Cosmetic Dentistry Procedures

There are many cosmetic dental techniques that can improve your smile.
For whitening of dark, dull, or stained teeth, bleaching may be the simplest solution.  Bleaching is performed by taking an impression of your teeth and making a duplicate model of them.  On this model, a soft, thin, clear tray is fabricated.  This tray is filled with a bleaching gel and placed directly over the teeth in the mouth.  This bleach filled tray can be worn for several hours during the day or worn at night while you sleep.  Results can be seen daily.  To attain maximum results, most patients must wear the bleaching tray for 1-2 weeks.  However, the timing of these results can be influenced by the different strengths of the bleaching gels which are available.
When teeth are chipped or slightly decayed, bonded composite resins may be the material of choice.  Bonding is applied to a tooth via a light gun.   First, the tooth structure is cleaned and etched.  Then a clear adhesive is applied to the area needing bonding.  Once applied, a tooth colored bonding material is placed on the tooth.  It is permanently hardened and fused to the tooth with a hand held white light gun.  This process is called photo curing.  Bonding makes a great tooth colored filling for small cavities and broken or chipped surfaces.  It can also be used to close spaces between teeth.  Additionally, it is used to cover the entire outside surface of a tooth to change its color and shape.  For the latter two applications, bonding has its limits.  It may not be strong enough, aesthetic enough, or durable enough for certain individual situations.  When these problems occur, the next choice would be porcelain laminate veneers.
Porcelain Laminate Veneers:
Many times, the demands of cosmetic changes in the mouth are too great for simple bonding.  This is when porcelain laminate veneers may be used.  Porcelain veneers (sometimes referred to as laminates) can change an entire smile.  Porcelain laminate veneers are quick, painless, and dramatic.  They can change shape, color, size, and arrangement of teeth or any combination of these factors.  They can be used as an alternative for orthodontic treatment.  The best part about porcelain laminate veneers is that they can be placed in two visits.  The technique consists of first shaving a thin layer of outer tooth structure (about the thickness of an eggshell).  An impression is then taken of the prepared teeth and is sent to a dental laboratory.  In the lab, a ceramist will make very thin porcelain facings consisting of all the changes in shape, size, color and teeth arrangement that are needed to have a great looking smile.  At the second visit, the laminates are bonded onto the prepared teeth with a white light gun.  The bonding material acts as an adhesive for the laminates.  Porcelain laminates are the most popular technique used for dramatic smile makeovers.
Porcelain Jackets:
When there is not enough tooth structure left, or the chewing demands in the mouth are too great for laminates, a stronger, more extensive restoration is needed.  Here we need porcelain jacket crowns.  Porcelain jackets are pure porcelain crowns placed on a fully prepared tooth.  They are the most life-like of all full crown type restorations.  The technique initially consists of preparing the teeth. Next, an impression is taken and then sent to the dental lab where the porcelain jacket is fabricated.  Finally, they are placed in the patient's mouth and permanently cemented onto the teeth.
Porcelain Fused to Metal Crowns:
When biting pressure is too great for porcelain jackets or gaps from missing teeth must be filled in, metal alloy must be placed under the porcelain for strength.  This is the porcelain fused to metal crown technique.  More tooth structure is removed to accommodate both metal and porcelain.  Once an impression is taken, a metal coping is made on the prepared tooth.  This is then covered with porcelain.  Porcelain fused to metal crowns do not have the translucency of pure porcelain crowns. Therefore, aesthetics may be slightly compromised in some situations.  However, a talented ceramist with experience in custom staining can usually overcome these limitations, thereby creating life like restorations.  When teeth are loose due to periodontal bone loss, this technique is used.   Here the crowns are splinted together by joining the metal substructure of the crowns so they are tied together like a small fence in the mouth.
Porcelain fused to Gold Inlays:
When individual back teeth are broken down but some good healthy tooth structure remains, porcelain fused to gold inlays are used.  These are the strongest and longest lasting of all the aesthetic back teeth restorations.  Once the tooth is properly prepared, the technique is similar to the porcelain fused to metal crown technique.  The benefit of this restoration is the advantage of gold underneath which supports the tooth during heavy biting loads, thereby protecting the tooth and the nerve within.


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