Cosmetic dentistry includes a variety of dental treatments aimed at improving the appearance of the teeth.
The purpose of cosmetic dentistry is to improve the appearance of the teeth using bleaching, bonding, veneers, reshaping, orthodontics, or implants.
Bleaching is done to lighten teeth that are stained or discolored. It entails the use of a bleaching solution applied by a dentist or a gel in a tray that fits over the teeth used at home under a dentist's supervision. Bonding involves applying tooth-colored plastic putty, called composite resin, to the surface of chipped or broken teeth. This resin is also used to fill cavities in front teeth (giving a more natural-looking result) and to fill gaps between teeth. Veneers are thin, porcelain shells that cover the front of the teeth. They can improve the appearance of damaged, discolored, misshapen, or misaligned teeth. Reshaping involves the removal of enamel from a misshapen tooth so that it matches other teeth. Orthodontics uses braces to correct the position of crowded or misaligned teeth. Implants are artificial teeth which are attached directly to the jaw to replace missing teeth.
Bleaching involves having a custom-made bleaching tray made by the dentist. This tray is worn at home for several hours each day or night. Teeth slowly become white over a period of one to six weeks. Bleaching can also be done in a dentist's office. A heator light-activated bleaching solution is applied to six to eight teeth per visit.
Bonding involves etching the surface of the tooth so composite resin can adhere. The dentist then contours the resin to the right shape, and smooths and polishes the resin after it is hard and dry.
To prepare for the application of a veneer, a thin layer of enamel is removed from the tooth (so that the finished tooth will be flush with surrounding teeth) and an impression of the tooth is taken from which the veneer will be created. Before a veneer is applied, the tooth is etched with an acid solution and an adhesive resin is painted on the tooth. The veneer is then applied, the resin is hardened with a bonding light, and the dentist polishes the veneer.
During cosmetic reshaping, some enamel is removed from the uneven tooth so it more closely matches other teeth.
Orthodontics involves applying braces to the teeth, and wires are threaded through the braces. These wires are adjusted to gradually move the teeth to the desired new positions. Over time, crowded or misaligned teeth are straightened.
Implants are more secure and natural looking than dentures or bridgework, but are much more expensive. First an anchor for the implant is attached to the jaw bone. This surgery can take several hours. About six months later, after the bone around the anchor has healed, a post is attached to the anchor, and an artificial tooth is attached to the post. The whole process may take about nine months to complete.
Periodic touch-up may be needed to keep the teeth white if the teeth have been bleached or bonded. Also, the resin used in bonded teeth can be chipped by ice, popcorn kernels, or hard candy, requiring repair. Veneered teeth may need to be reveneered after five to 12 years. Once orthodontic braces are removed, regular visits to the orthodontist are advised because teeth can shift position. Implanted teeth require regular dental checkups to ensure that the anchor and post are stable.
After teeth are bleached, they may darken faster if exposed to staining products such as coffee or tobacco. Some patients experience increased sensitivity to cold while teeth are being bleached, but the sensitivity usually disappears shortly after completion of the treatment.
Bonded teeth, like bleached teeth, may also stain more easily than natural teeth. Bonding materials also chip easily.
Because cosmetic reshaping involves the removal of enamel, the process is irreversible because enamel cannot be replaced once it is removed.
The anchors of implanted teeth can loosen and cause pain; regular dental checkups are recommended.
Cosmetic dentistry can improve the appearance of stained, chipped, misshapen, or crowded teeth.
American Dental Association. 211 E. Chicago Ave., Chicago, IL 60611. (312) 440-2500. <http://www.ada.org>.
Joseph Knight, PA
Bleaching—Technique used to brighten stained teeth.
Bonding—Rebuilding, reshaping, and covering tooth defects using tooth-colored materials.
Composite resin—Plastic material matching natural tooth color used to replace missing parts of a tooth.