DentalTreatments

Cosmetic Dentistry

Cosmetic Dentistry / Smile Designing / Teeth Whitening

What is Cosmetic or esthetic dentistry?

In very broad terms, any treatment that will improve the way your teeth or gums appear enhancing your smile is cosmetic dental treatment. You do not have to settle with stained, broken, irregularly placed or misshaped teeth or gums which are dark and pigmented or show a lot when you smile. With many advances in dentistry there may be some procedures that can help improve your smile.


Irregularly placed and misshaped front teeth	After cosmetic smile designing

How do I know if I require cosmetic dental treatment?

A smile plays a very important role in how we perceive ourselves, as well as in the impression that we make on the people around us. If you think your smile is flawed then it will lower your self esteem and affect the way you meet people. Evaluate the following statements:

You do not like the shape or color or placement of your teeth
You show too few or too many teeth while smiling
You tend to cover your face while laughing
Your lips stretch and hide some tooth/teeth while smiling
You feel others have better smile than yours
Your smile appears better only from certain angles in photographs
You do not like the way your gums appear while smiling

If you are able to identify with any of these statements then probably you are dissatisfied with your smile. Consult your dentist as some cosmetic treatment may be able to help you overcome these problems.

I think I need cosmetic treatment to improve my smile. How do I analyze my smile?

Once you are convinced that your smile can improve, try and self analyze your smile with the help of the following questionnaire. This will also help in effectively communicating your concerns to your dentist.

Check if:

the tips of your upper front teeth do not show or show too much when your lips are parted
your upper front two teeth are too long or same size or shorter than the neighboring teeth
your upper front two teeth are too wide or have space between them
some of your teeth are chipped, cracked or worn out
your lower front teeth are not even and straight
your teeth are irregularly placed or they stick out or protrude
all your teeth are not of similar color or some of them are discolored, or have white or brown stains
your fillings and caps do not appear natural
the gums are not pink or are swollen and red
the gums show too much while smiling or they appear uneven in shape
your mouth has cavities or gum disease that can produce foul odour

If you are able to identify with any of these statements then some cosmetic dental treatment may be able to help you overcome these problems.

What is whitening of teeth?

Whitening or bleaching is a procedure that brightens teeth that are discolored or stained or are darkened due to injury. It is an extremely safe and economical procedure and can be performed at any age. Whitening can be done “at home” or “in office” or more commonly, a combination of both.

“At home” procedure involves filling a customized soft transparent tray with a whitening solution or gel and wearing it for a few hours each day or overnight. The treatment duration will depend upon the nature and intensity of discoloration, but the results should be noticeable after just a few days of application.

During an “In office” procedure, a chemical gel is applied to the teeth by the doctor after adequately protecting the surrounding gums with a barrier. The gel is self activating or may be activated by light or heat or a combination of both. Up to 3 -4 visits may be necessary for the teeth to appear whiter, with each visit taking under an hour.

Before

After

Teeth Whitening with 1 Hour Teeth Whitening System

The disadvantages of teeth whitening are

Teeth may not whiten as per patient’s expectations
May induce mild temporary sensitivity to hot and cold foods and occasional moderate discomfort in a few individuals
“In office” whitening may not be enough and may have to be followed by “at home” whitening procedure
Treatment may extend to a few months of “at home” applications for desired results.

What is bonding and where are dental composite resins used?

Bonding is a procedure in which tooth colored composite resin materials are applied to the tooth surfaces. Dental resins are “photo-sensitive” and harden when exposed to a special light. Bonding results in composite resin adhering to the tooth surface making it a strong and enduring bond. To match your teeth, various color resins and pigments are carefully intermixed, sculpted and polished so that the bonded tooth will look completely natural.

These resins are placed as a coating over discolorations or can repair chips cracks or fractured teeth surfaces. They help in masking mild irregularities in placement of front teeth. They are also useful in filling gaps between teeth. Newer resin materials are strong enough to withstand chewing forces to be placed as fillings in back teeth.

Cavity on molar …filled with a composite resin

Composite resins will have to be periodically replaced because they can chip or crack and turn darker over a period of time.

What are laminates or veneers?

Laminates or Ceramic veneers are thin ceramic or resin shells fabricated in a dental laboratory from impression or measurement provided by a dental office. Veneers are useful in covering gaps or stained teeth. They are frequently used for masking poorly shaped or slightly crooked teeth. Laminates takes at least 2 appointments and typically costs more than bonding procedures. A major advantage is proportional accuracy that they provide resulting in a pleasant and symmetry in smile. Ceramics are far stronger and denser than composites resulting in restorations that do not discolor, or chip as easily as the composite resins.

Teeth prepared to receive ceramic veneers

4 ceramic veneers in place

What is a crown or a cap? I have a fractured ceramic crown in my mouth. What are my options?

A dental crown is a prosthesis fabricated in a dental laboratory from impression or measurement provided by a dental office. It covers a carefully prepared tooth which is fractured, extensively decayed or has undergone root canal treatment and effectively protects the tooth from further damage. Crown can be ceramic fused to a precious or non-precious metal or a ceramic crown without any metal. The newer ceramic crowns are extremely esthetic and can look natural due to absence of any metal. The choice will be based on the stresses that the crown is subject to and esthetic needs.

Extensively decayed upper front teeth After treatment and ceramic crown placement

All ceramics, being crystalline in nature, can fracture. Therefore, if a crown fractures when in use, it is often practical to smoothen out the fractured margins of the crown or repair it with bonding and overlaying of composite resin. However in case of a large part of crown having chipped off, it is advisable to replace it with a new crown.

What are my treatment options for stained teeth?

Stained teeth can be due to superficial surface deposits and stains. These can be easily removed with cleaning procedure. Teeth can also be darkened due to decay. Such cavities can be filled by process of bonding with composite resins resulting in natural looking restorations.

Teeth stained due to cavities… … filled with composite resin

Stains may be actually a part of the tooth structure. These include white, yellow or brownish patches on tooth enamel. These may be due to faulty formation of enamel arising out of high intake of fluoride in water, administration of certain antibiotics or certain diseases, resulting in interruption of normal enamel formation before or after birth. Stains may also develop due to injury or around large fillings. Root canaled or a non-vital tooth may also appear dark and stained. Stains may also develop due to injury or around large fillings or around old caps.

Stained front tooth due to old cap With a new ceramic without metal cap

Such teeth will require one of the following treatments depending upon the nature and severity of stains:

Polishing with abrasive substances to rub away the superficial stains
Whitening or bleaching to perceptibly reduce or remove the stains
Bonding to fill the cavities after removing stained tooth surfaces or cover the stained areas with composite resins
Laminate veneers to esthetically cover the stained areas
Crowning or capping the stained, usually root-canaled teeth after carefully reshaping them

I have spaces between my front teeth. Can it be corrected?

Bonding is an ideal procedure to fill in small spaces between front teeth. Bonding is a procedure in which tooth colored composite resin materials are applied to the tooth surfaces. Bonding results in composite resin adhering to the tooth surface making it a strong and enduring bond. To match your teeth, various color resins and pigments are carefully intermixed, sculpted and polished so that the bonded tooth will look completely natural.

Your doctor may advice a ceramic laminate or veneer to cover this space. Laminates or Ceramic veneers are thin ceramic or resin shells fabricated in a dental laboratory from impression or measurement provided by a dental office. Laminates takes at least 2 appointments and typically costs more than bonding procedures. A major advantage is proportional accuracy that they provide resulting in a pleasant and symmetry in smile. Ceramics are far stronger and denser than composites resulting in restorations that do not discolor, or chip as easily as the composite resins.

Your teeth will appear extremely broad and unsightly if a large space is closed with bonding or laminates. In such cases smile designing is a better choice. In this the available space across your front teeth is accurately calculated. On the basis of these calculations, principles of natural proportions and the extent of visibility of your teeth while smiling, you will be advised bonding, crowns or laminate veneers on your front two to ten teeth.

I have a broken front tooth. What are my treatment options?

Cosmetic contouring is an ideal treatment option for minor chips or cracks on front teeth. The procedure involved is to smooth-out the rough surfaces and reshape the tooth / teeth. In some situations contouring may not be ideal as it may damage the smile line due to shortening of the chipped tooth and grinding the neighboring teeth to match it. In such situations bonding is a better alternative.

Bonding is a procedure in which tooth colored composite resin materials are applied to the tooth surfaces. Bonding results in composite resin adhering to the tooth surface making it a strong and enduring bond. To match your teeth, various color resins and pigments are carefully intermixed, sculpted and polished so that the bonded tooth will look completely natural.

Your doctor may advice a ceramic laminate or veneer to cover a broken tooth. Laminates or Ceramic veneers are thin ceramic or resin shells fabricated in a dental laboratory from impression or measurement provided by a dental office. Laminates takes at least 2 appointments and typically costs more than bonding procedures. A major advantage is proportional accuracy that they provide resulting in a pleasant and symmetry in smile. Ceramics are far stronger and denser than composites resulting in restorations that do not discolor, or chip as easily as the composite resins.

If a large part of tooth has chipped off, or if it is a back tooth subject to high forces due to chewing, then the best option would be a crown. Crown can be ceramic fused to a precious or non-precious metal or a ceramic crown without any metal. The newer ceramic crowns are extremely esthetic and can look natural due to absence of any metal. The choice will be based on the stresses that the crown is subject to and esthetic needs.

All ceramics, being crystalline in nature, can fracture. It is often practical to smoothen out the fractured margins of the crown or repair it with bonding and overlaying of composite resin. However in case of a large part of crown having chipped off, it is advisable to replace it with a new crown.

I have irregularly placed teeth. Can cosmetic dentistry offer some solution to this?

Ideal solution to this problem is to move the irregularly placed teeth and bring them in correct alignment by treatment of braces. This specialty of dentistry is called orthodontia. With modern material science and understanding of how teeth move when forces are applied, it is possible to undergo orthodontic correction of irregularly placed teeth even in adulthood. The treatment options described below should be considered only if orthodontic treatment is ruled out for any reasons.

Cosmetic contouring is a treatment option for minor crowding of front teeth. The procedure involved is to smooth-out the rough surfaces and reshape the tooth / teeth. In moderate to severe crowding of teeth contouring may not be ideal. In such situations bonding is a better alternative.

Bonding is a procedure in which tooth colored composite resin materials are applied to the tooth surfaces after trimming and shaping the irregularly placed teeth. Bonding results in composite resin adhering to the tooth surface making it a strong and enduring bond. To match your teeth, various color resins and pigments are carefully intermixed, sculpted and polished so that the bonded tooth will look completely natural.

Your doctor may advice a ceramic laminate or veneer in case of severe irregularity of teeth. Laminates or Ceramic veneers are thin ceramic or resin shells fabricated in a dental laboratory from impression or measurement provided by a dental office.

Irregularly placed upper front teeth After placement of ceramic veneers

Laminates takes at least 2 appointments and typically costs more than bonding procedures. A major advantage is proportional accuracy that they provide resulting in a pleasant and symmetry in smile. Ceramics are far stronger and denser than composites resulting in restorations that do not chip or discolor as easily as the composite resins. Some of your teeth may also receive crowns. They can be ceramic fused to a precious or non-precious metal or a ceramic crown without any metal. The newer ceramic crowns are extremely esthetic and can look natural due to absence of any metal.