Why get a Ceramic Porcelain Veneer?

Porcelain veneers are an excel­lent alternative to crowns in many situations. They provide a much more conser­vative approach to changing a tooth’s color, size, or shape. Porcelain veneers can mask undesirable defects, such as teeth stained by tetracycline, by an injury, or as a result of a root-canal procedure, and are ideal for masking discolored fillings in front teeth. Patients with gaps between their front teeth or teeth that are chipped or worn may consider porce­lain veneers.

Generally, veneers will last for many years, and the technique has shown remark­able longevity when properly performed.

What happens during the procedure?

Patients need three appoint­ments for the entire proce­dure: diagnosis and treatment planning, preparation, and bonding.

Diagnosis and treatment planning: It’s critical that you take an active role in the smile design. Spend time in the decision-making and plan­ning of the smile. Understand the corrective limitations of the procedure. Have more than one consultation, if necessary, to feel comfortable that your dentist understands your objectives.

Preparation of teeth: This appointment will take from one to two hours. To prepare the teeth for the porcelain veneers, the teeth are lightly buffed to allow for the small added thickness of the veneer. Usually, about a millimeter of the tooth is removed, which may require a local anesthetic. At this appointment, a mold is taken of the teeth, which is sent to the laboratory for the fabrication of the veneers. This can take about one to two weeks. If the teeth are too unsightly a temporary veneer can be placed, at an additional cost.

Bonding of veneers: This appointment will take about one or two hours. First, the dentist places the veneers with water or glycerin on the teeth to check their fit and get a sense of the shade or color. While the veneers are resting on your teeth, view the esthetic results, and pay particular attention to the color. At this point, the color of the veneers can still be adjusted with the shade of the cement to be used. The color cannot be altered after veneers are cemented. To apply the veneer, the tooth is cleansed with specific chemi­cals to achieve a bond. Once special cement is sandwiched between the veneer and tooth, a visible light beam initiates the release of a catalyst to harden the cement.

How about maintenance?

For about a week or two, you will go through a period of adjustment as you get used to your "new" teeth that have been changed in size and shape. Brush and floss daily. After one or two weeks, you’ll return for a follow-up appointment.

Have realistic expectations????

Porcelain veneers are reason­able facsimiles of natural teeth, not perfect replace­ments. It’s not uncommon to see slight variations in the color of porcelain veneers upon close inspection, as this occurs even in natural teeth. Nevertheless, this procedure can greatly enhance your smile, and can heighten inner satisfaction and self-esteem

Bridges

What types of bridges are there?

Besides traditional bridges, another popular design is the resin bonded or "Maryland" bridge, primarily used for the front teeth. This is usually the most economical choice when the abutment teeth are healthy and don’t contain large fillings. The pontic is fused to metal bands that can be bonded to the abutment teeth with resin cement and hidden from view, reducing the amount of preparation on the adjacent teeth.

A cantilever bridge may be used if there are teeth on only one side of the span. This involves anchoring the pontic to one side over one or more natural, adjacent teeth. If there are no adjacent teeth to act as anchors, your dentist may recommend an implant-a metal post that is surgically imbedded into the bone and capped with a crown as an abutment.

In some cases where the span is large, your dentist may recommend a removable partial denture or even an implant-supported prosthesis.

What procedures are involved?

For a traditional fixed bridge, the first appointment consists of the dentist reducing the adjacent abutment teeth that will act as anchors. Impressions are made, from which a metal framework, including the pontic, is created. By the second appointment, the final bridge is fitted over the teeth.

The total treatment time is usually between two or four weeks, depending on the type of bridge. However, because it is often difficult to match the natural shade of your teeth, the treatment time may be longer.

How do I care for a bridge?

With a bridge, it is more important than ever to brush, floss and see your dentist regularly. If you do not control the buildup of food debris and plaque-the sticky film of bacteria formed from food acids-your teeth and gums can become infected, requiring further treatment and resulting in possible loss of the bridge. Your dentist may also recommend using floss threaders that help remove bacteria from hard to reach spaces between the bridge and adjacent teeth and gums.

If you maintain optimal oral hygiene care, you can expect your fixed bridge to last as many as 8-10 years, or even longer.

Dentures

What happens when you get a denture?

A dentist can make a full conventional denture when all teeth have been lost or all extraction sites have healed (up to eight weeks or longer.) The denture process takes about one month and five appointments: the initial diagnosis is made; an impression and a wax bite are made to determine vertical dimensions and proper jaw position; a "try-in’ is placed to assure proper color, shape and fit; and the patient’s final denture is placed, following any minor adjustments.

New denture wearers need time to get accustomed to their new "teeth" because even the best fitting dentures will feel awkward at first. While most patients can begin to speak normally within a few hours, many patients report discomfort with eating for several days to a few weeks. To get accus­tomed to chewing with a new denture, start with soft, easy-­to-chew foods. In addition, denture wearers often notice a slight change in facial appear­ance, increased salivary flow, or minor speech difficulty.

How do you care for a denture?

A denture is fragile, so it is important to handle it with care. Remove and brush the denture daily, preferably with a brush designed specifically for cleaning dentures, using either a denture cleanser or toothpastes. Never use harsh, abrasive cleansers, including abrasives toothpastes, because they may scratch the surface of the denture. Don’t sterilize your denture with boiling water because it will cause it to become warped. If you wear a partial denture, be sure to remove it before brushing your natural teeth.

When not in use, soak it in a cleanser solution or in water. Get in the habit of keeping the denture in the same safe and handy place to reduce the likelihood of misplacement.

Should a denture be worn at night?

While you may be advised to wear your denture almost constantly during the first two weeks- even while you sleep-under normal circumstances it is consid­ered best to remove it at night. Research has shown that removing the denture for at least eight hours during either the day or night allows the gum tissue to rest and allows normal stimulation and cleansing by the tongue and saliva. This promotes better long-term health of the gums.

Continue seeing your dentist regularly

It is important to continue having regular dental checkups so that a dentist can examine oral tissues for signs of disease or cancer. As of aging, your mouth will continue to change as the bone under your denture shrinks or recedes. To maintain a proper fit over time, it may be necessary to adjust your denture or possibly remake your denture. Never attempt to adjust a denture yourself and do not use denture adhesives for a prolonged period because it can contribute to bone loss. When in doubt, consult your dentist.

Teeth Whitening

How can you brighten your smile?

Your wedding is coming up and you want your smile to be its brightest. Or maybe you have an important speaking engagement. Whatever the reason, tooth whitening isn’t just for the movie stars, and it isn’t just for one day. Many people have had their teeth whitened, and probably millions more are thinking about it. The desire for a brighter smile with whiter teeth is very strong, and tooth whitening safely lightens the color of the teeth, lasting for up to five years. The most effective and safest method of tooth whitening is under the supervision of your dentist.

What’s involved?

First, the dentist will deter­mine whether you are a candidate for tooth whitening and what type of whitening system would provide the best results.

If you’re in a hurry for whiter teeth, you may decide to have your teeth lightened immediately. Your dentist will use either an in-office whitening system (see our Zoom page) 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, even if you choose Zoom, the dentist or hygienist will make impressions of your teeth to fabricate a mouthguard appliance for you. The mouthguard is custom made for your mouth and is lightweight so that it can be worn comfortably while you are awake or sleeping. The mouthguard is so thin that you should even be able to talk and work while wearing your mouthguard. Along with the mouthguard, you’ll receive the bleaching materials. You’ll be given instructions on how to wear the mouthguard.

Some whitening 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 well 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.

How long does it last?

Lightness should last from one to five years, depending on your personal habits such as smoking and drinking coffee and tea. 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 mouthguard. The retreatment time also is much shorter than the original treatment time.

How does it work?

The active ingredient in most of the whitening agents is 10 percent carbamide peroxide (CH4N202), also known as urea peroxide; when water contacts this white crystal, the release of hydrogen peroxide lightens the teeth.

Is it safe? Are there any side effects?

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

What are realistic expectations?

No one can really predict how much lighter your teeth will become. Every case is different. Typically, there is a two-shade improvement as seen on a dentist’s shade guide. The success rate depends upon the type of stain involved and your compliance. Whitening can only provide a shift in color from gray to a lighter shade of gray, for example. Whitening does not lighten artificial materials such as resins, silicates or porcelains

Improve your Smile

Bleaching

Bleaching is a common and popular chemical process used to whiten teeth. Some people get their teeth bleached to make stains disappear, while other patients just want a whiter shade.

Discoloration occurs in the enamel and can be caused by medication, coffee, tea and ciga­rettes. Discoloration also can be caused by your genetic make-up or simply getting older.

Bleaching can be performed by your dentist in the office or, under dental supervision, at home. Many patients enjoy bleaching at home because it is more convenient. Treatment begins when your dentist creates a custom mouthpiece to ensure the correct amount of whitening solution-10 percent to 20 percent carbamide peroxide-is used and that your teeth are prop­erly exposed. Typically, whitening at home takes two or three weeks, depending on the desired shade you wish to achieve. Whitening in the office may call for two to six 45-minute visits to your dentist’s office.

Bonding

Bonding is tooth-colored material used to fill in gaps or change the color of teeth. Requiring a single office visit, bonding lasts several years. Bonding is more susceptible to staining or chipping than other forms of restoration. When teeth are chipped or slightly decayed, bonded composite resins may be the material of choice. Bonding also is used as a tooth-colored filling for small cavities and broken or chipped surfaces. Additionally, it can be used to close spaces between teeth or cover the entire outside surface of a tooth to change its color and shape.

Crowns, also known as caps, are used in cases where other procedures will not be effective. Crowns have the longest life expectancy of all cosmetic restorations, but are the most time consuming.

Veneers

Veneers are placed over the front teeth to change color or shape of your teeth. Veneers are used on teeth with uneven surfaces or are chipped, discol­ored, oddly shaped, unevenly spaced or crooked. Veneers are thin pieces of porcelain or plastic cemented over the front of your teeth. Little or no anes­thesia is needed. Veneers are used to treat some of the same problems as bonding.

This treatment is an alter­native to crowns, which are more expensive. The procedure requires your dentist to take an impression of your tooth. Before the custom-made veneer is glued directly onto the tooth, your dentist will lightly buff the tooth to compensate for the added thickness of the veneer. Once the cement is between the veneer and your tooth, a light beam is used to harden it.

Porcelain veneers require more than one visit because they are fabricated in a labora­tory. Veneers have a longer life expectancy and color stability than bonding.

Contouring and reshaping

Tooth reshaping and contouring, is a procedure to correct crooked teeth, chipped teeth, cracked teeth or even overlapping teeth in a single session. Tooth reshaping and dental contouring, is commonly used to alter the length, shape or position of your teeth. Contouring teeth may also help correct small problems with bite. It is common for bonding to be combined with tooth reshaping.

This procedure is ideal for candidates with normal healthy teeth, but who want subtle changes to their smile. Your 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.

Which procedure is right for me?

Your dentist can answer many of the questions you may have about techniques used to improve your smile. The condition of your teeth and desired result you want often dictates the best procedure. If you are considering a treat­ment, there are a few questions you can ask your dentist before deciding if a particular proce­dure is right for you.

• What will the changes look like?
• What should I expect through the course of treatment?
• What type of maintenance will be required?

Your dentist will answer questions you may have about the procedure, maintenance and price to help you choose the treatment that best suits you.