Cosmetic Dentistry Cabanatuán Nueva Ecija

Country: Philippines
State: Nueva Ecija
City: Cabanatuán

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.

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.

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 tray bleaching teeth cost?

The standard fee for tray bleaching teeth procedures is about $500 or more in most cases. Depending on your cosmetic dentist, this may or may not include office visits. Costs can vary depending upon the area of the country you live in and the type of whitening treatment you undergo.

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.

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.

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.

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.

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.

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.

Types of Root Canals

There are generally two types of root canal procedures. The first (and hopefully only) root canal on a tooth, and the second root canal on the same tooth. Both procedures are the same, other than that if this is the second root canal done on the same tooth it requires more time and expense. This is because your dentist must remove all of the previous filling in the canal and pulp area in order to start again.

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.

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.

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.

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.

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.

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.

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.

Types of Tooth Caps

There are generally three types of caps - those made of gold, ceramic caps and ceramic-veneered gold caps. Gold and metal-ceramic caps are extremely durable and are normally used in molars, where the forces from chewing and grinding are most prevalent. Ceramic caps are used primarily for front teeth, since they can best resemble the natural tooth color and are more pleasing to the eye.

Types of Porcelain used with Dental Caps
There are basically two types of porcelain you're likely to hear and read about most when researching dental caps and crowns- 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 of the dental cap or crown 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 of the cap or crown. The stains and opaques are applied only to the surface of the porcelain to give a natural look for your new smile.

Resin and Porcelain Caps
The new reinforced resin or bonded all-porcelain type of cap has the nicest appearance. This cap can be made from pure ceramic or a new reinforced composite resin. It 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 the parts of your tooth that are in need. This procedure is metal-free.

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

Porcelain and Metal Caps
For a very natural appearance, porcelain fused to metal caps are the answer for you. However, they have a metal substructure and require an opaque below the porcelain, which can make the translucency of natural teeth difficult to match. Sometimes a darker line will be visible at the edge of the cap, near to your gum when your gum recedes with age.

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.

Overview of Dental Implants

Implants are surgically placed in your jaw bone while under anesthesia. It is a very time consuming procedure when having many implants placed. As this procedure is surgical, 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.

How are Dental Implants Attached in Your Mouth?

The implant procedure is a surgical placement of the implant or implants in your jaw bone which requires a three to six month healing period before the implant restoration to replace the missing tooth or teeth. During this healing time, the bone grows in and around the titanium implant creating a very strong support. Dental implants can be rejected. Usually they are replaced with another implant of a slightly larger size. The rejection or "failure" rate is minimal, only 1 to 2% of all implant procedures. You must go without wearing your dentures for one day to two weeks after an implant placement. After the implant has "taken" and you have sufficiently healed, a very natural crown is placed on the implant.

When missing one tooth, your cosmetic dentist may use a Flipper to fill the space. A Flipper is a false tooth to temporarily take the place of a missing tooth before the permanent crown is placed on the implant. 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 to be placed on your implant(s).

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. A procedure of building up the bone is known as Bone Grafting. Bone grafting is common with dental implants. The bone that is used is one of three types. The preferred bone to use is taken from other areas of your mouth or collected in a suction device as the drilling of the sites for dental implants occurs. Sometimes bone is taken from areas such as a hip (this requires an orthopedic surgeon and an operating room). The third source for needed bone is a synthetic type. This is the least preferred type of bone to be used for this procedure.

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.

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.

TOOTH BONDING

What is tooth bonding?

Bonding is a composite resin filling placed in the back teeth as well as the front teeth. Composites are the solution for restoring decayed teeth, making cosmetic improvements and even changing the color of your teeth or the reshaping of teeth. Bonding will lighten any stains you may have, close up minor gaps and can be used to correct crooked teeth. 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 and sculpt, color and shape it to provide a pleasing result. A high-intensity light then hardens the plastic, and the surface is finely polished.

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.

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.

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.

Pros and Cons of a Dental Bridge

Advantages of dental bridges:
Bridges are natural in appearance, and usually require only two visits to your dentist. If you maintain good oral hygiene, your fixed bridge should last as many as ten years or more.

Disadvantages of having a dental bridge:
It is common for your teeth to be mildly sensitive to extreme temperatures for a few weeks after the treatment. The build up of bacteria formed from food acids on your teeth and gums can become infected if proper oral hygiene is not followed.

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.

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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