Options for cosmetic dentistry

Published Feb. 9, 2012
By Staff Sgt. Katherine Cassandra
66th Medical Squadron Dental Clinic

HANSCOM AIR FORCE BASE, Mass. -- One of the first things people will often notice when meeting an individual for the first time is their smile.

Cosmetic dentistry is the area of dentistry that focuses on the appearance of teeth. Procedures include bleaching, veneers, crowns, implants and, in some cases, orthodontic treatment.

Bleaching, or tooth whitening, is the least invasive cosmetic procedure. This involves applying a chemical to the surface of the teeth, usually a diluted peroxide solution. There is no drilling involved.

There are many over-the-counter whitening systems available such as toothpastes, gels, rinses, strips or trays. A dentist can also prescribe an in-office or at-home bleaching treatment. The bleaching solution will lighten the teeth over a period of several treatments. However, the bleaching solution will not change the color of existing fillings so these may need to be redone to match the new color.

Occasionally, teeth and gums may become sensitive to the bleaching solution. Patients should check with their local dentist for recommendations on which system may work best for them.

A veneer is a thin layer of either plastic-type filling material or dental porcelain and is most often used on the top and bottom front teeth. They are used to mask stains that cannot be polished away, close small spaces or gaps or create a smile with homogenous tooth form and color.

Depending on the type of veneer, drilling may or may not be required. If it is required, it can often be done without the use of anesthesia, since the amount of drilling is often minimal. Veneers will usually take two to several appointments to complete, depending on the goal and complexity of treatment.

A crown can also be a form of cosmetic treatment when it is placed on a front tooth. Crowns can be placed to restore a fractured tooth due to trauma, or restore a tooth that has multiple large fillings present.

Crowns may have a metal base with porcelain baked over the metal or may be made completely of a ceramic material. The ceramic crown may produce a more "life-like" appearance but cannot be used in every situation. They do require drilling and the use of anesthesia.

Implants can be used to replace missing teeth. Individuals with multiple missing teeth may have a decreased ability to chew certain foods which can lead to other medical problems.

An implant is a piece of metal, often titanium, that is placed in the bone and then has a crown, bridge or denture attached. When implants are used to replace a single missing tooth, the procedure can be done without altering the teeth adjacent to the space, as is required with a traditional bridge.

Implants require a surgical procedure to place the body of the implant, a period of healing and then restoration of the implant. Implant placement will often involve multiple dental providers such as a general dentist, oral surgeon, periodontist or prosthodontist.

It is important for the dental team to thoroughly examine the teeth, gums and bone to develop a treatment plan that fits the patient's specific needs. Implants generally take several months for the entire process to be completed.

Orthodontics, or braces, is also a form of cosmetic dentistry. It can be used on adult patients with spaces, crowding or misalignment of teeth. If these teeth have no pre-existing cavities or restorations, braces may be the only required therapy.

Treatment may take a few months to more than a year depending on the complexity and goals of treatment. Orthodontic treatment for children and adolescents is done more often for functional reasons than cosmetic.

For active duty military, cosmetic treatment alone is not available, but can be done in conjunction with other necessary dental treatment. If an active duty member chooses to get elective braces on their own, it will be at their own expense and requires approval from their commander.

Regardless of which cosmetic treatment is chosen, oral hygiene is extremely important. Good oral hygiene will improve the longevity of any restorations that are placed. And remember, gums are also a part of a smile.

Gums that are red, inflamed or bleeding will certainly detract from the overall appearance of teeth. Brushing twice a day and flossing daily is still the number one fighter against tooth decay and bad breath, as well as helping one keep a beautiful smile.

USAF. (U.S. Air Force Graphic by Rosario "Charo" Gutierrez)