Tooth whitening

Whether you are self-conscious because you have yellowed teeth from smoking or drinking coffee, or if you just want to look your best, tooth whitening is a sure way to brighten your smile and gain increased confidence in your appearance.

The tooth whitening process eliminates discoloration and stains on the teeth, and can also brighten the natural pigmentation of the teeth. The degree of improvement will depend upon how severely the teeth are stained or discolored as well as the nature of the stains. When teeth are brown or yellow due to coffee, tea, or smoking, stains will generally lighten four to five shades. Teeth that are gray due to natural pigmentation or antibiotics use will lighten two to three shades. Regardless, your teeth will be noticeably brighter after teeth whitening. While there are a number of over-the-counter teeth whitening methods that make various claims, only a dental professional can recommend the most effective teeth whitening treatment for you.

Teeth Whitening Techniques

The most effective teeth whitening techniques available today are in-office laser teeth whitening and at-home teeth whitening with custom-fit trays. Both teeth whitening techniques are best performed under your dentist's supervision to ensure the safest results.

In-Office Laser Tooth Whitening

In-office teeth whitening methods are performed with bleaching gel and laser light. This is a good method of teeth whitening for sensitive teeth, as the process may be closely monitored by the cosmetic dentist. The teeth are carefully isolated from the lips and gums, and then a bleaching gel is applied to them. A laser is used in conjunction with the gel to accelerate and amplify the tooth whitening process.

At-Home Tooth Whitening

There are several choices for those who are interested in at-home teeth whitening methods. Your cosmetic dentist can take imprints of your teeth and then make custom-fitted trays for you to take home to complete the tooth whitening process. There are also teeth bleaching kits and other over-the-counter teeth whitening products available to brighten your smile.

Teeth Whitening Systems

Teeth whitening systems usually involve in-office applications of gel to the teeth and then the application of light in order to activate the gel. Popular teeth whitening systems include Zoom!®, Britesmile®, and Rembrandt® Teeth Whitening. Other teeth whitening products include a variety of whitening toothpastes and "paint-on" whitening products and whitening strips.

Teeth Whitening Side Effects

The gel that is used in various teeth whitening methods causes the teeth to be temporarily sensitive to hot and cold foods, drinks, and even to air. Trays used to bleach teeth can also cause sensitivity, primarily to the gums. Because of this, teeth whitening for sensitive teeth may best be performed in a dental office. Also, some over-the-counter products may wear down the enamel of the teeth if used overzealously. For this reason, and because in-office treatments are more effective, it is best to seek teeth whitening treatment under the supervision of a cosmetic dentist.

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Porcelain crowns

A crown is needed when a tooth is badly broken down - there are existing large fillings or a large area of tooth decay, because a filling isn't strong enough.

With old technology, dental crowns always needed to be made with a metal foundation. Today, we can make them out of pure porcelain, ceramic or aesthetic reinforced resins. These crowns can possess a translucency that makes them the most cosmetically pleasing of all of the different types of dental crowns.
The new bonding technology involved provides an exceptional bond your tooth. It is metal-free, and thus satisfies the needs of patients with metal sensitivities. This type of procedure is used to correct only those parts of the tooth that are in need.

Although they can be very life like in appearance, the overall strength of all-porcelain dental crowns is less than other types of crowns. While they can be a good choice for front teeth, due to the hefty chewing and biting forces that humans can generate, all-porcelain dental crowns may not be the best choice for back teeth. Your dentist's judgement will be required on this point.

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Porcelain veneers / Lumineers

Porcelain dental veneers are a beautiful way to correct stained, chipped, or crooked teeth. By placing glass-like ceramic porcelain on the surface of teeth, dentists can provide patients with bright, straight, and natural looking smiles.

Your first step toward cosmetic enhancement with porcelain dental veneers is to meet with a dentist and discuss your goals for treatment. At this time, the dentist you choose will provide you with a full consultation about the porcelain veneers procedure and determine what you can expect from treatment.

During your second office visit, your teeth will be prepared for your porcelain dental veneers. By lightly buffing the front surface of your teeth, a skilled cosmetic dentist will remove an approximately one-half-millimeter layer of enamel from the front of your teeth. The wafer-thin porcelain veneers will eventually be set in place of this enamel. A mold is then taken of your teeth. From this mold, your porcelain veneers will be custom made to fit your teeth and complement your smile. Porcelain dental veneers can even be specially fitted to reshape crooked teeth that may otherwise require orthodontics.

The porcelain veneers are then placed on your teeth in your third, and final, office visit. At this time, your dentist will be able to precisely match the color of your dental veneers to your surrounding teeth. If you are having porcelain veneers placed on all of your teeth, your dentist will be able to provide you with an appropriate color that has both a beautiful luster and a realistic appearance. After the fit and color of your dental veneers are ensured to be to your liking, the adhesive is hardened using a special light. You then have a bright, long-lasing smile with your new porcelain veneers.

What will my porcelain veneers look like?

The glass-like ceramic that forms porcelain veneers closely resembles natural tooth enamel. This is because, much like real tooth enamel, porcelain veneers are translucent. When light strikes a natural tooth’s surface, it is not immediately reflected off. Instead, it penetrates the tooth enamel and reflects off the opaque tooth dentin that lies just beneath. This translucent effect is what gives teeth their luster. By replicating this, porcelain dental veneers provide patients with bright, natural looking smiles.

Porcelain dental veneers can also cover and repair cracked and chipped teeth. Because porcelain veneers are custom made and fitted to your teeth by a skilled cosmetic dentist, you can customize and improve much more than just the color of your teeth. Crooked and chipped teeth can have their appearances improved to give you a beautiful new smile. Any broken teeth can be repaired using dental crowns, or caps, that can be color matched to your dental veneers.

Lumineers

Lumineers are contact lens-thin and are placed over existing teeth without having to remove tooth structure (unlike traditional veneers.) Lumineers is the painless, permanent cosmetic solution for stained, chipped, discolored or misaligned teeth.

Lumineers can only be made from patented Cerinate porcelain unavailable anywhere other than the Cerinate Smile Design Studio. In just 2-3 visits to your Lumineers dentist, you can have a custom-made smile that is clinically proven to last over 20 years - and it is completely reversible since your natural tooth structure is still intact.

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Porcelain inlays/onlays

This is a highly esthetic, non-metallic restoration that is bonded on a prepared tooth to restore the beauty, strength and function of the tooth. The procedure is similar to that of a crown, however, due to new, minimally invasive techniques, the dentist maintains as much sound tooth structure as possible.

To repair damage to the tooth’s biting surface, rather than using a simple filling, or a crown, a dentist will often use an inlay, or an onlay.
An inlay is similar to a filling and lies inside the cusp tips of the tooth. They are custom-made to fit the prepared cavity and are then cemented into place. An onlay is a more extensive reconstruction that covers one or more cusps of a tooth. Onlays are indicated in situations where a substantial reconstruction is required. However, more of the tooth structure can be conserved compared to the placement of a crown which covers the whole tooth.

Inlays are placed within the cusp tips of teeth.
Onlays are used for larger areas of damage and are placed over the tooth cusps

Inlays and onlays are applied in two dental visits.  At the first visit, the old filling, or decay, is removed, and the tooth is prepared for the inlay/onlay.  The dentist will then make an impression of the tooth, and send this impression to a dental laboratory.  This impression will be used by the laboratory to construct a custom-made porcelain, or gold inlay/onlay.  At this time the dentist will place a temporary sealant on your tooth and schedule a second appointment.

At the second visit, the temporary sealant is removed. Your dentist will then ensure that the inlay/onlay fits properly in the tooth and does not interfere with your bite.  The inlay/onlay is then bonded into the tooth with a strong bonding resin, and polished smooth.

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Tooth colored fillings for front and back teeth

Composite fillings are a mixture of glass or quartz filler in a resin medium that produces a tooth-colored filling. They are sometimes referred to as composites or filled resins. Composite fillings provide good durability and resistance to fracture in small-to-mid size restorations that need to withstand moderate chewing pressure. Less tooth structure is removed when the dentist prepares the tooth, and this may result in a smaller filling than that of an amalgam. Composites can also be "bonded" or adhesively held in a cavity, often allowing the dentist to make a more conservative repair to the tooth.

Tooth colored filling material comes in a great number of colors (shades), and are matched to your individual tooth color. Typically, a different type of material is used for front and back teeth. The materials used for front teeth have a high shine; whereas, the materials for back teeth are designed for strength — both look great! It’s nice that if you have a filling it can be virtually undetectable.

The procedure of restoring a tooth with a resin filling is similar to the traditional silver fillings. First the decay is removed and the tooth is prepared to receive the tooth colored composite. The composite material is layered into the cavity preparation and hardened with a curing light. The filling is then polished and the bite is checked. Tooth colored resin fillings blend well with the surrounding teeth and enhance a bright, youthful smile.

Tooth colored fillings now are harder and more durable than silver/amalgam fillings. A small filling could conceivably last your lifetime, and larger fillings can be expected to last many years. The factors that determine the lifespan of a particular filling include: the tooth (molars take more force than bicuspids), the size of the filling relative to the tooth (smaller fillings will usually be more durable than larger fillings), and how teeth are cleaned and maintained daily.

A new filling should feel natural, like your other teeth. After the anesthesia has worn away and you can feel your teeth and bite again, you should not notice anything particularly different. It should be smooth and comfortable.

You can eat on tooth colored fillings right away (as soon as anesthesia is gone) compared to silver/amalgam fillings, which you cannot.

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Implant-supported crowns and bridges

Dental implants typically are used to replace missing teeth when we do not want to prepare and attach to existing teeth. For instance, a person missing a front tooth, in the presence of healthy adjacent teeth, not in need of restoration, would greatly benefit from a single restored implant replacing that tooth. Sometimes, we will suggest an implant for the exact opposite reason. A patient will loose a tooth and the adjacent teeth are not healthy enough to support a typical fixed bridge. They can also be used to replace missing back teeth that don't have an existing natural tooth behind the space.
Shortly thereafter, a crown is made to fit on top of the implant(s) so as to replace a missing tooth or teeth with a "brand-new" tooth. In many cases, you can be functioning on your "new" tooth in as little as 6 weeks. Implant-supported crowns and bridges do not require neighboring teeth for support.

Prior to implants, there was no way to replace that tooth permanently (ie. not removable). So whatever the reason, sometimes restoring one's dentition with implants, results in a more conservative, stable result, or even an outcome that was previously unavailable.

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Complete or partial removable dentures

Dentures are prosthetic devices constructed to replace missing teeth, and which are supported by surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable, however there are many different denture designs, some which rely on bonding or clipping onto teeth or dental implants.

A denture helps you to properly chew food, a difficult task when you are missing teeth. In addition, a denture may improve speech and prevent a sagging face by providing support for lips and cheeks.

Removable partial dentures are for patients who are missing some of their teeth on a particular arch. Fixed partial dentures, better known as "crown and bridge", are made from crowns that are fitted on the remaining teeth to act as abutments and pontics made from materials to resemble the missing teeth. Fixed bridges are more expensive than removable appliances but are more stable.

Conversely, complete dentures or full dentures are worn by patients who are missing all their teeth in an arch (i.e the maxillary(upper) or mandibular(lower) arch).

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Laser gum surgery

We take our gums for granted. Yet they’re the unsung heroes of our mouths. The soft cushion that nestles the teeth must be properly cared for as part of your regular regime to foster a healthful mind and body. Gingivitis, which is classified as mild periodontal disease, can be remedied quite effectively with regular visits to the dentist.

Treating gum disease with surgery

When unable to prevent gum disease, medical treatment is the only solution. In years past, gum surgery would involve several months of painful visits. The mouth bleeds readily; subsequently, gum surgery was performed exclusively in small sections of the mouth (quadrants). The patient would need time to heal, a follow-up appointment would be necessary for suture removal, and then more healing time was required before the next step was taken.

This lengthy process has recently been replaced with the invention of laser periodontal therapy (LPT). This technology takes advantage of highly precise lasers.

This process is called laser assisted new attachment procedure (LANAP). There are several brands of lasers that perform this, the one we have in the office is Biolase. All of these products are similar in function and design.

How does it work?

The laser directs a small amount of energy, about the thickness of three strands of hair, between the gum and tooth. The laser removes the diseased tissue, eliminating infection. It does this without any type of incision. The laser immediately cauterizes the wound, resulting in little to no bleeding. An added benefit is its ability to seal nerve endings. The entire process results in only minor discomfort making anesthesia sometimes unnecessary.

The ease of surgery translates into a faster recovery. Traditional surgery requires a 2-4 week recovery time. With an LPT procedure, many return right back to work. Recovery is less than 24 hours.

Better than before

These lasers were created by dentists, receiving extensive clinical trials before receiving Federal Drug Administration approval. This is set to reinvent periodontal surgery as we know it.

Here are some more fabulous uses for the LPT:

• Cosmetic reshaping of gums. The laser can actually adjust the gum line and improve your smile.
• Treatment of gum disease. Removes diseased tissue and as an added benefit of gum reshaping, allows you better access to the gum for improved hygiene.
• Reduction of hyperplastic tissue. Patients who wear braces, or taking certain medicines, are prone to the overgrowth of gum tissue.
• Access to gum-covered decay. In elderly patients, the gums can grow over decayed teeth.

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Teeth straightening / Invisalign

Teeth straightening is performed to improve your bite and the appearance of your smile. Teens and pre-teens are the largest patient population undergoing orthodontic treatment; however, nearly one-third of orthodontic patients are adults.

Reasons for teeth straightening

• Your bite. Because malocclusion can cause problems with eating, or even speech, teeth straightening may be used to align teeth and improve mouth function.
• Tooth support. Teeth straightening repositions the tooth above and below the gum line. A strong root foundation helps create a strong tooth.
• Appearance. The esthetic appeal of a straight smile is one of the primary reasons many teens and adults undergo orthodontic treatment.
• Oral hygiene. Straight, well-aligned teeth provide fewer nooks and crannies for decay to develop. Brushing and flossing is effective and oral hygiene is easier to maintain.

Invisalign

While Invisalign can be used with virtually any treatment philosophy, special training is needed. All dentists interested in treating patients with Invisalign must attend and complete specialized instructional sessions to become trained Invisalign providers before cases will be accepted from their office.

Your Invisalign treatment will consist of a series of aligners that you switch out about every two weeks. Each aligner is individually manufactured with exact calculations to gradually shift your teeth into place. And since your Invisalign system is custom-made for your teeth and your teeth only, with a plan devised by you and your dentist, you know you'll end up with a smile that truly fits.

Primary benefits:

• Invisalign aligners are practically clear. No one may even notice that you’re wearing these virtually invisible “braces,” making Invisalign a seamless fit with your lifestyle and day-to-day interactions with others.
• Invisalign is removable. Unlike braces, you have the flexibility to eat and drink what you want during treatment by simply removing the aligners. And you can also remove the aligners to brush and floss as you normally would for fresh breath and good oral hygiene.
• Unlike braces, there are no metal brackets or wires with the Invisalign system that could cause irritation to your mouth. Plus since your office visits during treatment don’t involve metal or wire adjustments, you’ll likely spend less time in the doctor's chair.
• And finally, Invisalign allows you to view your virtual results and treatment plan before you start so you can see how your straight teeth will look when your treatment is complete.

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