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Frequently Asked Questions

How Can My Dentist Improve My Smile?

From subtle changes to major repairs, your dentist can perform a variety of procedures to improve your smile. There are many techniques and options to treat teeth that are discolored, chipped, misshapen or missing. Your dentist can reshape your teeth, close spaces, restore worn or short teeth or alter the length of your teeth. Common procedures include bleaching, bonding, crowns, veneers and reshaping and contouring.

These improvements are not always just cosmetic. Many of these treatments can improve oral problems, such as your bite.

Bleaching
Bleaching is a common and popular chemical process used to whiten teeth. Some people get their teeth bleached to make stains disappear, while other just want a whiter shade.

Discoloration occurs in the enamel and can be caused by medication, coffee, tea and cigarettes. Discoloration also can be hereditary or due simply to getting older.

Bleaching can be performed by your dentist in the office or, under dental supervision, at home. Many patients enjoy bleaching at home because it is more convenient. Treatment begins when your dentist creates a custom mouthpiece to ensure the correct amount of whitening solution is used and that your teeth are properly exposed. Typically, whitening at home takes two to four weeks, depending on the desired shade you wish to achieve. Whitening in the office may call for one or more 45-minute to one-hour visits to your dentist's office.

Bonding
Bonding is tooth-colored material used to fill in gaps or change the color of teeth. Requiring a single office visit, bonding lasts several years. Bonding is more susceptible to staining or chipping than other forms of restoration. 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. Additionally, it can be used to close spaces between teeth or cover the entire outside surface of a tooth to change its color and shape.

Crowns
Crowns, also known as caps, cover a tooth to restore it to its normal shape and appearance. Due to their cost, they 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.

Veneers
Veneers are thin pieces of porcelain or plastic placed over the front teeth to change the color or shape of your teeth. Veneers are used on teeth with uneven surfaces or are chipped, discolored, oddly shaped, unevenly spaced or crooked. Little or no anesthesia is needed. Veneers are used to treat some of the same problems as bonding.

This treatment is an alternative to crowns, which are more expensive. The procedure requires your dentist to take an impression of your tooth. Before the custom-made veneer is cemented directly onto the tooth, your dentist will lightly buff the tooth to compensate for the added thickness of the veneer. Once the cement is between the veneer and your tooth, a light beam is used to harden it. Porcelain veneers require more than one visit because they are fabricated in a laboratory. Veneers have a longer life expectancy and color stability than bonding.

Contouring and reshaping
Tooth reshaping and contouring, is a procedure to correct crooked teeth, chipped or irregularly shaped teeth or even overlapping teeth in a single session. Tooth reshaping and contouring, is commonly used to alter the length, shape or position of your teeth. Contouring teeth may also help correct small problems with bite. It is common for bonding to be combined with tooth reshaping.

This procedure is ideal for candidates with normal, healthy teeth but who want subtle changes to their smile. Your dentist will take X-rays to evaluate the size and location of the pulp of each tooth to ensure that there's enough bone between the teeth to support them.

Which procedure is right for me?
Your dentist can answer any questions you may have about techniques used to improve your smile. The condition of your teeth and desired result you want often dictates the best procedure. If you are considering a treatment, there are a few questions you can ask your dentist before deciding if a particular procedure is right for you.

    - What will the changes look like?
    - What should I expect through the course of treatment?
    - What type of maintenance will be required?


What are Crowns?

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. Crowns are necessary when a tooth is generally broken down and fillings won't solve the problem. 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 restore a tooth when there isn't enough of the tooth remaining to provide support for a large filling, attach a bridge, protect weak teeth from fracturing, restore fractured teeth or cover badly shaped or discolored teeth.

How is a crown placed?
To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of the 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.

Will it look natural?
Yes. The dentist's main goal is to create a crown that looks like a natural tooth. That is why your dentist takes an impression. To achieve a certain look, a number of factors are considered, such as the color, bite, shape and length of your natural teeth. Any one of these factors alone can affect your appearance.

If you have a certain cosmetic look in mind for your crown, discuss it with your dentist at your initial visit. When the procedure is complete, your teeth will not only be stronger, but they may be more attractive.

Why crowns and not veneers?
Crowns require more tooth structure removal, hence they cover more of the tooth than veneers. Crowns are customarily indicated for teeth that have sustained significant loss of structure or to replace missing teeth. Crowns may be placed on natural teeth or dental implants.

What is the difference between a cap and a crown?
There is no difference between a cap and a crown.

How long do crowns last?
Crowns should last approximately five to eight years. However, with good oral hygiene and supervision, most crowns will last for a much longer period of time. Some damaging habits like grinding your teeth, chewing ice or fingernail biting may cause this period of time to decrease significantly.

How should I take care of my crown?
To prevent damaging or fracturing the crown, avoid chewing hard foods, ice or other hard objects. You also want to avoid teeth grinding. Besides visiting your dentist and brushing twice a day, cleaning between your teeth is vital with crowns. Floss or interdental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown area where the gum meets the tooth. Plaque in that area can cause dental decay and gum disease.


What are Veneers?

Veneers are ultra-thin shells of ceramic (porcelain) or a composite resin material, which are bonded to the front of teeth. This procedure requires little or no anesthesia and can be the ideal choice for improving the appearance of the front teeth. Veneers are placed to mask discolorations, to brighten teeth and to improve a smile.

Why a veneer?
Veneers are an excellent alternative to crowns in many situations. They provide a much more conservative approach to changing a tooth's color, size or shape. Veneers can mask undesirable defects, such as teeth stained by tetracycline and damage due to an injury or as a result of a root-canal procedure. They are ideal for masking discolored fillings in front teeth. Patients with gaps between their front teeth or teeth that are chipped or worn may consider veneers. Generally, veneers will last for many years, and the technique has shown remarkable longevity when properly performed.

What happens during the procedure?
Patients may need up to three appointments for the entire procedure: diagnosis and treatment planning, preparation and bonding.

It's critical that you take an active role in the smile design. Spend time in the planning of the smile. Understand the corrective limitations of the procedure. Have more than one consultation, if necessary, to feel comfortable that your dentist understands your objectives.

To prepare the teeth for the veneers, the teeth are lightly buffed to allow for the small added thickness of the veneer. Usually, about half a millimeter of the tooth is removed, which may require a local anesthetic. Composite resin veneers are generally done in one appointment. After the tooth is prepared, the dentist carefully bonds and sculpts the composite material onto your teeth. For ceramic veneers, a mold is taken of the teeth, which is sent to the laboratory for the fabrication of the veneers. This may take several days. If the teeth are too unsightly, a temporary veneer can be placed, at an additional cost.

When your ceramic veneers are ready, the dentist places each veneer on the teeth to check their fit and get a sense of the shade or color. While the veneers are resting on your teeth, view the results, and pay particular attention to the color. At this point, the color of the veneers can still be adjusted with the shade of the cement to be used. The color cannot be altered after veneers are cemented. To apply the veneer, the tooth is cleansed with specific chemicals to achieve a bond. Once a special cement is sandwiched between the veneer and tooth, a light beam hardens the cement.

How about maintenance?
For about a week or two, you will go through a period of adjustment as you get used to your "new" teeth that have changed in size and shape. Brush and floss daily. After one or two weeks, your dentist will ask you to return for a follow-up appointment.

What are realistic expectations?
Veneers are reasonable facsimiles of natural teeth, not perfect replacements. It's not uncommon to see slight variations in the color of veneers upon close inspection, as this occurs even in natural teeth. Nevertheless, this procedure can greatly enhance your smile and can heighten self-esteem.


What Color is Your Smile?

There is beauty in the magic splendor of softly falling flakes of snow against the backdrop of winter's color palate, but when it comes to teeth, most people want one shade: the whitest white that white can be. Unfortunately, teeth come in many shades and can change color from a variety of causes.

As the tooth enamel develops, the color can be affected by many factors, says Academy of General Dentistry spokesperson Howard S. Glazer, DDS, FAGD. "White, bright teeth certainly help maintain a youthful appearance," said Dr. Glazer. Unfortunately, stains from food and drink can darken teeth over time, usually resulting in a yellow or orange hue. Illness, heredity or environmental factors can cause discoloration. In rare cases, injury can discolor teeth.

Maternal use of certain antibiotics, notably those of the tetracycline family, during pregnancy can cause brown or gray discoloration of the baby's tooth enamel. Children who take this medication during the period of permanent tooth development may have similar discoloration of the permanent teeth.

But you don't have to live with a dull smile, says Dr. Glazer. "With today's techniques and materials, we can change the color of a patient's teeth to provide a more healthy, youthful appearance," he said.

Professional tooth-whitening products can improve enamel color in many instances, although severe discoloration may require bonding procedures for good cosmetic results. Contact your dentist to obtain a proper diagnosis and to learn what treatment options are available.


The Fountain of Dental Youth

Members of the baby-boomer generation are increasing the demand for cosmetic dental procedures because they are looking for teeth that help them look and feel younger, reports the Academy of General Dentistry, an organization of general dentists dedicated to continuing dental education.

"The reason cosmetic dentistry is experiencing a boom is that baby boomers want to preserve their youthful appearance," believes Academy of General Dentistry spokesperson Susan Sup-Barnes, DDS, FAGD. She says that most patients who want to change and improve their smile are in their late 30s to early 50s and have more disposable income.

Dr. Sup-Barnes asks her patients to rate their smiles on a scale of 1 to 10. "If they rate their smile a five, I ask what it would take to get to a higher number," she says. If patients inquire about different procedures, she explains the different cosmetic options available.

There are many cosmetic dentistry treatments available that can help patients look and feel better about their smiles, such as bleaching, bonding and veneers. All of these options help teeth look brighter. Bleaching makes teeth whiter, and bonding and veneering can help change a tooth's shape.

"Cosmetic dentistry is popular for the same reasons that plastic surgery is baby boomers, more than every before, want to stay and look healthy and they are willing to pay for it, especially if it means cheating the fountain of youth," Dr. Sup-Barnes concludes.

Cosmetic Dentistry - Frequent Questions
Oral Health Resources - Academy of General Dentistry

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