3013 N. West St.
Flagstaff, AZ 86004
Engelberg, Ryan H D.D.S.
10802 N 71st Pl
Scottsdale, AZ, 85254-5204
Endodontics, Allen D.D.S.
6520 N 7th Ave # 7
Phoenix, AZ, 85013-1158
Dental Specialty Assoc
3923 E Camelback Rd
Phoenix, AZ, 85018-2609
Van Der Werf, Ray D.D.S.
1630 S Stapley Dr # 208
Mesa, AZ, 85204-6659
The color, size, and shape of your teeth all have a profound impact on your appearance. While it is often the desire of people to improve the look of their smiles, it should be the goal of aesthetic dentistry, or cosmetic dentistry, to do this while still maintaining a "natural" appearance of the teeth. This often requires addressing one or all of the above-mentioned criteria. How is it that alterations in these three characteristics enhance your smile?
Tooth color is most commonly what people see first. As you get older, your teeth get darker. The reasons for this include normal changes that occur within the tooth and repeated insults from environmental conditions (coffee or tea stains, for example). Generally, then, darker teeth are associated with older age. The easiest way that cosmetic dentistry can correct this is by teeth bleaching. But this alone may not entirely create a natural-looking appearance.
Size and shape also are major factors that define the appearance of teeth. The most common cause of changing tooth size and shape over time is tooth wear; and the most common cause of wear is tooth-to-tooth contact, or grinding. Wear on the edges of the teeth can give the appearance of aging because you do not show as much of your teeth when you smile. Another factor that affects how much of your teeth show when you smile is the loss of skin tone as you age.
This loss of tone causes your face to sag, thereby showing less of your upper teeth and more of your lower teeth. The aesthetic dentistry treatment to enable more teeth to show when you smile will depend on the cause. If the cause is due to wear of the teeth, dental veneers or dental crowns can be used to regain the lost length and fill out the smile. On the other hand, this may not have a significant effect if the cause is due to the loss of skin tone associated with age. If this is the case, plastic surgery may be indicated as part of the treatment.
Wear on teeth also will make the edges of the front teeth very flat. As this occurs, the edges of the front teeth will form a straight line rather than the more youthful appearance when the two front teeth are slightly longer than the teeth next to them. Also, as they wear, the proportion of length to width will be altered. Teeth will start to appear more square in their shape rather than rectangular.
Basically, any treatment that counteracts the above-mentioned appearance changes has the ability to enhance the appearance of your teeth and smile. The aesthetic dentistry treatment can vary from teeth bleaching to dental crowns or dental veneers. Depending on the severity, other forms of treatment such as braces and gum surgery also may be indicated to enhance the appearance and function of your teeth. It is important to remember that all areas need to be addressed. If treatment for teeth that are worn and dark only involves teeth bleaching, the final result will be whiter teeth that are still worn and short. The teeth will not appear natural, as there will be a conflict between white teeth (youthful) and worn teeth (aged) that do not work together. Instead, it is necessary to correct the color, size, and shape to create a more natural appearance.
By Greggory Kinzer, DDS, MSD
There are many cosmetic dentistry options available today that dentists can use to replace missing teeth. The decision to use one instead of another depends on many factors. The best cosmetic dentistry treatment option can be different from person to person or from one area to another in the same mouth.
The purpose of this article is to list the major treatment choices and some of the key factors involved in the cosmetic dentistry treatment decision.
There are four major categories of restorations available for single tooth replacement:
The goal in restoring a missing tooth is choosing the most conservative treatment that will provide you with a restoration that not only looks good but is functional and has long-term stability.
Bonded dental bridges use the teeth adjacent to the empty space to help support the missing tooth. To do this, a very thin piece of metal or tooth-colored material is overlaid and bonded onto the back of the adjacent teeth. Running between these two bonded pieces is a tooth that fills in the empty space.
The main advantage of bonded dental bridges is that it is the most conservative type of dental restoration that uses the adjacent teeth for support. So, if the teeth next to the empty space look good and are not in need of any other type of restorations (fillings), bonded dental bridges may be an option.
However, because this restoration mainly gets its strength from bonding only, the long-term success depends highly on how your teeth fit together, how hard your teeth come together (grinding), and if your teeth are loose or not.
So, how long can this type of dental bridge be expected to last? Looking at long-term research studies, the failure rate is about 25% at five years. This means that one out of every four dental bridges will come off within five years. Generally, they can be re-bonded when they come off, but once it is re-bonded, the chance of it coming off again increases.
A cantilevered type of restoration only uses one tooth next to the empty space to support the missing tooth. Designs for this type of dental bridge can range from only using the back of the tooth (more conservative) to using a full crown to help support the missing tooth (less conservative).
The choice of which is done again involves the amount of force (grinding) that is placed on the teeth and whether the tooth is in need of a full dental crown for any other reason. If used in the correct situation, with no history of grinding, this type of dental bridge has a higher success rate than bonded dental bridges. This type of design is particularly useful for replacing missing lateral incisors.
Conventional dental bridges are generally what people think of when they hear the word "dental bridges." This type of restoration uses crowns on the teeth next to the empty space that are hooked together to help support the missing tooth.
This type of bridge is also the treatment of choice if the two adjacent teeth need to have crowns for other reasons.
Conventional dental bridges are also one of the most predictable of all the options for replacing missing teeth. The failure rate of conventional dental bridges in the dental literature has a wide range of variation, ranging from 20% over 3 years to 3% over 23 years.
A dental implant is a titanium metal "screw" that is placed directly into the bone in the area of the missing tooth. Once the dental implant is integrated into the bone, it will act as the root of the missing tooth. A dental crown can then be made to fit onto the implant.
By far, a dental implant is considered the most conservative of all the aforementioned procedures regarding the adjacent teeth. On the other hand, it may not seem conservative due to the surgical implant placement.
To be able to place a dental implant in the correct position, two main things need to be addressed. The first is whether there is enough bone to hold the dental implant and the second is whether the roots of the adjacent teeth are tilted and in the way of where the implant needs to go.
To overcome these concerns, you may require either bone grafting to increase the amount of bone or orthodontics (braces) to help move the roots of the adjacent teeth out of the way. Although this seems like a lot of work to do in order to place a dental implant, if the teeth next to the empty space look good and are healthy, a dental implant is the only way to replace the missing tooth predictably without altering your own teeth.
As with the other treatment options like dental bridges, the amount of force placed on your teeth (grinding) can have an effect on the long-term predictability of implants and should be evaluated. The failure rate of the dental implant in the front part of the mouth is currently around 5% at ten years.
By Greggory Kinzer, DDS, MSD