Cosmetic Procedures.

Bonding
Crowns and Bridges
Cosmetic Fillings
Implants
Whitening

Bonding

Bonding is a process in which an enamel-like material is applied to a tooth's surface, sculpted to an ideal shape, hardened, and then polished for an ideal smile. This procedure usually can be accomplished in a single visit.

Bonding is often performed in order to fill in gaps or change the color of your teeth. It typically only entails one office visit, and the results last for several years.

Bonding is more susceptible to staining or chipping than other forms of restoration such as veneers. When teeth are chipped or slightly decayed, bonded composite resins may be the material of choice. Bonding also is used as a tooth-colored filling for small cavities and broken or chipped surfaces.

In addition, bonding can be used to close spaces between teeth or cover the entire outside surface of a tooth to change its color and shape. Crowns, also known as caps, are used in cases where other procedures will not be effective. Crowns have the longest life expectancy of all cosmetic restorations, but are the most time consuming.

Crowns and Bridges

Crowns are synthetic teeth-like coverings that are designed to make your tooth stronger and improve its appearance. Crowns are necessary when a tooth is generally broken down and fillings won't solve the problem. A crown is a restoration that covers, or "caps," a tooth to restore it to its normal shape and size, strengthening and improving the appearance of a tooth.

If a tooth is cracked, a crown holds the tooth together to seal the cracks so the damage doesn't get worse. Crowns are also used to support a large filling when there isn't enough of the tooth remaining, attach a bridge, protect weak teeth from fracturing, restore fractured teeth, or cover badly shaped or discolored teeth.

A crown can cover and support a tooth with a large filling when there isn't enough tooth left. In many cases, crowns are used after a root canal therapy, and are used to restore portions of the tooth (typically the top surface) removed during root canal treatment.

Crowns also can be used to attach a bridge, protect a weak tooth from breaking or restore one that's already broken. A crown is a good way to cover teeth that are discolored or badly shaped. It's also used to cover a dental implant.

To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of teeth and gums is made and sent to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown is made. On the next visit, the dentist removes the temporary crown and cements the permanent crown onto the tooth.

Because crowns require more tooth structure removal, they cover more of the tooth than veneers. Crowns are stationary and are normally used for teeth that have sustained significant loss of structure, or to replace missing teeth. Crowns may be placed on natural teeth or dental implants.

Crowns normally last between five and eight years. Many last much longer if you practice good daily oral hygiene.

Cosmetic Fillings

Cosmetic fillings are mercury-free, plastic material matching natural tooth color used to replace missing parts of a tooth. Since they bond to the tooth, composite fillings restore most of the original strength and natural appearance of the tooth. Silver fillings weaken the teeth and expand and contract more than enamel. This makes the tooth susceptible to breaking. Broken teeth can be expensive to restore, so composites can save you money over the long run.

Also referred to as composite fillings, they are a mixture of acrylic resin and finely ground glasslike particles that produce a tooth-colored restoration. Composite fillings provide good durability and resistance to fracture in small-to-mid size restorations that need to withstand moderate chewing pressure. Less tooth structure is removed when the dentist prepares the tooth, and this may result in a smaller filling than that of an amalgam. Composites can also be "bonded" or adhesively held in a cavity, often allowing the dentist to make a more conservative repair to the tooth. In teeth where chewing loads are high, composite fillings are less resistant to wear than silver amalgams. It also takes longer to place a composite filling.

Implants

Dentures are no longer the only way to restore a mouth that has little or no non-restorable teeth. Strategically placed support such as implants can now be used to support permanently cemented bridges, eliminating the need for a denture. The cost tends to be greater, but the implants and bridges more closely resemble the "feel" of real teeth. Dental implants are becoming the alternative of choice to dentures, but not everyone is a candidate for implants.

Dental implants are tooth root substitutes that are surgically placed in the jawbone and act as anchors to stabilize artificial teeth. They can replace one, some, or all missing teeth and help eliminate the instability associated with surface adhesives and removable bridges. Individuals with adequate bone level and density who are not prone to infection and can maintain stringent oral hygiene are good candidates for dental implants, according to the American Association of Oral and Maxillofacial Surgeons.

The benefit of using implants is that they don't rely on neighboring teeth for support, and are permanent and stable. Dental implants can also be used to attach full or partial dentures.

Implants are a good solution to tooth loss because they look and feel like natural teeth. Implant material is made from different types of metallic and bone-like ceramic materials that are compatible with body tissue. There are different types of dental implants: the first is placed directly into the jaw bone, like natural tooth roots; the second is used when the jaw structure is limited, therefore, a custom-made metal framework fits directly on the existing bone.

The cost tends to be greater, but the implants and bridges more closely resemble real teeth.

Whitening

People with stained or dull teeth usually benefit from whitening, which is a safe and effective way to brighten stained, discolored or dull teeth. Even a stubborn single tooth that is noticeably duller or less white than your other teeth can be individually brightened.

Teeth bleaching products, which contain peroxides, actually change your natural tooth color anywhere from five to seven -- but even up to twelve -- shades brighter.

One process known as chair side bleaching involves applying either a protective gel to your gums or a rubber shield to protect the soft tissues in the mouth. A bleaching agent is then applied to the teeth, and a special light is used to enhance the chemical action.

If your teeth aren't very dark or very stained, you may need only one bleaching session. Tooth bleaching safely lightens the color of your teeth, and can last up to five years.

In general, bleaching works for most people. Tooth bleaching is most effective if your teeth are darkened from age, coffee, tea or smoking. Teeth darkened with the color of yellow, brown or orange respond better to lightening. Other types of gray stains caused by fluorosis, smoking or tetracycline can be lightened, but with less-than-satisfactory results.

If you're interested in brightening your smile, have your teeth evaluated by me. Not everyone is a good candidate for bleaching. In some cases of serious discoloration and pitted teeth, for example, veneers may be more appropriate than bleaching. Moreover, crowns, bridges, and fillings do not bleach, so it may be necessary to replace dental work to make it blend with the new color of your bleached teeth. An X-ray of your teeth may be the only accurate way of making a true assessment.

The whitening process could cause you a lot of pain down the road if you have receding gums. Occasionally, people experience some sensitivity in their teeth and gums during the bleaching process. A Journal of the American Dental Association study recently found that 50% of people experience temporary tooth sensitivity as a result of home whitening treatment. Don't try to get your teeth too white, because you may have trouble matching new fillings later on.