MARK SAWYER, DDS
Lakeshore Dental Associates
ABOUT COSMETIC DENTISTRY
People choose esthetic dental procedures/surgery for various reasons—to repair a defect such as a malformed bite or crooked teeth, treat an injury, or just improve their overall appearance. Whatever the reason, the ultimate goal is to restore a beautiful smile.
For these and many other reasons, esthetic dentistry has become a vital and important part of the dental profession.
Common esthetic dental procedures can be performed to correct misshaped, discolored, chipped or missing teeth. They also can be used to change the overall shape of teeth—from teeth that are too long or short, have gaps, or simply need to be reshaped.
Which techniques should be used to improve your smile? A dental exam will take many factors into consideration, including your overall oral health.
Contouring and reshaping
Whitening and bleaching
Teeth that are badly stained, shaped or crooked may be improved by a veneer placed on the surface of the affected teeth.
Veneers are thin pieces of porcelain or plastic cemented over the front of your teeth to change their color or shape. They are used on teeth with uneven surfaces or are chipped, discolored, oddly shaped, unevenly spaced or crooked. Little or no anesthesia is needed. Veneers have a longer life expectancy and color stability than bonding, and highly resist permanent staining from coffee, tea, or even cigarette smoking.
How are veneers made?
Veneers are usually made by a dental lab technician working from a model provided by your dentist. Veneers are usually irreversible because it's necessary to remove a small amount of enamel from your teeth to accommodate the shell.
Porcelain veneers can mask undesirable defects, such as teeth stained by tetracycline, by an injury, or as a result of a root-canal procedure, and are ideal for masking discolored fillings in front teeth. Patients with gaps between their front teeth or teeth that are chipped or worn may consider porcelain veneers.
What is the process?
Typically, veneers entail at least three appointments: diagnosis and treatment planning, preparation, and bonding.
During the tooth preparation visit, usually lasting one to two hours, the teeth are lightly buffed to allow for the small added thickness of the veneer. Usually, about a half a millimeter of the tooth is removed, which may require a local anesthetic. During the same visit, a mold is taken of the teeth, and sent to the laboratory for the fabrication of the veneers.
For certain patients no preparation of the teeth may be necessary.
During the final "bonding" visit, also about one or two hours, the veneers are placed on the tooth surface with water or glycerin on the teeth to check their fit and get a sense of the shade or color. While the veneers are resting on your teeth, they can be adjusted with various shades of cement to match the color of your teeth. To apply the veneer, the tooth is cleansed with specific chemicals to achieve a bond. Once a special cement is sandwiched between the veneer and tooth, a visible light beam, or laser, causes a catalyst to be released, hardening the cement.
During a two-week period of adjustment that follows, you may notice the change of size and shape in your teeth. It is important to brush and floss daily. After one or two weeks, you`ll return for a follow-up appointment. Porcelain veneers are reasonable facsimiles of natural teeth, not perfect replacements. It`s not uncommon to see slight variations in the color of porcelain veneers upon close inspection, as this occurs even in natural teeth.
Bridges are natural-looking dental appliances that can replace a section of missing teeth. Because they are custom-made, bridges are barely noticeable and can restore the natural contour of teeth as well as the proper bite relationship between upper and lower teeth.
Bridges are sometimes referred to as fixed partial dentures, because they are semi-permanent and are bonded to existing teeth or implants. There are several types of fixed dental bridges (cannot be removed), including conventional fixed bridges, cantilever bridges and resin-bonded bridges. Unlike a removable bridge, which you can take out and clean, your dentist can only remove a fixed bridge.
Porcelain, gold alloys or combinations of materials are usually used to make bridge appliances. Appliances called implant bridges are attached to an area below the gum tissue, or the bone.
Crowns are synthetic caps, usually made of a material like porcelain, placed on the top of a tooth.
Crowns are typically used to restore a tooth's function and appearance following a restorative procedure such as a root canal. When decay in a tooth has become so advanced that large portions of the tooth must be removed, crowns are often used to restore the tooth.
Crowns are also used to attach bridges, cover implants, prevent a cracked tooth from becoming worse, or an existing filling is in jeopardy of becoming loose or dislocated. Crowns also serve an aesthetic use, and are applied when a discolored or stained tooth needs to be restored to its natural appearance.
A tooth must usually be reduced in size to accommodate a crown. An impression is then made from the existing tooth to create a custom-designed crown. The impression is sent to a special lab, which manufactures a custom-designed crown. In some cases, a temporary crown is applied until the permanent crown is ready. Permanent crowns are cemented in place.
Crowns are sometimes confused with veneers, but they are quite different. Veneers are typically applied only to relatively small areas.
Caring for your crowns
With proper care, a good quality crown could last up to eight years or longer. It is very important to floss in the area of the crown to avoid excess plaque or collection of debris around the restoration.
Certain behaviors such as jaw clenching or bruxism (teeth grinding) significantly shorten the life of a crown. Moreover, eating brittle foods, ice or hard candy can compromise the adhesion of the crown, or even damage the crown.
Newer kinds of fillings made from composite resins and porcelain can restore unsightly fillings; many people are surprised how natural these kinds of filling materials can make a tooth once covered by the old-fashioned silver amalgams.
Bonding is a process in which an enamel-like material is applied to a tooth's surface, sculpted to an ideal shape, hardened, and then polished for an ideal smile. This procedure usually can be accomplished in a single visit.
Bonding is often performed in order to fill in gaps or change the color of your teeth. It typically only entails one office visit, and the results last for several years.
Bonding is more susceptible to staining or chipping than other forms of restoration such as veneers. When teeth are chipped or slightly decayed, bonded composite resins may be the material of choice. Bonding also is used as a tooth-colored filling for small cavities and broken or chipped surfaces.
In addition, bonding can be used to close spaces between teeth or cover the entire outside surface of a tooth to change its color and shape. Crowns, also known as caps, are used in cases where other procedures will not be effective. Crowns have the longest life expectancy of all cosmetic restorations, but are the most time consuming.
Many people inherit the problem of excessive or uneven gums. An aesthetic surgical procedure called a gum lift can be used to correct this problem.
Special thin laminates, called veneers, can often be used to correct discolored, worn down, cracked and chipped teeth. Veneers can also be used to close unsightly gaps between teeth. Stronger types of veneers made of porcelain, also called composite veneers, typically last longer because they are bonded to the tooth.
Another process called bonding can accomplish some of the same things, but it does not last as long. Material that looks much like the enamel on your teeth is used during a bonding procedure. The material is shaped to the tooth, and when it becomes hard it is polished.
In addition, dental contouring and reshaping can correct chipped, cracked, crooked, or even overlapping teeth. This procedure can alter the shape, length, or position of teeth.