Cosmetic Dentistry Midland Texas

Country: United States
State: Texas
City: Midland

Cosmetic Dentistry Procedures: Teeth Whitening

Whitening of the teeth is performed for patients who desire a brighter smile. Tooth whitening can be performed to reduce discoloration and staining, or simply to provide the patient with whiter, brighter teeth.

We've prepared a primer on teeth whitening to help improve your understanding of what teeth whitening can and do for a patient. Just click on the next page graphic below to get started. Or, if you want to jump to a specific topic, use the handy outline.

How white can your teeth become?

How white your teeth can become from bleaching and whitening is a common question with a very subjective answer. Some whitening procedures claim they can whiten your teeth by up to nine shades, but that is highly unlikely. Just a change of two or three shades will make a significant difference in just about anyone's smile. There is no one standard system in the dental field to measure and determine tooth color. The most often heard about, however, is the Vita shade guide. This guide divides tooth color into four basic shade ranges:
A (reddish brown)
B (reddish yellow)
C (gray)
D (reddish gray).
In the A range there are five levels of darkness. Ranges B, C and D, each have four levels.

Not all of your teeth are the same natural color. Usually your eye teeth tend to be darker than the others, your front teeth are typically the whitest, and molars tend to be a shade between the two. The goal for everyone is to achieve their individual optimum whiteness while still looking natural. During your first consultation for tooth whitening, your dentist will go over what you personally can expect for your specific smile. How white teeth will become from a given procedure will vary from person to person. The structure of your teeth and the type of procedure implemented will affect the outcome.

The following chart will give you some idea of how to compare the two most popular methods for tooth whitening. As everyone's circumstances are different, both options should be further discussed with your cosmetic dentist prior to making a decision.

Procedure Usually Lasts For: May Cause During and Shortly After Procedure: Time for Procedure: Changes in Shade: Average Cost:
Gel/Tray 4 - 12 Months Sensitive Gums/Teeth 50 Hours 4 - 5 $ 400.
Laser 12 - 18 Months Minor Discomfort 2 - 3 Hours 7 - 8 $ 1,000.
BriteSmile 12 - 18 Months Minor Discomfort 2 Hours 8+ $ 600.

What causes discoloration of the teeth?

Teeth enamel discoloration can be caused by staining, aging, or chemical damage to teeth. Some of the more common causes of teeth discoloration are medications, coffee, tea or cigarettes. People who drink significant amounts of cola soft drinks can experience similar staining.

Aside from staining, there are other factors that can affect the color of an individual's teeth. Genetics can play a role. Some people have naturally brighter enamel than others. Disease can also be a factor and certain medications can cause a discoloration of the teeth. If you suspect that there is an underlying medical cause for your teeth discoloration, be sure to inform your cosmetic dentist.

Types of Teeth Whitening Procedures

There are a few teeth whitening procedures available that correct discoloration of the teeth by removing the brown and yellow staining. While each work effectively, there are advantages and disadvantages to each procedure dependent upon your objectives and commitment to the processes. The type of procedures available should be discussed with your cosmetic dentist, and a they will recommend the most appropriate teeth whitening procedure for you.

BRITESMILE TEETH WHITENING (In-Office)
Using a specail light with a whitening gel, this is an in-office bleaching system. It is often followed up with an at-home bleaching kit if needed.

The translucent bleaching gel is applied to the teeth and a specail activating light source is used to activate the crystals to absorb the energy from the light and penetrate the teeth enamel to increase the lightening effect on the teeth. The length of time in the cosmetic dentist's chair depends on the degree of discoloration you have, but two hours is common.

Advantage: One visit is usually all it takes for a bright smile. The tooth whitening treatment typically costs $600.

Disadvantage: The sudden change of color is likely to be noticed by those around you immediately.

LASER BLEACHING (In-Office)
Using a laser with a whitening gel, this is an in-office bleaching system.

The translucent bleaching gel is applied to the teeth and a laser light is used to activate the crystals to absorb the energy from the light and penetrate the teeth enamel to increase the lightening effect on the teeth. The length of time in the cosmetic dentist's chair depends on the degree of discoloration you have.

Advantage: One visit is usually all it takes for a bright smile.

Disadvantage: The sudden change of color is likely to be noticed by those around you immediately. This is the more expensive of the procedures available, but also the quickest.

LASER BLEACHING (In-Office)
Using a laser with a whitening gel, this is an in-office bleaching system.

The translucent bleaching gel is applied to the teeth and a laser light is used to activate the crystals to absorb the energy from the light and penetrate the teeth enamel to increase the lightening effect on the teeth. The length of time in the cosmetic dentist's chair depends on the degree of discoloration you have.

Advantage: One visit is usually all it takes for a bright smile.

Disadvantage: The sudden change of color is likely to be noticed by those around you immediately. This is the more expensive of the procedures available, but also the quickest.

CUSTOM FIT TRAY BLEACHING (In-Home)
A custom fitted tray is worn over your teeth. A small amount of the bleaching gel is placed in the tray and worn for a brief amount of time each day. This is the most common technique because it's easy to use and costs less. Impressions are taken of your mouth and a thin custom made plastic tray is made which you take home and wear for about one to two hours per day. While some results may be seen in a couple days, it usually takes one to two weeks to see the full whitening of your teeth. This procedure is sometimes used in conjunction with the in-office laser bleaching if you have severe discoloration (dark grey or purple) or internal teeth staining.

Advantage: A gradual whitening of your teeth over time will be less noticeable to others that you're undergoing this procedure. The cost is relatively low.

Disadvantages: This procedure will require two to four visits to the cosmetic dentists office.

How much does laser teeth whitening cost?

Costs can vary depending upon the area of the country you live in and the type of whitening treatment you undergo. Laser teeth whitening is typically over $1000. for the complete procedure.

Generally speaking, the price of teeth whitening increases with the number of in-office treatments required by the patient. Dental insurance does not typically cover the cost of the teeth whitening procedure.

Pros and Cons of Teeth Whitening

Advantages:
People typically have their teeth whitened to improve their appearance. Whiter teeth are associated with beauty and a healthier lifestyle. When people have a brighter smile, they tend to smile more often and are less self-conscious.

In addition, a whiter smile tends to minimize the appearance of facial wrinkles, giving way to a more youthful and energetic appearance.

Finally, a whiter smile gives people to whom you are speaking a place to focus on and gives you a friendlier appearance.

Disadvantages:

Although bleaching is very effective, there can be short term disadvantages, such as sore gums or teeth from the bleach. This disappears when bleach use is discontinued. Some individuals are more chemically sensitive. If you are one of them, inform your cosmetic dentist so that you can be tested for sensitivity to the solution.

Research indicates that bleaching is completely effective in more than 78% of people. In cases of serious teeth discoloration, bleaching may not be the best choice. Veneers or crowns may be the superior choice. Bleaching is usually the first solution to try due to its lower cost.

Some people experience discomfort from wearing the mouth tray. This typically goes away in short order, but if you suspect that there is a problem with the fit of your mouth tray, call your dentist's office. They can often make small adjustments that will minimize or eliminate the problem.

Who is a candidate for cosmetic gum surgery?
You should consult your dentist about cosmetic gum surgery if you believe you have "Gummy Smile" (small crown length), gum recession "long teeth", an uneven gum line due to "short teeth", gum loss or gums which appear to be collapsing (from missing teeth), dark or black areas between bridges, implants, crowns or teeth, or tooth sensitivity from receding gums.

There are two primary procedures for cosmetic gum surgery, depending on your current smile.

"Gummy Smile" (Excessive Gingival Display)
A "Gummy Smile" can occur due to wear of teeth from teeth grinding, a short upper lip, or having a longer than usual upper jawbone. This smile is when your teeth appear too small and your gums appear to large.

"Long Tooth Smile" (Gum Recession)
As your gums recede, your teeth appear longer than normal. While "long teeth" may result in an unattractive smile, you should also be concerned with root sensitivity and possible tooth loss. Recent advances in techniques and materials have resulted in significant improvements in both comfort, predictability and esthetics.

To Correct a "Gummy Smile"
Cosmetic gum surgery can be done to reduce the excess gum and bone. The removal of these tissues allows for normal sized teeth and for a normal gum line appearance by using an instrument, usually a laser, to remove the undesirable tissue. Typically your cosmetic dentist will prescribe an antibacterial mouth rinse to be used twice a day for a two-week period following your surgery.

To Correct a "Long Tooth Smile"
As your gums recede, your teeth look much "longer" than normal. Such gum recession exposes your sensitive root surface which often makes hot or cold foods and drinks a painful experience. Teeth can become loose as your gum recedes. The cosmetic gum surgery solution is basically when a cosmetic dentist or periodontist removes tissue from the roof of your mouth and then grafts it onto your gum line. This tissue then reinforces thin gums or fills in areas where your gums have receded. Typically your cosmetic dentist will prescribe an antibacterial mouth rinse to be used twice a day for a two-week period following your surgery.

How much does cosmetic gum surgery cost?

The costs involved in cosmetic gum surgery vary extensively based upon how much of your mouth is undergoing a procedure, which corrective procedure is being used, and which other cosmetic dentistry procedures will be needed to provide you with that perfect smile. It is common for other cosmetic dentistry procedures, such as crowns or veneers, to be recommended by your dentist as part of the overall strategy to cosmetically correct your gums. The overall strategy should be extensively discussed with your dentist and well understood by you prior to undergoing these procedures..

Pros and Cons of Cosmetic Gum Surgery

Advantages:
Healing is usually quick and your more youthful and beautiful smile is obvious early on. It has been reported that cosmetic gum surgery additionally improves the health of your gums. The procedure to correct receding gums may even reduce your tooth sensitivity to cold or hot foods or beverages while protecting your roots from decay and lessening further gum shrinkage.

Disadvantages:
Cosmetic gum surgery is of course, surgery. Surgery is often performed in segments under a local anesthetic - unless your entire mouth is undergoing this procedure at once, then a general anesthesia is typically used.

ROOT CANALS

Dental Root Canals for Your Teeth

Many of us have heard the comparisons of painful things to the root canal procedure. It's not that bad. There are tiny canals within your tooth that may become infected. This leads to the pulp inside your tooth also becoming diseased. Either your dentist or an endodontist to remove any infection performs the root canal procedure. The canals are then filled and the tooth receives either a filling or a crown. Crowns are more common in most cases as they add strength to the tooth itself. The procedure itself takes one to two visits.

What are Root Canals?

There are tiny canals within your tooth that may become infected. This leads to the pulp inside your tooth also becoming infected as well. Either your dentist or an endodontist to remove any infection performs the root canal procedure. The canals are cleaned and then filled and the tooth receives either a filling or a crown.

How are Dental Root Canals Performed?

Depending on the number of teeth and severity affected, root canals usually require one to two visits not including any follow-up visits. Your dentist or endodontist will numb the area around the affected tooth, or may offer you the option of mild sedation. The tooth is then drilled to the pulp area either through the top or the back of the tooth. The actual root canals are measured after some of the pulp has been removed. This is done so that the dentist can clean the entire canal, and so that enough of the filling material will be used to completely fill the canal. The actual measuring is done with either x-rays or electronic imaging devices.

All of the diseased pulp in the tooth is removed, and the canal is cleaned out thoroughly with an antiseptic solution. This solution will clean all of the canals within the tooth. The canals are then filled with gutta percha, a flexible plastic material. A temporary filling is then put on top of that. A crown or permanent filling will be done after there has been no sign of infection. Crowns are most common since the root canal procedure weakens the tooth. The crown is usually placed as soon as possible, within a month or less.

Expect two to three days of soreness after the procedure, or longer if the infection in the root canal was severe.

How much do dental root canals cost?

Expect the cost of a root canal treatment to be about $400. to $600. per front tooth and about $500. to $800. for a molar. The difference is because front teeth usually have only one root canal and molars usually have three or more. The costs for a crown or permanent filling are additional. Costs for a second root canal, hopefully not needed, on the same tooth are slightly higher.

Overview of Tooth Veneers

Often an alternative to crowns, veneers are very thin pieces of specially-shaped porcelain or plastic that are glued over the front of your teeth with little or no anesthesia needed. They are the cure for teeth that are severely discolored, chipped, have small holes or pits, misshapen or crooked, or for the correction of unwanted or uneven spaces. Unlike crowns, veneers won't require the dentist to remove much of the tooth itself in most cases. It is important to ask your cosmetic dentist how much tooth will be removed. In some cases more tooth will need to be removed, which may increase the risk of trauma to the tooth. Veneers are created from an impression taken in your cosmetic dentist's office. Your custom veneer is then glued directly onto your tooth. Typically costing less than crowns, veneers won't stain, making veneers a very popular solution for many people seeking that perfect smile. Strong and very durable, veneers last from ten to fifteen years, and come in colors that will brighten dark teeth without the worry of them changing color.

How are Tooth Veneers Attached to your Tooth?

In your first appointment, it is important to initially discuss with your cosmetic dentist that you will want to "try in" your veneers with temporary cement that is the same color cement as will be used for the permanent attachment. During this "try-in" phase, be sure to look at your veneers in natural light in addition to the office light. Teeth are prepared for veneers by lightly buffing to allow for the small added thickness of the veneer. Veneers are thin like contact lenses, and will usually only need tooth reduction of 0.5mm to 1.0mm. If a drastic change is being made for the result you want, reduction may be 1.0mm to 2.0mm. A mold is taken of the teeth, from which the veneers are modeled after. Temporary veneers will be placed and worn until your permanent veneers are ready. While wearing the temporary veneers, advise your cosmetic dentist of any adjustments or changes you would like made, such as in shape or size. These changes will be translated into your permanent veneers, so good communication between you and your dentist is important in achieving your new smile.

Your dentist places the veneers with water or glycerin on the teeth to verify their perfect fit and the shade or color. The color cannot be changed after the veneers are adhered to your teeth. The tooth is then cleansed with chemicals to achieve a durable bond. Once the glue is between the veneer and your tooth, a light beam is used to harden the glue/cement.

Types of Tooth Veneer Procedures:

There are two tooth veneers procedures available that correct discoloration of the teeth by removing the brown and yellow staining. While each work effectively, there are advantages and disadvantages to each procedure dependent upon your objectives and commitment to the processes. The type of procedures available should be discussed with your cosmetic dentist, and a they will recommend the most appropriate tooth veneers procedure for you.

Composite Veneer Procedure:

Composite (direct) veneers are usually performed in a single visit to your cosmetic dentist. The procedure is an application of a bond and enamel directly to the tooth's surface.

Porcelain Veneer Procedure:

Porcelain (indirect) veneers are a very thin porcelain material. Usually porcelain veneers require two visits and also require a dental laboratory to create the final tooth restoration piece.

How much do tooth veneers cost?

Porcelain Veneers typically cost between $900 - $2,500. per tooth and require two or more visits one to two weeks apart. Veneers made of porcelain provide a greater longevity than plastic, typically ten years to fifteen years or more.

Composite Veneers cost significantly less, around $250 per tooth or more, but only last from five to seven years typically.

Generally speaking, the price of tooth veneers and whitening increases with the number of in-office treatments required by the patient. Dental insurance does not typically cover the cost of the tooth veneers procedure.

How to select a color for your veneers.

When considering veneers a common question is how white the veneers should be. Usually, the answer is to whiten your natural teeth to either the level of whiteness you want or to the brightest they can be. Your cosmetic dentist will then have the veneers made to that color. Teeth are of course not monochromatic, so typically more than one color is used to create a very natural look. This color variation is critical in avoiding fake or artificial looking teeth. It is the internal contrast of colors that help create vitality. The internal play of light on the porcelain in the restoration helps to create this vitality. Surface texture is also very important, and helps to break up light reflections and make the crown or veneer look more natural.

There is no one standard system in the dental field to measure and determine tooth color. The most often heard about, however, is the Vita shade guide. This guide divides tooth color into four basic shade ranges:
A (reddish brown)
B (reddish yellow)
C (gray)
D (reddish gray).

In the A range there are five levels of darkness. Ranges B, C and D, each have four levels.

Not all of your teeth are the same natural color. Usually your eye teeth tend to be darker than the others, your front teeth are typically the whitest, and molars tend to be a shade between the two. The goal for everyone is to achieve their individual optimum whiteness while still looking natural.

Most dentists will show you a shade chart (like the above mentioned Vita Shade Guide) for you to pick from. Keep in mind, with a good cosmetic dentist this is merely a starting point. Other considerations when determining the color of veneers for each patient are your complexion, hair color, the color of your natural teeth and even your eye color.

TOOTH CONTOURING AND RESHAPING

What is tooth contouring and reshaping?

Tooth reshaping, or contouring, is one of few instant treatments now available in cosmetic dentistry. Dental reshaping and contouring is a procedure to correct crooked teeth, chipped teeth, cracked teeth or even overlapping teeth in just one session.

The dental contouring procedure can even be a substitute for braces under certain circumstances. It is also a procedure of subtle changes. A few millimeters of reduction and a few millimeters of tooth-colored laminate can create a beautiful smile when performed by a cosmetic dentist, with no discomfort to you. Tooth reshaping, or dental contouring, is commonly used to alter the length, shape or position of your teeth.

Overview of tooth contouring and reshaping

Dental reshaping and contouring is a procedure to correct crooked teeth, chipped teeth, cracked teeth or even overlapping teeth in just one session. This procedure is even a substitute for braces under certain circumstances. This is also a procedure of subtle changes. A few millimeters of reduction and a few millimeters of tooth-colored can create a beautiful smile when performed by a cosmetic dentist, with no discomfort to you. Tooth reshaping, or dental contouring, is commonly used to alter the length, shape or position of your teeth.

How is tooth contouring and reshaping accomplished?

Preparation for dental contouring and reshaping is a team effort with your cosmetic dentist. Some dentists in cosmetic dentistry even use computer imaging to show you how you will look after the procedure.

Your cosmetic 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.

The cosmetic dentist will mark your teeth with a pencil prior to performing the procedure. This helps the cosmetic dentist in their sculpting process. As your cosmetic dentist sculpts the tooth, imperfections are artfully eliminating or minimized. A sanding drill or laser may be used to remove small amounts of surface enamel gradually. Abrasive strips are then moved back and forth between your teeth to shape the actual sides of your teeth. Then the teeth are smoothed and polished. Usually anesthetic is not needed. Teeth contouring and reshaping usually takes one to three visits.

Contouring teeth may also help correct small problems with bite. It is common for bonding to be combined with tooth reshaping to achieve a beautiful smile.

Types of Tooth Contouring and Reshaping Procedures
There are actually several ways to change the appearance of your teeth. Many times these various procedures are combined in different ways to deliver that smile of your dreams.

Tooth Contouring and Reshaping

The reshaping of a your teeth is a procedure that involves the removal of a very small amount of tooth structure to help achieve a more desirable smile. Chipped or fractured areas are smoothed out and specific angles or edges can be rounded or squared. Contouring creates better alignment and can create a more feminine or masculine smile. It is sometimes done to prevent chipped areas from getting worse. Tooth reshaping is a conservative way to improve the teeth. Since teeth can become weaker if large amounts of enamel are removed, this procedure is limited to minor changes or combined with veneers or bonding for a terrific smile.

Dental Veneers

Veneers are sometimes used in conjunction with contouring. Dental veneers are very thin pieces of specially-shaped porcelain or plastic that are glued over the front of your teeth with little or no anesthesia needed. They are the cure for teeth that are severely discolored, chipped, have small holes or pits, misshapen or crooked, or for the correction of unwanted or uneven spaces. Unlike crowns, veneers won't require the dentist to remove much of the tooth itself. Veneers are created from an impression taken in your cosmetic dentist's office. Your custom veneer is then glued directly onto your tooth.

Tooth Bonding

Basically, bonding will cover any natural flaws applying a thin coating of a plastic material on the front surface of your teeth. After this, your cosmetic dentist will apply a bonding material sculpt, color and shape it to provide a pleasing result. A high-intensity light then hardens the plastic, and the surface is finely polished. This procedure often accompanies contouring and teeth reshaping procedures.

How much does tooth contouring and reshaping cost?

Your dental insurance is likely to cover tooth contouring and reshaping only if it is needed as a result of an accident, but this is a relatively inexpensive procedure. The cost depends on how much the dental reshaping is needed, but average costs are approximately $50 to $350 per tooth.

DENTURES

What are dentures?

Dentures are removable replacements for missing teeth typically made out of an acrylic resin which at times incorporate porcelain or metal for additional structural support. There are two main types of dentures. Both Complete Dentures and Partial Dentures are finely crafted, custom-fitted. If you properly maintain your dentures they will appear natural and provide a perfect smile. Additionally, dentures help strengthen muscles controlling your expressions that require the support of your teeth, rid you of pronunciation problems caused by missing teeth and aid with chewing.

Who is a candidate for dentures?

If you've lost, or are losing, all of your teeth a Complete Denture is something to discuss with your cosmetic dentist. If some of your teeth remain and are healthy, a partial denture may be your way to a great smile.

This procedure should be thoroughly discussed with your dentist as there are several personal and medical factors to take into consideration. You may instead be a candidate for dental bridges and dental implants as optional procedures.

Complete Dentures

These replace all of your teeth, upper or lower. Their comfort depends on muscle, bones, tongue, and saliva. Patients begin wearing conventional dentures after healing the teeth that were pulled.

Immediate Dentures

Immediate Dentures are placed all at once, and may require additional adjustments after the healing process. It can take months for your bone and tissue to stabilize after tooth extractions.

Upper Dentures

Upper Dentures, tend to be a bit easier to adjust to. These are made of the same materials as a Complete Denture, but are designed to provide you with upper teeth only.

Over Dentures

Over Dentures are a type of conventional denture similar to Complete Dentures. The difference is that not all teeth are extracted and they use one or more natural teeth for their support. This type provides greater stabilization during chewing. Over Dentures cost more and typically require more preparation dental appointments until the procedure is fully complete.

Partial Dentures

Designed to correct the gaps in your smile when only some of your teeth are missing. Metal attachments anchor the dentures to your natural teeth. Partial Dentures maintain tooth alignment by preventing your remaining teeth from shifting. Partial Dentures can also help prevent your loss of more teeth due to decay or gum disease.

Pros and Cons of a Dentures

Advantages:
Dentures definitely provide a great smile with a very natural appearance. They're made of very durable materials and last very long when properly taken care of. Typically dentures last from five to ten years. They also correct several problems, from speech to chewing, for many patients.

Disadvantages:
There's no doubt that dentures take a little getting used to. There is maintenance involved, and initial speech issues to overcome (these are temporary and last only a couple of days). Mouth irritation or sores may occur, but are usually caused by poor dental hygiene, and not removing your dentures when needed. It is common that your mouth change over the life of your dentures, so even though they last long, they may need to be replaced to achieve a better fit before they are worn out. With a denture a person typically chews at only 15-23% efficiency compared to a person chewing with their natural teeth. In the case of a full upper denture, the upper palate is covered which can reduce taste of foods you're chewing.

TOOTH CAPS

What are Tooth Caps?

Grinding of your teeth, an improper bite, age, fillings and tooth decay can all be contributing factors in the wearing down, cracking or breakage of your teeth. Dental caps cover the entire visible surface of your affected tooth and add strength, durability and stability.

Pros and Cons of Dental Caps Types

Dental caps in general add a good deal of strength to a weakened or worn tooth, and last ten to fifteen years. Depending on your habits and the condition of your gums, there may be some drawbacks for you. Your cosmetic dentist will advise which is best for you given several factors, such as how important appearance is to you. The following are the advantages and disadvantages of the most common types of caps.

Gold Caps

Advantage: The preparation of your tooth for a gold cap is the simplest and least complicated preparation. There is minimal tooth structure removal with as much as possible of the healthy tooth structure remaining untouched. As porcelain is hard by comparison, it may cause wear on opposing teeth over the years where gold is not as likely to do this. Gold is also easier to place to the area where the tooth and cap meet for a better fit. Gold is also a healthier environment for the gum tissue.

Disadvantage: The biggest disadvantage to gold caps is cosmetic, unless it is being used in the back of your mouth.

Porcelain Caps

Advantage: Porcelain caps or the new reinforced resin types are considered to be the most aesthetically pleasing, as it is so easily matched in color to your surrounding teeth.

Disadvantage: The thickness of the porcelain required for pleasing aesthetics also requires that more tooth structure is removed. Also, it is more difficult for your cosmetic dentist to get an ideal fit where your gum meets the cap. Gingival inflammation is typically more common with porcelain caps than gold caps.

Porcelain Fused-to-Metal Caps

Advantage: Porcelain fused-to-metal caps have a very natural and pleasing appearance.

Disadvantage: They have a metal substructure and require an opaque below the porcelain, which can make the translucency of natural teeth difficult to replicate. Occasionally a darker line will be visible at the edge of the cap, by your gum as your gum recedes with age.

What are dental implants?

Dental implants are fixtures of titanium which are surgically screwed into your jaw bone. The implant is an anchor for a naturally-appearing false tooth or a set of false teeth. The success rate of dental implants depends on where the implants are placed and their purpose. They are typically best placed in the front portion of your lower jaw. Implants are great for replacing missing teeth. It is important that you have enough bone in the area of the missing teeth for the implants to be attached to. Implants are not only used to replace one tooth, but rather people missing most, if not all, of their teeth benefit greatly as well. Implants are increasingly being used to replace certain types of bridges and removable partial dentures.

Who is a candidate for dental implants?

If you're missing one tooth or all of your teeth, implants may well be for you. So long as you have enough bone in the area of the missing tooth to facilitate the anchorage of the implants, this procedure can yield terrific results. If you don't have enough bone for this purpose, a bone graft may be necessary. If you have a small dental bridge or partial dentures (removable type), implants will be a welcome alternative. Implants are an alternative to a fixed bridge. The implant will last a lifetime, but the crown on top of it will last ten to fifteen years.

Types of Dental Implant Procedures

Implants rely on titanium fixtures inserted into the jawbone. Most implants are made of titanium, which is very effective at fusing with living bone (osseointegration). There are three types of dental implants which your cosmetic dentist will discuss with you:

Root Form Implant

This screw type implant is shaped like the root of a tooth. This is the most commonly used implant and is used where there is plenty of width and depth to your jawbone. If your jawbone is too narrow or short for placement of the Root Form implants, bone grafting may be needed to allow for their placement. After you've received anesthesia, your cosmetic dentist will expose an area of your jawbone and prepare the bone for the implant. The number of incisions and bone preparations depend on how many implants you need. The implant will be set into place and your gums are closed with stitches. It will take three to six months for healing. After you've fully healed, your implant is uncovered and an abutment is attached.

Plate Form Implant

If your jawbone is too narrow for bone grafting, a Plate Form implant is placed into your jawbone. The Plate Form implant is unique for this purpose as it has a flat and long shape for a better fit into a narrow jawbone. After you've received anesthesia, your cosmetic dentist will expose an area of your jawbone and prepare the bone for the implant. The number of incisions and bone preparations depend on how many implants you need. The implant will be set into place and your gums are closed with stitches. It will take three to six months for healing (some Plate Form implants are immediately ready for restoration without the long healing process).

Subperiosteal Implants

If there's not enough bone width or height for the Root Form or Plate Form implants, the Subperiosteal implant is recommended. The Subperiosteal implant is custom made to rest on top of your jawbone and under your gums like the Plate Form implant, but the Subperiosteal implant is placed through one of two special methods.

The first method of placement involves your cosmetic dentist making an impression of your jawbone. After you've received anesthesia, your cosmetic dentist exposes your jawbone and takes an impression of it. The impression is used by a dental laboratory to make a custom-fit implant for your jaw. The next procedure, after your custom-fit implant is created, is to again expose your jawbone and place the implant. Your gums are then closed with stitches and replacement teeth are installed.

The second method of placement requires a CAT scan of your jawbone. Through computer modeling techniques, a model of your jawbone is made from the CAT information. The next procedure, after your custom-fit Subperiosteal implant is created by a dental laboratory, is to again expose your jawbone and place the implant. Your gums are then closed with stitches and replacement teeth are installed.

Pros and Cons of Dental Implants

Advantages:
As our life span increases, a permanent dental replacement like implants is increasingly important as we get older. While dentures and removable bridges are usually loose and unstable, implants provide you with dental replacements that are both natural looking and very functional. Implants look much better, and feel better, than traditional removable bridges, and offer the same force for biting as bridges that are fixed in place. Implants will last your lifetime.

Disadvantages:
Implants are a major investment and not without risk. The extensive use of implants can cost tens of thousands of dollars to achieve a great result. It is also a very time consuming procedure when having many implants placed. As this procedure is surgery, it is very important to research and find a well credited cosmetic dentist that you are comfortable with. For some people there are varying degrees discomfort or pain, which subsides in a couple of days. As with similar types of surgery, bruising and minor swelling might also develop shortly after the procedure. The crown (false tooth placed on top) will need to be replaced in ten to fifteen years.

How to choose the color of dental implants?

When considering dental implants a common question is how white the dental implants should be. Usually, the answer is to whiten your natural teeth to either the level of whiteness you want or to the brightest they can be. Your cosmetic dentist will then have the dental implants made to that color. Teeth are of course not monochromatic, so typically more than one color is used to create a very natural look. This color variation is critical in avoiding fake or artificial looking teeth. It is the internal contrast of colors that help create vitality. The internal play of light on the porcelain in the restoration helps to create this vitality. Surface texture is also very important, and helps to break up light reflections and make the dental implants look more natural.

There is no one standard system in the dental field to measure and determine tooth color. The most often heard about, however, is the Vita shade guide. This guide divides tooth color into four basic shade ranges:
A (reddish brown)
B (reddish yellow)
C (gray)
D (reddish gray).
In the A range there are five levels of darkness. Ranges B, C and D, each have four levels.

Not all of your teeth are the same natural color. Usually your eye teeth tend to be darker than the others, your front teeth are typically the whitest, and molars tend to be a shade between the two. The goal for everyone is to achieve their individual optimum whiteness while still looking natural.

Most dentists will show you a shade chart (like the above mentioned Vita Shade Guide) for you to pick from. Keep in mind, with a good cosmetic dentist this is merely a starting point. Other considerations when determining the color of dental implants for each patient are your complexion, hair color, the color of your natural teeth and even your eye color.

How long does tooth bonding last?

While the traditional silver fillings last about seven years, these composites should last about seven to eleven years.

How is Tooth Bonding Accomplished?

A very mild etching solution is applied to your teeth to create very small crevices in the tooth's enamel structure. These small crevices provide a slightly rough surface permitting a durable resin to bond materials to your teeth. The resin is then placed on your tooth and high-intensity light cures the resins onto your tooth's surface - with each individual layer of resin hardening in just minutes. When the last coat has been applied to your tooth, the bonded material is then sculpted to fit your tooth and finely polished.

The resin comes in many shades so that we can match it to your natural teeth. Due to the layers involved, this procedure will take slightly longer than traditional silver fillings because multiple layers of the bonding material are applied. Typically bonding takes an hour to two hours depending on your particular case.

Who is a candidate for tooth bonding?

If you have close, small gaps between your front teeth, or if you have chipped or cracked teeth, you may be a candidate for bonding. Bonding is also used for patients who have discolored teeth, uneven teeth, gum recession or tooth decay. Bonding material is porous, so smokers will find that their bonding will yellow. If you think you are a candidate for bonding, discuss it with your dentist.

DENTAL BRIDGES

What is a dental bridge?

A dental bridge is a false tooth, known as a pontic, which is fused between two porcelain crowns to fill in the area left by a missing tooth. The two crowns holding it in place that are attached onto your teeth on each side of the false tooth. This is known as a fixed bridge. This procedure is used to replace one or more missing teeth. Fixed bridges cannot be taken out of your mouth as you might do with removable partial dentures.

In areas of your mouth that are under less stress, such as your front teeth, a cantilever bridge may be used. Cantilever bridges are used when there are teeth on only one side of the open space. Bridges can reduce your risk of gum disease, help correct some bite issues and even improve your speech. Bridges require your commitment to serious oral hygiene, but will last as many ten years or more.

Who is a candidate for dental bridges?

If you have missing teeth and have good oral hygiene practices, you should discuss this procedure with your cosmetic dentist. If spaces are left unfilled, they may cause the surrounding teeth to drift out of position. Additionally, spaces from missing teeth can cause your other teeth and your gums to become far more susceptible to tooth decay and gum disease.

Overview of dental bridge procedure

If you a space from a missing tooth, a bridge will be custom made to fill in the space with a false tooth. The false tooth is attached by the bridge to the two other teeth around the space - bridging them together.

How is dental bridge accomplished?

Your cosmetic dentist will prepare your teeth on either side of the space for the false tooth. You will be given a mild anesthetic to numb the area, and the cosmetic dentist will remove the an area of each abutment (teeth on either side of the space) to accommodate for the thickness of the crown. When these teeth already have fillings, part of the filling may be left in place to help as a foundation for the crown.

The dentist will then make an impression, which will serve as the model from which the bridge, false tooth and crowns will be made by a dental laboratory. A temporary bridge will be placed for you to wear while your bridge is being made until your next visit. This temporary bridge will serve to protect your teeth and gums.

Your cosmetic dentist may have you use a Flipper appliance. A Flipper is a false tooth to temporarily take the place of a missing tooth before the permanent bridge is placed. A Flipper can be attached via either a wire or a plastic piece that fits in the roof of your mouth. Flippers are meant to be a temporary solution while awaiting the permanent bridge.

On your second appointment, the temporary bridge will be removed. Your new permanent bridge will be fitted and checked and adjusted for any bite discrepancies. Your new bridge will then be cemented to your teeth.

Types of Dental Bridge Procedures

There are three types of dental bridges:

Traditional Fixed Bridge

A dental bridge is a false tooth, known as a potic, which is fused between two porcelain crowns to fill in the area left by a missing tooth. There two crowns holding it in place that are attached onto your teeth on each side of the false tooth. This is known as a fixed bridge. This procedure is used to replace one or more missing teeth. Fixed bridges cannot be taken out of your mouth as you might do with removable partial dentures.

Resin Bonded Bridges

The resin bonded is primarily used for your front teeth. Less expensive, this bridge is best used when the abutment teeth are healthy and don't have large fillings. The false tooth is fused to metal bands that are bonded to the abutment teeth with a resin which is hidden from view. This type of bridge reduces the amount of preparation on the adjacent teeth.

Cantilever Bridges

In areas of your mouth that are under less stress, such as your front teeth, a cantilever bridge may be used. Cantilever bridges are used when there are teeth on only one side of the open space. This procedure involves anchoring the false tooth to one side over one or more natural and adjacent teeth.

TOOTH CROWNS

What are Tooth Crowns?

Grinding your teeth, an improper bite, age, fillings and tooth decay can all be contributing factors in the wearing down, cracking or breakage of your teeth. Dental crowns cover the entire visible surface of your affected tooth and add strength, durability and tooth stability.

Types of Tooth Crowns
There are basically three types of crowns, those made of gold, ceramic crowns and ceramic-veneered gold crowns. Gold and metal-ceramic crowns are extremely durable and are normally used in molars, where the forces from chewing and grinding are most prevalent. Ceramic crowns are used primarily for front teeth, since they can best resemble the natural tooth color.

Resin and Porcelain Crowns
The new reinforced resin or bonded all-porcelain type of crown has the nicest appearance. This crown can be made from pure ceramic or a new reinforced composite resin, and is almost indistinguishable from natural teeth. The new bonding technology involved provides an exceptional bond your tooth. It is metal-free, and thus satisfies the needs of patients with metal sensitivities. When correcting your back teeth with bonding, the cosmetic dentist will perform a tooth colored onlay. This type of procedure is used to correct only those parts of the tooth that are in need. This is a metal-free procedure.

Crowns Made of Gold
Gold crowns are appropriate when appearance is not a priority to you. The gold metal is extremely workable making gold crowns a more precise fit than any other type. While there exists a slight possibility of chipping with porcelain crowns, gold crowns provide no such possibility.

Porcelain and Metal Crowns
For a very natural appearance, porcelain fused to metal crowns are the answer. However, they have a metal substructure and require an opaque below the porcelain. This can make the translucency of natural teeth difficult to replicate. Occasionally a darker line will be visible at the edge of the crown, near to your gum when it recedes with age.

Types of Porcelain
There are basically two types of porcelain you're likely to hear and read about most - the felspathic and pressed ceramic porcelains. The felspathic type is the original method that has been around for 20 years. A Ceramist in a dental lab bakes porcelain onto tin foil and then heats it in an oven. The Ceramist is able to create tints and opaques inside the porcelain to give the natural look we seek.

Pressed ceramic is created from a single ingot. The single ingot is milled in one piece to create the desired shape. The stains and opaques are applied only to the surface of the porcelain to give a natural look.

Pros and Cons of Dental Crowns Types

Tooth crowns in general add a good deal of strength to weakened or worn teeth. Depending on your habits and the condition of your gums, there can be some drawbacks. Your cosmetic dentist will advise which is best for you given many factors, including how important appearance is to you. The following are the advantages and disadvantages of the most common crown types.

Gold Crowns

Advantage: The preparation of a tooth for a gold crown is the simplest and least complicated preparation as there is minimal tooth structure removal with as much as possible of the healthy tooth structure remaining untouched. While porcelain is hard by comparison, it may cause wear on opposing teeth over the years where gold is not as likely to do so. Gold is also easier to fit to the area where the tooth and crown meet for a better fit. Gold is also a healthier environment for the gum tissue.

Disadvantage: The biggest disadvantage to gold crowns is the cosmetic aspect, unless it is being used in the back of your mouth.

Porcelain Crowns

Advantage: Porcelain crowns or new reinforced resin are considered to be the most aesthetically pleasing, as it is so easily matched in color to the surrounding teeth.

Disadvantage: The thickness of the porcelain required for pleasing aesthetics also requires that more tooth structure needs to be removed. It is more difficult for your cosmetic dentist to get an ideal fit where your gum meets the crown. Gingival inflammation appears to be more common with porcelain crowns than gold crowns. All-porcelain crowns require a higher skill level from your dentist and lab.

Porcelain Fused-to-Metal Crowns

Advantage: Porcelain fused-to-metal crowns have a very natural appearance.

Disadvantage: They have a metal substructure and require an opaque below the porcelain. This can make the translucency of natural teeth difficult to replicate. Occasionally a darker line will be visible at the edge of the crown, near to your gum when it recedes with age.

   

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