Because These Teeth were made for Smiling

Botox and Juvederm Tackle More than just Wrinkles!


photo credit Aesthetic Study Journal

Dr Garrett uses old but new techniques to enhance your smile.


Jane has beautiful teeth but when she smiled, all you saw were her gums. When she smiled, her upper lip stretched up so high that a ribbon of pinkish gum was exposed, giving her a so-called “gummy smile.” She hated it.

Gummy smiles occur for a variety of reasons, most commonly a short upper lip, excessive gum tissue or small teeth. Doctors who specialize in cosmetic procedures estimate that about 14 percent of women and 7 percent of men have excessive gingival exposure when smiling.


In the past, surgery was the main treatment option, but that is often costly and painful. Laser therapy is also sometimes used. Now people are going another route, Botox and Dermal fillers like Juvederm.

Relaxing the Upper Lip

For the last few years, dentists have been injecting Botox into the upper lip “elevator” muscles. It paralyzes the muscles, inhibiting contraction of the upper lip when smiling to prevent the gummy smile.

In contrast to surgery, Botox is quick and easy, doctors who do the procedure say.

Gentle Lip Enhancement (Without Surgery)

Over time, some unwanted changes take hold of our faces. Some of these have a more intense aging effect than others. One that’s universally disliked is loss of lip volume. Without the same full, luscious lips, you look older and less attractive. Flattening lips will also lead to wrinkles above and below the mouth.

Fillers, like Juvederm, are an ideal option for patients seeking subtle lip enhancement – and hoping to avoid invasive treatment. When you think about plumping your lips, you don’t ever want to look cartoony or unnatural. In order to end up with the gentle results you’re really seeking, you’ll need to do two things: find a talented provider, and ask about dermal fillers. Fillers allow for delicate tweaks to be made to your lips, resulting in a wholly natural-looking plumping.


Fillers for Black Triangles in Your Smiletreating the dreaded black triangle

Our gums are also prone to losing volume over time. This loss of gum tissue can be sped up by so many different dental problems, ranging from gum disease to bruxism (chronic teeth grinding) to orthodontic treatment.

When your gum tissue recedes, you’re likely to see a change across your smile. Sensitive or dark areas of the tooth roots may be revealed, and the balance of the tooth-gum ratio may be off. Additionally, black triangles can form between your teeth. These dark spaces add unwanted age to your smile, and make the overall grin appear triangle 2

You deserve to have your smile stand out for positive reasons – not because it has dark spaces between teeth. With dermal fillers, you can plump the areas of your gums that need a little extra help. Minimal treatment at the gum line will puff out your gums and fill out your smile. The end result is a gorgeous grin.

Botox and Juvederm are quick procedures that are done same in our office.

Call us for special pricing and to see how we can help your smile! 901-347-3527

Healthy Body, Healthy Mouth!

If you are like us, we are looking forward to the upcoming summer season. But wait! We need to kick up our healthy body routines and get in shape. Getting in shape is good for your body but also for your mouth! Remember, as Dr Garrett has said before, the mouth is the gateway to the body!fitibit

Since we are kicking up our healthy body routines at work, we are having a contest to win a Fitbit Flex. Here are some ways you can win:

  1. Facebook: Like our Facebook page (GermantownSmiles), then share it with your friends, and post a comment on our page. Each one of these things will get you one entry. The more you share, the more chances you have to win.
  2. Share a good story about us on a local Facebook page like Shop Germantown.
  3. Follow us on Twitter and retweet to your friends.
  4. Join our Fitbit group or if you don’t have a fitbit yet, have your friends join our group to win other prizes monthly! Our group is Germantown Cosmetic and Family Dentistry.
  5. Each time a friend that you refer to us comes in for a new patient appointment, you get another entry!

We are excited to get healthy with our patients and friends. Hopefully we can continue this contest and stay healthy with you!

Do you have a Killer right under your nose?

The Importance of Oral Cancer Screening

Today, Dr Garrett is going to help you see how important advanced oral cancer screening can be to your life.oral cancer

Oral cancer is one of the most deadly cancers diagnosed in America today. In fact, oral cancer kills over half of all who are diagnosed. However, if diagnosed early – over 80% of patients survive. This statistic alone should encourage you to receive regular and thorough oral cancer screenings, especially if you are at risk.

With more than 43,000 Americans estimated to be diagnosed this year, educating yourself on prevention methods, early detection, and treatment options is more important than ever.

Just because you are not a tobacco user, smoker, or heavy drinker, doesn’t mean you cannot get oral cancer. Due to the rapidly growing number of HPV-related oral cancer diagnoses, all people 18 years and older should get screened yearly.

What Does Dr Garrett do during an Oral Cancer Screening?

An oral cancer screening takes only three minutes. It consists of a verbal, visual, and physical examination and incluidentafides the following:

  • – A thorough review of your oral health history, as well as your overall health history.
  • – A visual inspection of all the areas of your mouth and throat in an effort to locate any abnormalities, such as sores and red or white patches; this inspection includes the lips, cheeks, gums, tongue, floor of the mouth, roof of the mouth, and far-back section of your tongue. An advanced oral cancer detection tool, like Identafi, can enhance the exam and let Dr Garrett see changes that the naked eye cannot see.

Oral Cancer Signs and Symptoms

In between routine dental exams, you should perform self-examinations, and be sure to keep an eye out for the following signs and symptoms that may indicate the presence of oral cancer:

  • – Red or white patches on the lining of the mouth or tongue
  • – Swelling or thickening of areas inside the mouth
  • – Unexplained bleeding
  • – Sores on the face, neck, or mouth that do not heal
  • – Chronic sore throat
  • – Hoarseness
  • – A change in the way your dentures fit
  • – Suspicious lumps found by palpating your mouth, jaw, and neck
  • – Dramatic weight loss

Oral Cancer Prevention Tips

While oral cancer is prevalent, there are measures you can take to minimize your risk.

  • – Avoid smoking and the use of all tobacco products.
  • – Limit or refrain from drinking alcohol.
  • – Avoid overexposure to the sun, and use sunblock on your skin and lips.
  • – Practice safe sex.
  • – Maintain a healthy diet.

Contact our office, at 901-347-3527, to see how early detection with Identafi can help save your life.

Am I Grinding My Teeth Away?

Clench-grind-teethDo you wake up in the morning with a sore jaw? Do you get tension headaches? Are your teeth sensitive? You may be grinding or clenching your teeth and not even be aware of it. Bruxism is a condition in which people grind or clench their teeth without knowledge of doing so. This can be caused by different reasons that Dr Garrett at Germantown Cosmetic and Family Dentistry will address in this blog and how it affects your teeth and jaws.



Causes of teeth grinding

Tension, stress, and anxiety experienced during the daytime can carry over to an individual’s sleep, and lead the person to grind his or her teeth together or clench the teeth unknowingly. Sleep apnea is another condition that can result in bruxism.  effect-teeth-grinding

Effects of Teeth Grinding

Frequent clenching and teeth grinding wears down the chewing surfaces of the teeth, reduces tooth enamel, and can result in a cracked or chipped tooth, crown, or filling. The alignment of your teeth can be effected which causes more jaw problems. These jaw problems can lead to joint issues, tension headaches, and muscular problems.

Nightguards for teeth grinding

Custom nightguards are fabricated to fit like a glove and protect your teeth from the adverse effects of bruxism. Nightguards are created through a non-invasive process that simply takes an impression or scan of the bottom and top rows of teeth. The result is a nightguard that is flexible, comfortable, and personalized to your mouth.

Benefits of nightguards

Nightguards are helpful to reduce or eliminate the symptoms of dental damage incurred as a result of teeth grinding. They can reduce the discomfort associated with a sore jaw, headaches, tooth sensitivity, ear pain, and facial pain that many patients experience as a result of clenching or grinding of their teeth. In severe cases of bruxism, patients can develop loss of hearing, jawbone misalignment, and TMJ. Therefore, customized nightguards can help prevent the progression of teeth grinding into these more serious conditions.

At-home tips to reduce or prevent teeth grinding

Although it’s important to wear your nightguard faithfully if you grind your teeth at night, you can follow a few self-care tips to help to prevent your teeth grinding from worsening.

  • Reduce tension and stress. Whether you take a warm bath before bed, listen to soothing music, or exercise, practice stress-relieving activities to wash away the tensions of the day.
  • Avoid alcohol. In some patients, alcohol increases teeth grinding tendencies.
  • Avoid caffeine. In some individuals, caffeine increases the likelihood of teeth grinding.
  • Focus on relaxing jaw muscles. Make a conscious effort to keep your jaw relaxed. A warm washcloth against your cheek, sticking your tongue between your teeth, and avoiding chewing pencils, pens, and gum are all ways to train the muscles of your jaw to stay relaxed.

If you suffer from any of these symptoms, ask Dr Garrett or one of our excellent staff members how we can make a custom nightguard just for you!

Wedding Season is Approaching. How can Dr Garrett improve your Smile with Teeth Whitening and Botox?

A lot of clients come to Dr Garrett to improve their appearance before wedding and reunion season. Some are scheduling for their first ever teeth whitening, botox, and juvederm treatments before a big event such as a wedding, big birthday, or reunion. You wouldn’t believe how many ladies appear with just 2 weeks or even worse a few days to go before a big event. Sadly, we have to turn these brave people away, as ideally we need at least 1 month to work some pre-event magic.

Botox and Juvederm treatment has to be perfect

wedding botox juvederm teeth whitening

wedding botox juvederm teeth whitening

before the event date, because they only get one shot at the big day! But those pictures last forever.

Teeth whitening can also be nerve racking. Too little time between the procedure and the big event and the teeth can appear miscolored or splotchy. Teeth can also be sensitive for a few weeks.

Some brides to be, however, would wake up in a cold sweat at the thought of being outed as having had ‘work done’. We want all work performed to look as natural as possible. The goal is that people think you look beautiful, not to think you had ‘work done’.

Here are some suggestions to make your appearance more natural looking prior to your big event:

  1. Schedule your first treatment 6 months early!

Botox treatment takes a few minutes to do, but takes 2 weeks to work and lasts 3 months. If you want pre-wedding botox and juvederm, ideally come to see us 6 months before the wedding so we can complete a whole treatment cycle before the cycle that will be active on your wedding day.

If you can’t get a full treatment cycle in before the wedding, come 6 weeks before the wedding. That leaves 2 weeks for the final treatment to work, 2 weeks for you to get back to see us (brides can be busy!) and 2 weeks for any tweaks that are necessary at review to kick in.

Juvederm last for 12 months, but there can be bruising and swelling. For these reasons, we suggest 6 months prior but no less than 3 months prior to the big event.

Get your evaluation for teeth whitening at this appointment. We want to clean and whiten your teeth about 4 weeks prior to the wedding and need to make sure there is nothing preventing us from whitening your teeth.

About a month prior to your wedding, we can perform the teeth whitening to make your smile exceptional for your pictures.

  1. Go Easy With Your Botox Treatment!

Please don’t ask us to freeze your face. The best treatments hands down are the ones where people ask themselves ‘OMG What cream is she using?’ rather than ‘OMG Who does her botox?’. Although it may look good in a photo, if you don’t lift an eyebrow even 1mm during the best man’s speech, you’ve been overtreated.

  1. Come Back!

If we don’t see you after your botox and juvederm treatments we can’t review our work. Although botox is a scientific miracle, it is not a one size fits all treatment. Some people require 4 times as much as others to get a good result. The only way to tell whether you are sensitive or resistant is by good guesswork and trial and error. This takes time and it is essential that you are reviewed 2 weeks after each treatment as part of this process. 9 times out of 10 at review, clients are delighted with the results and feeling like the review is a wasted visit, but about half the time, we will spot something that they didn’t. And we will make an adjustment there and then and adjust the notes for the next time in 4 months.

Something to consider is a Botox and Teeth Whitening party for you and your wedding party. All of them will be in the pictures, so why not make a day of pampering and beautification. We would love to arrange a party for you and your bridal party.

Call us to schedule your consultation so we can help make you the most beautiful person on your big day! 901-347-3527

Do you want to look Younger? Now we can help!

Do you look in the mirror and say, “Where did these wrinkles come from?” We understand! That is why Dr Garrett at Germantown Cosmetic and Family Dentistry have decided to take our cosmetic practice to a new level. We now are offering Facial Esthetics procedures to make you look younger along with creating beautiful, healthy smiles.

Botox and Juvederm have been used in the medical and spa community for years, but who better to perform these procedures than the doctor who has studied and worked in peoples’ faces for years. Dr Garrett knows the facial anatomy inside and out and can help your facial lines.


We have put together some FAQ about our facial esthetics offerings:


Botox and Juvederm Frequently Asked Questions:

What can I expect during my Appointment?

Tiny injections of BOTOX® will be administered directly into the targeted muscles that cause the moderate to severe frown lines between the brows and around the eyes and forehead. Discomfort is rare, if any, and is minimal and brief without downtime. You may see a marked improvement in the moderate to severe frown lines within days. Improvement may continue for up to two weeks, and can last up to 3-4 months. During Juvederm appointments, we numb up the areas with local anesthetic and inject the fillers into the lines and lips to plump the areas.

What’s the difference between BOTOX® and Fillers such as Juvederm?

BOTOX® targets and relax facial muscles to keep them from creating wrinkles. Cosmetic enhancement products, such as Juvederm smooth and fill in existing wrinkles, restoring skin fullness and volume. Think of BOTOX as both a corrective and preventive measure against future facial lines and Juvederm as a way to deal with existing lines restoring the volume that has been lost. Juvederm is injected under the skin to add facial volume and diminish the appearance of wrinkles, scars, and nasolabial folds instantly.

Will it hurt?

BOTOX® is injected into your skin in tiny amounts with ultra fine needles. Most people do not find the procedure uncomfortable but we can use a topical lotion to help prevent discomfort if you choose. It is relatively painless and fast. There may be minimal discomfort and swelling. Juvederm can be more uncomfortable, therefor we use local anesthetic to numb the area. Some natural swelling will occur with Juvederm which will decrease over a few days.

Will it look natural – will I still be able to have normal facial expressions?

Both treatments can give you a more youthful and relaxed appearance- without making you looks unnatural. Facial expressions and sensation will remain unaffected, and you will emerge with smoother, younger-looking skin.

It’s hard for me to make time for appointments. Can I get treatments during my lunch hour or between errands?

BOTOX® and Juvederm are simple procedures that take very little time out of your day and because any visible side effects are minimal, you can return to work or normal activities immediately.

How soon will treatments work, and for how long?

Individual results may vary, but most clients usually notice improvements from BOTOX within several days and immediately with Juvederm. BOTOX lasts for about 3-4 months and Juvederm lasts for a year.

Will one treatment be enough?

One treatment will provide you with a more youthful and relaxed appearance. We do suggest you return in two weeks for a followup appoitment to make sure no areas need touch up. For longer lasting results, it is recommended that an average of three Botox treatments will show a remarkable long-lasting improvement. Regular touch-ups every 3-4 months are recommended for Botox and yearly for Juvederm.

Will I experience any side effects?

A patient may experience localized pain, inflammation, tenderness, swelling, redness, and/or bleeding/bruising.

Will my facial expressions continue to look natural?

Although the results are visible, a treatment with BOTOX® will not radically change your facial appearance or make you look as if you “had work done.” The muscle activity that causes frown lines between the brows is simply reduced, so you can still frown or look surprised without the wrinkles and creases between your brows. Juvederm will plump any areas we treat and we use the minimal amount required to achieve a natural, beautiful appearance.

What will happen to the frown lines between my brows if I choose not to continue treatments?

If you do not continue treatments, the moderate to severe frown lines between your brows will gradually with time look like they did before treatment.

What is the cost of BOTOX® and Juvederm?

When considering your facial aesthetic options, BOTOX® and Juvederm are quite affordable. All of our consultations are complimentary – our friendly consultants will be able to advise how you can get the best results based and the costs. Schedule your appointment with Dr Garrett for a consultation.

Who should not use BOTOX® and Juvederm?

BOTOX and Juvederm should not be used in the presence of infection at the proposed injection site(s) and in individuals with known hypersensitivity to any ingredient in the formulation. Patients with neuromuscular disorders such as ALS, myasthenia gravis or Lambert-Eaton syndrome may be at increased risk of serious side effects. Juvederm should not be used in people who have had anaphylactic reactions to the ingredients. Botox and Juvederm should not be used in pregnant or nursing patients. Patients who are immunosuppressed or on blood thinners should not have either treatment.




How do I take care of my Invisalign Aligners?

Many patients have questions about Invisalign treatment and what is involved in the daily care. Dr Garrett has put together some basic instructions for how to make sure your Invisalign treatment is successful.

Invisalign InstructionsInvisalign logo

General Soreness and Speech

Most people experience soreness for a day or two after starting each new set of aligners. This is normal.  It is a sign that the aligners are working and moving your teeth to their final destination. You may take an anti-inflammatory such as Ibuprofen(Advil) or Naproxen(Aleve) if necessary.  On rare occasions, aligners may temporarily affect your speck slightly.  However, as your tongue gets used to having the aligners in the mouth, any minor disturbance in normal speech caused by the aligners will disappear within the first week.   Read out loud for 5 to 10 minutes for the first day or two and this will help you get your speech back to normal.  The more your wear your aligners, the quicker you will feel normal again.


We suggest that you remove your aligners when eating and drinking. It is ok to drink plain water with them in.  Remove your aligners just before you eat and/or drink as sugars and acids become trapped between aligners and teeth, which can cause tooth decay and other problems.  Make sure you brush or rinse well with water before putting your aligners back in so food and sugars are not trapped on your teeth.


Important things to Know

You must wear your aligners 22 hours a day, unless you are told otherwise by Dr. Garrett.

You should change your aligners every 2 weeks (14 days).  Do not change sooner or your teeth will become very sensitive and your aligners will not work as they should. Dr. Garrett recommends that new stages be placed after the last evening brushing and not removed until the next morning.  If you find that you are ready to change, and you do not have the new set, do not panic! Keep wearing your current aligners until your next appointment.  If you have lost or damaged your aligners, please call us right away. You can move back to the previous set or we may instruct you to move forward, depending on where you are in treatment. But please call us so we can discuss.

Wearing and Using your Aligners

Aligner Insertion:

  1. Make sure you have the correct aligner – upper for top teeth and lower for bottom teeth. To help you avoid confusion each aligner is engraved with your unique case # and “U” for upper and “L” for lower, followed by the stage number.
  2. You may insert either the upper or lower aligner first. When inserting each aligner, gently push the aligners over the front teeth.  Then, apply equal pressure, using your fingertips, to your left and right back teeth, until the aligner snaps into place.  DO NOT BITE your aligners into place.  This will damage them.
  3. Minor discrepancies between the new aligner and the current tooth position are normal since the teeth need time to conform to the new position. However, if there is a problem with the fit do not proceed to the next aligner stage until you are seen by Dr. Garrett.  If you have more than 2mm space between the edge of the front teeth and then end of the aligner, and the aligner will not seat more, call our office.

Aligner Removal:

  1. Using your fingers, start on one side at the back teeth and slowly work your way, pulling forward, around to the other side.
  2. DO NOT use any sharp object to remove your aligners.
  3. Immediately rinse the aligners with water, shake off excess water, and store your aligners in a case. Please do not put your aligners in a tissue or pocket as them may be thrown away or break.
  4. As you proceed to each new stage, the last two or three stages are to be saved in their corresponding zip lock packets or red case.
  5. It is rare that an aligner is unable to be removed. A #2 crochet hook from Michael’s will assist in removing the aligner if you have short fingernails. Call our office for assistance.

Daily Care and Maintenance of Aligners:

  1. Clean your aligners after removal and prior to each insertion. Use a soft toothbrush with toothpaste and water.
  2. Rinse each aligner thoroughly with water after each cleaning.
  3. DO NOT use denture cleaners to clean aligners or soak them in mouthwash. These products can damage the surface of the aligner, causing it to become dull.
  4. Store your aligners in their blue case when not wearing them. Keep a case with you at all times.

Here is a printable version of these instructions: Invisalign Instructions

Are Carbonated Drinks Bad for You?

A lot of people like carbonated drinks over flat drinks, but are these hurting our teeth? Dr. Garrett looks into which drinks are bad and which ones are safe.

Any drink that has sugar or acid in them will be bad for your teeth. Sodas, sports drinks, flavored water, and energy drinks usually contain sugar or a sugar substitute. When you drink these beverages, the sugar will stick to your teeth and the bacteria in your mouth will feed on the sugar and decay develops as a result. Then when you add carbonation to the beverages, the acidity level goes up to close to the acidity in your stomach which desolves food. This is a double whammy, which can lead to more rapid destruction of your teeth.

But what about just plain carbonated water? Carbonation results in the formation of carbonic acid, which gives plain carbonated water its distinctive flavor, but neither carbonation nor carbonic acid seem to have a significant effect on tooth enamel erosion. According to a 2001 study published in the Journal of Oral Rehabilitation, “sparkling mineral waters showed slightly greater dissolution than still waters, but levels remained low and were of the order of one hundred times less than the comparator soft drinks.”2 This is not true of flavored soda water, by the way. The flavoring agents make the soda water significantly more acidic and these flavored seltzers could contribute to dental erosion.   If you’re swilling multiple sugary drings every day, you’re going to have eroded tooth enamel, cavities, and a whopping dentist’s bill, but don’t fault the carbonation in sparkling water, it’s not bad for you.


The best drink for your teeth is regular tap water! If you want the fizz, go ahead and have some plain carbonated water or add your natural flavoring. But stay away from sodas and energy drinks full of sugar. Unless you really like coming to see us, then we can fix all of those terrible cavities 🙂

Call us today to schedule a checkup so Dr Garrett can make sure those sugary drinks haven’t damaged your teeth! 901-347-3527


1 .Take Part 07/31/2013

2. Monica Reinagel, MS, LD/N, CNS,Nutrition DivaDecember 28, 2010


Don’t slip on Your New Year’s Resolutions

Now that we are at the end of January, don’t slip on some important resolutions. Dr. Garrett wants to encourage you to keep going!

Being healthy is more than just eating right and exercising. You need to make sure you are keeping your mouth, body, and mind healthy. Here are a few suggestions from Dr Alexandra Garrett to get and stay healthy this year:

  • Start a healthy body routine everyday to make it a habit. Research has shown that if you do something for 3 weeks, it becomes a habit. Start with a 3 week calendar checklist (we have provided one here for you.) Some things to make sure you do daily: Drink 8 glasses of water throughout the day, eat atleast 3 servings of fresh fruits and veggies, get some cardio exercise for 20 minutes, and floss once and brush twice daily.  3 week habit chart


  • Make appointments with healthcare providers for checkups and go to the appointments. Most preventative appointments are now covered by insurance so you need to make sure you get the checkups to stay healthy. Early detection and prevention is the best medicine. Here is a list of healthcare providers you should see yearly: Internal or Family physician, Optometrist, Dentist, Dermatologist, and, if female, Gynecologist. If you do not have insurance to help pay for your appointment, ask about non-insured coverage like our In-office Dental Plan. Call our office at (901) 347-3527 or request an appointment online .


  • Reward yourself. When you do something nice for yourself, you feel better and are more motivated to continue on your healthy track. Once a month, go to reward yourselfthe movies, get a manicure, get a massage, download a new song, or take a day trip with a friend. These can re-energize you and reduce your stress.

Foods you can eat to help you from being sick.


It is that time of year again. We are staying inside more and getting sick. Who has time for being sick? I know wsicke don’t have time at Germantown Cosmetic and Family Dentistry.





Dr Garrett has a few recommendations that may help you keep healthy:

1.) Micronutrients: The micronutrients (vitamins and minerals) in foods are vital for ward

Leafy greens

Leafy greens

ing off illness. Make sure you’re getting plenty of Vitamin A, B2, B6, C, D, E, zinc and selenium. The best foods containing these are:

  • Leafy greens like spinach and kale
  • Nuts like almonds and peanuts
  • Fruits like bananas and oranges
  • Cold-water fish like tuna
  • Foods high in carotenoids like carrots
  • Sweet potatoes and pumpkins

2.) Probiotics: There are hundreds of different kinds of bacteria in the digestive tract, and there is some evidence that having the right amount of “good bacteria” has a positive effect on the immune system. Probiotics are good bacteria that can be found in dairy products, like yogurt and kefir.

3.) Teas: An amino acid called L-theanine, found in green and black teas, has been shown to help the body fight off viruses. In one study, people who drank several cups of tea a week had more ability to fight off viral infections than those who drank a placebo.

4.) Also remember, the mouth is the gateway to the rest of your body. By maintaining good oral hygiene, you can help reduce the bacteria in your mouth and thus reduce the bacteria in your blood stream.