For some time now, you’ve noticed things about your teeth and gums — your overall smile — that you would like to change. But you’re in unfamiliar territory: you don’t know where to begin.
Here, then, are a few basic cosmetic dentistry questions you should ask yourself and us to get you moving in the right direction.
Am I a candidate for cosmetic dentistry? Invariably, the answer is yes — there’s always a way to enhance your appearance, starting with basic hygiene or whitening. But whether you’re a candidate for a particular procedure will depend on a full examination of your mouth — a “smile analysis” — to assess its current condition and needs, and what cosmetic options would best fit those needs.
Are my expectations realistic? That will first depend on what we find with your smile analysis. It will, however, also include studying the bigger picture — how certain changes might affect not only your smile but your overall facial appearance. Your wants and desires are extremely important in this process, but they should also be balanced with a dose of reality — some things may not be in your best interest health-wise to undertake, or are not in keeping with basic aesthetic principles of beauty.
Will I be able to have an idea beforehand how the changes will look? We’ve come a long way in providing patients ways to preview their new smile before undertaking a procedure. It’s often possible to “see” your proposed smile through computer simulation, or in some cases “test drive” it with temporary (provisional) crowns or veneers. For restorations involving porcelain crowns, it may be possible to take your input and fine-tune the shape and color of the permanent crown before it’s completed.
What will it cost? This will depend on the treatment plan we develop. Some treatments like teeth whitening are relatively inexpensive, while procedures like dental implants or orthodontics are major investments. You should also consider the costs to your time — some treatments require only a single visit, while others may take months or even years to complete. Depending on your financial means and comfort level, cost will need to be factored into the final plan, as well as your expectations.
If you would like more information on cosmetic dentistry, 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 “Cosmetic Dentistry: A Time for a Change.”
The primary goal of dental care is to preserve teeth. But there are circumstances in which removing a tooth, even a relatively healthy one, could prove best in the long run.
A malocclusion (poor bite) related to crowding might fit such a circumstance. Crowding occurs when the size of the jaw is too small for the teeth coming in. With not enough space, some teeth could erupt out of their proper positions. Removing certain teeth frees up space to eventually allow braces or other orthodontic devices to re-align the teeth.
The teeth most frequently removed are the first bicuspids, located between the cuspid (the "eyeteeth" directly under the eyes) and the back teeth, and the second premolar. Removing these won't normally affect appearance or functionality once orthodontic or cosmetic treatments are complete.
Because of the mechanics of jaw development it might be necessary to perform these extractions several years before orthodontic treatment. This could create another potential problem: the time lag could adversely affect bone health.
This is because bone, as living tissue, has a life cycle with cells forming, functioning and then dissolving, and new cells taking their place. When teeth are chewing or in contact with each other they generate force that travels through the tooth roots to the bone and stimulates cell growth at a healthy replacement rate.
But when a tooth is missing, so is this stimulation. This slows the replacement rate and eventually leads to decreased bone volume. Too much bone loss could create obstacles for orthodontic treatment or a future dental implant.
To avoid this, the dentist will often place a bone graft with processed bone mineral within the empty tooth socket right after extraction. The graft serves as a scaffold for bone cells to grow upon. The graft (plus any other added growth boosters) can help maintain a healthy level of bone volume to facilitate future orthodontic or restorative treatments.
Since targeted extraction for orthodontics is time-sensitive, you should have your child's bite evaluated by an orthodontist by age 7 to see if any action is necessary. The earlier a malocclusion is detected, the more likely a more attractive and healthy smile will be the ultimate outcome.
If you would like more information on correcting poor bites, 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 “Tooth Removal for Orthodontic Reasons.”
Philosopher Will Durant wrote, "…We are what we repeatedly do. Excellence, then, is not an act but a habit." While that observation could aptly apply to a great deal of life, it's certainly true of dental health. Strong, healthy teeth and gums are largely the result of good oral habits started in early childhood.
Here are some important dental care habits you'll want to instill in your child, as well as yourself.
Practice and teach daily oral hygiene. Keeping your child's mouth clean helps prevent future dental disease. It should begin before teeth appear by wiping your baby's gums with a clean, wet cloth after every feeding to keep decay-causing bacteria from growing. Once teeth appear, switch to brushing with just a smear of toothpaste until age 2, when you can increase to a pea-sized amount. As your child matures, be sure to teach them to brush and floss for themselves, especially by modeling the behavior for them.
Begin dental visits early. Besides daily hygiene, regular professional dental care is one of the best habits for keeping healthy teeth and gums. Plan to begin your child's dental visits by age 1 when some of their teeth may have already come in. And by beginning early, it's more likely your child will view dental visits as a routine part of life, a habit they'll more likely continue into adulthood.
Keep your oral bacteria to yourself. Many strains of bacteria, especially harmful ones, don't occur spontaneously in a child's mouth. They come from the outside environment, most often from their parents or caregivers. To avoid transmitting disease-causing bacteria from you to your baby don't share eating utensils, don't lick a pacifier to clean it, and avoid kissing infants (whose immune systems are immature) on the mouth.
Encourage your teenager to avoid bad habits. Hopefully when your children reach adolescence, they've already developed good oral habits. But there are some bad habits you should also help your teen avoid. While piercings are a popular expression among this age group, teens should avoid tongue and lip bolts and other piercings that could damage teeth. A tobacco habit can also have negative consequences for dental health including increased decay or gum disease risk and cancer.
If you would like more information on dental care for children, 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 “Dentistry & Oral Health for Children.”
Transforming your smile with veneers, crowns or other restorations could be a life-changing decision. To help make that change a successful one, it’s possible to fit you with a kind of temporary restoration that allows you to “try out” your new look and even make modifications before you receive the permanent one.
Referred to as a prototype or provisional restoration, it’s different from other temporary, “one-size-fits-all” restorations that serve mainly a functional purpose until the permanent restoration is ready. By contrast, a provisional restoration is a customized “blueprint” of the final restoration so you can better communicate with your dentist to get what you want.
Provisional restorations are test runs — they help both patient and dentist evaluate three key areas critical to ultimate success:
Your Smile — with provisional restorations you can get input from others (and from what you see in the mirror) regarding tooth coloring and how it blends with other teeth, the attractiveness of the crown shapes, and whether the teeth appear proportional and balanced with the gums.
Your Facial Appearance — changing the look of teeth may also alter overall facial appearance. Do the new teeth fit well with the lips and other facial features? Do they change the smile line, and does it appear harmonious with the rest of the face?
Your Mouth Function — There’s more to teeth, of course, than how they look. Teeth are essential for biting, chewing and speaking. So, can you perform these tasks comfortably with the provisional restoration?
While you’re wearing the provisional restoration, we’ll discuss these and other areas, what might look or work better, or if you feel we’ve hit the mark just right. We can then modify or verify our specifications with the dental lab creating the final restoration.
Of course, a provisional restoration will allow you to function normally like other temporary options. But their custom detail serves a higher purpose — to help us improve your future smile.
If you would like more information on customized temporary restorations, 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 “Concepts in Temporary Restorations.”
Porcelain veneers are one of the best ways to transform your teeth’s appearance with only a small amount of tooth preparation. But even that small amount could leave a veneered tooth permanently altered.
As the name implies, veneers are thin layers of custom-designed porcelain bonded to the outside of a tooth to cover defects. They’re usually ideal for minor chipping, staining or even slight tooth misalignments. But although they’re thin—often just a millimeter or so in thickness—they can still make a tooth appear or feel bulky.
To reduce this extra width, we usually need to remove some of the tooth’s surface enamel. Since enamel doesn’t replenish itself, this alteration could mean the tooth will require a restoration from then on.
But now, you may be able to take advantage of new advances in this popular restoration: No-Prep or Minimal Prep veneers that involve little to no tooth alteration. In most cases they’re simply bonded to the teeth with only slight enamel reshaping.
Because of their ultra-thinness, No-Prep veneers (usually between 0.3 to 0.5 mm, as thin as a contact lens) are bonded directly to teeth that are practically untouched beforehand. A Minimal Prep veneer usually requires only enamel reshaping with an abrasive tool before it’s placed. And unlike traditional veneers, they can often be removed if needed to return the teeth to their original form without another restoration.
These new veneers are best for people with small teeth, often from wear due to teeth grinding, narrow smiles (the side teeth aren’t visible while smiling), or slightly misshapen teeth like underdeveloped teeth that can appear peg-shaped. But people with oversized teeth, some malocclusions (bad bites) or similar dental situations may still require enamel removal to avoid bulkiness even with ultra-thin veneers.
If you don’t have those kinds of issues and your teeth are reasonably healthy, we can apply No-Prep or Minimal Prep veneers in as few as two appointments. The result could be life-changing as you gain a new smile you’re more than happy to share.
If you would like more information on no-prep veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “No-Prep Porcelain Veneers.”
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