Cosmetic Dentistry

Cosmetic dentistry is a discipline within dentistry in which the primary focus is the modification of the appearance of a patient's oral cavity and surrounding structures.  Cosmetic dentistry is used in conjunction with the prevention and treatment of organic, structural or functional oral disease. Through cosmetic dentistry, the appearance of the mouth can be altered to more closely match the patient's subjective concept of what is visually pleasing.

Materials

In the past, dental fillings and other tooth restorations were made of gold, amalgam, and other metals -- some of which were veneered with porcelain. Now, dental work can be made entirely of porcelain or composite materials that more closely mimic the appearance of natural tooth structure. These tooth colored materials are bonded to the underlying tooth structure with resin adhesives. Many dentists offer these procedures as cosmetic options.

Treatments

Todays common cosmetic dental treatment options include:

Whitening, or "tooth bleaching," is the most commonly prescribed cosmetic dental procedure. While many whitening options are now available, dentist-supervised treatments remain the recommended procedures for lightening discolored teeth.

• Enamel shaping removes part of the contouring enamel to improve the appearance of the tooth.  Enamel shaping may also be used to correct a very small chip.The removed enamel is irreplaceable. This procedure is also known as enameloplasty, odontoplasty, recontouring, reshaping, slenderizing and stripping.
• Bonding is a process in which an enamel-like composite material is applied to a tooth's surface, sculpted into shape, hardened and then polished.  This is a great option for chipped or cracked teeth.
• Veneers, ultra-thin, custom-made laminates that are bonded directly to the teeth, are an increasingly popular procedure. They are an option for closing gaps or disguising discolored teeth that did not respond well to whitening procedures.

 

 

Before and after cases:

Case I: Smile makeover
Before:

Discolored, decayed and missing front teeth made this patient self-conscious and insecure.

After:


Restored teeth with porcelain bridge, crowns and veneers, and laser gum surgery brought this patient confidence and attractive smile.


Case II
Porcelain crowns:

Before:

Decayed front teeth with discolorations and a non-matching old crown.  Note the dark line along the gum margin.

After:

Beautifully restored front teeth with porcelain crowns

Case III:
Before:



Patient had old, unattractive crowns and worn out teeth


After:




Attractive and natural smile with porcelain upper crowns and lower veneers.  Patient was thrilled that these "looked like her own teeth...only better!"

Case IV:

Before:


Young patient with spaces between his teeth after orthodontic treatment was still unhappy with appearance of his smile.

After:


Four veneers without teeth preparation have given this smile beauty and confidence.

Case V:

Before:

After:

Tooth Whitening

There are many ways to whiten your teeth. One option is to have your dentist add or remove tooth structure (such as porcelain laminates) but a much less costly choice is to use a bleaching agent (typically hydrogen peroxide and carbamide peroxide).

There are three popular bleaching methods, each with pros and cons. The least expensive involves over-the-counter (OTC) bleaches you can use at home without professional help. A two-week OTC course typically costs $20-$30, and entails applying a liquid whitening agent with either a one-size-fits-all tray or by applying strips to the teeth. OTC products contain low concentrations of hydrogen peroxide (3 to 6 percent) so they need to be applied more frequently or for longer periods of time than methods used by your dentist. This option does whiten, but it takes longer to see results. Plus, peroxide is acidic and can irritate gum tissue as well as cause tooth sensitivity, especially to cold. My advice is to work with your dentist so he or she can supervise your care. A professional can also determine the underlying reason for staining and help select the best whitening method.

Another option that is slightly more costly but delivers more noticeable results, is having your primary dentist take impressions of your mouth and make a custom tray that delivers the appropriate concentration of bleaching agent for your specific tooth color. This method allows for the use of greater concentrations of peroxide, ranging from 10 to 20 percent, and costs anywhere from $350 to $850. Bleaching trays work well (and fairly quickly) for most people. Another advantage: any sensitivity can be quickly diagnosed, allowing your dentist to back off on the duration or frequency of the applications. (Most sensitivity in all methods goes away with time.)

The fastest, easiest method is power bleaching by a dental professional. This is sometimes called laser bleaching, although that is not an accurate name. There are no lasers involved — the tool is a light lamp which activates the bleaching agent. The concentration is 25 to 35 percent, which is considerably higher than the other two methods. Because the higher concentration and lamp, with this technique you get instant results in one visit.