Today, cosmetic dentistry is more popular than ever, from whitening and shaping to closing spaces and replacing teeth. And dentists have a wide array of tools and techniques at their disposal for improving the look of your smile.
Before deciding to undergo any cosmetic procedure, it’s important to know the benefits and risks and what you can expect during the process. Make sure you’re clear about what it will cost, how much experience your dentist has with the procedure, and whether any special maintenance will be needed afterward.
Over time, teeth can become stained or discolored, especially after smoking, taking certain medications, or consuming foods and beverages such as coffee and tea. Using a chemical process, your dentist can bleach your teeth in one of two ways. He can do an in-office procedure, or provide you with a system to use at home.
Your dentist can create a custom mouthpiece tray that ensures the right amount of whitening solution reaches your teeth. You may find whitening at home more convenient. But it can take two to four weeks or longer depending on the strength of peroxide used. In-office whitening can take place in one or more 1- to 2-hour visits.
Keep in mind, your teeth can become stained again if you continue exposing them to the same substances that originally stained them. Because whitening products are not meant to clean teeth, it is still important to continue practicing daily oral hygiene by brushing twice a day, flossing at least once a day, and rinsing with an antiseptic mouthwash daily.
Bonding may improve how your teeth look if they have excess space between them, or if they are chipped, broken, stained, or cracked.
Dentists also use bonding materials to fill small cavities or to protect the exposed root of a tooth.
The dentist can usually do this procedure in a single office visit by applying an etching solution followed by tooth-colored materials — sometimes composite resins — directly to the tooth’s surface where needed.
Although bonding can last for several years, it is more likely than other types of restorations to chip or become stained or just wear down.
These custom shells, typically made of porcelain (sometimes plastic), cover the front sides of the teeth to change their color and/or shape. Veneers last longer than bonding and provide a superior appearance. Veneers can improve teeth that:
- Have spaces between them
- Have become chipped or worn
- Are permanently stained
- Are poorly shaped
- Are slightly crooked
Before inserting veneers, the dentist first takes an impression of your tooth, then buffs the tooth before cementing the veneer in place. A beam of light helps harden the cement, which secures the veneer to your tooth.
Porcelain veneers are made in a laboratory, so you need a second visit to the dentist to have them inserted.
Sometimes called caps, crowns completely cover a tooth, restoring a normal shape and appearance. You may need a crown to:
- Cover a misshapen or discolored tooth
- Protect a weak tooth
- Restore a broken or worn tooth
- Cover a tooth with a large filling
- Hold a dental bridge in place
- Cover a dental implant
- Cover a tooth that’s had a root canal procedure
Crowns can be made from metal, porcelain fused to metal, resin, or ceramic materials. Because crowns are costly, dentists usually suggest them only when other procedures can’t produce a pleasing result.
Sometimes, a dentist can make an in-office same-day crown, or a temporary crown. Some offices can mill a crown in the same day. The dentist prepares the tooth for the crown, makes molds of the tooth or takes a digital impression, provides you with a temporary crown if sending it to a lab, and then places the permanent crown at a separate time.
Permanent crowns can have a long life if you take good care of them.
Enamel Shaping and Contouring
Enamel shaping and contouring involves removing or contouring dental enamel to improve the appearance of your teeth. Dentists may combine this process with bonding.
Often used to alter the length, shape, or position of teeth, reshaping and contouring can correct:
- Crooked or overlapping teeth
- Chipped and irregular teeth
- Minor bite problems
You may be a good candidate for reshaping and contouring if you have normal, healthy teeth, and there’s still adequate bone between your teeth to support them.
Today, people of almost all ages are benefiting from braces. Braces not only improve the look of teeth that are crooked or crowded. They can improve an irregular bite and correct jaw positioning and jaw joint disorders.
Braces are worn to apply pressure to and reposition the teeth, usually over the a few months to longer for more advanced cases.
To place braces, your dentist or orthodontist bonds brackets made of metal, ceramic, or plastic to your teeth. Then she places wires through the brackets, which guide the teeth into their correct positions. Sometimes, dentists can attach lingual braces to the backs of teeth, hiding them from view.
After your braces are attached — and after each visit in which your dentist tightens your braces — expect some discomfort for a few days. Also, regular oral hygiene becomes especially important while you are wearing braces.
Risks with braces are minimal. But people with allergies to metal or latex, or those who have periodontal disease, are at greater risk for problems during treatment. Root shortening is also a problem if teeth are moved too quickly.
An alternative for correcting minor spacing problems involves wearing a series of clear, customized appliances called aligners, or invisible braces. Your dentist will reshape and replace them about every two weeks to progressively move your teeth. Unlike traditional braces, aligners can be removed while eating, brushing, and flossing.
Often there are two phases to treatment with braces: wearing braces, and then using a retainer to hold your teeth in their new position. Retainers can be removable or permanently bonded in behind your teeth.
Sometimes called a fixed partial denture, bridges are used to replace missing teeth with artificial teeth. Bridges can be made of gold, alloys, porcelain, or a combination. Dentists anchor them onto surrounding teeth after preparing them for crowns. Then a false tooth joins to the crowns and the bridge is cemented onto the prepared teeth. Only your dentist can remove a fixed bridge.
The success of your bridge depends upon its foundation. So, remember that oral hygiene to keep remaining teeth healthy is particularly important if you wear a bridge.
Implants require an involved and expensive cosmetic dentistry procedure but are a long-term solution for replacing missing teeth. They are an alternative to bridges — which use adjacent teeth as anchors — and to removable dentures, which rest on your gums. A surgeon implants them surgically into the jawbone.
Implants have three parts:
- Titanium metal, which fuses to the jawbone
- An abutment, which fits over the part of the implant that sticks out from the gums
- The crown, which a special restorative dentist creates for a natural, tooth-like appearance
You can get an implant to replace a tooth. Or two or more implants can provide a stable support for replacing several teeth. If you have bone loss from periodontal disease or lost teeth, the surgeon will likely need to first graft bone so the implant has something to secure to.
Having implants requires several steps, including:
- A comprehensive exam, X-rays, and consultation
- Surgical implantation of the titanium screws
- Taking impressions of the upper and lower jaws
- Making a model for the creation of the dentures or crowns
- Placement of the crown
- Follow-up exams with members of your implant team
Other Periodontal Plastic Procedures
An array of other procedures can also improve your smile. They include procedures to help with:
- An uneven gum line
- Teeth that look too short or too long
- Exposed roots
- Indentations in your gums or jawbone
If problems like these are a concern for you, ask your dentist about your best options for correcting them and creating a smile that you can be proud of.Ascent Family Dental Medical Reference
Academy of General Dentistry: “How Can My Dentist Improve My Smile?”
American Dental Association: “Cosmetic Dentistry” and “Bridges.”
Cleveland Clinic: “Dental Crowns.”
American Association of Oral and Maxillofacial Surgeons: “Dental Implants.”
American Academy of Periodontology: “Periodontal Plastic Procedures.”
American Dental Association: “Dental Minutes: Tooth Whitening Is Not Equal to Tooth Brushing.”