Now even dentistry goes cosmetic

"Cosmetic dentistry is complete oral care that combines art and science to optimally improve dental health and function" - Dr Achuth Baliga Implantologist Medical Advisor and Visiting Consultant, Dentistry, Manipal Cure and Care

Cosmetic dentistry is one of the most sought after services in dentistry today. Due to the advancements in technology, cosmetic changes in one's smile can be achieved in few visits without having to wait for years, as in the early days. Cosmetic dentistry includes composite filling, bleaching, ceramic veneers, ceramic crowns, zirconium crowns. In the coming few paragraphs, all aspects of cosmetic dentistry services that can be availed at Manipal Cure and Care are discussed in detail.

Composite filling

A filling is a way to restore a tooth damaged by decay or fracture, back to its normal function and shape. When a dentist gives you a filling, he or she first removes the decayed tooth material, cleans the affected area, and then fills the cleaned out cavity with a tooth colored filling material. By closing off spaces where bacteria can enter, a filling also helps prevent further decay.

Porcelain fillings are called inlays or onlays and are produced to order in a lab and then bonded to the tooth. They can be matched to the color of the tooth, hard and resist wear and tear as well the stains. A porcelain restoration can cover most of the tooth.

If decay or a fracture has damaged a large portion of the tooth, a crown, or cap, may be recommended. Decay that has reached the nerve may be treated in two ways: through root canal therapy (in which the damaged nerve is removed) or through a procedure called pulp capping (which attempts to keep the nerve alive).

What happens when you get a filling done?

If your dentist decides to fill a cavity, he or she will first remove the decay and clean the affected area. The cleaned-out cavity will then be filled with composites or porcelain.

How do I know if I need a filling?

Only your dentist can detect whether you have a cavity that needs to be filled. During a checkup, your dentist will use a small mirror and probe to examine the surfaces of each tooth, to check any catch is there on the discolored surface or decayed surface.

Anything that looks abnormal will then be closely checked with special instruments. Your dentist may also take the X-rays of the entire mouth or a section of it. The type of treatment your dentist chooses will depend on the extent of damage caused by decay.

Tooth-colored fillings and inlays

Tooth-colored fillings and inlays replace the gold and silver of the past with natural looking materials.

In the 1970's, "white fillings" came into common use. These "tooth-colored fillings" were made of a plastic dental resin filled with microscopic filler particles and were called composites. When dental composites were first introduced, they could only be used in the front teeth, because they weren't strong enough to withstand the chewing pressure of the back teeth.

The composites of today have been vastly improved over the ones developed nearly forty years ago. They are strong, durable, and attractive.

Some advantages of porcelain inlays and onlays are:

• Extremely durable
• Excellent choice for restoring severely fractured teeth, heavily filled tooth
• Highly resistant to stain or color change
• No black line at the gum line

Who is a candidate for cosmetic fillings?

If you have a cavity in a tooth, broken fillings, mercury fillings, or amalgam fillings, this type of dental filling is well worth discussing with your dentist. Mercury fillings or amalgam fillings are harmful and should be removed and replaced with far more safe and attractive tooth colored fillings. These fillings actually strengthen your tooth beyond the level it had with the amalgam fillings.

Composite resins may also be used to enhance the appearance of any tooth, which is a tooth bonding procedure. The composite resin will strengthen and enhance the natural tooth structure as it does with use as a dental filling.

How is composite resin fillings accomplished?

Your dentist will give you a local anesthetic to numb the area or if the cavity is small he do it without local anesthesia. The dentist then prepares an access to the decayed area of the tooth and removes the decayed portions. This is accomplished with traditional drills, micro air abrasion. With a composite filling, your dentist will preserve more of the natural tooth as the composite resin is bonded to the tooth and can be filled in thin layers. If your tooth's decayed area is close to a nerve, a special liner will be used to protect the nerve.

A special dental etching gel material is then used to open up the pores of your tooth's dentin and roughens up the surface of the exposed enamel. This achieves better and stronger bond strength and their wear and tear. The bond resin is applied to stick the composite to your tooth surface. This material is made of the same dental resin as the composite however it is more fluid in nature. This layer is then hardened and cured with a blue light.

Composite resin fillings are applied in thin layers, and slowly built up to form the complete filling. A blue dental light will harden each layer before the next is applied.

Once your filling is completed, your dentist will use a special paper, articulating paper, to adjust the height of your dental filling and that your bite remains correct. Your tooth is then polished.

If such a filling is not going to be enough to protect your damaged tooth, or if your tooth enamel is thin and will easily fracture, or if your tooth is a root canal treated which is brittle in condition, it may require additional protection such as a crown.

Inlays and Onlays

If over half of your molar tooth's biting surface is decayed an inlay or onlay may be a better option than a filling. These options are basically for when more than a filling is needed but less than a crown will do. An inlay is placed in between the cusps of the tooth, whereas an only will cover one or more of the cusps. They can be made of a gold alloy, porcelain or tooth-colored resin and are cemented into place, but the tooth colored inlays like ceramic is the best choice.

How much do composite resin fillings cost?

They are slightly expensive than the amalgam filling but safe and no compromise on the looks and functions

Pros and Cons of composite resin fillings

Advantages:

• The composite of composite resin fillings bonds to further support the remaining tooth structure, which helps prevent breakage and damage to your tooth.
• They certainly look better, and are color blended to match your natural tooth color.
• These fillings are often used to improve the appearance of misshapen, chipped or discolored teeth.
• Composite resin fillings last about six to twelve years or more, and the procedure usually takes just one visit to your dentist.
• There is very little sensitivity to hot or cold items often experienced with amalgam fillings.
• The dentist won't need to drill as much of the tooth structure as with amalgam fillings.

Disadvantages:

Technique sensitve

Several factors influence the performance, durability, longevity and cost of dental restorations. These factors include: the patient's oral and general health, the components used in the filling material; where and how the filling is placed; the chewing load that the tooth will have to bear; and the length and number of visits needed to prepare and adjust the restored tooth.

With so many choices, how do you know what's right for you? To help you better understand what's available, here are the advantages and disadvantages of commonly used dental restorations.

The ultimate decision about what to use is best determined by the patient in consultation with the dentist. Before your treatment begins, discuss the options with your dentist. Teeth bleaching or teeth whitening

Why do my teeth have stains and discolorations?

Most stains are caused by age, tobacco, coffee, or tea. Other types of stains can be caused by antibiotics, such as tetracycline; or too much fluoride.

What treatments are used for stained teeth?

Ask your oral health care professional about tooth-whitening options. They include a number of over-the-counter whitening systems, whitening toothpastes, and the latest high-tech option--laser tooth whitening. For maximum whitening, experts agree that peroxide is usually the way to go. Supervised bleaching procedures that are done in-office and at-home have become among the most popular treatment options. In some cases, the procedure is performed entirely in the office, using a light or heat source to speed up the bleaching process. In other cases, an oral health care professional gets the procedure started during an office visit and then gives you what you need to complete it at home. Still another popular procedure is one that you complete entirely at home.

At-home procedures, sometimes called nightguard vital bleaching, consist of placing a bleaching solution, usually a peroxide mixture, in a tray (nightguard) that has been custom fitted for your mouth by an oral health care professional. The bleaching solutions may vary in potency and may be worn for an hour, or throughout the night. Your oral health care professional can advise you on the appropriate type of application and the length of time needed to whiten your teeth, based on the severity of tooth discoloration and your specific needs.

How effective are bleaching systems?

Bleaching is effective in lightning most stains caused by age, tobacco, coffee, and tea. Based on clinical studies, 96 percent of patients with these kinds of stains experience some lightening effect. Other types of stains, such as those produced by tetracycline use or fluorosis (too much fluoride), respond to bleaching less reliably. And one cosmetic dentist points out that bleaching systems are not fully predictable. If you have a tooth-color filling when your teeth are bleached, the filling will stay yellow-dental restorations do not change color when tooth whitener is applied.

Are there any side effects to tooth bleaching?

In some studies, patients have experienced uncomfortable short-term side effects when having teeth bleached. Hydrogen peroxide can increase temperature sensitivity in the teeth, particularly at higher concentrations.And overzealous use of over-the-counter home bleaching products can wear away tooth enamel, especially with solutions that contain acid. Therefore, bleaching is a procedure best done under the care of an oral health care professional.

Ceramic veneers

These are the ceramic based laminate which are thin, translucent which will be bonded on the prepared tooth surface. It is normally done to the tooth, which has stained or discolored or misaligned or chipped or malformed tooth or gaps in between the teeth. This highly precise treatment.