Cosmetic Dentistry: The Art and Science of Improving Your Smile
An attractive Smile shows you at your very best! However, in spite of good oral hygiene habits and professional care, your smile may not be as bright as it could be. Cosmetic and restorative dentistry can enhance your smile through a unique combination of science and art.
Recent scientific breakthroughs have made dental enhancements feasible and affordable for more people than ever before. Today, dentists can contour, color, fill-in, align and even replace teeth – with advanced materials and techniques. New materials are remarkable strong and durable, yet less expense than before. Techniques involving bonding and porcelain veneers have also advanced in recent years. In many cases, cosmetic and restorative dental treatment can be used in place of more involved and costly orthodontic or surgical procedures.
When your smile is attractive, dentists and patients agree that other benefits follow – like an improved self-image, better dental hygiene, an improved sense of personal well being and better overall health.
Walk up to a mirror mounted on a wall. Do not use a hand-held mirror. Smile at yourself. Now think of something funny that happened to you.
Look in the mirror again.
Is your smile the same or is it bigger? Usually it is bigger.
This is called your "funny smile" because it is the one that you show when you hear or see something funny. It is a much larger smile than when you pose especially when you are not happy with your teeth. However, when your teeth are improved, your big "funny smile" returns and you look great!
O.K., now let’s figure out what’s holding your smile back… what it is that bothers you about your teeth.
- Are there spaces between your teeth?
- Are your teeth dull, dark or stained?
- Are they crooked, misshapen or out of line?
- Do you show too much gum?
- Are your gums irregularly shaped, higher on some teeth, lower on others?
- Are your teeth too small or too large?
- Are the edges of your teeth (as a group) too long or too short?
- Do your teeth slant on way or the other?
- Is the midline of your two front teeth centered with your face and nose?
- Are the edges of your canines (eye teeth) too pointy or too flat?
- Are the biting edges worn down?
- Are any of your teeth missing?
- Have your gums receded?
- Are any ugly dental fillings showing?
- Do any old or recently crowned teeth not match your natural teeth?
- Are any of your teeth that have silver filling stained blue or gray?
If you answered yes to ANY of the above questions, you can be helped by cosmetic dentistry!
Now you have to learn what cosmetic dentistry can do for you.
For whitening of dark, dull or stained teeth, bleaching may be the simplest solution. Bleaching is performed by taking an impression of your teeth and making a model of them. From this model, a clear soft bleaching tray is made. Think of the tray as a "Jell-O mold" of your teeth. The tray is filled with bleaching gel and placed into the mouth directly over the teeth. This bleach filled tray may be worn during the day or while you sleep. Results can be seen daily. To obtain maximum results, most patients must wear the bleaching tray for about two weeks.
When teeth are chipped or slightly decayed, bonded plastic resins called composites may be the materials of choice. Bonding is hardened on the tooth using a light gun. First the tooth structure is cleaned and etched with a mild acid solution (exactly the same type and strength of acid for in sodas). Microscopically, the tooth surface resembles an English muffin with nooks and crannies. Then a clear adhesive liquid is painted onto the tooth and flows into the indentations. A putty-like tooth colored plastic filling material is applied to the tooth and shaped. It is permanently hardened and fused to the tooth with a handheld very bright blue light. This process is called photo curing. Bonding makes a great tooth colored filling for small cavities, chipped or broken surfaces, and for filling in small gaps. When the restoration reaches too large a size, the bonded material becomes too weak to withstand the forces placed upon it. If problems with bonding occur, the next choice for restorations would be porcelain laminate veneers or simply "veneers".
Example 1:
Example 2:
Many times the demands of cosmetic changes in the mouth are too great for simple bonding. This is when porcelain laminate veneers may be used.
Porcelain veneers can dramatically change an entire smile. They can change the shape, color, size and arrangement of teeth or any combination of these factors. They can often be used as an alternative to orthodontic treatment.
The technique consists of shaving a thin layer of outer tooth structure. An impression is then taken of the prepared teeth and is sent to a dental laboratory. In the lab, a ceramist will make very thin porcelain facings consisting of all the changes in shape, size, color and tooth arrangement that are needed to have a great looking smile.
At the second visit, the laminates are bonded onto the prepared teeth with the blue light gun. The bonding material acts as an adhesive for the laminates. Porcelain laminates are the most popular technique used for dramatic smile makeovers.
Example 1:
Example 2:
Porcelain Jackets (All Porcelain Crowns):
When there is not enough tooth structure left, or the chewing demands in the mouth are too great for laminates, a stronger, more extensive restoration is needed.
Here we place porcelain jacket crowns. Porcelain Jackets are pure porcelain crowns placed on a fully prepared tooth. They are the most life-like of all full crown preparations.
The technique consists of preparing the teeth and taking an impression.
Temporary crowns are made while the permanent restorations are being fabricated in a dental lab.
Within two weeks, the porcelain jackets are permanently bonded onto the patient’s teeth.
Porcelain Fused to Metal Crowns:
When biting pressure is too great for porcelain jackets or when gaps from missing teeth must be filled in, metal alloy must be placed under the porcelain for strength. This is the porcelain fused to metal crown technique.
Again, the teeth are prepared for a full coverage restoration. After the impression is taken, a metal coping is made for the prepared tooth. This is then covered with porcelain.
Porcelain fused to metal crowns do not have the translucency of pure porcelain crowns. Therefore, the esthetics may be slightly compromised in some situations. However, a talented ceramist with experience in custom staining can usually overcome the limitations, thereby creating lifelike restorations.
When teeth are loose due to periodontal bone loss, this technique is used. Here the teeth are splinted together by joining the metal substructure of the crowns.
The crowns are tied together like a small fence in the mouth.
Full Gold Onlays and Crowns:
When individual back teeth are broken down, but some good healthy tooth structure remains, gold onlays or crowns are used.
These are the strongest and longest lasting of all the posterior restorations. These restorations are used when esthetic concerns are outweighed by the need for strength and longevity.
Once the tooth is properly prepared, the technique is similar to the porcelain fused to metal crown technique.
The benefit of this restoration is the advantage of the gold, which supports the tooth during heavy biting loads, thereby protecting the tooth and nerve.
