Dentistry is no longer just a case of filling and extracting teeth, as it was for many years. Nowadays, many people turn to cosmetic dentistry, or aesthetic dentistry, as a way of improving their appearance, much as they would use cosmetic surgery or even a new hairstyle. Cosmetic treatments include veneers, crowns, bridges tooth-coloured fillings, implants and tooth whitening.
For over 150 years standard fillings have been made out of a silvery-grey material called ‘amalgam’. This is still one of the strongest and longest lasting materials available for fillings. However, many people find it unattractive and some are concerned about possible health risks. White fillings are now a popular alternative to amalgam fillings. The new dental materials mean it is much easier to find a perfect match for the shade of a particular tooth. In most cases, it is quite impossible to see that the tooth even has a filling.
Composite filling is resin based and is applied as a putty-like material. This can be moulded to the exact shape of the tooth and is then set using a visible blue light. It can be matched exactly to the shade of your tooth and most are now as strong as amalgam, proving to be a successful alternative.
Modern techniques now involve sticking fillings to teeth using special dental adhesives. This technique is often called ‘adhesive’ or ‘sticky’ dentistry. The area is treated with a solution that roughens the surface of the tooth – much the same as using sandpaper ‘keys’ the wall ready for painting. The adhesive is applied and the filling is ‘bonded’ to the tooth. The advantages of this method are that the cavity needs less preparation and in some cases it may not be necessary to numb the tooth first.
Veneers are thin slices of porcelain. These are precisely made to fit over the visible surface of front teeth, very much like a false fingernail. There are also ‘composite’ veneers and these can be completed in just one visit.
Veneers are an ideal way of treating discoloured or unsightly teeth, closing gaps between front teeth, or repairing chips and cracks.
Porcelain veneers are made by a dental technician, using impressions taken by the dentist. The veneers are made in the laboratory and bonded to the tooth to form a strong and natural-looking repair. Composite veneers can be completed in one visit and involve bonding tooth-coloured filling material to the front of the tooth. Although these veneers are slightly more prone to staining and have a shorter life, they are easily replaced.
Yes. Again, using either tooth-coloured filling material or porcelain, the dentist can change the shape or size of the tooth very slightly, closing the gap between the teeth.
Veneers usually need very little work on the tooth itself, and in many cases don’t even need an anaesthetic.
In some cases, the cavity that needs filling is quite large, but the surrounding tooth is healthy. A composite filling may not be strong enough, but it would seem pointless to remove more of the healthy tooth in order to make a crown. In these cases an inlay may be the answer. The dentist can make an inlay by preparing the cavity in much the same way as they would for a filling. But instead of putting in a filling, the dentist takes an impression of the tooth. The impression is then sent to the laboratory where the technician makes an ‘inlay’ using porcelain, resin-material or gold. The dentist then bonds this into place.
The usual procedure for fitting a crown involves shaping the tooth under local anaesthetic and then taking an impression using a rubber-like material. The impression is then sent to the laboratory along with the details of the shade to be used, where the technician makes the crown.
While your crown is being made, the prepared tooth can be protected with a temporary crown, which is easily removed just before fitting the permanent one. In most cases, the temporary crown is in place for about two weeks later.
There are different types of crown, the most popular being ‘white’ or tooth coloured. These are usually made entirely of porcelain, which can be quite thin and ideal for the front teeth. They can also be made of porcelain bonded to precious metal, which is much stronger and ideal for back teeth. Crowns can also be made from metal alloy. Silver metal and gold crowns are suitable for back teeth, where they need to be strong enough to stand up to heavy chewing pressure, but appearance is often not so important. Gold crowns have the advantage of being made very thinly and are often used on teeth that bite together particularly closely. The latest crowns are made from castable glass. They are very natural looking and are stronger than pure porcelain, but not as strong as porcelain bonded to precious metal. There are different crowns for different situations and it is always a good idea to discuss the matter with your dentist. Let them guide you in deciding which crown would be best for you.
There are many commercial toothpastes specially formulated to whiten teeth. They are good at removing any staining on the teeth, but are not strong enough to change the natural shade of the teeth.
If a tooth is missing, or needs extracting and the space needs to be filled, there are several ways to fill the gap that is left. In some cases it is important to try to replace any missing teeth in order to balance the way your jaw bites. If you have several missing teeth, the remaining teeth are under more pressure, which can lead to broken fillings or even jaw problems.
Bridges are ideal for people who don’t like dentures or only have one or two teeth missing. Conventional bridges are made by crowning the teeth on either side of the gap and attaching a false tooth in the middle. These bridges are made of the same materials and fixed in the same way as crowns.
Adhesive bridges are another way of bridging a gap, and less of the tooth needs removing. These bridges are made up of a false tooth with metal ‘wings’ on either side. These wings are made to bond to the teeth on either side, with very little drilling of these teeth. The teeth are roughened and the bridge is fitted using a very strong composite resin.
Implants are a fixed alternative to natural tooth roots, and mean no damage to remaining teeth. Implants are titanium rods, which are surgically placed into the jawbone, leaving parts sticking out through the gum. These act as anchors for fastening dentures, crowns or bridges onto.
Teeth can be straightened with braces. This is usually done during the teenage years, when the teeth are going through a period of growth. However, many adults also have treatment to straighten their crooked teeth or improve their appearance. For cosmetic reasons, tooth coloured , clear plastic invisalign or totally invisible lingual braces can be used which are hardly noticeable.
To keep you healthy smile, it is important to visit your dentist regularly, clean your teeth regularly and thoroughly, and stick to a healthy diet. Good dental health begins with you. By following this simple routine, you can keep your mouth clean and healthy:
Further brushing/oral health advice here.