Cosmetic Dentistry Sangre Grande St. Andrews

Country: Trinidad and Tobago
State: St. Andrews
City: Sangre Grande

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.

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.

Types of Teeth Whitening Procedures

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

How much does laser teeth whitening cost?

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

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

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.

Who is a candidate for a root canal?

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

How are Dental Root Canals Performed?

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

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

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

How much do 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.

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.

DENTURES

What are dentures?

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

Who is a candidate for dentures?

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

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

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.

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.

What are dental implants?

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

Who is a candidate for dental implants?

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

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.

How long does tooth bonding last?

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

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.

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.

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.

   

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