| |
Armed with newer materials, dentists now have a wide variety of ways to improve smiles by closing gaps, fixing chips, improving color, and even making crooked teeth appear straighter.
Until fairly recently, most people were satisfied if their teeth were straight and free of stains, chips or other obvious imperfections. But in the last few years, the combination of Hollywood glamour and advances in cosmetic dentistry has led to what might be called "smile inflation:" People often want their teeth to be perfectly uniform and dazzlingly white.
No one's sure how many cosmetic dental procedures are performed annually in the United States. Since 1996, the American Academy of Cosmetic Dentistry has doubled its ranks to about 4,700 members. More than 95 percent of dentists offer bleaching products and virtually all dentists perform some types of cosmetic services.
Cosmetic dentistry is rarely covered by insurance, and the cost of some procedures can easily exceed $1,000 per tooth. But despite the cost and inconvenience, many people feel that a "smile makeover" is just as important as buying nice clothes or having attractive hair. For models, public relations executives and others who spend their careers in the public eye, a high-wattage smile may be almost as much of a job requirement as showing up at work on time.
Advances in cosmetic techniques have also made it possible for dentists to repair damaged teeth without using amalgam or other unattractive metals.
"I had crooked teeth for years," recalls Mike Gagliardi, 43, an account supervisor at the Philadelphia Inquirer and Daily News who decided to have his upper teeth capped to give them a straighter look. "At one point, when the dentist took a break, I went into the bathroom and looked in the mirror. It was awesome."
Good as New
Dentists have been doing cosmetic restorations for decades, but the materials that were used -- the early composite resins -- tended to stain, chip, and change color over time, which limited their use.
The materials used today, such as the new composite resins, "invisible" fillings, porcelain veneers, and high-strength resin cements, are stronger, long lasting, and do not change color over time. "Every few months we're getting new materials, and there's been a real jump forward in the things we can do," says Amer Abu-Hanna, D.D.S., M.S., assistant professor of restorative dentistry and director of operative and esthetic dentistry at the University of Pennsylvania School of Dental Medicine.
A few decades ago, people who chipped or broke a tooth either lived with it or had a crown (also called a cap) installed, a time-consuming and often expensive procedure. Crowns still are used sometimes, but it's often possible to "patch" minor imperfections, chips, or fractured teeth with bonding composite resin that can be smoothed and color-matched to the surrounding teeth.
Cosmetic dentists have also pioneered a technique called computer imaging, that allows them to perform "virtual restorations" on a computer screen. A patient who is thinking about having work done can see what the results will look like before he or she makes the decision to go forward.
Many Choices
Even if you're lucky enough to have straight teeth, there may be small imperfections, such as gaps or dingy stains, which you'd just as soon do without.
With a technique called bonding, for example, your dentist can repair damaged areas by applying a "paste" made of a material called composite resin. The resin comes in a wide variety of shades. It hardens almost instantly when it's exposed to a special ultraviolet light and it can be sanded, smoothed, and buffed until it exactly matches the tooth shine.
The most popular cosmetic dental procedures include bonding, whitening the teeth and tooth-colored fillings, which, unlike traditional amalgam fillings, are nearly invisible.
Cosmetic procedures aren't as aggressive as they used to be, says Dr. Abu-Hanna. Many techniques, in fact, can be done without cutting or minimal preparation of the tooth's enamel structure.
There are many cosmetic options to choose from, depending on what you need to have done. For example:
- Stained or discolored teeth
The enamel that covers the teeth isn't impervious to stains and the underlying tooth structure (the dentin) often yellows over time. As long as the teeth are healthy, it's easy to eliminate stains by applying a bleaching agent, explains Dr. Abu-Hanna
- Chips or rough spots
These can be filled with a tooth-colored material called composite. The color of the composite can be chosen so that it matches the color of your teeth. Once the material has been smoothed and polished, it's virtually indistinguishable from the surrounding area
- Cavities or cracks
Traditional amalgam fillings work fine in the back of the mouth, but most people don't want to reveal a metal mouth" when they smile. An alternative is to use tooth-colored fillings," which match the color of the teeth. These fillings are made with composite material similar to that used to repair chips or cracks. Some white fillings (direct composites) are pressed into the cavity and cured (hardened) with a special ultraviolet light. Others (indirect composites) are made in a laboratory and then cemented in place. They cost much more than amalgam fillings, but are much more attractive
- Uneven teeth
It's not uncommon for a tooth to be slightly longer or have a different shape than its neighbors. With a procedure called recontouring, your dentist can reshape the tooth so that it's a better match
- Gaps between the teeth
Small gaps can be closed by applying composite material between the teeth. For large gaps or other imperfections on the surfaces of the teeth, your dentist may recommend veneers.Veneers are among the most expensive cosmetic procedures. Made from ultra-thin shells of porcelain that come in every shade of white, veneers are permanently bonded to the fronts of the teeth, giving them an entirely new esthetic appearance
- Broken or crooked teeth
If a tooth has been badly broken or is structurally weak, you may need a crown. Crowns used to be made of metal, but today they're often made of tooth-colored porcelain materials
It was worth every penny," says Gagliardi, who had his teeth capped in 1985. "I was told that they would probably last about 10 years, but it's been about 15 years and I haven't had any problems.
Perfect Smiles
People who come to the United States from other countries are often amazed by the uniform perfection of people's teeth. White is hardly good enough any more; cosmetic dentists say that one of the most popular shades is the blindingly bright "Hollywood White."
Cosmetic dentistry is a real boon for people who have lived most of their lives with damaged or discolored teeth. Even simple procedures such as bleaching or bonding can be real confidence-boosters.
But, unless you are planning a career as a runway model, beware of choosing the whitest of white for your teeth. Teeth are rarely pure white, and you may not be satisfied once the shade is on your smile. A less intense shade may be more likely to give the look you are seeking.
"Some people overdo it," Dr. Abu-Hanna said. "If you get the teeth too white they look unnatural," he says.
©2001-2002 InteliHealth Inc. All rights reserved. |
|
Personal Care
