Cosmetic Dentistry

White fillings

Cosmetic dentistry

White fillings started off as a cosmetic alternative for anterior teeth (front teeth)

There are several types of white fillings but the two most commonly used in everyday practice are, glass ionomers and composites.

1. Glass ionomers are white fillings which usually are less aesthetic/cosmetic or natural looking compared to composites and are less hard wearing but they contain varying amounts of fluoride which is a compound that makes teeth more resistant to decay.

Glass ionomers can also soak up fluoride from toothpaste and can release it to the tooth and give it enhanced protection against tooth decay/caries.
Glass ionomers are therefore useful to fill areas of teeth which are not subjected to direct biting from opposing teeth, such as the outer or inner surfaces or surfaces close to the gum line.

Glass ionomers are particularly suitable for children or adults who have an increased risk of developing tooth decay, for example patients who suffer from mouth dryness or patients who cannot avoid a sugary diet or who have insufficient plaque control

2. Composites are white fillings which are usually more aesthetic or cosmetic than glass ionomers.

Composites bond very well to enamel and are very useful nowadays for not only cosmetic reasons but also as effective solutions when we need to build up short teeth which have been worn down by a hard bite or an abrasive diet.

Composites can be used for direct composite veneers, saving the patient from expensive and invasive procedures such as ceramic veneers or crowns.
Composite fillings do not require as much drilling as silver/amalgam fillings and are therefore kinder on the teeth.

One disadvantage is that composite fillings need completely dry teeth when they are put in, which makes the procedure more complex than silver fillings. They also could shrink a little which can open the way for new bacteria and future decay. (This risk is usually managed quite acceptably)

Dental Veneers - Porcelain Veneers

Dental veneers

A veneer is a thin layer of restorative material placed over the outer surface of the tooth, either to improve the aesthetics of a tooth or to protect against past or future damage. The most popular types of veneers are porcelain, which usually could be stronger and more durable alternative to composite veneers. They are made by a dental technician and fitted by your dentist. Composite veneers are a quick non invasive alternative to porcelain veneers. Composite veneers are ideal for small changes in the appearance of the teeth and allows the dentist to preserve as much healthy tooth as possible.

Indirect veneers are made in 2 or more sessions and consist of first removing tooth substance with a bur, then taking impressions and sending them on to the dental technician for manufacturing.

Most veneer procedures require two appointments to complete, the first of which is dedicated to preparing and taking an impression of the teeth. After the tooth or teeth are prepared, an impression is taken, which, along with accompanying photos and models, is sent to the dental technician. The dental lab fabricates porcelain shells, which fit onto your teeth. These are called veneers. During your second appointment, the dentist will cement your veneers onto your teeth. Each veneer will be assessed for aesthetic before final cementation. If required, fine adjustments will be made prior to or immediately after final cementation.

On the second or third sitting the veneers could be cemented in place.

Indirect veneers could be made of ceramic or composite

When Should I opt for treatment with dental veneers?
You should opt for dental veneers if your teeth are stained, damaged by decay or an accident, or if you have got gaps between your teeth.

What will you do?

Most veneer procedures require two appointments to complete, the first of which is dedicated to preparing and taking an impression of the teeth. After the tooth or teeth are prepared, an impression is taken, which, along with accompanying photos and models, is sent to the dental technician. The dental lab fabricates porcelain shells, which fit onto your teeth. These are called veneers. During your second appointment, the dentist will cement your veneers onto your teeth. Each veneer will be assessed for aesthetic before final cementation. If required, fine adjustments will be made prior to or immediately after final cementation.

Tooth Whitening – Bleaching

Difference between “whitening” and “bleaching”

Teeth whitening

Many patients buy whitening toothpaste in the belief that it is an effective bleaching product. What is the difference? Until now, usually, the term “whitening” meant that the product removes dark deposits from the surface of teeth like a sandpaper removes an old layer of paint. In doing so, it appears that it makes the teeth whiter. In fact, it only removes a layer of superficial discoloration without any deep bleaching effect.

Bleaching means that the tooth becomes whiter in depth and after the procedure it will end up whiter than the original natural shade. Most patient would expect bleaching when they use whitening products.

Please see the explanations below:

Whitening

Original Natural shade of teeth

SHADE A2

Some extra environmental stains from food and drink

Teeth end up darker. Some stains are deposited on the tooth surface and some penetrate deeper

SHADE A4

Use of whitening products

END RESULT

Teeth lose some surface staining and become whiter but not whiter than they were originally.

SHADE A3

Bleaching

Original Natural shade of teeth

SHADE A2

Some extra environmental stains from food and drink

Teeth end up darker. Some stains are deposited on the tooth surface and some penetrate deeper

SHADE A4

Use of reliable bleaching products

END RESULT

Teeth become whiter than the original shade

SHADE A1

What patients expect when they read “whitening” is actually “bleaching”.

The truth is that up to date, no toothpaste is very effective at bleaching teeth. The effect is very marginal and the process is very slow. To do effective bleaching at home in a reasonable time (1-3 weeks) you would need a bleaching procedure performed by a dental professional.

There are some very good products for bleaching teeth but in order to persuade you, some manufacturers promise you “nine shades whiter” or similar offers. Nine shades whiter than what? Unless they state which shade guide they use to make their claims, these claims are useless.

Furthermore, whatever you do, do not use any Internet products or cures seen on YouTube until you have asked your dentist!!! Never use an acid like lemon juice, lime juice or vinegar to bleach your teeth. You will lose dental enamel and you will destroy your teeth!!!

So, again, to save yourself some disappointment, if in doubt, ask the professionals. Remember, teeth are live structures with a living nerve inside. They are not like a strand of hair.

To bleach teeth legally in the UK you need to be a trained dentist, hygienist or dental therapist and be registered with the General Dental Council.

Cosmetic Crowns

Cosmetic crowns are basically ceramic crowns made by dental technicians with a well-developed skill for aesthetics.

Like with artists, the skill for making a beautiful crown can only be taught up to a certain level. The final touch comes with genuine talent. The best technicians in this respect have both technical skills and talent. They also spend a lot longer making these crowns so their fee is usually higher.