Improve Your Smile: Cosmetic Dentistry 101

Today, cosmetic dentistry is more popular than ever, from whitening and shaping, to closing spaces and replacing teeth. And dentists have a wide array of tools and techniques at their disposal for improving the look of your smile.

Before deciding to undergo any cosmetic procedure, it's important to know the benefits and risks, and what you can expect during the process. Make sure you're clear about what it will cost, how much experience your dentist has with the procedure, and whether any special maintenance will be needed afterward.

 

Teeth Whitening

 

Over time teeth can become stained or discolored, especially after smoking, taking certain medications, or consuming foods and beverages such as coffee and tea. Using a chemical process, your dentist can bleach your teeth in one of two ways. He can do an in-office procedure, or provide you with a system to use at home.

Your dentist can create a custom mouthpiece that ensures the right amount of whitening solution reaches your teeth. You may find whitening at home more convenient. But it can take two to four weeks. In-office whitening can take place in one or more 45- to 60-minute visits.

Keep in mind, your teeth can become stained again if you continue exposing them to the same substances that originally stained them. Since whitening products are not meant to clean teeth, it is still important to continue practicing daily oral hygiene by brushing twice a day and flossing at least once a day.

 

Bonding

 

Bonding may improve how your teeth look if they have excess space between them, or if they are chipped, broken, stained, or cracked.

Dentists also use bonding materials to fill small cavities or to protect the exposed root of a tooth.
The dentist can usually do this procedure in a single office visit by applying an etching solution followed by tooth-colored materials -- sometimes composite resins -- directly to the tooth's surface where needed.

Although bonding can last for several years, it is more likely than other types of restorations to chip or become stained.

 

 Veneers

 

These custom shells, made of porcelain or plastic, cover the front sides of the teeth to change their color and/or shape. Veneers can improve teeth that:

• Have spaces between them
• Have become chipped or worn
• Are permanently stained
• Are poorly shaped
• Are slightly crooked

Dentists often suggest veneers for some of the same problems that bonding addresses. Yet, the process for inserting veneers is not reversible like dental bonding, which can be removed.
Veneers are less expensive than crowns. And they last longer and have better color stability than bonding.

Before inserting veneers, the dentist first takes an impression of your tooth, then buffs the tooth before cementing the veneer in place. A beam of light helps harden the cement which secures the veneer to your tooth.
Porcelain veneers are made in a laboratory. So you would need a second visit to the dentist to have them inserted.

Crowns

 

 Sometimes called caps, crowns completely cover a tooth, restoring a normal shape and appearance. You may need a crown to:

• Cover a misshapen or discolored tooth
• Protect a weak tooth
• Restore a broken or worn tooth
• Cover a tooth with a large filling
• Hold a dental bridge in place
• Cover a dental implant
• Cover a tooth that's had a root canal procedure

Crowns can be made from metal, porcelain fused to metal, resin, or ceramic materials. Because crowns are costly, dentists usually suggest them only when other procedures can't produce a pleasing result.
Sometimes a dentist can make an in-office same-day crown, or a temporary crown. But it takes more than one visit to receive a permanent crown. The dentist prepares the tooth for the crown, makes molds of the tooth, provides you with a temporary crown, and then places the permanent crown at a separate time.
Permanent crowns can have a long life if you take good care of them.

 

Enamel Shaping and Contouring

Enamel shaping and contouring involves removing or contouring dental enamel to improve the appearance of your teeth. Dentists may combine this process with bonding.
Often used to alter the length, shape, or position of teeth, reshaping and contouring can correct:

• Crooked or overlapping teeth
• Chipped and irregular teeth
• Minor bite problems

You may be a good candidate for reshaping and contouring if you have normal, healthy teeth, and there's still adequate bone between your teeth to support them.

 

Braces

Today, people of almost all ages are benefiting from braces. Braces not only improve the look of teeth that are crooked or crowded. They can improve an irregular bite and correct jaw positioning and jaw joint disorders.

Braces are worn to apply light pressure to the teeth and reposition them slowly, usually over the course of one to three years.

To place braces, your dentist or orthodontist bonds brackets made of metal, ceramic, or plastic to your teeth. Then she places arch wires through the brackets, which guide the teeth into their correct positions. Dentists can attach lingual braces to the backs of teeth, hiding them from view.
After your braces are attached -- and after each visit where your dentist tightens your braces -- expect some discomfort for a few days. Also, regular oral hygiene becomes especially important while you are wearing braces.

Risks with braces are minimal. But people with allergies to metal or latex, or those who have periodontal disease, are at greater risk for problems during treatment. Root shortening is also a minor problem for some people.

An alternative for correcting minor spacing problems involves wearing a series of clear, customized appliances called aligners, or invisible braces. Your dentist will reshape and replace them about every two weeks to progressively move your teeth. Unlike traditional braces, aligners can be removed while eating, brushing, and flossing.

Often there are two phases to treatment with braces: wearing braces, and then using a retainer to hold your teeth in their new position. Retainers can be removable or permanently bonded in behind your teeth.
 

Bridges

Sometimes called a fixed partial denture, bridges are used to replace missing teeth with artificial teeth. Bridges can be made of gold, alloys, porcelain, or a combination. Dentists anchor them onto surrounding teeth after preparing them for crowns. Then a false tooth joins to the crowns and the bridge is cemented onto the prepared teeth. Only your dentist can remove a fixed bridge.
The success of your bridge depends upon its foundation. So remember that oral hygiene to keep remaining teeth healthy is particularly important if you wear a bridge.

 

Implants

Implants are one of the more involved and expensive cosmetic dentistry procedures, but are a long-term solution for replacing missing teeth. They are an alternative to bridges -- which use adjacent teeth as anchors -- and to removable dentures, which rest on your gums. An oral and maxillofacial surgeon implants them surgically into the jawbone.
Implants have three parts:

• Titanium metal, which fuses to the jawbone
• An abutment, which fits over the part of the implant that sticks out from the gums
• The crown, which a special restorative dentist creates for a natural, tooth-like appearance

You can get an implant to replace a tooth. Or two or more implants can provide a stable support for replacing several teeth. If you have bone loss from periodontal disease or lost teeth, the surgeon will likely need to first graft bone so the implant has something to secure to.
Having implants requires several steps, including:

1. A comprehensive exam, X-rays, and consultation
2. Surgical implantation of the titanium posts
3. Taking impressions of the upper and lower jaws
4. Making a model for the creation of the dentures or crowns
5. Placement of the crown
6. Follow-up exams with members of your implant team

 

Other Periodontal Plastic Procedures

An array of other procedures can also improve your smile. They include procedures to help with:

• An uneven gum line
• Teeth that look too short or too long
• Exposed roots
• Indentations in your gums or jawbone

If problems like these are a concern for you, ask your dentist about your best options for correcting them and creating a smile that you can be proud of.

 

Dental Health and Veneers

Dental veneers (sometimes called porcelain veneers or dental porcelain laminates) are wafer-thin, custom-made shells of tooth-colored materials designed to cover the front surface of teeth to improve your appearance. These shells are bonded to the front of the teeth changing their color, shape, size, or length.

Dental veneers can be made from porcelain or from resin composite materials. Porcelain veneers resist stains better than resin veneers and better mimic the light reflecting properties of natural teeth. Resin veneers are thinner and require removal of less of the tooth surface before placement. You will need to discuss the best choice of veneer material for you with your dentist.

What Types of Problems Do Dental Veneers Fix?

Veneers are routinely used to fix:

• Teeth that are discolored -- either because of root canal treatment; stains from tetracycline or other drugs, excessive fluoride or other causes; or the presence of large resin fillings that have discolored the tooth
• Teeth that are worn down
• Teeth that are chipped or broken
• Teeth that are misaligned, uneven, or irregularly shaped (for example, have craters or bulges in them)
• Teeth with gaps between them (to close the space between these teeth)

What's the Procedure for Getting a Dental Veneer?

Getting a dental veneer usually requires three trips to the dentist – one for a consultation and two to make and apply the veneers. One tooth or many teeth can simultaneously undergo the veneering process described below.

• Diagnosis and treatment planning. This first step involves your active participation. Explain to your dentist the result that you are trying to achieve. During this appointment, your dentist will examine your teeth to make sure dental veneers are appropriate for you and discuss what the procedure will involve and some of its limitations. He or she also may take X-rays and possibly make impressions of your mouth and teeth.

• Preparation. To prepare a tooth for a veneer, your dentist will remove about 1/2 millimeter of enamel from the tooth surface, which is an amount nearly equal to the thickness of the veneer to be added to the tooth surface. Before trimming off the enamel, you and your dentist will decide the need for a local anesthetic to numb the area. Next, your dentist will make a model or impression of your tooth. This model is sent out to a dental laboratory, which in turn constructs your veneer. It usually takes 1-2 weeks for your dentist to receive the veneers back from the laboratory. For very unsightly teeth, temporary dental veneers can be placed for an additional cost.

• Bonding. Before the dental veneer is permanently cemented to your tooth, your dentist will temporarily place it on your tooth to examine its fit and color. He or she will repeatedly remove and trim the veneer as needed to achieve the proper fit; the veneer color can be adjusted with the shade of cement to be used. Next, to prepare your tooth to receive the veneer, your tooth will be cleaned, polished, and etched -- which roughens the tooth to allow for a strong bonding process. A special cement is applied to the veneer and the veneer is then placed on your tooth. Once properly position on the tooth, your dentist will apply a special light beam to the dental veneer, which activates chemicals in the cement, causing it to harden or cure very quickly. The final steps involve removing any excess cement, evaluating your bite and making any final adjustments in the veneer as necessary. Your dentist may ask you to return for a follow-up visit in a couple of weeks to check how your gums are responding to the presence of your veneer and to once again examine the veneer's placement.

Invisalign v/s Traditional Orthodontics

What is Orthodontics ?

Orthodontics is the diagnosis, prevention and treatment of dental and facial irregularities. This specialty field of dentistry offers correction for people with an irregular or "bad" bite, also known as a malocclusion.

Orthodontic care involves the use of corrective appliances, usually braces. These corrective appliances can be used to:

•    Straighten teeth
  
•    Correct bite irregularities
  
•    Close unsightly gaps
  
•    Bring teeth and lips into proper alignment
  

In young children, orthodontic treatment also may guide proper jaw growth and permanent tooth eruption.

The benefits of orthodontic treatment include a healthier mouth, a more pleasing appearance, and teeth that are more likely to last a lifetime.

I. How do I Know if I Need Orthodontics?

Only your dentist or orthodontist can determine whether you can benefit from orthodontics. Based on diagnostic tools that include a full medical and dental health history, a clinical exam, plaster models of your teeth, and special X-rays and photographs, an orthodontist or dentist can decide whether orthodontics are recommended, and develop a treatment plan that's right for you.

If you have any of the following, you may be a candidate for orthodontic treatment:

• Overbite, sometimes called "buck teeth" — where the upper front teeth lie too far forward (stick out) over the lower teeth
  
• Underbite — a "bulldog" appearance where the lower teeth are too far forward or the upper teeth too far back
  
• Crossbite — when the upper teeth do not come down slightly in front of the lower teeth when biting together normally
  
• Open bite — space between the biting surfaces of the front and/or side teeth when the back teeth bite together
  
• Misplaced midline— when the center of your upper front teeth does not line up with the center of your lower front teeth
  
• Spacing — gaps, or spaces, between the teeth as a result of missing teeth or teeth that do not "fill up" the mouth
  
• Crowding — when there are too many teeth for the dental ridge to accommodate

                      

                   Underbite           Openbite           Crowding

                          

                                   

                               Crossbite           Overbite

II. Invisalign v/s Traditional Orthodontics

The top most advantage of Invisalign treatment is cosmetic: the aligners are completely transparent, therefore far more difficult to detect than traditional wire and bracket braces. This makes the method particularly popular among adults who want to straighten their teeth without the look of traditional metal braces, which are commonly worn by children and adolescents. In addition, the aligners are marketed as being more comfortable than braces. Due to the removable nature of the device, food can be consumed without the encumbrance of metallic braces.

Invisalign may not be appropriate for certain cases of misalignment or complex bite problems. Fixed orthodontic appliances (traditional wire and bracket braces) can be used for complex malocclusions.

Though not as esthetically appealing as clear aligners like Invisalign, today's traditional braces have been improved so they are smaller, less visible and more efficient. These newer wire-and-bracket braces also help to correct misalignment much faster than before.

Only a dentist can determine which treatment option might be right for you. In addition, an orthodontic specialist (orthodontist) can advise you about orthodontic treatment alternatives. If Invisalign is not appropriate, traditional orthodontics can still be used.

III. More on Invisalign Treatment:

Invisalign is a product of Align Technology, Inc. and is used as a treatment for correcting misaligned teeth.

• Invisalign® is the invisible way to straighten your teeth without braces.
  
• Invisalign® uses a series of clear removable aligners to straighten your teeth without metal wires or brackets.
  
• Invisalign® has been proven effective in clinical research and in orthodontic practices
  

Invisalign treatment will consist of a series of aligners that you switch out about every two weeks. Each aligner is individually manufactured with exact calculations to gradually shift your teeth into place. And since your Invisalign system is custom-made for your teeth and your teeth only, with a plan devised by you and your dentist or orthodontist.

The Invisalign procedure requires a specially trained dental professional, like Dr. Uma Patel, who has been certified by Align Technology.

What are the primary benefits of Invisalign?

1. Clear aligners make Invisalign treatment almostinvisible.
   
2. Removable Invisalign aligners mean you can eat and drink whatever you want and alwaysmaintain optimum dental hygiene by brushing and flossing normally.
   
3. Comfortable Invisalign aligners are replacedfrequently so you may forget you’re evenstraightening your teeth and will spend less time in the dentist’s chair having adjustments.  
   

Invisalign is currently approved for adults and teenagers with completely erupted permanent teeth who can faithfully follow the directions for treatment – how long they have to wear the aligners each day, what they can and cannot eat and drink, seeing their dentist for follow-up appointments, etc.

Invisalign Clear-Transparent-Removable braces (tray)

                  

 

What You Can Do About Bad Breath

Worried about bad breath? You're not alone. Forty million Americans suffer from bad breath, or halitosis. Bad breath can get in the way of your social life. It can make you self-conscious and embarrassed. Fortunately, there are simple and effective ways to freshen your breath.

1. Brush and floss more frequently.

 

One of the prime causes of bad breath is plaque, the sticky build-up on teeth that harbors bacteria. Food left between teeth adds to the problem. All of us should brush at least twice a day and floss daily. If you're worried about your breath, brush and floss a little more often.  But don't overdo it. Brushing too aggressively can erode enamel, making your teeth more vulnerable to decay.

2. Scrape your tongue.

 

The coating that normally forms on the tongue can harbor foul-smelling bacteria. To eliminate them, gently brush your tongue with your toothbrush. Some people find that toothbrushes are too big to comfortably reach the back of the tongue. In that case, try a tongue scraper. Tongue scrapers are an essential tool in a proper oral health care routine. They're designed specifically to apply even pressure across the surface of the tongue area, removing bacteria, food debris, and dead cells that brushing alone can’t remove.

3. Avoid foods that sour your breath.

 

Onions and garlic are the prime offenders. "Unfortunately, brushing after you eat onions or garlic doesn't help," says dentist Richard Price, DMD, a spokesperson for the American Dental Association. "The volatile substances they contain make their way into your blood stream and travel to your lungs, where you breathe them out." The only way to avoid the problem is to avoid eating onions and garlic, especially before social or work occasions when you're concerned about your breath.

4. Kick the habit.

 

Bad breath is just one of many reasons not to smoke. Smoking damages gum tissue and stains teeth. It also increases your risk of oral cancer. Over-the-counter nicotine patches can help tame the urge to smoke. If you need a little help, make an appointment to talk to your doctor about prescription medications or smoking cessation programs that can help you give up tobacco for good.

5. Rinse your mouth out.

 

In addition to freshening your breath, anti-bacterial mouthwashes add extra protection by reducing plaque-causing bacteria. After eating, swishing your mouth with plain water also helps freshen your breath by eliminating food particles.

6. Skip after-dinner mints and chew gum instead.

 

Sugary candies promote the growth of bacteria in your mouth and add to bad breath problems. Instead, chew sugarless gum. Gum stimulates saliva, which is the mouth’s natural defense mechanism against plaque acids which cause tooth decay and bad breath.