ntroduction Are you afraid to smile? Would you rather take the picture instead of be in it, because you are too self-conscious of the color, shape, or positioning of your teeth? Are you afraid to yawn for fear of revealing all of those silver fillings?
Many of my patients think that their teeth are too dark, too crooked, overcrowded, chipped, or just misshapen. They want that "Hollywood" smile, and they often bring a magazine to my office, point to the cover and say, "I want a smile just like that!"
There are a wide range of cosmetic dental enhancements available that can help you achieve the look you want. Though these enhancements are only "skin deep", they can bring you pleasure, and perhaps give your self-confidence a little boost.
Below is a general introduction to some of the latest cosmetic techniques.
Bleaching and Whitening
Extrinsic stains, or stains on outer surfaces of the teeth, can usually be removed during a thorough professional dental cleaning. However, intrinsic stains, which are stains within the tooth itself, must be removed through bleaching. This can be accomplished either at home when overseen by your dentist, or in the dental office with a carbamide-peroxide or hydrogen-peroxide solution. It is usually two to three years before it is necessary to repeat the bleaching process. I caution you to avoid any whitening procedure without supervision by your dentist for several reasons that include:
- Not everyone is a candidate for bleaching, so you should be evaluated first by a dentist. One reason to check with your dentist is to ensure that you will not be sensitive to the procedure. It may be necessary to replace some older fillings with new fillings prior to the process, to avoid sensitivity. Also, because porcelain and tooth-colored fillings tend not to bleach, you may want to replace them after bleaching in order to improve aesthetics.
- Not all over-the-counter bleaching solutions are pH-balanced. Some may cause irritation of the gums.
- Bleaching can sometimes lead to sensitive teeth, which your dentist can help by changing the concentration of the solutions or administering fluoride.
- It is important to have a custom-fitted mouth guard so that the bleaching gel remains on your teeth, rather than on your gums. The combination in-office/take-home whitening procedure In this procedure, models are taken of your mouth, and a custom-fitted bleaching tray is made for you. I instruct my patients to wear the tray for a period of two weeksfor four hours each day, or they may wear it overnight. Results vary depending upon the original color and shade of your teeth (i.e., some teeth are naturally yellow, reddish-brown, or gray.)
Health
As a matter of convenience, many of my patients choose in-office whitening. A special external light source (laser, halogen or gas plasma) is used to activate the bleaching gel solution. The process is safe, easy, and fast. Results are accomplished in just one appointment. Sometimes it may be necessary to use a combination of in-office and at-home bleaching in order to achieve the patient's desired results.
Whitening toothpastes
Although whitening toothpastes may remove stains, I only recommend them for maintenance after the bleaching process has been completed.
Bonding
Bonding is actually a process by which we affix a tooth-colored material (hard plastic) to your teeth, creating a bond. We can use bonding to change tooth color, shape and size, or to repair fractured teeth. We can also use bonding to give the appearance of straight teeth. However, we caution our patients to avoid hard foods, as this may cause the bonded restoration to chip or fracture. A bonded restoration can be polished to look the same as your natural teeth and may also stain in a similar manner as your own teeth. Stains are removed during the patient's regular cleaning appointments by polishing these restorations.
Porcelain veneers
If my patients want something that is more stain-resistant and less likely to chip than bonding, I recommend porcelain veneers. Like bonding, porcelain veneers are also used to change tooth color, shape, and size. We can also use porcelain veneers to give teeth a straighter appearance and to close spaces. Porcelain veneers are thin porcelain shells that are fabricated in a dental laboratory. I often liken porcelain veneers to fake fingernails. We bond the porcelain veneers to the teeth using a special cement. Porcelain veneers are more expensive than bonding, since there is a laboratory process involved. I prefer porcelain veneers to bonding when there are several teeth involved because I can achieve a more consistent cosmetic result.
Tooth-colored fillings
Due to recent technological advances and improved materials, there are now alternatives to silver fillings. I have never had a patient thank me for a silver filling because they like the way it looks. I get more gratification and many more thanks from patients when I use tooth-colored fillings. When teeth require smaller restorations or fills, we can fill these holes in the office with a tooth-colored material (hard plastic) that is bonded to the tooth. If the filling is large, I prefer to use a tooth-colored inlay or onlay, which is custom-made in the laboratory to fit the tooth and is permanently cemented in place. If there is a considerable amount of tooth structure missing, we must crown the tooth.
Porcelain crowns (caps)
In my practice, I use both all-porcelain crowns and porcelain-fused-to-gold crowns (a gold crown that is covered by porcelain). I use porcelain to match the shade of a natural tooth. Since more light is reflected in the front of the mouth, I feel that all-porcelain crowns look more natural when restoring front teeth. Crowns are custom-made in a laboratory and are cemented in place.
Orthodontics
I work with orthodontists in our practice to straighten teeth, reduce crowding, and close spaces in order to achieve the best possible smiles. Although it often requires a much longer time frame, I often prefer orthodontics over porcelain veneers or bonding. Orthodontics may take at least two to three years to achieve the desired results. Sometimes it is necessary to use both orthodontics and bonding or veneers to achieve the best results.
Periodontics
Sometimes it is necessary to work with a periodontist (gum specialist) to alter gum tissue to enhance a patient's smile. You may have seen at one time or another a person who will show a lot of gum when they smile.. If a person is uncomfortable with the amount of gum that shows, a periodontist can help to reduce this.
Conclusion
If you have a hankering for a smile overhaul, rest easy. There are many options available to you, and the best way to begin is to speak with your dentist. He or she can point you in the direction of a specialist who can address your concerns. And remember, everyone is entitled to a beautiful smile.
