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Cosmetic Dentistry Procedures
Good cosmetic dentistry can give you a smile that is the envy of others. The hit television reality show Extreme Makeover has given us an inside view of how a dentist can transform almost anyone’s smile into the beautiful bright smile that most of us have always dreamed about.

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 perfect smile:

Tooth Contouring and Reshaping

Composite and Porcelain Tooth Veneers

Dental Bonding and Tooth-coloured Fillings

Teeth Whitening

Cosmetic Gum Surgery

Dental Crowns & Bridges

Dental Implants

What is tooth contouring and reshaping?


Tooth reshaping, or dental contouring is commonly used to alter the length, shape or position of your teeth. This procedure can be used to correct chipped teeth, cracked teeth or even overlapping teeth, and can be completed in just one appointment. It is a procedure of subtle changes, and can even be a substitute for braces if the orthodontic problem is very minor. A millimeter or two of reduction and a few millimeters of tooth-colored laminate can create a beautiful smile, with no discomfort to you.

Who is a candidate for tooth contouring and reshaping?
If you have teeth that appear slightly uneven or overlapped, or have fractured or chipped edges, grooves or pits on the surface of the teeth, then you are likely to benefit from tooth contouring and reshaping. Sometimes a little dental contouring can make a huge difference in the way you feel about your smile. However, tooth contouring requires that you have normal, healthy teeth. Since 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. Contouring teeth may also help correct small problems with bite.

The Procedure of tooth contouring and reshaping
The reshaping of your teeth is a procedure that involves the removal of a very small amount of tooth material to help achieve a more desirable smile. Chipped or fractured areas are smoothed out and specific angles or edges can be rounded or squared. Areas of uneven wear and tear are evened out. Contouring creates better alignment and can create a more feminine or masculine smile. It is sometimes done to prevent chipped areas from getting worse.

Your dentist will take x-rays to evaluate the size and location of the pulp of each tooth, and also to ensure that there's enough bone between the teeth to support them.

Your dentist will sculpt each tooth using the dental drill and specialized drill bits and smoothening stones to gradually eliminate or minimize the imperfections. A sanding drill 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 may take one to three visits. It is common for bonding to be combined with tooth reshaping to achieve a beautiful smile.

Dental Veneers
Veneers are sometimes used in conjunction with contouring. Veneers are very thin pieces of specially-shaped porcelain (ceramic) 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 (for example, tetracycline-stained), 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 material. Veneers are created from an impression (measurement) taken in your dentist's office. The dentist will also determine the exact shade and shape of the teeth that are adjacent to the teeth being prepared for the veneer in order to match the shade and shape of the custom-made veneer. The veneer may take a few days to be made in the dental laboratory, and is then bonded (a special gluing process) directly onto your tooth.

Tooth Bonding
Bonding will cover any flaws on the front surface of your tooth using a thin coating of a plastic composite material. Your dentist will apply the composite material to the existing tooth surface, and then sculpt, color and shape it to provide a pleasing result. A high-intensity light is then used to harden the material, and then the surface is finely polished. This procedure often accompanies contouring and teeth reshaping procedures.

How is Tooth Bonding done?
A very mild etching solution is applied to the surface of your tooth for less than a minute to create very small crevices in the tooth's enamel structure. These small crevices provide a slightly rough surface permitting a durable composite resin (plastic) to bond to your teeth. The composite resin is then placed on your tooth and high-intensity light cures and bonds the resins onto your tooth's surface - with each individual layer of resin hardening in just seconds. When the last coat has been applied to your tooth, the bonded material is then sculpted to fit your tooth shape, and polished.

The composite resin comes in many shades so that we can match it to the color shade of 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. Bonding may take an hour or more depending on the work to be done. There are basically two types of bonding. The type indicated for you would depend on the area that requires correction. For small corrections, one appointment color-matched fillings may be done. These are most appropriate for small fillings and front fillings as they may not require much durability. For larger corrections,

Dental lab-created tooth-colored fillings may have to be used. These require two appointments and involve making a mold of your teeth after preparation. A temporary filling will be then placed. A dental laboratory then creates a very durable filling to custom-fit your teeth. These fillings are typically made of porcelain. The custom-fit filling is then bonded to your tooth on your next appointment. These fillings are typically more natural looking, more durable and more stain resistant. However, they are more expensive.

Teeth Whitening
Also called “teeth bleaching”, it can brighten and whiten your teeth from discoloration and/or staining. This procedure can be done in the dental clinic or at home. Not everyone’s teeth can be bleached, so it is very important to check with your dentist first.

There are a number of different whitening techniques that might be employed, including:
professional teeth whitening treatments, tray-based teeth whitening, teeth whitening strips, and paint-on teeth whiteners.

While most teeth whitening techniques can usually be counted on to make some improvement in the color shade of a person's teeth, one disadvantage of any whitening process is that (with a few exceptions) it will not produce a lightening effect on existing dental work (fillings, crowns, etc...). Additionally, that teeth whitening effect that is achieved will have a tendency to fade with time.

A note about “tooth whitening toothpastes”: We do not recommend that you use these toothpastes, as they are most often abrasive and harmful to the enamel of the teeth. Prolonged use of such toothpastes may cause hypersensitivity of the teeth.

Cosmetic Gum Surgery
If your gums are slightly thick and fibrous and cover more of your tooth than they actually should, the periodontist (gum specialist) can correct this with a minor gum surgery done under local anesthesia. Cosmetic gum surgery can also be used to even out the levels of the gums of adjacent teeth, and also correct the gummy smile if it is mild.

A dental implant is a metal device designed to replace missing teeth. The implant is made primarily out of titanium and is surgically placed into the jawbone where the tooth is missing. Unlike a dental bridge, an implant is permanent. The dental implant is designed to act as the tooth root and can anchor an artificial tooth or teeth such as a crown, bridge or denture.

Crowns are also called caps. They are custom made to fit over your whole tooth after the dentist has prepared it. They are usually made out of acrylic or porcelain that has been fused to metal, to withstand biting pressure. Crowns can be used in cosmetic dentistry to treat teeth that are poorly shaped, badly decayed, broken or chipped, have large fillings, and to close spaces in between teeth. In comparison to porcelain veneers, dental crowns are stronger and more durable. But because making a dental crown involves trimming away a significant amount of tooth structure, they usually aren't the best choice for making a cosmetic change for a tooth unless the tooth also requires the non-cosmetic benefits that crowns can provide. Like porcelain veneers, dental crowns are relatively more expensive.

Understanding the life-span of cosmetic dental work
Some of the cosmetic changes you might choose to make with your teeth could have very long-term consequences. You must realize that no dental work will last forever. This is especially true when cosmetics are a primary consideration.

A benefit of teeth whitening in general is that as a process, it makes no structural changes to a tooth. However, a disadvantage of any teeth whitening method is that its effects will fade with time. At some point in the future you may feel that the entire benefits of the teeth whitening procedure have been lost.

Having porcelain veneers or dental crowns placed means that there will always need to be a porcelain veneer or dental crown on the tooth. So, if a crown or veneer comes off, breaks, or its appearance deteriorates another crown or veneer will need to be made. In general, this applies to dental bonding as well.

Thus it is prudent to find out from your dentist about their expectations for the longevity of the treatment. Also find out what solutions will be available to you when the original cosmetic appearance of the dental work has deteriorated after a period of time.