Dental FAQ Cosmetic Dental Treatment FAQ's

Cosmetic dentistry is more popular than ever before, and for good reason. Today cosmetic dentistry techniques yield impressive, long-lasting results.

Cosmetic Dentistry deals with improving tooth structure, shape, arrangement and smile design.

Besides Braces, there are three common procedures available; Bonding, bleaching, and veneering.

Generally, bleaching is successful in at least 90 percent of patients, though it may not be an option for everyone. Consider tooth bleaching if your teeth are darkened from age, coffee, tea or smoking. Teeth darkened with the colour of yellow, brown or orange respond better to lightening. Other types of grey stains caused by fluorosis, smoking or tetracycline are lightened, but results are not as dramatic. If you have very sensitive teeth, periodontal disease, or teeth with worn enamel, your dentist may discourage bleaching.

First, the dentist will determine whether you are a candidate for tooth bleaching and what type of bleaching system would provide the best results. If you are in a hurry for whiter teeth, you may decide to have your teeth lightened immediately. Your dentist will use either an in-office bleaching system or laser bleaching while you sit in the dental chair. However, most patients choose dentist-supervised at-home bleaching, which is more economical and provides the same results. At the next appointment if you don not choose laser bleaching, the dentist or hygienist will make impressions of your teeth to fabricate a bleaching tray appliance for you. The bleaching tray is custom made for your mouth and is lightweight so that it can be worn comfortably while you are awake or sleeping. The bleaching tray is so thin that you should even be able to talk and work while wearing your bleaching tray. Along with the bleaching tray, you will receive the bleaching materials. You will be given instructions on how to wear the bleaching tray. Some bleaching systems recommend bleaching your teeth from two to four hours a day. Generally this type of system requires three to six weeks to complete, and works best on patients with sensitive teeth. Other systems recommend bleaching at night while you sleep. This type of system usually requires only 10-14 days to complete.

Lightness should last from one to five years, depending on your personal habits such as smoking and drinking coffee and tea but on an average 3 years. At this point, you may choose to get a touch up. This procedure may not be as costly because you can probably still use the same bleaching tray. The re-treatment time also is much shorter than the original treatment time.

The active ingredient in most of the whitening agents is 10 percent Carbamide Peroxide (CH4N2O2), also known as urea peroxide; when water contacts this white crystal, the release of hydrogen peroxide lightens the teeth.

Several studies, during the past five years, have proven bleaching to be safe and effective. The American Dental Association has granted its seal of approval to some tooth bleaching products. Some patients may experience slight gum irritation or tooth sensitivity, which will resolve when the treatment ends.

Dentists have been doing what is called "non-vital" bleaching for many years. Non-vital bleaching is done on a damaged, darkened tooth that has had root canal treatment. "Vital" bleaching is done on healthy teeth and has become more popular in recent years. Vital bleaching, also called whitening, may be carried out in the dental office or the dentist may instruct the patient on how to do the bleaching at home. There is also a wide variety of products for sale in stores. Not all products are the same and not all give you the same results.
Different products, including those used by dentists, may also have different risks and side effects. Here is an overview:

  • Whitening toothpastes with abrasive ingredients are really not bleaching products at all, but work on surface stain only. These products are sold in many stores.
  • Some whitening toothpastes do contain a chemical ingredient (or "bleach") that causes a chemical reaction to lighten teeth. Generally, they have the lowest amount of "bleach." They may not whiten as well as stronger products, but they have less chance of side effects. These pastes are brushed onto teeth and rinsed off, like regular toothpaste.
  • Bleaching kits sold in stores stay on your teeth longer than toothpaste and contain stronger bleach." These store-bought products do not come with the added safety of having your dentist monitor any side effects. They also come with a one-size-fits-all tray that holds the "bleach" and is more likely to leak the chemical into your mouth.
  • Dentists may use products with stronger "bleach", but they give patients careful instructions to follow. They are also trained to spot and treat the side effects that patients sometimes report during bleaching. In addition, if a tray is needed to apply the "bleach", dentists supply custom-made trays. Because products used by dentists are strong, they tend to produce the best results.
  • Patients should be aware that the long-term use of whitening or bleaching products may cause tooth sensitivity or tooth abrasion. Please consult with your dentist before using a whitening or bleaching product

I would like to have my teeth whitened. There are so many products and ads for whiteners that it is hard to decide which is best. What do you recommend? You are correct. There are many products and techniques available. Some work great and some don not work at all. The various over the counter products give the least predictable results. To get a really great result you should probably use one of the products sold through dental offices which utilize custom made trays for home application of a bleaching gel. There are several great ones out there.

Laser Whitening: With this method a laser is used as a light source to activate the bleaching gel which is applied to your teeth in the dental office. It may be necessary to use the at home trays in addition to this initial lengthy treatment. Side effects include sensitivity to the treated teeth.

Dentist supervised teeth whitening systems are widely considered to provide the safest cosmetic dentistry treatments. Tooth whitening is a conservative method for completely making over your smile. Chair side teeth whitening procedures are performed with a specially formulated peroxide gel that allows oxygen to permeate your tooth enamel, lifting stains. The structure of your tooth enamel is not affected. The most common side effect is temporary tooth sensitivity.

Luckily, your options for correcting crooked teeth mean you don not have to endure the uncomfortable metal braces of the past! Invisalign is a cosmetic system of orthodontics that uses invisible plastic aligners to comfortably shift your teeth into place. Numerous other Cosmetic dentistry techniques exist that can provide "instant orthodontics" that require no braces at all. Composite bonding and the application of porcelain veneers are both conservative ways to mask the appearance of crooked teeth. Be aware that these cosmetic approaches cannot address orthodontic issues such as an overbite, underbite, or crossbite and therefore are not suitable for every patient.

Definitely. The teeth can be made to look white by cleaning/polishing and by bleaching. In certain cases, teeth capping, composite material treatment or ceramic veneer are applied.

We take an individualized approach toward each patients treatment & apply an artistic eye to smile makeovers. We always consider your facial shape, the natural form of your teeth, and other factors so that you achieve optimal results.

A cavity is the destruction of the tooth Enamel, Dentin, Cementum and may involve the tooth pulp.

The formation of a cavity is due to many factors. For example, the tooth itself plays a role (how strong it is); the mouths ability to cleanse itself (your flow of saliva); diet (frequency and selection of sugary foods); the bacteria in your mouth (good or bad); and the length of time the tooth is under attack by the bacteria in your mouth.

may play a major role in how susceptible you are to the formation of a cavity, for example:

  • Tooth structure, size and shape of the tooth may be passed down through generations. This includes deep pits and grooves which are ideal "plaque traps", and therefore, are susceptible to decay
  • There may be a higher risk of cavities forming if your parents also had a large number of cavities
  • Teeth that are malpositioned in the mouth, that are hard to access with your toothbrush or floss may also provide an ideal breeding ground for the bacterial dental plaque.
  • The absence of fluoride during tooth formation and following tooth eruption can increase the incidence of cavities. fluoride promotes strong tooth development and remineralization of the tooth

has a protective function in the mouth, for example:

  • A good flow of saliva washes away food and bacteria that sit on the teeth and gum tissues
  • Salivary flow helps to neutralize the acids produced by bacteria from plaque, thus a good flow helps reduce the chances of a cavity formation

a well balanced diet from each of the four major food groups is essential for your oral health, as well as, your overall health.

  • Avoid frequent consumption of high sugar foods, especially sticky foods
  • The longer the time the food stays on your teeth, the greater the chance of forming a cavity. If you do have a sugary snack, it is best to brush your teeth soon after
  • Select between meal snacks that are low in sugar concentrations such as white milk, fresh fruits, raw vegetables, dark breads and whole grain and enriched cereals
  • Sugar free candies, gum and other snacks are an option

the actual amount of sugar eaten in one sitting is not as important as when and how often you choose a sugar containing food. The consumption of high sugar foods is best if eaten with a regular meal. This will confine the sugar exposure to one sitting. It is best to eat the whole chocolate bar at once instead of at different periods throughout the day

the mouth harbors many types of bacteria that are considered to be normal in the human mouth. Bacteria, in a healthy mouth tends to live in balance, but for reasons yet to be truly identified, that balance can be tilted and oral disease may result

Fluoride provides many benefits. It is found in many products such as toothpaste, mouth rinse, fluoridated drinking water and periodic topical fluoride treatments applied by your dental professional.

  • It aids in the development of sound enamel
  • It helps reduce enamel solubility and increases enamel resistance to acid attack
  • It prevents demineralization (the white spot phase of the beginning stages of a cavity)
  • It enhances remineralization of beginning stages of a cavity. Fluoride may arrest further development of a cavity by depositing the fluoride mineral called fluoroapatite

Fluoride used in addition to daily brushing and flossing helps to reduce the chances of a cavity.

The first sign of a cavity forming may be a white spot, which in time may turn brown. If it is a white spot, low concentrations of fluoride applied frequently can arrest further development.

  • White spot phase: If the white spot phase progresses, further breakdown of enamel will occur. At this point, a visit to your dental professional is necessary. The cavity may be restored with a filling.
  • Breakdown of enamel between the teeth

The loss of enamel surface of tooth due to action of plaque or due to improper brushing is called cavity. The acid attacks the soft inner layer of tooth causing severe pain. Bacteria could infect the inner pulp of teeth and destroy nerves; there could be bad breath and bad taste in mouth.

The carious or decayed part of tooth has to be removed and cavities filled.

Following are the habits which you can inculcate to prevent cavities:

  • Regular visits with your dental professional on an appointment schedule that he/she recommends based on your own needs. Regular visits will ensure you have the benefits of preventive care and early diagnosis, as well as, treatment for any dental problems. Guidance about home dental care can also be provided to avoid future problems
  • Diet plays an important role. Minimize the frequency of sugary foods, thus reducing the amount of acid produced. Select snacks that are less cavity causing, such as fresh fruit, plain yogurt and raw vegetables
  • The use of fluoride will help decrease the risk of cavity formation
  • Good plaque control. Maintain a strict and regular home care routine to minimize plaque growth
  • It is recommended that you consult your dental professional before using any commercial products. You want to make a selection based on the effectiveness of the product and your own personal needs

The best way to avoid cavities is by eating right, brushing with fluoridated toothpaste, flossing daily and visiting your dentist every six months. Children and some adults can benefit by having Sealants placed.

Bacteria could infect the inner pulp of teeth and destroy nerves. This would require root canal therapy to remove damaged nerves. Also a pulp polyp may form.

A pulp polyp, also called as Chronic Hyperplastic Pulpitis, is found in an open carious lesion, fractured tooth or when a dental restoration is missing. Due to lack of intrapulpal pressure in an open lesion pulp necrosis does not take place as would have occurred in a closed caries case. Also a good vascular and immune supply is necessary, therefore found in adults. It is a productive pulpal inflammation where the development of granulation tissue is seen.

Composite fillings and Silver Amalgam fillings are the most widely used filling materials today. A Composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a composite filling. Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth, and are more aesthetically suited for use in front teeth. Another advantage of composite resins is that the tooth/composite bond actually supports the remaining tooth structure, deterring breakage and insulating against temperature changes. In addition, composite resins allow us to keep more of your natural tooth structure intact than amalgams thereby conserving natural tooth structure. Most of the fillings are done under Rubber Dam.

Rubber dam is a device that is used to isolate a single tooth or a group of teeth from the rest of the oral cavity in order to keep the tooth being treated away from saliva and also to increase visibility. In addition the rubber dam prevents accidental swallowing of delicate instruments, solutions, etc. It is used in filling procedures and is a must in root canal treatment.

Zinc Oxide Eugenol cement, Glass enamel, silver, composite materials etc. are used.

This could be due to damaged tooth pulp. Consult your dentist who will refer you to a specialist, in the event of any other problem.

The sensitivity could be due to gum recession which exposes small areas of root surface, a loose filling or tooth decay.

May be due to tooth decay, a loose filling, damage to tooth pulp tissue or a crack in tooth.

The placement of tooth-colored composite fillings is one of the most commonly performed general dentistry procedures at our clinic. In addition to filling new cavities, these beautiful restorations can replace old metal fillings that have blackened, fractured, popped out, or that simply take away from the beauty of your smile.

Silver amalgam fillings, which are composed of 50% mercury and 50% silver alloy, eventually need to be replaced. Average life span of a silver filling is five to eight years. Your dentist can tell you when they appear to need to be replaced due to leakage, breakdown or recurrent decay. If your concern is strictly cosmetic, there are many new methods available to replace the fillings with beautiful, functional long lasting restorations. Such things as white filling materials, porcelain inlays, crowns and veneers may be used to give you the smile you are seeking. There is currently a great deal of interest in new reinforced hybrid materials. These beautiful resin materials may be reinforced with fibers, similar to fiberglass, and used in very conservative inlays and bridges without having to grind away a whole healthy tooth.

Scientific studies have not verified that dental amalgam is causing illness in the general population. It has been known for some time that amalgam fillings release minute amounts of mercury vapours, especially with chewing, and that this mercury can be absorbed, reach body organs, and cross the placenta. This is also true of mercury absorbed from natural sources, such as food.

As a single element, mercury is a poisonous metal to which we are all exposed through air, water, soil and food. In dental amalgam, it is bound in an alloy, which also includes silver, copper and tin. Very small amounts of mercury vapours are released from amalgam with chewing. Mercury toxicity is related to the amount absorbed. The mercury absorbed from all sources accumulates in body organs and tissues, mostly in the kidneys, but also in the brain, lungs, liver and gastrointestinal tract.

The amount depends on a number of factors, such as the type of food you eat, your occupational exposure, environmental levels and the number of amalgam fillings you have. For an average adult 20 to 59 years old, the amount of mercury absorbed by the body from all sources is about nine millionths of a gram per day. Of this total dental amalgam is estimated to contribute about three millionths of a gram per day.

For the overwhelming majority of people no harmful effects are known to be caused by the average levels of mercury exposure from amalgam fillings. For those subject to high exposures, for example, in industrial settings, the severity of any scientifically validated harmful effects depends upon the duration and amount of exposure. Subclinical effects (effects which are observable but are below the threshold of disease or illness) have been observed in groups of people with tissue mercury levels ten times higher that those in the general population. However, at the low levels of exposure associated with amalgam fillings, the relationship between levels and duration of exposure and any possible effects is not known.

Every time a foreign substance is used in the human body for therapeutic purposes, there is an element of risk. Health professionals must constantly weigh the known risks of a particular intervention against known benefits. The risks associated with the use of dental amalgam appear to be limited, and the benefits to patients are known to be large. Dental amalgam is much stronger and more durable than alternative restorative materials, and amalgam restorations can be completed at a more reasonable cost. Recent advances, such as the development of amalgam bonding techniques, have made amalgam even more advantageous as a restorative material. Gold alloy inlay castings would be a reasonable substitute if the material and required procedures were not so costly. It is also possible that alternative materials, subjected to the same level of scrutiny as dental amalgam, will prove to have other advantages and disadvantages. The dental profession is aware of research to find more durable alternatives to amalgam, and these materials may be available within the next decade.

No, there are patients who are sensitive to the components of amalgam, just as there are individuals who are sensitive or allergic to other chemical substances or even foods such as milk or bread. It has been estimated that the prevalence of mercury sensitivity in the general population is approximately three per cent. Dentists may consider the use of composite fillings or other restorative materials in individual cases. Dentists routinely take a number of considerations into account in selecting a restorative material, including tooth size, location and the individuals condition and medical and dental history. For example, alternatives may be considered for individuals who are immunologically compromised, or who suffer from a neurological condition.

Dental materials are developed by dental manufacturers and carefully governed by the rules and regulations of the Government. The materials, including resins and sealants, are all very low risk. Unfortunately, no material can completely replace real tooth structure. This is why prevention is so important. With proper care from you and your dentist - it is achievable to maintain oral health throughout a lifetime. Whenever an intervention is required, it is important to have a variety of options - since no one material or treatment is likely to be ideal for everyone and for every purpose.

Dentists consider a number of factors in determining treatment for children and for pregnant patients. Assuming that they are aware of the pregnancy and in consultation with the patient, dentists may recommend alternative restorative materials, other forms of treatment, or delay of treatment. In many instances amalgam presents the best possible option for restorative treatment. There is no scientific evidence of ill effects, although mercury is known to cross the placenta.

The concern is related to galvanic effect, which occurs when two different metals are in close proximity and create the potential for electric current to be generated. Dentists are aware of the possibility of abutting metals creating a galvanic effect. It is also recognized that galvanic effect, through corrosion of metallic dental materials, may increase the release of mercury and other elements or compounds. Some recent evidence suggests that galvanic effect may also slightly increase the release of mercury vapours from amalgam. For all these reasons, it is prudent for dentists, in suggesting a restorative material, to avoid creating a galvanic effect whenever patient care will not be compromised. It is also inadvisable to remove existing fillings unless the patient complains of symptoms which may be attributed to galvanic effect. At the same time, the placement of orthodontic braces on patients with amalgam is often necessary and desirable, and has not been shown to be associated with ill effects. It may also be necessary, for the purpose of adequate restorative treatment, to place restorations in close proximity and to create the potential for galvanic effect.

If you are esthetic conscious, then the answer is Yes and also on the basis of the current questions being asked about possible amalgam toxicity. Replacement may also be considered for individuals sensitive to dental amalgam.

Yes, dentists recognize patient concerns with respect to choice of restorative materials and the patients right to choose a dental material or to refuse treatment with any material. You should note, however, that the dentist may be concerned about the retention, durability or strength of alternative restorations in particular applications, and advise you to choose amalgam. The final choice, however, is yours.

There are also new and different ways to prepare a cavity for a filling. Lasers are a fairly new tool in dentistry. They have been used for several years on soft tissues, like the gums. Some dentists are starting to use lasers in place of drills to remove tooth decay. Lasers work best on decay close to the tooth surface. Over the next few years, lasers will likely be refined and more dentists may be using them instead of drills. Air abrasion is another new way to remove tooth decay. It uses a fine, sand-blasting spray and works best on surface decay. If you are interested in having air abrasion, call your local dental society or a few dentists in your area to find out which dentists are using it.

Pin retained restorations can be a useful adjuvant in restorative dental practice for management of extensively damaged tooth structure and for certain cases of fracture marginal ridge on posterior teeth.
Caries occur infrequently on palatal embrasure or beyond the confines of the contact area on the palatal aspect without involvement of the contact area. Even though not very common, it is frequently seen in the teeth treated / undergoing treatment orthdontically. In these situations, pin retained restorations gives an ideal solution with a long standing successful restoration.

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