Dr. Boff & Dr. Goujani
50 North Central Ave. 
Ramsey, NJ 07446
(201) 327-3060

My Blog
By Robert E. Boff, D.M.D. and Banafsheh Goujani, D.M.D.
June 13, 2018
Category: Oral Health
Tags: gummy smile  
FindingtheRightSolutionforYourGummySmile

Even with picture perfect teeth, you may still be unhappy with your appearance. The problem: too much of your upper gums show when you smile.

There’s no precise standard for a “gummy smile”—it’s often a matter of perception. As a rule of thumb, though, we consider a smile “gummy” if four or more millimeters of upper gum tissue show while smiling. In any event if you perceive you have a gummy smile, it can greatly affect your self-confidence and overall well-being.

The good news is we can often correct or at least minimize a gummy smile. The first step, though, is to find out why the gums are so prominent.

There are a few possible causes: the most obvious, of course, is that there’s more than normal gum tissue present. But the cause could be the front teeth didn’t fully erupt in childhood and so the gums appear more prominent. Other causes include the upper lip moving too far upward when smiling (hypermobile) or an elongated upper jaw that’s out of proportion with the face.

Finding the exact cause or combination of causes will determine what approach we take to minimize your gummy smile. If too much gum tissue or not enough of  the teeth show, we can use a surgical procedure called crown lengthening to expose more of the crown (the visible part of a tooth), as well as remove excess gum tissues and reshape them and the underlying bone for a more proportional appearance.

A hypermobile upper lip can be treated with Botox, a cosmetic injection that temporarily paralyzes the lip muscles and restricts their movement. But for a permanent solution, we could consider a surgical procedure to limit upper lip movement.

Surgery may also be necessary for an abnormal jaw structure to reposition it in relation to the skull. If, on the other hand it’s the teeth’s position and not the jaw causing gum prominence, we may be able to correct it with orthodontics.

As you can see, there are several ways varying in complexity to correct a gummy smile. To know what will work best for you, you’ll need to undergo an orofacial examination to determine the underlying cause. It’s quite possible there’s a way to improve your smile and regain your self-confidence.

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.”

By Robert E. Boff, D.M.D. and Banafsheh Goujani, D.M.D.
June 03, 2018
Category: Dental Procedures
Tags: facial pain  
FacialNervePaincanbeReducedwiththeRightTreatmentApproach

Our nerves serve a vital purpose, alerting us to bodily discomfort, injury or disease — we couldn’t remain in good health for long without them. But when they malfunction due to genetics or disease, they can themselves become a source of pain and discomfort.

One such nerve disorder that affects the face is known as trigeminal neuralgia (TN) or tic douloureaux (from the French for “painful”). The nerves in question are the trigeminal, a pair that travel up from the brain stem through the skull into each side of the face where they each branch into the upper, middle and lower parts of the face and jaw. The pain can radiate from one or more of these branches.

TN is characterized by recurring episodes of brief but severe pain with accompanying muscle spasms. It may begin as a short twinge recurring over weeks, months or years before becoming increasingly painful. The slightest actions can trigger a painful episode: chewing, speaking, shaving or even the wind blowing on your face.

While it may be hard to determine its exact cause, it often seems to result from an artery or vein pressing on the nerve, causing it to signal pain at the slightest stimulation and then failing to stop transmitting when the stimulation is removed. It’s also associated with other inflammatory disorders like multiple sclerosis where the protective insulation around a nerve is damaged.

Before receiving treatment you should undergo a complete examination to rule out any other facial pain causes like temporomandibular (jaw joint) disorders or a dental abscess. You may also need to undergo a neurological examination and possible MRI imaging to pinpoint the exact cause, like a tumor or blood vessel pressing on the nerve.

Although the condition may not be curable, there are several effective management treatments. The more conservative approaches usually involve medications to block the nerve’s pain signals or decrease its abnormal firing. If this isn’t sufficient to diminish symptoms, there are surgical options: passing a thin needle through the nerve to selectively prevent fibers from firing, or moving aside a blood vessel pressing on it. High-dose targeted radiation may also be effective, especially with older patients.

The best treatment approach will depend on the exact cause, your age and overall health. Whatever the approach, you can gain significant relief from the pain of TN.

If you would like more information on facial nerve disorders, please contact us or schedule an appointment for a consultation.

By Robert E. Boff, D.M.D. and Banafsheh Goujani, D.M.D.
May 30, 2018
Category: Dental Procedures
Tags: cosmetic dentistry   veneers  

Could your smile benefit from a few enhancements? Upgrading your smile doesn't have to involve complicated cosmetic dentistry veneerstreatments, thanks to veneers. Ramsey, NJ, dentists Drs. Robert Boff, Banafsheh Goujani, and Kenneth Gluck offer veneers and other cosmetic dentistry services that can transform your smile.

Veneers are thin, yet effective

Veneers are tooth-shaped shells that are cemented to the fronts of your teeth. Although they're no thicker than a contact lens, veneers are made of translucent porcelain, a material that offers superior coverage and looks like natural tooth enamel. Veneers offer a simple way to conceal many types of flaws in tooth enamel.

Veneers offer several important advantages

Ramsey-area residents who choose veneers appreciate these benefits:

  • No Change to Tooth Structure: Crowns can also be used to cover flaws, but the restorations require filing all four sides of your tooth. Veneers won't affect your tooth structure. They only require removal of a tiny amount of tooth enamel for a good fit.
  • Longevity: You can expect your veneers to look good for as long as 10 years. If you take good care of them, they may not need to be replaced for many more years.
  • Easy Care: Veneers don't require any special care instructions. In fact, you'll only need to brush and floss as usual. Non-abrasive toothpaste is recommended, as abrasive products can scratch veneers. You'll also need to avoid using your teeth as tools or eating very hard foods to avoid chipping or breaking your veneers.
  • A Complete Tooth Transformation: Adding veneers to your teeth hides the flaws that make you reluctant to share your smile with the world. The restorations are often used to change the shape of crooked or twisted teeth, lengthen short teeth, hide discolorations, close slight gaps between teeth, and conceal bumps, pits, cracks, or chips.
  • No More Dingy Teeth: Teeth whitening treatment can whiten your teeth by as much as eight shades, but that may not be enough if your teeth are naturally a little yellow. When you improve your smile with veneers, you choose your ideal level of whiteness. Using lighter-colored dental cement can also enhancing the whitening effect.

Improve your smile with veneers! Are you interested in learning if this cosmetic dentistry option is a good choice for you? Call Ramsey, NJ, dentists Dr. Robert Boff, Dr. Banafsheh Goujani, and Dr. Kenneth Gluck at (201) 327-3060 to schedule an appointment.

By Robert E. Boff, D.M.D. and Banafsheh Goujani, D.M.D.
May 24, 2018
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 Robert E. Boff, D.M.D. and Banafsheh Goujani, D.M.D.
May 14, 2018
Category: Oral Health
Tags: pregnancy   dental care  
4ThingsYouShouldFocusonDuringPregnancyforOptimalDentalHealth

Pregnancy creates enormous changes in your physical body. These changes, especially on the hormonal level, can impact many aspects of your health including teeth and gums.

While it’s easy to let dental care take a back seat to other health concerns, you should actually pay close attention to it while you’re expecting. Here are 4 things to focus on during pregnancy to avoid problems with your dental health.

Don’t avoid dental work unless otherwise advised. You may be concerned about undergoing dental procedures during pregnancy, especially those that involve anesthesia. But both the American Congress of Obstetricians and Gynecologists (ACOG) and the American Dental Association (ADA) encourage pregnant women to continue regular dental visits for cleanings and checkups. And unless your obstetrician advises otherwise, it’s usually safe to undergo dental work that can’t wait.

Be on the lookout for pregnancy gingivitis (gum disease). Because of the hormonal changes that occur during pregnancy, your gums could be more susceptible to gum disease caused by plaque buildup. That’s why you should be on alert for signs of a gum infection like swollen, reddened or bleeding gums. And be sure to practice diligent, daily brushing and flossing to remove disease-causing plaque, as well as regularly visiting your dentist for professional cleanings.

Make sure your diet is “tooth” friendly. Because of the changes in your body, you may experience food cravings that alter your normal dietary habits. So as much as possible, try to keep your food choices in line with what’s best for your teeth and gums: minimize your sugar intake (a prime food source for disease-causing bacteria); and focus on nutritiously balanced meals and snacks.

Keep your entire healthcare team informed. When you make your next dental appointment, tell your dentist you’re pregnant and how far along, any medications and supplements you’re taking, or any complications you may be experiencing. This information could have a bearing on how your dentist approaches any treatment. Likewise, let your obstetrician know about any issues with your teeth and gums, as well as any suggested dental work you may need.

If you would like more information on dental care during pregnancy, 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 “Dental Care during Pregnancy.”





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