This can be anything done to correct imperfections in the appearance of the mouth. Anyone who is unhappy with their smile can have it fixed. The upper teeth show, usually, only when smiling, while the lower teeth remain hidden. This is reversed when talking, with the upper teeth remaining hidden while the lower teeth show. The color, alignment, spacing as well as regularity of the teeth are the characteristics that give the overall appearance. Any of these can be repaired to give a stunning look to the mouth.
We offer a wide variety of cosmetic options. Some of these options are whitening, smile design, recontouring of the shape of the teeth, veneers, bonding, and all ceramic/porcelain crowns.
This is the procedure of making teeth whiter, and therefore more attractive. We are happy to discuss various approaches to Home Care whitening. We also use several methods of Office involved bleaching: Passive tray whitening, and professional strength white strips.
The tray method involves having impressions taken at the office, from which laboratory fabricated custom vinyl trays are made. A carbamide peroxide gel is placed in these trays and the trays with gel are worn for about 30 minutes twice a setting for up to two times a day. The entire process takes about 2 weeks of daily use. Three different strengths of gel may be used, however the higher the strength the greater the likelihood of reactions or tooth sensitivity. The tray method is recommended for badly stained teeth, such as tetracycline staining, and it may take several months of use to see significant color improvement. For maintenance of whitened teeth the trays should be used about once a year.
The end results whether using Over the Counter aids or Custom Fabricated trays at home is about the same. The cost of the tray method is greater, but once owned, the trays last for a long time and deliver the bleach into the contours of your tooth setup better than the strips. Although approved by the ADA, my personal feeling is bleach teeth may become brittle over time, and I caution not over doing this cosmetic approach.
If strips are used, I suggest bleaching the lowers until a satisfactory color is attained, then bleaching the uppers to match. There are at least two good reasons for this. If you bleach both together, you may not be aware that the shades are lightening. Also, the lower teeth are thinner and will attain color change faster. Bleaching both at the same time may result in over bleaching the lowers, possibly adding to internal changes (brittle tendancies) of the teeth.
A patient who works with poitrait paintings has suggested the whites of the eyes need to be whiter than the teeth, so the gaze of the viewer is drawn to the eyes of the subject and not the mouth. Our recommendation is to be mindful of this and not try for "appliance white" teeth!
Veneers are a dental procedure in which a covering is placed over the outside (visible area) of the tooth. Veneers are usually only done to the part of the teeth that are visible when talking or smiling. The procedure can be direct or indirect.
The direct technique usually involves placing composite resin on the outside of the tooth using bonding. This method is usually referred to as bonding.
The indirect technique usually involves two appointments because the veneers will be fabricated at a dental laboratory. At the first appointment the teeth are prepared, impressions taken, and the teeth are given a temporary covering. In two to three weeks the veneers are back from the laboratory, the temporaries are removed and the veneers are bonded to the teeth. The laboratory fabricated veneers are usually made using porcelain or pressed ceramic, and are very esthetic.
The advantage of veneers versus crowns is that much less tooth material is removed, and the procedure is generally less uncomfortable. Veneers are recommended for teeth that have large fillings or little tooth structure.
Often times cosmetic results are better if like teeth are restored at the same time. If one front tooth has an issue, it is ofter more predictable to work in pairs and have two look alike than to try to match only one tooth to all the remaining. I do one tooth at a time, but I do appreciate that to control a general full smile appearance, sometimes cases will do multiple front teeth. The Las Vegas Institute routinely suggests veneer cases cover 8 to 10 front teeth. An processed resin overlay for the arch has resently been developed which can cover all remaining teeth in an arch and create an asthetic appearance for a fraction of the cost of multiple veneers. We have experience with these "instant smile" appliances as well.
LIMITED ORTHODONTIC TREATMENT
An Orthodontist collegue in our neighborhood will consider straightening "the social six" top or bottom front teeth. This is an amazing service. For about the cost of a single veneer, all six of the affected teeth may be able to be aligned, usually within about 6 to 9 months, then maintained with a retainer. It has been his policy to offer a free consultation for this service. Often this alone makes such a nice impact to the eye that no other work may be needed for a pleasing aesthetic result.
GUM TISSUE APPEARANCE
The contours of the gums aroung the necks of the teeth can now be shaped comfortablely with Laser surgery. Periodontis are skilled in this technique. I refer to a number of specialist who are competent in this procedure. The effect of balancing the ratio of tooth to gum often has a positive effect to aesthetics.
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