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Cosmetic dentistry may involve:

• addition of a dental material to teeth or gums: bonding, porcelain veneers (laminates), crowns (caps), gum grafts
• removal of tooth structure or gums: enameloplasty, gingivectomy
• teeth whitening (bleaching), laser whitening, gum depigmentation
• straightening of teeth accompanied by improvement in appearance of face: orthodontics

Whitening (tooth bleaching) is among the most common aesthetic dental procedures. Many whitening options are now available. While over-the-counter products are getting more and more popular, dentist-supervised treatment is recommended for quality and lightening of discolored or yellowing teeth.

Teeth reshaping (sculpting), bonding and other procedures

• Laser whitening is a teeth whitening technique in which gums are covered with rubber and a bleaching chemical is applied on the teeth. A beam of argon laser, which is intended to accelerate the process of bleaching, is then projected upon the teeth. This laser activates the bleaching chemical and lightens the teeth color. Laser whitening is said to be six times more effective in teeth whitening compared to other methods.

• Tooth reshaping removes parts of the enamel to improve the appearance of the tooth. It may be used to correct a small chip or alter the length, shape or the position of the teeth. It can be used to correct crooked or excessively long teeth.

The removed enamel is irreplaceable. This procedure is also known as enameloplasty, recontouring, odontoplasty, contouring, slenderizing, stripping. The procedure offers fast results and can be used as a substitute for braces under certain circumstances.

• Bonding is a process in which an enamel-like dental composite material is applied to a tooth's surface, sculpted into shape, hardened and then polished.

• Dental bridges are false teeth, known as a pontics, which are fused between two porcelain crowns to fill in areas left by missing teeth. Two crowns hold it in place, these are attached to adjacent sides of the false tooth. Bridges require serious oral hygiene and can carry risk. The average life of bridges is similar to that of crowns - nearly ten years.

• Veneers are very thin, custom-made porcelain laminates that are bonded directly to the teeth. They are an option for closing gaps, enhance the shape, or change the color of teeth that do not respond well to whitening procedures. In the majority of the cases, some level of tooth reduction is necessary for optimal results.

• Dental implants are prosthetic replacements for missing teeth. There are three parts of an implant: the implant device which is predominantly made of titanium (which is inserted into the bone), the abutment, and a dental crown or a denture which are connected to the implant through the abutment.

• 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.

• Bite reclamation is for patients who have had years of excessive wear to their teeth due to grinding or acid reflux can alter their vertical dimension. This gives them a closed or shorter look to their face and smile. By opening up their bite, a qualified professional can reclaim their vertical dimension.

• Inlays and Onlays are used to repair decayed & cracked teeth. These are helped at those parts of teeth when a filling is too small to correct the decayed teeth and a crown would be excessive.

What materials are being used in cosmetic dentistry?

In the past, dental fillings and other tooth restorations were made of gold, amalgam and other metals. Some were veneered with porcelain. Nowadays porcelain and composite materials are most commonly used. They closely mimic the appearance of a natural tooth. These materials are bonded to the underlying tooth structure using resin adhesives. They are entirely mercury- free, unlike silver fillings (amalgam).

What Are Dental Implants?

Dental implants are replacement tooth roots. Implants provide a strong foundation for fixed (or permanent) or for removable replacement teeth that are made to match the natural teeth.

What are the main advantages of dental implants?

There are many advantages to dental implants, including:

• improved appearance
• improved speech
• improved comfort
• easier eating
• improved self-esteem
• better oral health
• overall durability and convenience

Success rate of dental implants

Success rates of dental implants vary depending on where the implants are placed. In general dental implants have a success rate as high as 98%. With proper care implants can most certainly last for life.

Who can get dental implants

Usually anyone healthy enough to undergo a routine dental extraction or oral surgery can be considered for a dental implant. Patients should have healthy gums and enough bone to hold the implant. They also must be committed to good oral hygiene and regular dental visits. Heavy smokers, people suffering from uncontrolled chronic disorders such as diabetes or heart disease, or patients who have had radiation therapy to the head/neck area need to be evaluated on an individual basis. If you are considering implants, talk to your dentist to see if they are right for you.

How are dental implants done

The first step in the dental implant process is the development of an individual treatment plan. The plan addresses your specific needs and is prepared by a team of professionals who are specially trained and experienced in oral surgery and restorative dentistry. This team approach provides coordinated care based on the implant option that is best for you.

The tooth root implant - which is a small titanium post - is placed into the socket of the missing tooth. The jawbone heals and it grows around the implanted post, anchoring it securely into the jaw. The healing process takes from 6 to 12 weeks.

When the implant has bonded to the jawbone, a small connector post (an abutment) is attached to the post. This is how the new tooth is holding securely. To make the new tooth or teeth, your dentist makes impressions of your teeth and recreates a model of your bite. This captures all of your teeth, type and arrangement. A replacement tooth (a crown) is attached to the abutment after the healing process.

There are numerous dental whitening systems:

• whitening toothpaste
• OTC (over-the-counter) whitening strips/whitening gels
• whitening rinse
• tray-based whitening
• in-office supervised whitening

Teeth whitening is not permanent. People who expose their teeth to foods and beverages that cause staining may see the whiteness start to fade in as little as one month. Those who avoid foods and beverages that stain may be able to wait one year or longer before another whitening treatment or touch-up is needed.

The degree of whiteness will vary from individual to individual depending on the condition of the teeth, the level of staining, and the type of bleaching system used.

Supervised or unsupervised whitening

Your dentist can perform an oral exam and consider your complete medical history, which can be helpful in determining if bleaching is an appropriate course of treatment based on the type and extent of stains, and the number and location of restorations. A dentist can match the type of stain with the best treatment to lighten those stains.

Whitening is not recommended or will be less successful in the following circumstances:

• age
• pregnancy issues
• sensitive teeth
• allergies
• gum disease
• excessively worn enamel
• tooth decay and cavities
• exposed roots
• various fillings, crowns, restorations
• very darkly stained teeth

While yellowish teeth respond well to bleaching, brownish-colored teeth respond less well and grayish-hue or purple-stained teeth may not respond to bleaching at all. Blue-gray staining caused by the antibiotic tetracycline is more difficult to lighten and may require up to six months of home treatments or several in-office appointments to successfully lighten.

Teeth that have dark stains may be better candidates for another lightening option, such as veneers, bonding, or crowns. Your dentist can discuss the options best suited for you.

Risks Associated With Whitening

The two side effects that occur most often with teeth whitening are a temporary increase in tooth sensitivity and mild irritation of the soft tissues of the mouth, particularly the gums. Tooth sensitivity often occurs during early stages of the bleaching treatment. Tissue irritation most commonly results from an ill-fitting mouthpiece tray rather than the tooth-bleaching agent. These conditions usually are temporary. Most of the time they will disappear within 1 to 3 days of completing the treatment procedure.

If you do experience sensitivity, you can reduce or eliminate it by:

• wear the tray for a shorter period of time (i.e. 2 x 30-min. sessions vs. 2 x 60-min.).
• stop the whitening procedure for 2 to 3 days and allow teeth to adjust to the process.
• use a high fluoride-containing product to help remineralize your teeth
• brush teeth with a toothpaste for sensitive teeth, containing potassium nitrate – this helps soothe the teeth's nerve endings

Cosmetic treatments can be used to straighten, lighten, reshape and repair teeth. Cosmetic treatments include veneers, crowns, bridges, tooth-coloured fillings, implants and tooth whitening.

There are primarily two dental specialties that predominantly focus on dental esthetics (9). They are:

• prosthodontics
• orthodontics

Cosmetic dentistry also includes endodontics and periodontics.

Caring for your teeth starts at an early age.

In children healthy milk teeth are important for developing proper chewing process and the proper location of the permanent teeth. Maintenance and good oral hygiene prevents damage, decay and other problems.

Regular medical check-ups

Preventive examinations should be attended at intervals of six months. Regular check-ups help potential problems of the teeth to be treated at an early stage and helps a great deal if you want to avoid complications.

Whether you get an in-office bleaching treatment or spend weeks whitening your teeth at home, you likely to put a lot of effort into your beautiful smile. You may wonder, "How can I keep my teeth white?" After spending time and money on tooth whitening, the last thing you want to see in the mirror is discoloration. Find out how to keep the bright, white color you have worked so hard for.

Daily cleaning care

Daily brushing and flossing will help to keep your mouth clean, healthy and stain-free. Brush after breakfast and before going to bed at the very minimum.

You can also clean your teeth at any time during the day to help fight discoloration. Rinse with water after drinking coffee, tea, cola or red wine. Take your toothbrush and toothpaste with you to work or school to brush after meals.

Regular dentist appointments

Aside from regular daily care, what more can I do to keep my teeth white? Visit your dentist's office for regular checkups. Your dentist or dental hygienist can polish away surface stains when she cleans your teeth. The abrasive action of a professional cleaning is an effective tool for fighting discoloration without having to bleach your teeth again.

With good brushing habits and professional cleanings, you can maintain a healthy and bright smile.

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