Cosmetic Dentistry Bandung West Java

Country: Indonesia
State: West Java
City: Bandung

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.

Overview of Teeth Whitening

Teeth whitening is used to correct discoloration of the teeth by removing the brown and yellow staining. The term "teeth whitening" can refer to a number of techniques to improve the brightness of the patient's teeth. Among them are chemical whitening, mild acid whitening, abrasive teeth brightening and the newest technique, laser teeth whitening.

Teeth Bleaching

Teeth bleaching is chemical process used to lighten the color of the patient's teeth. The procedure can be performed entirely in the cosmetic dentist's office or it can be performed by the patient in their home, using a materials provided by the dentist. The home method is often used because it saves the patient from having to make an office visit for each treatment.

Before the patient embarks on the home teeth whitening regimen, the cosmetic dentist creates a custom mouth tray for the patient. The custom tray is a critical component of the treatment. It ensures that the correct amount of whitening solution is used and that the patient's teeth are properly exposed to the whitening solution. The custom made mouth tray provides for a better fit than a one-size-fits-all mouth tray to help increase the margin of patient safety.

The steps in the home teeth whitening regimen are fairly straightforward. The cosmetic dentist's office provides the patient with the materials and instructions and also answers questions the patient may have about the routine. Your dentist's office can also provide you with off-site supervision should you have any questions once you've begun.

A home whitening session can last for two to three hours, during which time you will have the tray and solution in your mouth. Depending upon your needs and desired results, your dentist may instruct you to keep the tray in your mouth overnight. Typically, you will follow your home teeth whitening regimen for two to three weeks, after which time you will return to your cosmetic dentist for a follow up visit.

How long does teeth whitening last?

Teeth whitening is not a permanent procedure. Results can last for one to or more years, depending upon your personal habits. In most cases, the whitening procedure is very effective and the patient is pleased with the results.

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.

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.

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.

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.

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 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.

Pros and Cons of Dental Root Canals

Advantage: Pain is always associated with root canals, but should actually be little to no pain during the procedure. The procedure is not for cosmetics, but rather your health. The infect will only get worse with time if left untreated. The root canal procedure is successful over 92 percent of the time. The biggest advantage is that the tooth will not need to be extracted in the future.

Disadvantage: Not often, but sometimes infected tissue is pushed through the ends of the root, which will infect the gum. This is easily treated, but is also painful until the infection is cleared up. Canals are irregularly shaped, and if the canal is not accurately measured or branches of the canal were not discovered, it cannot be completely cleaned or filled requiring the procedure to be done again when this area becomes infected.

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.

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.

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.

Overview of dentures

Dentures are removable replacements for missing teeth typically made out of an acrylic resin which may at times incorporate porcelain or metal for additional structural support. There are two main types of dentures, complete and partial. Both Complete dentures and partial dentures are finely crafted and custom-fitted to the patient. 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.

How are dentures accomplished?

It is somewhat common to require for some teeth to be extracted, and surgery in some cases is necessary to improve the bony ridges that stabilize your dentures.

The procedure begins with a wax bite impression of your mouth that will give your dentist exacting measurements. A try-on appointment will fine tunes color, shape, and custom-fit.

After your final dentures are fabricated, they will be placed and informed of their required care.

How much do dentures cost?

Costs will vary depending on where you live and your needs. Prosthodontists' prices are typically between $500 to $2,500 per upper or lower arch. Cosmetic Dentist fees are usually $300 to $1,200 per arch. This is a procedure for which you should definitely research your dental insurance coverage. Much of the cost is often covered.



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.

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.

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 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.

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.

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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