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Cosmetic Dentistry FAQ

Q	Most of my teeth are bunched too near the front of my mouth. Is there a way to get rid of that crowded look?
A.	With removable orthodontics, cosmetic contouring, and/or bonding and veneering, teeth can be reshaped and polished for long-lasting results: a stronger, less crowded-looking appearance.
Q.	My back teeth have a lot of silver and gold. Is there a less obvious way to fill cavities?
A.	New advances in tooth-colored porcelain and composite materials not only allow fillings to go unnoticed, but are stronger and more wear-resistant than silver and gold.
Q.	There's a big gap between my two front teeth. Can that be changed?
A.	Yes. Bonded veneers can close gaps and help create the smile you desire. Bonded resins generally require one office visit, while porcelain veneering takes two. Bonded veneers, along with good oral hygiene and a healthy lifestyle, are effective ways to enhance a smile. We can explain the various techniques and help determine which is the best suited to your specific needs.
Q.	How can I make my discolored teeth whiter?
A.	Tooth whitening, the process for lightening discolored teeth, can be accomplished in the dentist's office or with dentist-supervised, at-home systems. Teeth can be whitened to the desired shade over several office visits. At-home systems should be individually fitted by a cosmetic dentist.
Q.	I don’t like my teeth or my smile –what can I do?
A.	A wide variety of options are available to improve how your teeth work and the way your smile looks. Check out our “Smile Gallery”section to see how other patients with similar problems were helped, then look for a dentist near you to get started on your new smile.
Q.	How much does it cost to get a great smile?
A.	Like most services, cost will vary based on the time required and the difficulty of the procedures. Generally, improving a smile will require a combination of treatment options such as bleaching, reshaping gums and using bonded materials (resin or porcelain) to improve the appearance of teeth. A great way to start is having a consultation with a dentist to determine the ways that you can reach your goals. Improving your smile is an investment in you.
Q.	What are some of the benefits of cosmetic dentistry?
A.	A great smile should improve your self-confidence, which can have a positive impact on the social and professional aspects of your life. Cosmetic dentistry is not just about pretty smiles though. New techniques and materials are available for back teeth as well as the ones you see when you smile. Now your mouth can look great, get healthy and function better at the same time. Ask an IDA dentist what's available for you.
Q.	How many office visits will it take to fix my teeth and improve my smile?
A.	That will vary for each person, depending on his or her needs. Sometimes, you can dramatically improve your oral health and appearance in just a couple of visits. Most IDA dentists will work to make your treatment as convenient as possible, perhaps choosing slightly longer visits instead of more trips to the office. Talk to your dentist about your goals and concerns so the best plan can be developed for your individual situation. If you start today, a new smile can be yours sooner than you think.
Q.	If my teeth are reshaped for veneers or crowns, what will they look like? Will they be sensitive?
A.	Generally, cemented restorations like crowns or veneers (see our procedure section) will require two visits –one to shape the teeth, and one to cement the restorations to the teeth. In between, your dentist can place attractive temporary restorations to help prevent sensitivity, allow function and provide a nice smile. These temporaries are designed to be in your mouth for a limited time, but should be comfortable and natural looking until you can get your new smile completed.
Q.	Is my new smile permanent?
A.	With good home care and regular visits to your dentist, modern materials can last for many years and possibly decades. Like most things, excellent maintenance will extend the life of your dental restorations.

 

Q. Can existing porcelain crowns or laminates be bleached?

A. No, porcelain does not change color when exposed to dental bleach.

Q: What are the effects of whitening your teeth? Can it damage the teeth?

A: If by whitening you mean a dentist-administered bleaching treatment, it is currently thought to present little risk except for some short-term soreness of the gums and a transient increase in tooth sensitivity to heat, cold, contact, and sweets. It is a relatively new technology, and the long term cumulative effects, if any, are not known. This may be significant, since bleaching may need to be repeated at indefinite intervals to maintain the whitening.
The same degree of safety cannot be assumed for unregulated over the counter bleaching agents, due to the unknown nature of their content.

Q: My husband has darkened teeth from taking antibiotics as a child. Is there anything he could do to make them look white again?

A: Intrinsic stain (that is, discoloration of the tooth structure itself, rather than a surface stain) responds moderately well to bleaching. The difficulty presented by staining that results from tetracycline use is that it is not uniform, but usually presents as horizontal light and dark bands. For such teeth, the banding effect will remain after bleaching, albeit in a lighter color.
The only practical way of eliminating the staining you describe is by covering it up. This can be done by the placement of crowns, or more conservatively by placing porcelain laminate veneers. I would advise your husband to ask your dentist about these options.

Q: I am having 5 new caps made on my upper row of teeth. They will be made to match the colour of the two natural teath that I have on that row. My dentist suggets that I have those two teeth bleached first, and then have the new caps to match the colour of my newly bleached teath. My concern is that the bleached teeth may change colour over time and then all those new caps will not match them any more. I have not heard much about bleaching, and I certainly do not know anyone who has had it done to ask them. What do you think?

A: It is true that once bleached, teeth will eventually tend to relapse and darken. There's no reason why they can't be repeatedly re-bleached, but this is something you may prefer not to do. In any case, the bleaching causes only a modest amount of whitening, and the disparity between your new caps and the bleached natural teeth is not likely to be great even if the bleached teeth darken.

Do you think your natural teeth are too dark? This is entirely a subjective judgement, and your opinion is just as valid as the dentist's. If you like the color of your natural teeth, skip the bleaching, and just have your dentist match the caps to them as they are. This is the basis on which you should base your decision whether to bleach.

Q: Why do some people's teeth discolor a yellow to brownish color upon aging? There are no injuries to the teeth. I have been told that it is just a part of aging?

A: Often it is just a part of aging. The surface enamel becomes worn and thin during a lifetime of chewing, allowing the underlying dentin (which is a darker color) to shine through, or even become exposed to the surface. The central pulp tissue becomes increasingly calcified and the surrounding dentinal tissue becomes sclerotic, darkening and opacifying the teeth. Recession of the gum exposes the root surfaces, which are often darker than the crowns of the teeth.
Of course, some people become less motivated to clean their teeth, or may become physically incapacitated. This can cause their oral hygiene to suffer, allowing the accumulation of extrinsic staining. All of this can contribute to darkening of teeth with age.

Q: I am a 20 year old female. My teeth are stained, their color is not yellow but grey. I think the stains are called "intrinsic". When I was a child I always got a cold or flu and had to use a lot of medication; I was injected mostly. I don't know whether it is the reason, but my teeth were like this all the time. What is strange is that sometimes there appear some white spots (not natural, too white); sometimes the stain becomes less. I guess it is connected with my behavoir, i.e. eating, smiling a lot. Would you please explain to me what does this mean, and how can I make my teeth look brighter.

A: Intrinsic stain does not noticeably vary over short intervals; any change is gradual and usually escapes notice. If the stain you see is intrinsic, i.e. a staining of the tooth structure itself rather than a surface deposit of stained material, any changes you see are probably the result of some change in ambient lighting. You'd be surprised how important quality and quantity of light is in evaluating tooth color. It's an important consideration in dental practice, since dentists must frequently evaluate color and other optical qualities when matching restorative materials to natural teeth. Of course, what you are seeing may be some combination of intrinsic and extrinsic stain, which would further explain the variability in the appearance of your teeth.
Besides a thorough professional cleaning to remove extrinsic stain, your options are the same as anyone else with intrinsic dental stain: 1-bleaching, or 2-porcelain laminate veneers. One or the other may be more appropriate, depending on the severity of the stain, the uniformity of the discoloration, the structural integrity of the teeth, and the position and shape of the teeth. Your dentist will be able to discuss the pros and cons of these two approaches.

Q: Hi! You have been very helpful. I have been asking you about bleaching the teeth.I have been told that before getting my teeth bleached I should get them cleaned first (some receptionist told me that over the phone). Is that true? Is that what you recommend to your patients? To tell you the truth I have not had them cleaned in a while so I am sure it wouldn't hurt; I was just curious as to why. Will getting a professional cleaning remove some stains and maybe whiten them a little?

A: Getting your teeth cleaned prior to bleaching makes good sense, for two reasons:

• You might decide that your teeth don't need bleaching after you remove all that coffee/tea/cigarette stain. Bleaching agents must come into intimate contact with tooth enamel in order for them to work. This cannot happen if your teeth are covered by a layer of plaque or similar accretion.
  
• Additionally, clean teeth are a virtue to which most people aspire. You don't want whitened dirt on your teeth-- you want whitened teeth! Also, due to the slight postoperative sensitivity following bleaching, a good cleaning may be more comfortably performed prior to this procedure.
  

Q: My teeth aren't as white as I'd like them to be, even though I have them cleaned every six months as recommended. I drink 1-2 cups of very light coffee per day, and I'm wondering if I were to cut coffee out of my diet completely, would this help lighten the shade of my yellowish teeth, or is this "staining" due to the natural acids in my mouth?

A: The appearance of the teeth is due to a combination of their intrinsic coloration and that of any surface deposits. The intrinsic color of the teeth can be assumed to be what you see immediately after a good professional cleaning, assuming all surface deposits have been removed. If this color is not what you'd like it to be, it's unlikely that eliminating coffee, smoking, or anything else known to cause surface stains will yield sufficient improvement. In this case, benefit can be derived from some other cosmetic treatment, such as bleaching or porcelain laminate veneers.
On the other hand, if the color of your teeth after professional cleaning is satisfactory, you'll need to be a bit of a detective in determining just what is responsible for the surface stain. Common offenders include coffee, tea, and tobacco.

Q. How long should bonding last?

A. Bonding lasts 3-5 years, depending on wear and tear.

Q. How long do porcelain laminates last?

A. In excess of 10 years, when properly maintained.

Q. Why do people choose porcelain laminates over bonding?

A. Laminates look more realistic, do not stain, feel more natural, and are stronger.

Q. When do you need to see a periodontist?

A. When local gum inflammation cannot be controlled by a hygienist and residual pockets that cannot be maintained are left around the teeth.

Q. Can porcelain laminates or crowns give me lip support?

A. Yes, if they are built out with bulk, provided it does not interfere with function and local biology.

Q. How do you get rid of spaces between teeth?

A. With porcelain laminates or bonding but Crowns may be used on more severe cases.

Q. Does it hurt to have teeth prepared for laminates?

A. No, it is a painless, two-visit procedure. Local anesthesia can be given to highly sensitive patients, but is usually not necessary.

Q. I have some old silver fillings which are beginning to look bad. What can be done to improve them.

A. Silver amalgam fillings, which are composed of 50% mercury and 50% silver alloy ,eventually need to be replaced. It may surprise you to know that the average life span of a silver filling is five to eight years. Your dentist can tell you when they appear to NEED to be replaced due to leakage, breakdown or recurrent decay.

If your concern is strictly COSMETIC, there are many new methods available to replace the fillings with beautiful, functional long lasting restorations.

Such things as white filling materials, porcelain inlays , crowns and veneers may be used to give you the smile you are seeking.

There is currently a great deal of interest in new reinforced hybrid materials. These beautiful resin materials may be reinforced with fibers, similar to fiberglass, and used in very conservative inlays and bridges without having to grind away a whole healthy tooth.

Q. What are the advantages of laminates versus orthodontic treatment?

A. Orthodontic treatment takes 18 months to 2 years while porcelain laminates correct crooked teeth in two visits.

Q. There are so many different toothbrushes on the market today. How do I know which one is the right one for me?

A. This is a good question, which we hear daily. The brand of the toothbrush is not nearly as critical as the type of bristle, the size and shape of the head and how frequently you replace your brush.

We recommend a soft bristled brush with a small head. The soft bristles are most important for the health of your gums. A small head allows you to get around each tooth more completely and is less likely to injure your gums.Daily frequency of brushing and replacement with a new brush are much more important issues than the brand you choose.

We recommend replacing your brush at least once a month.

My employees and I all brush, on average, 5 times a day. We brush first thing in the morning, after each meal and at the end of the day .

If you are not able to do this because of your busy schedule, we recommend brushing twice a day at a bare minimum.

Q. I just recently went to a new dentist for a checkup and cleaning and asked him to check a cap that that was put on one of my front teeth by my former dentist. He informed me that I did not have a cap on any of my teeth. I know my last dentist fixed a broken front tooth and said he capped it. Who should I believe?

A. You have just experienced one of a number of common misunderstandings we see in dentistry today. Terminology used in dentistry is not 100% uniform throughout our profession. Both dentists were probably "correct".

The word "cap" as used in dentistry by different dentists can refer to a number of different things. A pulp cap refers to a calcium containing dressing placed under a deep filling to stimulate healing. A full crown, made by a dental laboratory which completely covers the outside of your tooth is frequently called a cap. A partly broken tooth may be built up by your dentist in the office with a bonded filling material. This is called a cap or "capping" by some dentists. This sounds like what you probably had done.

For more information about cosmetic dentristry, you can refer to American Academy of Cosmetic Dentistry or American Dental Association