Designing a better smile sometimes requires a change in the size, shape, or color of your teeth. Porcelain laminate veneers (thin layers of dental ceramic material) enhance your appearance by replacing the natural enamel on the outside of your teeth. A veneer is physically bonded to the surface of a tooth, in essence, becoming part of it.
Traditionally, a small amount of the natural tooth enamel is drilled away to allow room for the veneer. But today, in some circumstances, it is possible to use an approach where enamel reduction or preparation is not necessary because the veneers can be bonded directly onto the tooth's natural surface. These are called “Prepless” or “No-prep” veneers, and are used to create aesthetically pleasing and natural looking restorations. An advantage of the prepless procedure is that the process is reversible so that you can give your new smile a “test drive.”
You may be a good subject for Prepless veneers if:
- Your smile is narrow because the teeth in the sides of your smile are positioned inward and do not show from a frontal view.
- There is spacing between your teeth, and the teeth appear too small.
- You have a fairly common genetic condition in which one or both of the teeth directly next to the two upper front teeth are very small and peg-shaped.
- There is an imbalance between the size of your lips and teeth (large lips and small teeth), which are not in proportion to show off your best smile.
Prepless veneers are probably not for you if:
- Your teeth are not aligned properly in your bite.
- Your teeth are very crowded, resulting in poor facial profile.
- Your teeth are already relatively large or positioned forward.
In these cases you may need to have some form of orthodontic treatment to move your teeth into better position. Sometimes veneers can be used to create an illusion of proper tooth alignment, but some amount of tooth reduction may be required.
We can assess whether prepless veneers are right for you. There is no substitute for an expert dentist's talent and expertise with the various cosmetic techniques available today. These skills combined with a thorough diagnostic evaluation, and a clear understanding of your goals, are the keys to providing you with a successful and beautiful smile.
Contact us today to schedule an appointment or to discuss your questions about cosmetic dentistry. You can also learn more about prepless veneers by reading the Dear Doctor magazine article “Porcelain Veneers Without the Drill.”
The goal of restorative dentistry is to return the teeth to full form (shape) and function. For years, a key tool for achieving this goal has been through the use of metal amalgams (silver looking dental fillings). However, this technique does have some disadvantages. One is the fact that they can involve removal of healthy tooth structure to retain them. Too much “undercutting” can undermine and weaken a tooth resulting in less resistance to biting forces possibly leading to fatigue fractures and cracked tooth syndrome. Another approach is call “biomimetic” which literally means mimicking life. This approach to dentistry is made possible through the structured use of tooth-like materials such as composite resins. Scientific studies and clinical experience have validated their use as both safe and predictable.
By mimicking life, we rely upon our delicate balance of artistry, experience and expertise to provide you with properly restored teeth that function and wear normally, while appearing indistinguishable from natural teeth. Dental composite are now the most commonly used materials for tooth-colored adhesive restorations and have properties similar to a natural tooth's enamel and dentin. They consist of resin which are plastic and fillers made of silica (a form of glass). The fillers give the composites wear resistance and translucency (see through properties). However, most of the properties of enamel are also mimicked quite well by dental porcelains. Porcelains are a form of ceramic, that are formed by the action of heat. Dental porcelains come in all colors and shades so we can easily and perfectly match the color of virtually any natural tooth. As for longevity, porcelain is typically your best option because it is the closest option in mimicking a natural tooth.
To learn more on this subject, you can continue reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.” Or contact us today to schedule an appointment to discuss your specific questions.
When it comes to restoring both the beauty and functionality of a smile, two of the most commonly used techniques are porcelain crowns and veneers. Why? They consistently deliver beautiful, natural-looking results that are permanent and require very little maintenance. And while they have many things in common, they also have just as many differences.
Here are some facts that apply to both porcelain veneers and crowns:
- Both enable changes to a tooth's color and shape.
- Dental laboratory technicians use precise molds made by our office to hand-craft porcelain veneers and crowns.
- Both are made using high-quality dental porcelain.
- Neither respond to tooth whitening products — the color of the veneer or crown remains the same color as the day it was placed.
- Neither procedure is reversible once completed.
Here are some of their differences:
- Crowns are used to replace a larger amount of tooth structure while veneers are thin shells that are placed over the front surface of teeth.
- Veneers require much less tooth preparation (reduction by drilling) than crowns.
- Crowns allow for greater change of tooth shape, while veneers allow for more minor changes.
- Crowns are generally used to restore teeth that have lost tooth structure from decay or trauma.
- Veneers are generally used where teeth are structurally healthy and intact, but color and shape change are required.
- Veneers are used mostly for teeth that are visible when smiling, while crowns can be used to restore virtually any tooth.
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What does it mean when your dental hygienist recommends root planing? To put it simply, root planing is a method of cleaning the roots of your teeth in order to avoid periodontal (“peri” – around, “odont” – tooth) disease.
Periodontal disease happens when dental plaque, a biofilm of bacteria, is not regularly removed and begins to build up on teeth near the gum line. The bacteria cause inflammation, and this in turn causes the gum tissue to detach from the teeth. The widening spaces between the gum tissue and the teeth, called pockets, are environments in which bacteria can continue to collect and cause further inflammation and infection. Ultimately, this can lead to infection, bone loss, and loss of teeth.
Root planing is a technique designed to avoid such dire results. The bacteria, along with products they manufacture as part of their metabolism, can become ingrained in the surfaces of the tooth's root (the part of the tooth that is below the enamel). These bacterial products will form hard deposits called tartar or calculus.
Deep Cleaning Your Teeth
Of course, the best idea is to brush and floss away the plaque before the bacteria begin to build up on your teeth. If this is not done and pockets begin to form, the bacteria and toxic products are more difficult to remove in order to deep clean your teeth.
The first step is scaling. My hygienist or I will remove superficial collections of calculus. If material still remains within deep pockets, root planing is the next step. It involves actually planing the surface of the root, smoothing the surface free of calculus, bacteria, and toxins that have ingrained into the root surfaces.
Root planing is most often done under local anesthesia so that you remain comfortable while the cleaning procedures are done. The initial cleaning may be done by an ultrasonic instrument that vibrates particles off the root surfaces and flushes the pockets with water. Small hand instruments called curettes are used to finish the process. Antibacterial medication may then be used to help clear away infection from the pockets. Sometimes you may experience some tooth sensitivity to hot and cold after the root planing. If needed, this can be treated by applying fluoride to the root surfaces.
Depending on the extent of your gum disease, it may not be possible to remove all the deposits at one appointment, and it may be necessary to have multiple appointments over a few weeks to remove the remaining deposits. Often after three to four weeks the inflamed tissues have healed, leaving you with healthy gums once again.
Tooth sensitivity is an issue that can range from a slight twinge at times to downright excruciating pain. However, before we continue, understanding the cause of tooth sensitivity is helpful to both relieving and treating it.
Tooth enamel is inert in that it has no nerve supply and thus it protects the teeth from temperature and pressure changes — the main cause of sensitivity. Once it is compromised, worn thin, or exposed due to gum recession, it leaves the delicate nerve fibers within the dentin vulnerable to touch, acid, and temperature change. These nerve fibers most often grab your attention when they come in contact with heat, cold, or a “double whammy” combination of both cold and sweet. They also become sensitive to touch — even the bristles of a soft toothbrush can irritate exposed dentin.
As for the causes of tooth sensitivity, one common cause we see is aggressive brushing. Yes, too much brushing can be bad for you! To be more specific, excessive, improper brushing with a sawing back and forth motion can erode the gum tissues, expose, wear, and even groove the dentin. Another cause for sensitivity can be from the destructive process of tooth decay that eats through the enamel and into the dentin.
If you are experiencing tooth sensitivity or have questions about this condition, please contact us to schedule an appointment. Or you can learn more about this topic by reading the Dear Doctor magazine article “Sensitive Teeth.”
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