Although there may be a number of causes, most of the time, halitosis originates in the mouth. It is caused by oral bacteria breaking down stubborn food debris and their decay. This process creates byproducts called volatile sulfur compounds, which emit a smell similar to rotten eggs. The type of bacteria that initiates this process needs an environment that is free of oxygen, so they usually inhabit areas that are difficult to reach, such as the pockets around teeth and the fissures of the tongue. In some circumstances, the odor may be caused by a systemic condition such as diabetes or a problem in the sinuses, pharynx, lungs, or stomach. Other debris in your mouth and poor oral hygiene can also cause odor. Therefore, the first step in solving bad breath problems is to undergo a medical examination to ensure that there are not any systemic problems contributing to the condition. Other factors can also cause halitosis: tobacco, alcohol, mouth rinses containing alcohol, garlic, onions, spicy food, hunger and dry mouth. These are all secondary to the main culprit - oral bacteria. If you have concerns about bad breath, please discuss this with us.
Bad breath also may occur in people who have a medical infection, gum disease, diabetes, kidney failure, or a liver malfunction. Xerostomia (dry mouth) and tobacco also contribute to this problem. Cancer patients who undergo radiation therapy may experience dry mouth. Even stress, dieting, snoring, age and hormonal changes can have an effect on your breath. An odor that comes from the back of your tongue may indicate post-nasal drip. This is where the mucus secretion, which comes from the nose and moves down your throat, gets stuck on the tongue and causes an odor. Bad breath originating in the stomach, however, is considered to be extremely rare.
If it is clear that bacteria are the culprits, methods to reduce them are the first line of defense. That's why if you have bad breath, you should make sure to obtain a complete dental examination that includes a periodontal examination. Keeping your mouth as clean as possible helps eliminate bacteria. In fact, it's valuable to consider this cleaning process as "full-mouth disinfection," focusing on all areas where bacteria may reside. This "disinfection" includes thorough brushing, proper use of dental floss, mouth rinse and cleaning the tongue. At the Atlanta Center for Cosmetic Dentistry, we have a full line of breath control products from companies like BreathRx, which are designed to control or eliminate bad breath. Remember, you're not alone. We are here to help.
It is also important to practice good oral hygiene, such as brushing and flossing your teeth at least twice a day. To alleviate the odor, clean your tongue with your toothbrush or a tongue scraper, a plastic tool that scrapes away bacteria that builds on the tongue. Chewing sugar-free gum also may help control the odor. If you have dentures or a removable appliance, such as a retainer or mouthguard, clean the appliance thoroughly before placing it back in your mouth. Before you use mouth rinses, deodorizing sprays or tablets, talk with our dentist because these products only mask the odor temporarily, and some products work better than others.
Saliva is the key ingredient in your mouth that helps keep the odor under control because it helps wash away food particles and bacteria, the primary cause of bad breath. When you sleep, however, salivary glands slow down the production of saliva allowing the bacteria to grow inside the mouth. To alleviate "morning mouth," brush your teeth and eat a morning meal. Morning mouth also is associated with hunger or fasting. Those who skip breakfast, beware because the odor may reappear even if you've brushed your teeth.
Very spicy foods, such as onions and garlic, and coffee may be detected on a person's breath for up to 72 hours after digestion. Onions, for example, are absorbed by the stomach and the odor is then excreted through the lungs. Studies have even shown that garlic rubbed on the soles of the feet can show up on the breath.
Bonding is done by placing tooth-like material onto the tooth to both build and alter its shape. Because natural tooth structure is usually not removed, its best use is somewhat limited to broken or chipped teeth. The advantage of bonding is that it is a relatively inexpensive and conservative way to restore a tooth. One disadvantage is that over time, the bonded portion of a tooth may change color as compared to the natural, un-bonded portion of the tooth. Another disadvantage is that it is more prone to breakage. A porcelain veneer or crown on the other hand, will not discolor and will be far stronger in the long run. This may cost more and the preparation of the affected tooth will be more extensive, but may be necessary in order to get a smooth, natural appearance.
Veneer covers the front, sides, and biting surface of the tooth. Once properly "seated," it becomes your tooth. It should be seamless. They are very strong and durable and are no more likely to break than a real tooth. And like a real tooth, the veneer is repairable if it were ever to chip or break.
A very important question. For the best results, it is important to know the qualifications and experience of the treating cosmetic dentist. The term "cosmetic dentistry" has become trendy and many dentists are promoting themselves as cosmetic dentists. At this time, cosmetic dentistry is not a recognized specialty (like orthodontics, for example). However, it is a discipline of dentistry that requires a thorough knowledge of science and an artistic eye. Ask your cosmetic dentist about his or her training, credentials, and experience in this area. A very effective way to understand your dentist's skills is asking to see their portfolio of before and after photographs. Dentists who are dedicated to the art of cosmetic dentistry always take photographs of their cases.
No. Each person is different and each case is different, and has to be planned very carefully. There are many differences between male and female teeth and between all people. The design of the teeth has to be in proportion with the gum line, the lips, and the construction of the face of each individual to achieve a beautiful and natural smile.
In adolescence we generally have a white, bright smile but over the years our teeth pick up stain and become discolored. When undergoing cosmetic dental procedures the question then is how pearly white do we want to make your teeth? Many people are choosing shades that are whiter than in years past. Brilliantly white, opaque teeth on older individuals are a true sign they have undergone some type of cosmetic dentistry. In our office we strive to give your smile a sense of realism, we call it perfect imperfections. You will attain a beautiful white esthetic outcome, but there will still be a sense of realism.
The first thing we do is listen - to what your desires are for your smile. We then can perform computerized cosmetic imaging. We simply take a number of photos showing different views of your face with a digital camera. We then use graphic artist software to generate a computerized image showing you with various smile enhancements. We work with you to determine things like how white you would like your smile, the shape of your teeth, and other aspects of your smile. Cosmetic imaging, although an artificial rendering, can assist in giving you a better idea of what you can look like after cosmetic dental improvements. We also may want to have our in-house dental lab perform a "wax-up" of your new smile, which would show in life-like, tangible form the proposed treatment.
In most cases, bonding can be completed in one visit. Accelerated whitening can be completed in one visit. At-home whitening requires an initial visit to be fitted for the splint. You need to return in a few days to pick-up your splint and we make sure it is fitted properly. Then depending on how often you wear the splint, you should see results from the first wearing to a few weeks or more. Porcelain veneers require two visits, about 10 days apart for fitting and application. Since each person's cosmetic dental needs are unique, the above time guidelines are only an estimate. When we develop your customized treatment plan, we can give you a more precise schedule based on your cosmetic dental needs.
There are too many factors to accurately predict how long any cosmetic dental treatment will last. The longevity of cosmetic treatment varies from procedure to procedure and person to person. The condition of the teeth prior to treatment influences the longevity of the restorations. Home care (hygiene) and eating habits are part of the equation. Of course, the quality of the treatment itself influences the long-term outcome as well. And, we do our best to deliver high-quality treatment that will last many years. Regular visits to the cosmetic dentist can help insure that your dental treatment is being maintained. While there is nothing we can do to render a tooth completely immune to future problems, preventive maintenance will prolong the life of your cosmetic dental treatment for many years. For estimated time frames for specific procedures, look at the treatment sections on this website or come in for a consultation for a more personalized estimate.
A crown is a restoration that covers, or "caps," a tooth to restore it to its normal shape and size, strengthening and improving the appearance of a tooth. Crowns are necessary when a tooth is generally broken down and fillings won't solve the problem. If a tooth is cracked a crown holds the tooth together to seal the cracks so the damage doesn't get worse. Crowns are also used to support a large filling when there isn't enough of the tooth remaining, attach a bridge, protect weak teeth from fracturing, restore fractured teeth, or cover badly shaped or discolored teeth.
To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of the teeth and gums are made and sent off to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown in made. On the next visit, the cosmetic dentist removes the temporary crown and cements the permanent crown onto the tooth.
This is usually caused by the metal margin of a porcelain fused to metal (or PFM) crown. In the "old days," many dentists used PFM crown, but now in most cases, cosmetic dentists use all porcelain crowns, which provide virtually the same strength but are highly superior in their aesthetic result.
Some restorations are designed with a metal lining, covered with porcelain (porcelain- fused-to-metal or PFM). At one point in time, most restorations were made this way. When placed, they usually look opaque or "flat" because they do not let light pass through like a natural tooth. There is often a tell-tail dark line next to the gum-line that is undesirable (often the darkness invades the adjacent gum tissue as an adverse reaction).
All-porcelain restorations are what we chose to use unless there is a compelling reason otherwise. Again, when properly seated, they are as strong or stronger than their metal predecessor. And the appearance can be identical to a natural tooth, allowing light to pass through (referred to as translucency).
Crowns require more tooth structure removal; hence, they cover more of the tooth than veneers. Crowns are stationary and are customarily indicated for teeth that have sustained significant loss of structure, or to replace missing teeth. Crowns may be placed on natural teeth or dental implants.
Cosmetic dentistry now offers options beyond having a partial denture. One option is to have an implant and crown placed. An implant is a titanium cylinder that is placed in the bone (under the tissue) and functions to replace what was once the root of the tooth. After a period of 5-6 months a stress or load can be placed into this implant and then the crown is placed over the abutment. This tooth is now cared for like all the other teeth in your mouth. Another option is a bridge. A bridge is like a crown that is bonded to the teeth on either side of the missing tooth. Some people prefer to not go through the surgical procedure of having the implant placed. Others prefer to have a quick fix and to not go through the waiting period of 5-6 months before a crown can be placed on the implant.
As soon as you are seated, we will numb the area to be worked on using a local anesthetic. Depending upon the type of local anesthetic used, you can expect to feel numb for one to four hours. If your anesthesia should last longer, do not be concerned. Individuals react differently to anesthesia. While the area is numb, please be careful not to bite your lip or tongue. You may want to consider a soft diet or no meal at all while until your sensation returns in the affected area. Once the appropriate area is numb, one of our cosmetic dentists will prepare the tooth to maximize the function, retention and aesthetics of your new crown. After the tooth is fully prepared, we proceed to the impression stage where we create a model of your prepared tooth for our in-house lab to custom-fabricate your crown.
Should you experience any discomfort you can take a mild analgesic (Tylenol, Advil, or aspirin, etc.) as long as there is no medical contraindication based upon your medical history. Typically, you can take anything you would normally take for a headache. If the discomfort persists, please call our office.
To prevent damaging or fracturing the crowns, avoid chewing hard foods, ice or other hard objects - just like you should avoid for your natural teeth. You also want to avoid teeth grinding. Besides visiting our office, and brushing twice a day, cleaning between your teeth is vital with crowns. Floss or interdental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown area where the gum meets the tooth. Plaque in that area can cause dental decay and gum disease.
A dental bridge is a false tooth, known as a pontic, which is usually fused between two porcelain crowns to fill in the area left by a missing tooth. The two crowns holding it in place that are attached onto your teeth on each side of the false tooth. This is known as a fixed bridge. This cosmetic is used to replace one or more missing teeth. Fixed bridges cannot be taken out of your mouth as you might do with removable partial dentures. Bridges can reduce your risk of gum disease, help correct some bite issues and even improve your speech. Bridges require your commitment to serious oral hygiene, but can last as many ten years or more.
Yes. If you are an appropriate candidate, a porcelain bridge can look as natural as (or in many cases better than) your own teeth, in color and shape, in proportion and alignment, with no clasps or metal appearance. Some bridges are designed with a metal support structure or a metal lining, covered with porcelain (porcelain-fused-to-metal or PFM). At one point in time, most restorations were made this way. When placed, they usually can often look opaque or "flat" because they do not let light pass through like a natural tooth. There can also be a tell-tail dark band showing through the teeth or showing next to the gum-line that is undesirable (often the darkness invades the adjacent gum tissue as an adverse reaction).
All-porcelain bridge restorations are what we chose to use unless there is a compelling reason otherwise. Again, when properly seated, they are virtually as strong or stronger than their metal predecessor. And the appearance can be identical to a natural tooth, allowing light to pass through (referred to as translucency).
If you have one or more missing teeth and have good oral hygiene practices, you should discuss this procedure with your cosmetic dentist. If spaces are left unfilled, they may cause the surrounding teeth to drift out of position. Additionally, spaces from missing teeth can cause your other teeth and your gums to become far more susceptible to tooth decay and gum disease.
We prepare your teeth on either side of the space for the false tooth. You will be given a mild anesthetic to numb the area, and then remove an area from each abutment (teeth on either side of the space) to accommodate for the thickness of the crown. When these teeth already have fillings, part of the filling may be left in place to help as a foundation for the crown. We will then make an impression, which will serve as the model from which the bridge, false tooth and crowns will be made by our dental laboratory. A temporary bridge will be placed for you to wear while your bridge is being made until your next visit. This temporary bridge will serve to protect your teeth and gums. On your second appointment, the temporary bridge will be removed. Your new permanent bridge will be fitted and checked and adjusted for any bite discrepancies. Your new bridge will then be cemented to your teeth.
Traditional Fixed Bridge - A dental bridge is a false tooth, known as a pontic, which is fused between two porcelain crowns to fill in the area left by a missing tooth. There are two crowns holding it in place that are attached onto your teeth on each side of the false tooth. This is known as a fixed bridge. This procedure is used to replace one or more missing teeth. Fixed bridges cannot be taken out of your mouth as you might do with removable partial dentures.
Resin Bonded Bridges - The resin bonded is primarily used for your front teeth. Less expensive, this bridge is best used when the abutment teeth are healthy and don't have large fillings. The false tooth is fused to metal bands that are bonded to the abutment teeth with a resin, which is hidden from view. This type of bridge reduces the amount of preparation on the adjacent teeth.
Cantilever Bridges - In areas of your mouth that are under less stress, such as your front teeth, a cantilever bridge may be used. Cantilever bridges are used when there are teeth on only one side of the open space. This procedure involves anchoring the false tooth to one side over one or more natural and adjacent teeth.
The advantages include that bridges are natural in appearance, and usually require only two visits to place. If you maintain good oral hygiene, your fixed bridge should last as many as ten years or more. Some of the disadvantages of having a bridge include that it is common for your teeth to be mildly sensitive to extreme temperatures for a few weeks after the treatment. The build up of bacteria formed from food acids on your teeth and gums can become infected in proper oral hygiene is not followed.
The three most common types of filling materials are amalgam, composite, and porcelain.
Amalgam Fillings -- Amalgam fillings (sometimes called "silver fillings") are a mixture of mercury liquid and small pieces of silver and other metals such as copper, tin and zinc. Amalgams have multiple disadvantages. Amalgam is a metal, which expands and contracts with hot, cold and biting. Therefore, with every meal the teeth are being weakened and over time and depending on the size of the filling the tooth becomes susceptible to fracturing. Amalgam fillings also raise a red flag because they contain mercury, which is a very toxic element. The literature is very unclear as to the amount of mercury that is released from amalgams and the long-term effects on the entire body. The safety of amalgam fillings has been in question for a number of years due to concerns over the absorption of elemental mercury contributing to several diseases, including Alzheimer's, multiple sclerosis, dementia and arthritis.
Composite Resin Fillings -- A composite resin is a tooth-colored plastic mixture filled with glass (silicon dioxide). Introduced in the 1960s, dental composites were confined to the front teeth because they were not strong enough to withstand the pressure and wear generated by the back teeth. Since then, composites have been significantly improved and can be successfully placed in the back teeth as well. Composites are not only used for restoring decay, but are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth. There are no known health risks of receiving composite fillings. Composite resin dental fillings were created as an alternative to traditional metal dental fillings. Tooth fillings colored to look like a natural tooth are known as composite resin fillings and are made of a plastic dental resin. Composite resin fillings are strong, durable, and make for a very natural looking smile. Many dental insurance plans cover their use.
Porcelain Inlays and Onlays -- The real advances have been made in laboratory processed white porcelain fillings called "inlays" and "onlays". They are beautiful, strong, and usually long lasting. The cost is similar to a gold "inlay" or "onlay". Like most things in life, if there is more value, there is more cost, but they are truly worth it if you want solid white fillings instead of ugly metal.
Amalgam fillings, bonding and composite resin fillings do not bleach. If you are unhappy with the look, it is time to replace those restorations with newer, more aesthetic materials. Silver fillings ("Amalgam") are becoming a thing of the past. There are many ways to restore teeth with materials that virtually disappear and blend with the natural color of your teeth. Remember, only replace these fillings and bonding after whitening in order to match the new improved color of your own natural tooth. You may also want to consider replacing old fillings with tooth-colored bonded restorations or porcelain veneers.
Following preparation, we place the composite in layers using a light specialized to harden each layer. When the process is finished, we will shape the composite to fit the tooth. We then polish the composite to prevent staining and early wear.
In cases with larger cavities or broken down areas, an inlay or onlay to cover more of the tooth's surface may be indicated. These restorations are indirect because they require two visits and fabrication by our dental laboratory. The ceramic restorations are considerably more expensive and therefore simple, one-visit composite fillings are typically used instead for small fillings. Ceramic restorations are much more durable and will not stain. Naturally speaking, the final result with ceramics is spectacular. White inlays or onlays are actually glued into the tooth and there is now a body of research that claims that because of this the tooth ends up stronger after such a procedure, less prone to problems down the road.
These are also called "porcelain laminates," "porcelain laminate veneers," and just "veneers," For our purposes, we will just call them veneers. Veneers are formed porcelain shells that are used to create a new front surface to a tooth. These are thin sculpted pieces of tooth-shaped porcelain that fit over the front of the teeth and are the premier standard of care in cosmetic dentistry. Permanently bonded to the front surface of a tooth, to restore or improve position, shape and tooth color, they can make a dramatic, immediate difference to one's smile and overall facial appearance. Veneers are wonderful for fixing common problems such as midline spaces (the gap-toothed look of the two front upper teeth) or chipped, crooked, missing, discolored, pitted, malformed or improperly positioned teeth. Once only accessible to the wealthy and top Hollywood stars and models, veneers are now a popular way for many people to obtain the smile of their dreams.
Yes, there is a real blend of art and science behind high-end aesthetic dentistry. All veneers are not created equal. Our cosmetic dentists have extensive training in the art of smile design, which determines the colors, line angles, shapes, thickness, translucency, occlusion, and many other factors that our cosmetic dentists prescribe to our in-house laboratory. Our lab then hand makes the veneers to our specifications. Veneers should be custom-designed to fit your face, smile, gender and personality. Done correctly, they look and feel like real teeth. You can be as much a part of the selection process as you wish, but part of why you select a cosmetic dentist is his or her experience and artistry in what looks great. Computer imaging as well as before and after photos of other cases will help you decide on the style, shape and color that work best for you. Veneers are bonded in place with a high intensity curing light. You can tell the quality by the photos of the work you see in our office.
Veneers are made from a thin shell of porcelain and are permanently bonded to the teeth. Our selected, world-class dental ceramists fabricate the veneers from our impressions and color mapping specifications. Each veneer is custom-designed to fit naturally and comfortably over each tooth like a ballet slipper. After placement, these veneers are designed to look like beautiful, natural teeth.
Veneers can be used to correct the size, shape, color and alignment of teeth. So if your smile suffers from teeth that are stained, crooked or malformed for any reason (cracks, chips, fractures, spaces, smoking or tetracycline stains, etc.), then you may be a great candidate for porcelain veneers. Many people want straighter teeth without the hassle and time orthodontic braces require. Now teeth can be straightened with porcelain veneers and crowns. Most people can get the shape, length and degree of whiteness they want, and they don't stain!
But what many people don't realize is that the shape of veneers in combination with occlusal adjustments, such as opening the bite, can also have profound impact on the entire face. This can result in giving the appearance of a face-lift or elimination of wrinkles without any plastic surgery. So in developing your personalized Smile Design, we take into account building out certain teeth or reduce others to achieve such desired objectives. This is why for a number of our quests, they actually look 10 years younger after our Smile Designs and just imagine their rejuvenated spirit!
Composite bonding (also sometimes called "direct veneers" or "plastic veneers") is a tooth-colored plastic resin material. Bonding can usually be placed in one visit and is used many times to repair a smaller chip in a tooth or to make aesthetic improvements in more than one tooth. Bonding usually requires little to no tooth reduction or anesthesia. Because they are made out of porcelain in a lab, porcelain veneers are usually more aesthetic in terms of the spectrum of colors, realism and translucency. Porcelain veneers are also more of a long-term solution than bonding, as they do not stain, discolor, and are stronger than bonding. Porcelain veneers usually require only a couple of office visits - the first visit to prepare the teeth and the second to seat the veneers.
Our quests can usually get the smile of their dreams in a couple of visits. At the first veneer appointment, your teeth are prepared, impressions are taken, and you will walk out of the office with custom temporary veneers. In the second appointment, we permanently seat the veneers. Imagine getting a new smile within one month -- one that actually fits your face and personality and gives you the confidence to express the real you!
Porcelain veneers are a perfect alternative to braces for many adults. Veneers can correct the shape of teeth that are not aligned correctly, have gaps and spaces. Older patients, who have always wanted straighter teeth but no desire to undergo years of treatment with braces, usually love this new technique. Instead of months and years in braces, crooked teeth can usually be corrected in as little as two weeks with veneers. In fact, even if you have had braces in the past but the size and shape of your teeth is not pleasing to you, veneers may be the perfect solution. See our Before & After photo gallery for amazing examples of what "instant ortho" looks like.
Braces are most desirable for people under the age of 18. At this stage in life, the bone is more malleable, teeth move easier and are more likely to stay once the bone "remodels" around the newly positioned teeth. Many adults also wear braces, but for a longer duration and almost always need a permanent retainer to hold the new positioning. There are numerous office visits in addition to the general hassles of wearing braces. Also, teeth may be repositioned, but continue to be the same shape and color which may or may not be desirable. Orthodontic braces, however, do not require the teeth to be reshaped or restructured in any way.
Sometimes called, "instant ortho," veneers can give the appearance of straightening teeth, closing gaps, and changing the shape of teeth to give a perfect smile. A veneer is a thin shell of porcelain. After the enamel on teeth are reduced, usually only slightly, the veneers are bonded in place covering the visible part of a tooth. Seated correctly, they are strong and should last a very long time. The bite is most often enhanced and veneers do not stain or discolor.
Unlike crowns, usually only a thin layer of enamel is removed from the teeth to make room for the veneers. Usually, only about 5/10 to 8/10 of a millimeter is removed from the outer surface. This small amount of reduction is required to make room for the porcelain. This allows us to make the veneers to the proper contour without them appearing to be bulky or unnatural. Some teeth on some individuals may not need any tooth reduction, and some may require a lot.
New advances in bonding technology allow us to create an extremely strong bond between your teeth and the veneers. The teeth are first prepared with a bonding adhesive and special resin cement is used as the "glue." The resin cement is available in a number of different colors to give the best possible aesthetic result. After approval, resins are then used to permanently bond the veneers to the teeth using a special dental curing light, which helps to create a stronger, longer-lasting bond between the veneer and your tooth. The durability, look and simplicity of application make it easy to see why veneers have become one of the most popular cosmetic dental treatments available today.
This depends entirely on the desired result. If there is only one tooth that is discolored or malformed, then a single veneer may be able to be used. To get a more balanced and even looking result, many times it is recommended that several veneers (from 4 to 8) be done at the same time. This allows us to get the most beautiful result possible. When closing large gaps between teeth, 6 to 10 veneers may be necessary to get a proper aesthetic result.
There are no hard and fast rules about how long porcelain veneers will last. While you can certainly expect your veneers to last many years (some patients have had them for 20 or more years), it is unrealistic to expect them to last forever. With good home care and by exercising good judgment, it seems likely that a porcelain veneer could last well in excess of 10 to 15 years. Ask about our limited warranty.
Some people experience sensitivity (to hot and cold or pressure, etc.) after the placement of veneers. Some sensitivity is absolutely normal and usually dissipates spontaneously from a day or so to a couple of weeks. The reason for the sensitivity can arise from the amount of enamel left on your tooth after preparation, the proximity of the nerve, as well as several other factors. If this sensitivity remains or concerns you at all, please contact your cosmetic dentist.
Once placed, your veneers are very strong and will resist most of the forces placed upon them by a normal diet, so a normal diet should pose no problem at all. Porcelain has great crushing strength but poor tensile strength. Therefore, you should avoid anything that will bend or twist the veneers. As with your regular teeth, opening bottle caps with your teeth or crunching on hard candy or ice is not a good idea.
With proper home care and scheduled dental visits, veneers can provide you with a beautiful smile for many years. A week or two after the placement of your veneers, we ask that you return to our office for a cosmetic polish and treatment evaluation. This visit is extremely important. It gives us the opportunity to evaluate the placement of the veneers, the tissue response and to answer any questions you might have regarding your new smile design. For example, if you grind or clench your teeth, please let us know. We can fabricate a soft night guard for you to wear to minimize the stresses placed upon your teeth while you sleep.
The maintenance of your porcelain veneers is relatively simple. Brush and floss as you normally would to prevent oral hygiene problems. Once placed, veneers are typically the kindest restoration to the gum tissues that we currently have available. Don't be afraid that you'll damage your veneers by either flossing or brushing. Any non-abrasive toothpaste is acceptable. A good home care regimen will help ensure the aesthetic success of your veneers.
If you have unhealthy teeth. Porcelain veneers cannot be placed on teeth where there is decay or active periodontal disease (gum disease). These conditions must be treated by your dentist before porcelain veneers can be successfully fabricated and placed.
If you have weakened teeth. If a significant amount of tooth structure has been lost as a result of decay or fracture, or else already replaced by a dental filling, the tooth may not be a good candidate for a porcelain veneer. Porcelain veneers do not significantly strengthen the teeth on which they are placed. Teeth that have, or have had, a history of a loss of a significant amount of tooth structure are usually better treated by placing a dental crown on them, not a porcelain veneer.
If you have an inadequate amount of enamel on the tooth. A porcelain veneer can only be successfully bonded onto tooth enamel. Some teeth, as a result of excessive wear or previous attempts at dental bonding, may have little or no enamel remaining on their front side. These teeth do not make good candidates for porcelain veneers.
If you clench or grind your teeth. Persons who clench and grind their teeth can make poor candidates for porcelain veneers. The forces created by these activities, termed bruxism by dentists, can easily chip or break porcelain veneers. Possibly a person can successfully control their bruxing habits during their waking hours, but during sleep a bruxer has essentially no control over this activity. If a person who bruxes does have veneers placed, they must be committed to wearing a plastic dental night guard when they sleep so to minimize the amount of stress placed on their veneers.
The active ingredient in most of the whitening agents is 10 percent carbamide peroxide, also known as urea peroxide; when water contacts this white crystal, the release of hydrogen peroxide lightens the teeth.
There are a number of different ways to whiten teeth. There are accelerated in-office approaches using a light activated technique with the peroxide gel. There are also at-home whitening kits used with a peroxide gel. Also, porcelain veneers can have the effect of whitening teeth to the shade determined by you and your cosmetic dentist.
A number of different studies have been performed over the years showing this method of whitening to be safe and effective. The American Dental Association has granted its seal of approval to a number of teeth whitening products. Some patients may experience slight gum irritation or tooth sensitivity, which will resolve when the treatment ends.
Whitening can be performed by our cosmetic dentist in the office or, under dental supervision, at home. Many patients enjoy whitening at home because it is more convenient. Treatment in our office begins when we create a custom mouthpiece to ensure the correct amount of whitening solution (composed of 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 one hour and ½ visit to our office.
Generally, whitening is successful in at least 90 percent of patients though it may not be an option for everyone. Consider tooth whitening if your teeth are darkened from age, coffee, tea, or smoking. Teeth darkened with the color of yellow, brown, or orange respond better to whitening. Other types of gray 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, we may discourage whitening.
Like skin tone, each person is different. In addition to genetics, it depends on how many cups of coffee, glasses of cola, red wine and other staining drinks and food you have cross your teeth. Many people can go from one to three years without significant need for touch-ups in whitening. The ultimate whitening is through porcelain veneers, which can last much longer.
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 resin, composite, or porcelain.
The difficulty presented by staining that results from tetracycline use is that it is not uniform, but usually presents as horizontal light and dark bands. For such teeth, the banding effect will remain after whitening, albeit in a lighter color.The only practical way of eliminating the staining you describe is by covering it up. This can be done by the placement of crowns, or more conservatively by placing porcelain veneers.
A good cleaning in our dental office with a prophy jet using baking soda spray is a good start. In-office whitening using a light activated technique, especially when combined with matrix home whitening can also help.
First, get a hygienic cleaning with a prophy jet, which uses a baking soda spray followed by tooth polishing. This will help determine the type and amount of real discoloration present in the enamel of your teeth. Then, you can either opt for in-office whitening using a light activated approach, at-home whitening, or porcelain veneers to get a more permanent whiteness.
Frequently, dentists hear from people who have not gotten the results they wanted through over-the-counter whiteners. In fact, I have never seen a patient that has gotten good results this way. Several factors can contribute to the darkening of teeth, including the effects of age, foods and drinks, smoking and some medications. Darkened teeth caused by oral supplements or medications pose more of a challenge. The whitening process involves placing a whitening solution in contact with the teeth, causing oxidation of stains and subsequent lightening. There are a variety of systems available, ranging from those done in the dental office to dentist supervised at-home systems.
Laser whitening is a procedure that is becoming less popular and is being replaced by light-activated in-office whitening systems. For a high percentage of our patients, this whitening technique has been very successful. It usually takes a couple of hours and usually costs about $500 many times, the laser whitening used to cost from $1,200 to $2,000).
A smile darkened with the color of yellow, brown or orange responds better to whitening than brown or white spots caused by fluorosis, smoking or tetracycline (grayed teeth). If you have very sensitive teeth or teeth with worn enamel, we can use whitening materials that are designed specifically for sensitive teeth.
The more traditional tray whitening takes a little longer to complete. Tray whitening is accomplished by wearing a form-fitted matrix containing a whitening or whitening agent at home for two to four weeks. The take home systems tend to cost a little less than in-office systems.
In the take-home system, we mold your teeth and make the trays to fit snugly to your teeth to prevent spillage of the whitening gel. Usually you place these trays over your teeth before going to sleep and take them out in the morning.
With tray whitening most people will notice a change in the color of their teeth the first night they bleach. Tray whitening takes about seven to ten days to complete.