Posts for: August, 2013
Today's cosmetic dentist can bring amazing transformations to their patient's smiles. That's because we now have a versatile array of materials and processes that precisely replicate the appearance of natural teeth.
Two of the most useful are porcelain veneers and crowns. Although different in structure and function, veneers and crowns both utilize a material known as dental porcelain, a ceramic material that can be shaped to resemble an individual patient's natural tooth shape, with the same color, hue saturation and translucence as the original or surrounding teeth.
As the name implies, veneers are a thin layer of dental porcelain that adheres to the outer surface of a tooth, essentially as a replacement for enamel. They solve a number of esthetic issues patients have with their teeth, especially those in front: poor color, shape and contours; broken teeth; poor tooth position; and staining that can't be removed with conventional bleaching. They most often require minimal tooth preparation, as only 1 mm or less of tooth enamel needs to be removed. Occasionally, no tooth reduction is required.
However, they are not a good solution where there is not an adequate amount of tooth structure to work with. In this case, a crown may be the best choice. A crown (or cap) covers the remaining tooth structure completely, reinforcing the remaining tooth structure 360°. This is an excellent choice for patients who have lost a large amount of tooth structure due to decay, trauma or grinding habits that have eroded the enamel.
To determine if you are a true candidate for either of these applications you should undergo a smile analysis in our office. During this process it's even possible to create a diagnostic mock-up — a “trial smile,” if you will — with temporary tooth-colored materials applied to your teeth and then photographed for your review.
The smile analysis helps us recommend the best solution for you and in turn will help you make an informed choice on the right application for you. Although either option may not be feasible in all situations, they may just be the right choice to change your smile for the better.
If you would like more information on how porcelain veneers and crowns can help transform your smile, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Porcelain Crowns and Veneers.”
Orthodontic treatment (commonly known as braces) can be a lengthy process to re-align your teeth to a more functional and aesthetic position. Once the orthodontic devices are removed, however, the treatment isn't finished. Wearing a retainer is the final step to ensuring that the re-alignment doesn't eventually fail. It's designed to do just what its name implies — to “retain” the teeth's new position and prevent a relapse to the old.
This can happen because of the way teeth fit into the jaw bone. The teeth are joined to the bone by the periodontal ligament, which works somewhat like a hammock: the ligament's fibers act like threads that fit into the tooth on one side and into the bone on the other, and hold the teeth in place.
As living tissue, the ligament's cell structure is dynamic and can adapt to the gentle pressure applied by an orthodontic device. However, once this pressure subsides after the device is removed “muscle memory” can cause the ligament to resist the new position and pull the teeth back to their original setting. The retainer helps hold the teeth in the new position while the bone and ligament continue to mature and stabilize around the teeth.
There are two basic types of retainers; the one recommended for you will depend on your age and the extent of your orthodontic treatment. One type is a removable device that is typically worn around the clock initially, but may eventually only need to be worn at night or for even a lesser interval of time. The other type is attached permanently behind the teeth and can only be removed by an orthodontist. Permanent retainers have the benefit of not being as visible as the removable type, and there's no bother with putting them in and taking them out.
You may consider wearing a retainer a nuisance especially after months of orthodontic treatment. But consider it the last lap in a long race — only by finishing can you achieve that winning smile.
If you would like more information on the use of a retainer, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Why Orthodontic Retainers?”
There are a number of materials and techniques available in cosmetic dentistry that help us improve our patients' smiles. Porcelain veneers stand out as one of the most popular and least interventional of these options.
As the name implies, a veneer is a thin layer of dental restorative material that covers the original tooth surface. Veneers don't require an extensive amount of tooth preparation or removal of sound tooth structure, as with a crown or bridge.
Veneers are made of dental porcelain, a material compatible with living tissue and with a very life-like appearance. The dentist as artist can fashion the porcelain to precisely imitate an individual's natural teeth, including the natural color and hue of surrounding teeth.
Are porcelain veneers an option for you? Only a smile analysis in our office can determine that. Your teeth must be in a somewhat normal position. The teeth in question must have a sufficient amount of remaining tooth structure to support veneers. And you must have symmetrical gum contours that will allow for proper framing of the teeth, which will enhance the final cosmetic result.
If your current dental health meets these criteria, then porcelain veneers could help correct spaces between teeth that aren't too wide, improve poor color, or address poor shape, contours or minor bite problems. Veneers, however, do have their limitations. They aren't effective if you have poor tooth position, if the root positions are widely out of line, or if you have a poor profile. Some form of orthodontics may be needed initially for these situations.
That being said, porcelain veneers are an excellent long-term option in the right situation. Depending on your individual circumstance and how you care for your teeth, a veneer application can last for several years, or if they come loose or become chipped they can be repaired in most cases. The material is strong enough to withstand normal pressures exerted during chewing or biting, as long as you avoid activities like opening nutshells with your teeth or chewing on very hard candy.
Overall, porcelain veneers can give your smile a whole new look with little impact on your remaining tooth structure.
If you would like more information on porcelain veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Smile Design Enhanced With Porcelain Veneers.”
The “Hollywood Smile” — dazzlingly white — is associated in our society with youth, health and vitality. Achieving that smile through either professional or home whitening applications has become very popular.
Teeth become discolored or dull for a number of reasons. It can be something intrinsic with the teeth — changes in enamel or dental structure during development, inherited disorders, heavy exposure to fluoride or tetracycline, or changes in mineral structure or wear due to aging. It can also be extrinsic, resulting from environmental or lifestyle causes. Eating foods with tannins (red wine, coffee or tea) or carotene pigments found in plant foods like oranges or carrots, or using tobacco may all cause staining.
Most modern applications involve an oxidizing chemical (usually hydrogen peroxide) that bleaches the teeth. Professional applications in a dentist's office use high concentrations of hydrogen peroxide (usually 35 to 45%) applied directly to the teeth with control measures to protect the lips and gums. This type of application can lighten the color of teeth up to ten shades.
There are a number of home options too: whitening strips, “Paint on” or “Brush on” whitening, and even whitening gum. We can also provide you with a “Take home” kit that resembles the professional application but is generally less expensive. Although all these home applications are generally safe and effective, they typically take longer for results (several repeated days as opposed to about one hour for an office application), and not always to the same level of lightness as the professional.
Just about anyone can be a candidate for a whitening application. However, if you have thinner than normal dentin and more porous enamel, or suffer from gum recession or enamel loss, then whitening may increase tooth sensitivity. And, whitening is not a permanent solution: the brightness will fade over time, usually within a year. You can slow the fading by avoiding foods and habits that contribute to staining. It's also possible to touch up the initial whitening once or twice a year to extend the life of your new, bright smile.
If you would like more information on teeth whitening, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Teeth Whitening.”