All dentistry should be cosmetic. When we talk about “cosmetic dentistry” we are referring specifically to a treatment plan that gives emphasis to the aesthetic appearance of the smile. Cosmetic dentistry follows a sequence demonstrated in this pyramid:
First, the teeth are whitened, then straightened with orthodontics, then the periodontal health is improved, and finally the teeth are restored with porcelain veneers or crowns, or composite bonding. While some may benefit from all stages of cosmetic treatment to reach the ideal smile, others may only need one or two stages to get to the ideal.
This patient suffered from tooth decay, chewing tobacco stain, and short teeth. His smile was improved by 1) whitening, 2) periodontal surgery to change the level of the gums and make the tooth look longer, and 3) restorative dental treatment of six porcelain crowns:
Veneers are a thin porcelain facing bonded by strong cement to the front surface of the teeth for esthetic improvement. Veneers can correct problems of stain, discoloration, or crooked or poorly shaped teeth.
The patient shown on the right didn’t like the stain or general yellow color of her teeth. (Before treatment shown above. After treatment shown below.) She also had old discolored fillings and areas of recession, root exposure, and tooth sensitivity. To correct these problems she had 10 veneers made for the upper teeth and 10 for the lower teeth. She was thrilled with the appearance of her teeth, felt more confidence to smile more, and had much less sensitivity of the teeth.
Porcelain crowns differ from veneers in that they surround the tooth 360o. Traditionally crowns have had a layer of metal for strength covered by a layer of porcelain, as shown below on the left. The porcelain we now use for veneers and crowns is more cosmetic and stronger than ever.
Notice the tooth with the dark line along the gumline. The metal in the crown causes a dark shadow at the top edge of the crown and the porcelain has a dull appearance. This was replaced with an all-porcelain crown, as shown on the right. It is more esthetic, bright, and lifelike. This IPS e.Max Press porcelain crown has strength that compares to the old metal-porcelain crown. The patient also had the gaps between other teeth closed with composite filling material.
Porcelain crowns can be made for front teeth and back teeth.
Composite filling material can be bonded on the front teeth to improve the cosmetic appearance. The patient shown below drank 5 or 6 sodas a day and had poor home care. The result was decay in multiple teeth. After the teeth were anesthetized and the decay removed, composite was bonded to restore the form, function, and esthetics of his teeth and smile.
In conjuction with these cosmetic services, consider whitening the teeth first for a brighter smile and better final result.
Improving the appearance of your smile will increase your confidence and happiness. A recent study suggested that a more esthetic smile can even improve your success in the workplace. Consult with us about how we can help you get the smile you’ve always wanted.