Cosmetic dentistry focuses on improving the appearance of patient’s teeth and gums. Some procedures that are aesthetic in nature (such as cosmetic crowns) may also improve function. However, unlike general dentistry, most cosmetic procedures are not considered essential for oral health. For this reason, these services are not reimbursable under typical dental insurance plans. Many patients choose to pursue cosmetic treatment anyway to correct one or more of the following problems:
- Chipped or cracked teeth
- Discolored enamel
- Gaps between teeth
- Uneven or too-noticeable gums
- Teeth that are irregularly shaped
- Crooked or misaligned teeth
Fixing these dental flaws provides patients with relief from feelings of embarrassment over the appearance of their teeth. They may smile more readily and feel greater self confidence in social situations. Certain cosmetic issues such as staining or crookedness tend to become more pronounced with age. So, when teeth are restored to look white, whole, even and undamaged, this can make a person’s entire face appear younger.
Commonly Requested Cosmetic Dentistry Procedures
Due to its affordability, speed and effectiveness, tooth whitening is one of the most popular cosmetic dentistry treatments in the United States. The various whitening agents used by cosmetic dentists rely on the same active ingredient (hydrogen peroxide). This substance may be combined with other chemical agents to increase the speed and depth of whitening or provide added dental protection. A UV lamp may be used to further enhance the action of hydrogen peroxide. Patients may whiten their teeth at home or have the procedure done in the office.
For at-home whitening, the cosmetic dentist will take a cast of the patient’s mouth and create a custom plastic tray. This tray molds to the teeth and ensures the whitening ingredient stays in contact with the enamel during treatment. Patients add the whitening gel to the tray and place it in their mouth for the prescribed period of time. This varies from 20 minutes to overnight depending on the strength of the gel and the patient’s sensitivity. Treatment may be done every day for one to two weeks to achieve the desired level of whiteness.
In-office whitening using a UV lamp system that may whiten teeth six to 10 shades. This procedure is performed in a single treatment consisting of three or four 15 minute sessions under the lamp (done consecutively). The patient’s gums are coated with a protective material to lessen exposure to the hydrogen peroxide gel. Some individuals report sensitivity or discomfort during or after this treatment while others find it pain free. In-office whitening must usually be followed with at-home whitening to maintain the dramatic results.
These prosthetics are placed over the front surface of relatively undamaged teeth to correct minor problems like permanent staining, chipped edges, small gaps, teeth that appear short or misshapen and slightly crooked teeth. The ceramic material is resistant to staining and will retain its white color over time. Veneers are custom made for each patient in an off-site lab. Treatment consists of a consultation, a session to prepare the enamel to receive the veneers, and a session to affix the custom veneers in place and bond them to the enamel. Veneers do not typically last a lifetime and will need to be replaced if they come loose or sustain damage.
Veneers are only placed on front teeth since they are not designed to withstand chewing forces in the mouth. Some patients choose to veneer all the top and bottom teeth that are visible when they smile. However, it is also possible to veneer just one tooth that has a cosmetic issue. In this case, the surrounding teeth are generally whitened first. The veneer is custom matched to the whitest naturally achievable shade of the surrounding teeth so it won’t appear out of place.
Dental composite can be used to correct many tooth flaws in a single visit. The composite is mixed and applied in the office, so there is no need to wait for lab fabrication. The tooth surface is roughened slightly and treated with a conditioning agent to allow the composite to adhere to the surface. The color-matched resin is sculpted in place directly on the tooth. It is cured with a special lamp that hardens the composite and makes it stick firmly to the tooth. Chipped tooth edges, minor fractures, stains, small gaps, and uneven or misshapen teeth may be corrected with resin composite. This material is not considered the most long-lasting solution, and it may discolor and degrade over time. However, it is less expensive than veneers and does provide short-term improvement of a smile.
Gums that are too prominent or uneven can make teeth look short and stubby or irregularly shaped. Laser contouring can be used to correct this problem without damaging the surrounding gums. Cosmetic dentists may also use lasers to change the shape of teeth to even out rough edges.
This is a catch-all term that includes all the cosmetic dentistry services listed above as well as cosmetic crowns, inlays and onlays and reconstructive procedures such as dental implants. The specifics of a smile makeover treatment vary based on each patient’s needs. The goal is to restore both function and beauty to a smile. For this reason, tooth colored materials are used in a smile makeover for any prosthetic surfaces that will be visible. For example, a dental composite might be used to replace a small metal amalgam filling. Crowns would typically be ceramic rather than gold.