Cosmetic dentistry is synonymous with a nice smile. In the last decade we have became conscious of the colour of our teeth, and when whitening became available an interest in porcelain veneers and crowns also increased.
Originally performed by oral surgeons and periodontists, today, many well-trained general dentists perfom cosmetic dentistry. The focus now is not only on preservation, but on creating an attractive smile too. Attention is focused on the lightening and cosmetic restoration of teeth or on orthodontia, which allows crooked and badly positioned teeth to be straightened.
Cosmetic dentistry includes processes which involve adding a dental material to teeth or gums, for example bonding, porcelain veneers or laminates, or crowns (caps). Other procedures available are gum grafts, and the removal of teeth or part of the tooth structure or gums -this is enameloplasty.
Lightening the teeth is the most common cosmetic dental procedure performed. While many lightening options are available, including over-the-counter products, professional treatments are recommended for the process.
A peroxide gel is put on the teeth and left in place for a variable amount of time. In a professional setting, heat or special curing lights speed up the process, where the face and gums are protected from the chemicals and lights. The process continues at intervals at home, where a gel is applied and held in place with a form-fitting tray for half an hour a day for approx two weeks. Users should be made aware that the process of whitening may irritate the gums and cause tooth sensitivity. It will not lighten fillings or crowns, and can also result in blotchiness of the teeth.
Sculpting, or tooth reshaping, removes a certain amount of enamel to improve the appearance of a tooth, and used with the bonding process is used to fill a small chip, or to alter the length, position or shape of teeth, and it can be used to correct excessively long or crooked teeth. It is also known as enameloplasty, odontoplasty, contouring, recontouring, stripping, slenderising or sculpting. The process offers results in a short time, and can even be a substitute for braces under certain circumstances. The bonding process uses an enamel-like dental composite material, which is applied to a tooth’s surface, sculpted into shape, hardened, and then polished.
Veneers are extremely thin, custom-made porcelain pieces which are bonded directly to teeth. They are a great option for reducing gaps or disguising discolored teeth that do not respond well to whitening processes.
Crowns are also generally made from porcelain, but require the tooth being shaved down much more than is required for veneers. The process is used when the structure of a tooth is significantly decayed or twisted out of shape.
Implants are titanium metal anchors screwed into the bone, with crowns later attached to these anchors.
Dental bridges are false teeth, known as pontics, which are fused between two porcelain crowns to fill in areas left by missing teeth. This is known as a fixed bridge, and is used to replace one or more missing teeth. Bridges may reduce the risk of gum disease, help correct some bite issues and can even improve speech, however they require excellent oral hygiene. They last up to ten years or more.
Gum lift is a cosmetic dental procedure that raises and sculpts the gum line. The procedure involves reshaping the tissue and/or underlying bones to create the appearance of longer or more symmetrical teeth.
Striaghtening teeth gives both functional and cosmetic benefits. By improving the bite, the teeth don’t bang into one another, so they last longer. Invisalign is a new technique to straighten teeth that uses clear plastic mouthpieces, with sequential trays made and used, further positioning the teeth correctly. Invisalign is an alternative to old-fashioned metal braces, and the most obvious advantage of the treatment is cosmetic: the aligners are completely transparent, therefore more difficult to detect than wire and bracket braces. Invisalign is also more comfortable, with people ‘graduating’ to a new set of aligners in the treatment series approximately every two weeks, whereas metal braces are adjusted approximately every six weeks and apply greater forces. In addition, Invisalign is removable, therefore food can be consumed without the encumbrance of metallic braces, which also reduces the occurrence of tooth decay compared to using metal braces, as these cannot be removed for eating and cleaning, and also prevent accurate x-rays from being taken.
The average treatment time is about one year, depending on the complexity of the individual’s treatment, and simple treatments (minor crowding, minor spacing) may be as short as twenty weeks.
This branch of dentistry deals with the replacement of teeth by removable and fixed dentures. The latest improvement is the use of a flexible material that replaces the ugly metal wires that hold partial dentures in place. The new material is tooth coloured, snaps into place almost invisibly, and is lighter and thinner and stronger than the older materials.
Tooth-coloured materials are starting to replace the more noticeable silver-coloured fillings, which are also extremely damaging to general health as they contain high amounts of mercury. First used in the 1970s, the modern materials have been improved and now last much longer, and will eventually replace mercury fillings completely. New dental drills are also much faster than the older drills, and are air- and water-cooled, creating less heat and less pain.