Cosmetic Dentistry Cuenca Azuay

Country: Ecuador
State: Azuay
City: Cuenca

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.

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.

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.

TOOTH WHITENING

Sometimes a single tooth becomes discolored causing it to look out of place with the rest of your smile. In these cases you may want to consider having the tooth whitened to match the rest of your teeth. If you'd like to learn more about what causes the discoloration and what can be done about it, please follow the links below.


How much can a tooth be whitened?

How white an individual tooth can become from bleaching and whitening is a common question. Some whitening procedures claim they can whiten your teeth by up to nine shades, but that is highly unlikely. 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. However, the Vita shade guide is the most used. This guide divides individual 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. As strange as it may sound, usually your eye teeth are darker than the others, and your front teeth are almost always the whitest, and molars tend to be a shade between those two. When your cosmetic dentist is whitening one particular tooth, they will take this into account. The goal for everyone is to achieve an overall 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 a white tooth will become will vary from person to person. The structure of your tooth and the type of procedure implemented will affect the outcome.

The following chart will give you some idea of what to expect. As everyone's circumstances are different, options should be further discussed with your cosmetic dentist prior to making a decision. Most people are not seeking a gradual whitening of an individual tooth. The laser whitening procedure affords the cosmetic dentist the needed control and the patient the instant results sought.

Procedure: Usually Lasts For: May Cause During and Shortly After Procedure: Time for Procedure: Changes in Shade: Average Cost:
Laser 12 - 18 Months Minor Discomfort 2 - 3 Hours 7 - 8 $ 300.

COSMETIC GUM SURGERY

What is cosmetic gum surgery?

Your gum tissue is like a frame that provides form and shape to the top of your tooth. A less than attractive smile results when the integrity of the gum is compromised or the actual gum between your teeth becomes weak. Usually due to poor hygiene (gum disease), you actually begin to lose gum tissue. Cosmetic dentistry provides many cosmetic solutions such as composite resin bonding, crowns, and veneers to create a great smile. These solutions are usually part of an overall strategy which may involve cosmetic gum surgery. Used to correct a 'gummy smile' (a significant portion of your gum is exposed when you smile), cosmetic gum surgery is the procedure of lengthening your teeth from the neck of the tooth upwards. Your teeth then appear to be longer and much less gum is seen when you smile.

The "Long in the Tooth" Smile - Cosmetic gum surgery, or periodontal plastic surgery, can correct almost any deformity or gingival problems preventing you from a beautiful smile. As we age, our gums may shrink and recede which makes our teeth look longer. While this is often age-related, it can also occur due to a bad bite. A cosmetic dentist or a periodontist can correct this to such an extent, that you'll have a very youthful appearing smile.

The "Gummy Smile" - This is a problem where your teeth appear to be too short. Gum sculpting is often the solution. To solve this, a dentist uses a laser to remove the excess tissue of your "gummy" smile, which then exposes more of your tooth.

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..

Who is a candidate for a root canal?

If your tooth is infected or there's severe damage to the pulp, a root canal will be recommended. An untreated cavity is the most common cause for this infection. The pulp inside the tooth can become inflamed from trauma or extensive restorative work. It can even be affected from a series of fillings being applied in a short period of time. This inflammation usually leads to infection. Pain in the tooth is the most common and obvious symptom.

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.

Pros and Cons of Tooth Veneers

Advantages:
Porcelain veneers are common in creating new smiles and smile makeovers. With porcelain veneers, you can have the smile of your dreams in a very short period of time. Typically veneers are difficult to 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. Veneers are typically done in only two one and a half hour long appointments, and can actually strengthen your tooth.

There is no additional maintenance, other than a follow-up visit to your cosmetic dentist and proper brushing and flossing on a daily basis.

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

Disadvantages:
It takes roughly a week or two of a period of adjustment to get used to your teeth that have been changed in color, size, spacing and shape. While very little tooth is removed in most cases, there are situations where more tooth must be removed which increases the risk of trauma to the tooth. The amount of tooth to be removed for the veneers should be discussed with your cosmetic dentist beforehand.

It is common to have minor sensitivity after your teeth have been prepared for your veneers while wearing the temporary veneers. Some people can experience a difference in speech, usually pronouncing "s" and "f" sounds. This is corrected through minor adjustments your cosmetic dentist can make to your veneers. Veneers are very reasonable facsimiles of natural teeth, but not perfect replacements for natural teeth. It's common to see slight variations in the color of veneers upon very close inspection, as with natural teeth. It can take up to a month or two before your new smile feels a part of you.

If you suffer from bruxism, clenching or grinding of your teeth, veneers can be damaged, chipped or cracked from this. If you suffer from bruxism, speak with your cosmetic dentist about wearing a mouth guard at night to protect your new smile.

Who is a candidate for tooth contouring and reshaping?

If you want your teeth to appear less crowded, lack chips and fractures, have decreased overlaps or to be without pits or grooves in the enamel, this procedure should be discussed with your cosmetic dentist. With a little dental contouring, you can make a huge difference in the way you feel about your smile. Good cosmetic dentistry can give you a smile that is the envy of others. Tooth contouring by a cosmetic dentist does require that you have normal, healthy teeth.

Tooth reshaping, or tooth sculpting, is a safe and conservative way to improve your smile. Teeth may become weaker if large amounts of enamel are removed, tooth reshaping should be limited to minor changes or combined with veneers or bonding for the best 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.

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.



Who is a candidate for dental caps?

If you grind your teeth, have an improper bite, have fillings or tooth decay you have contributing factors to 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.

A cosmetic dentist will usually be able to identify problem areas in your mouth that might lead to tooth damage and a need for caps. Chewing patterns play a big role too. By selectively grinding the tips of your middle and back teeth (cusps) will alter your bite to reduce the stress on your at-risk teeth.

How are Dental Caps Attached to your Tooth?

A cosmetic dentist will make an impression (mold) of your tooth and a dental laboratory will create the needed custom cap. You will typically leave the office with a temporary cap to wear while the permanent cap is being made - this takes about fourteen days. The permanent cap is then cemented onto your tooth. Typically, only two visits are required for this part of the procedure. Often, a preliminary restoration of your tooth may be needed before the permanent cap is actually placed. To stabilize your tooth, a filling must first be put in place prior to placing a cap to counter any loss of your original tooth structure.

It is important to discuss with your cosmetic dentist that the cement color used for your permanent cap will be the same as used for the temporary cap (try in paste). The color of the cement does affect the overall color of a porcelain cap, so this needs to be discussed well before your temporary cap is placed.

In some cases your cosmetic dentist may choose to use a Flipper instead of a temporary cap. A Flipper is a false tooth to temporarily take the place of a missing tooth before the permanent crown 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 cap.

How much do dental caps cost?

Porcelain caps cost more because they are usually more time-consuming than gold caps. Porcelain and gold caps will average between $500. to $3,100. in total cost.

The relatively new reinforced resin or bonded all-porcelain type of caps cost more, and may exceed your insurance plan coverage for caps.

Usually, the price of dental caps increases with the number of in-office treatments required by the patient. Dental insurance does not typically cover all the costs of the dental cap procedure.

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.

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.

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.

Types of Tooth Bonding Procedures

There are two types of bonding. What type is indicated in your situation depends upon whether you have a small area or a larger area that requires correction.

For small corrections

These are one appointment fillings which are color-matched to the tooth and are bonded to the surface for added strength. These are most appropriate for small fillings and front fillings as they may not be as durable for large fillings.

For larger corrections

Dental lab-created tooth-colored fillings require two appointments and involve making a mold of your teeth and placing a temporary filling. A dental laboratory then creates a very durable filling to custom-fit the mold made from your teeth. These fillings are typically made of porcelain. The custom-fit filling is then bonded to your tooth on your return visit. This type is even more natural looking, more durable and more stain resistant.

How much does tooth bonding cost?

As with all procedures, prices vary depending on your location. The cost of dental bonding will also vary with the extent of the bonding process you need. Many dental insurance plans cover most of the cost of the bonding, particularly when it is done for structural reasons.

The average cost of cosmetic dental bonding ranges from $300 to $600 per tooth.

Pros and Cons of Tooth Bonding

Advantages of dental bonding:
Esthetics is the big advantage over silver fillings. As silver does not stick to teeth, entirely healthy tooth structure is usually removed to keep a silver filling in place. Composites permit your cosmetic dentist to remove only the decayed area of your tooth. Unlike silver fillings, composite bonding expand just like your teeth and are much less likely to cause cracks in your tooth. Composites bond directly to the tooth providing support. Composites can be used to fill in cracks, chips and gaps - and will match the color of your other teeth.

Disadvantages of the dental bonding procedures:
Bonding with composites simply costs more in material and time.

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.

How much do dental bridges cost?

The average cost of a single fixed bridge depends on many factors, from which region you're in to how many and which type of bridges are needed. Typically dental bridge cost ranges from $500-900 per tooth. Dental insurance typically pays for about half of the cost of the bridge.

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.

Who is a candidate for 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.

Your cosmetic dentist will usually be able to spot problem areas in your mouth that might lead to tooth damage and a need for crowns. Chewing patterns play a big role as well. By selectively grinding the tips of your middle and back teeth (called cusps) will alter your bite to reduce the stress on at-risk teeth.

In other instances, crowns are used to replace a actual missing tooth. These crowns are anchored to the teeth on either side, with a bridge section connecting the two crowns. Instead of bridges, single tooth dental implants may be used that eliminate the need for supporting the crowns.

How are Tooth Crowns Attached to your Tooth?

Your cosmetic dentist will make an impression of the tooth and a dental laboratory will create the crown. You will typically leave the office with a temporary crown to wear while the permanent crown is being made - this takes about two weeks. The permanent crown is then cemented onto your tooth. Typically, only two visits are required for this part of the procedure. Often, a preliminary restoration of your tooth may be needed before a crown can be placed. To stabilize your tooth, a filling must first be put in place prior to placing a crown due to the loss of original tooth structure. Tooth crowns usually last ten to fifteen years.

Be sure to discuss with your cosmetic dentist that the cement color used for your permanent crown will be the same as used for your temporary crown. A try in paste is used for this purpose. The color of the cement does affect the overall color of a porcelain crown, so this needs to be discussed long before your temporary crown is placed.

In some cases your cosmetic dentist may choose to use a Flipper instead of a temporary crown. A Flipper is a false tooth to temporarily take the place of a missing tooth before the permanent crown 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 crown.

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.

How much do tooth crowns cost?

Expect to pay more for porcelain crowns because they are usually more time-consuming than gold crowns. Porcelain, porcelain over metal and gold crowns average between $600. to $3100. each in total cost.

The new reinforced resin or bonded all-porcelain type costs more than other types, require more skill from your dentist and the lab, and may exceed your insurance plan coverage for crowns.

Generally speaking, the price of tooth crowns increases with the number of in-office treatments required by the patient. Dental insurance does not typically cover all the costs of the tooth crown procedure.

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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