe they want their teeth to be longer, or they want to close a gap between the front teeth. The good news is that, there are several dental services that allow you to choose the best option for you based on your unique dental needs and personal preferences.

In order to change the shape of your teeth, dentists use crowns, dental bonding, veneers, or they recontour your teeth.

Treatment options

• A dental crown is a tooth-shaped cap that is placed over teeth. When crowns are put in, they fully encase the tooth so that only the crown is visible, which allows a dentist to make the crown in the shape of desirable teeth.
• Dental bonding, on the other hand, is a procedure in which a tooth-colored resin material is applied to the tooth’s surface. The resin is then hardened with a special light, which will bond the material to the tooth.
• Porcelain veneers can also be used used more and more to change the shape of teeth. They are very thin, custom-made shells of tooth-colored materials that are designed to cover just the front surface of teeth to create a visibly appealing smile. 
• Recontouring or reshaping of the teeth is a procedure that involves small amounts of tooth enamel being removed to change a tooth’s length, shape or surface.
• All of these options have different costs, different levels of durability, and different amounts of time to complete.

Contact Expressions Dental™ if you want to discuss how to change the shape of your teeth using one of the methods mentioned here.

How to Fix Gap between Front Teeth?

Causes of gapped front teeth

• A mismatch between the size of the jaw bones and the size of the teeth can cause either extra space between teeth or crowding of teeth. If the teeth are too small for the jaw bone, spaces between the teeth will occur.
• Sometimes some teeth are missing or undersized. This happens most often with the upper lateral incisors. That can cause spaces to develop in the upper front teeth.
• Habits can also lead to gaps between the teeth. Thumb sucking tends to pull the front teeth forward, creating gaps. 
• Spaces can develop from an incorrect swallowing reflex. For most people, the tongue presses against the roof of the mouth (palate) during swallowing. Some people develop a different reflex known as a tongue thrust. When they swallow, the tongue presses against the front teeth. Over time the pressure will push the front teeth forward. This can cause spaces to develop.

Children may have temporary gaps as their baby teeth fall out. Most of these spaces close as the permanent teeth reach their final positions.

Treatment:

• Some people get braces, which move the teeth together. If your lateral incisors are too small, your dentist may suggest widening them using crowns, veneers or bonding.
•  If you have a space because you are missing teeth, you might need more extensive dental repair. This might include dental implants, a bridge or a partial denture.
•  If the gap is caused by periodontal disease, then periodontal treatment by a dentist or gum specialist (periodontist) is necessary. When gum health is restored, in many cases braces can be used to move the teeth into place.

In many cases, a gap between the front teeth in the upper jaw will close by itself. An oral health professional or orthodontist should be able to advise about the need for treatment for a child from about 10 or 11 years of age.
 
If you have a space between your teeth or see one in your child's mouth, contact Expressions Dental™. Our general dentists will help determine the reason for the space and will provide treatment options.