On Cosmetic Dentistry

by Carey O’Rielly, DDS

Cosmetic dentistry is a broad term for the type of dental work that enables you to have a dazzling smile that you feel great about. Millions have witnessed this potential on Reality TV “Cinderella stories”. Shows like The Swan, Extreme Makeover and America’s Next Top Model have demonstrated how cosmetic dentistry can create positive, even transformational changes in appearance. Technical advances now available combined with the recent media attention have popularized cosmetic dentistry to an unprecedented degree.

Viewers of these shows have also seen the willingness needed on the part of subjects to undergo the various cosmetic procedures. Fortunately some of the processes, such as tooth whitening and veneer application, have been simplified to a great extent. Tooth whitening, the process by which teeth are made several shades lighter than their natural color, can be done using customized trays that are molded to fit your mouth.

The trays are filled with a bleaching gel and worn whenever convenient. The length of time for this method of whitening teeth depends on the strength of the bleaching gel, the frequency and consistency with which the trays are worn and the degree of lightness desired. It can take from 2 – 4 weeks and costs vary according to the dental office. Teeth whitening is in demand because it not only removes stain and brightens smiles, it also contributes to a more youthful appearance.

Another method of teeth whitening that has become popular uses a plasma light focused on the teeth after a special solution has been applied. This procedure takes approximately an hour and the teeth can be lightened three shades or more. It generally costs around $500 depending on the dental office. Whether the trays or plasma light is used, tooth sensitivity can be a factor so it’s important to have your dentist’s recommendation on the tooth whitening method right for you.

A veneer is a thin shell placed over the body of a tooth that completely alters its appearance and can be customized in both color and shape. Veneers used to require a substantial removal of tooth structure in order to achieve the desired outcome. A very thin veneer, almost like a glove, is molded to the tooth and bonded. This cosmetic process is quick, painless and seems almost magical to the patients who qualify when they see how the beauty of their smile is enhanced.

Laser dental surgery has become popular as a means to do some simple cosmetic procedures, like the recontouring of “gummy” smiles. Cosmetic contouring of the gums is done with a soft tissue laser that can also be used to treat and heal gums using light energy. Healthy pink gums are an important feature of a beautiful smile that laser dentistry procedures can enhance. Lasers can also reduce post operative pain and discomfort after restorative work for dental crowns and bridges.

Another advance in cosmetic dentistry uses bonded dentistry to replace any metal filling with tooth-colored ones that are natural and durable. This requires two-steps in which the filling is removed and an impression is taken and sent to a dental lab. The patient is given a temporary filling until they return for final placement. The inlay or onlay is then bonded to the tooth which in some cases can actually make the tooth stronger. The nerves of the tooth are sealed and protected, thus preventing root canals in many cases.

Another advantage to this type of cosmetic work is that inlays and onlays conserve tooth structure. This allows an intermediate step between a filling and a crown or cap, should that ever be necessary. It is also less costly. Inlays and onlays can range from $695 to $900 while crowns can cost anywhere from $1,000 to $1200 in a typical cosmetic practice. When the old metal filling is small, it can usually be replaced by a less expensive, one-step composite filling.

It is important to replace metal fillings, also known as amalgams, using a protocol that minimizes the patient’s exposure during removal. One component of this, called a rubber dam, isolates the tooth and protects the mouth. Patients may also be given protective eyewear and a nosepiece that allows them to breathe purified air during the procedure. Auxiliary filtration should also be in place to eliminate gaseous metals produced by drilling during removal. We have also installed additional filtration to keep metal waste out of the water lines and other dentists throughout the country have begun to follow suit.

From the point of view of conservative dentistry, it’s also helpful to realize that metal fillings more than twenty years old can cause micro-fractures in the surrounding tooth. This is partly due to the minute contraction and expansion of the tooth caused by temperature changes such as hot coffee or ice cream. The abrasion of the metal against the tooth is another factor that can cause tiny fissures in the tooth over time. Gradually these pressures produce hairline fractures that can grow into cracks and eventually break the tooth.

Given the structural reasons to replace metal fillings as well as the fact that they can discolor and create unsightly teeth, the new alternatives make cosmetic repair of any tooth that does not look natural and beautiful more attractive than ever. Replacement of broken or missing teeth can also be achieved by dental implants, another process which has gained in increasing popularity by providing cosmetic solutions not possible before. A post made of pure titanium is placed in the bone and an implant crown is attached to complete the restoration. The cost of placing the implant is generally in the range of $1800, while the implant crown is around $1500. Dental offices often have financing plans available to help with the cost of this type of treatment.

Don’t you deserve a healthier, more appealing smile? Find out today how your dentist can help. It may be safe to say that, given the new options and techniques at your dentist’s disposal, any work you have done on your teeth can be considered cosmetic dentistry. Procedures like veneers, dental implants and metal removal are bringing the options offered by cosmetic dentistry to a whole new level.

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