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Desciption of cosmetic dentistry
What causes discoloration of a tooth?
Tooth enamel discoloration can be caused by staining, aging, or chemical damage to teeth. Some of the more common causes of tooth discoloration are medications, coffee, tea or cigarettes. People who drink significant amounts of cola soft drinks can experience similar staining. Damage to the root may also contribute to discoloration.
Aside from staining, there are other factors that can affect the color of a tooth. 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 a tooth. If you suspect that there is an underlying medical cause for your tooth discoloration, be sure to inform your cosmetic dentist
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.
Porcelain Veneers
Porcelain veneers can be used to correct both color and shape problems and make for a great smile makeover.
Who is a candidate for Dental Porcelain Veneers?
Veneers, porcelain or plastic, are placed over the front teeth to change color shape of the teeth. Veneers are ideal for teeth that are too small, too big, or have uneven surfaces. It is very common for people to have imperfect teeth, either oddly shaped teeth, chipped teeth, crooked teeth, teeth with small holes in them, or an inappropriate sized tooth or teeth that have an odd appearance. Veneers solve such irregularities and create a durable and pleasing smile.
Tooth Veneers
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.
Cosmetic Dental Bonding
Introduction to dental bonding
The dental bonding procedure utilizes a composite resin and is used for a variety of structural as well as cosmetic purposes. One can draw a parallel between dental bonding materials and a sculptor's clay. By using dental composite resin bonding your dentist can restore chipped or broken teeth, fill in gaps and reshape or recolor your smile

How is Tooth Bonding Accomplished?
A very mild etching solution is applied to your teeth to create very small crevices in the tooth's enamel structure. These small crevices provide a slightly rough surface permitting a durable resin to bond materials to your teeth. The resin is then placed on your tooth and high-intensity light cures the resins onto your tooth's surface - with each individual layer of resin hardening in just minutes. When the last coat has been applied to your tooth, the bonded material is then sculpted to fit your tooth and finely polished.
The resin comes in many shades so that we can match it to your natural teeth. Due to the layers involved, this procedure will take slightly longer than traditional silver fillings because multiple layers of the bonding material are applied. Typically bonding takes an hour to two hours depending on your particular case.

Who is a candidate for tooth bonding?
If you have close, small gaps between your front teeth, or if you have chipped or cracked teeth, you may be a candidate for bonding. Bonding is also used for patients who have discolored teeth, uneven teeth, gum recession or tooth decay. Bonding material is porous, so smokers will find that their bonding will yellow. If you think you are a candidate for bonding, discuss it with your dentist.
What are Dental Contouring and Tooth Reshaping?
What is tooth contouring and reshaping?
Tooth reshaping, or contouring, is one of few instant treatments now available in cosmetic dentistry. Dental reshaping and contouring is a procedure to correct crooked teeth, chipped teeth, cracked teeth or even overlapping teeth in just one session.
The dental contouring procedure can even be a substitute for braces under certain circumstances. It is also a procedure of subtle changes. A few millimeters of reduction and a few millimeters of tooth-colored laminate can create a beautiful smile when performed by a cosmetic dentist, with no discomfort to you. Tooth reshaping, or dental contouring, is commonly used to alter the length, shape or position of your teeth.
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.
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.
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 pontic, 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.
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.
Root Canal Procedure
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.
Tooth Crown Procedure

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.
Are Dental Implants for You?
Dental Implants
Tooth loss is something no one looks forward to. If you lose one or more teeth, you have a number of options, one of which is dental implants. You owe it to yourself to be informed as possible about these options. With this in mind, we've created this section on dental implants. To begin learning more about dental implants for tooth replacement, click the blue "Continue" arrow below or choose from one the subtopics on the list that follows.
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.