282 E River Rd.
Tucson, AZ 85704
14122 West McDowell Road Suite 200
Goodyear, AZ 85395
12320 North 32nd Street, Suite 1
Phoenix, AZ 85032
Steinbrunner, Ron L D.D.S.
18555 N 79th Ave # D104
Glendale, AZ, 85308-6040
Kogan, Paul D.D.S.
706 E Bell Rd # 106
Phoenix, AZ, 85022-6641
Melde, Michael J D.D.S.
3003 Highway 95 # 103
Bullhead City, AZ, 86442-7802
Church, Justin D.D.S.
550 W 16th St
Yuma, AZ, 85364-4632
Throughout history, dentists have tried to recreate the function and beauty of natural teeth when tooth structure has been lost. Restoring function used to be the main goal of a dentist because prior to the 1970's, dentistry lacked the proper technology to achieve fine esthetics as well as function. Dentists could only predictably offer patients a restoration that would simply "fill" the empty space. Today, dentistry has more advanced dental materials and newly developed techniques that allow dentists to offer artistically-recreated, natural-looking crowns and modern tooth bonding that would fool even the most critical eye.
Before you can understand how crowns and tooth bonding can mimic teeth you must understand why natural teeth appear as they do.
It is a common mistake for patients to think that their teeth are all one color. Your teeth are never just one color. They are a series of superimposed translucent layers of varying shades. Teeth also have different surface textures that reflect light in ways that affect the color of your teeth.
Your teeth are made up of three layers: pulp, dentin, and enamel. Each layer has a specific thickness, composition and structure. Additionally, the way light reflects off of or transluces through the layers gives you the color of your teeth. Using knowledge about the three layers of teeth allow dentists and dental technicians to recreate natural-looking dental crowns and tooth bonding.
Dental crown technicians are the true artisans in dentistry. Dentists begin the crown-making process by reducing the size of the tooth, making an impression of the reduced tooth, and selecting the proper shades of the tooth. This information is then transferred to the dental technician so a crown can be made.
Dental technicians blend science with artistic knowledge to recreate natural-looking teeth. Artistically, they use frame and reference, proportion and idealism, perspective and illusion as well as symmetry to mimic nature. Understanding the language of colors and using new dental materials and techniques has allowed the dentist to not only "fill" missing spaces but create cosmetic dentistry artwork from crowns and tooth bonding as well.
By Benjamin O. Watkins, III, DDS
The appearance of your teeth is heavily impacted by the position of the surrounding gum tissue. In a normal situation, two teeth that are side by side in your mouth have contact with each other. Below this contact, the area is filled in with gum tissue in the shape of a triangle. This triangular-shaped gum tissue is called the papilla. It is not uncommon to have an empty space in the area where the papilla is supposed to be. If this occurs, the result is perceived as a black space.
They are caused by a loss of the gum tissue itself or by the shape and/or position of the teeth. For any black space that is present, the first thing that needs to be done is to diagnose what caused it to occur. Once this is done, the restorative dentistry treatment choice can be made. The best decision will be the most conservative treatment that corrects the black space.
One of the most common causes of loss of gum tissue is due to the gum disease known as periodontitis. This gum disease acts on the supporting bone around the teeth, causing a loss of bone. This loss of bony support causes the papilla to slump and flatten, creating a black space between the teeth. The first step in treating the resulting black space in this situation is to treat the cause. Once the gum disease is under control, the black spaces can then be addressed with restorative dentistry.
To remove the black spaces, the teeth need to have restorations placed that will change the shape of the teeth and fill in this space. The type of restorative dentistry can vary depending on whether or not there are any other problems with the teeth. The simplest and most conservative restoration is composite, a tooth-colored filling material. It can be bonded directly on the tooth in the area of the black space. Since it is placed only in the affected area, the situation where this is used requires that the overall appearance of the tooth is acceptable and does not need to be changed.
If the overall appearance of the tooth needs to be altered, then a different type of restorative dentistry needs to be used. The choice is either a dental veneer or a dental crown. The choice between the two depends on both the appearance and the structural changes that need to be done. Usually, to correct a black space, both teeth on either side need to be restored. In doing this, the symmetry between the teeth will remain the same. If you restored just one tooth, you would end up with one tooth being wider than the other. The advantage of using restorative dentistry to correct black spaces is that it usually results in a shorter treatment time.
Another cause of the black space is due to the position of the teeth themselves. One example is teeth that are tilted towards each other. When this occurs, the area for your gum tissue to fill becomes too large for the amount of tissue you have. This same concept may occur with certain types of tooth shapes. In these instances, the restorative dentistry treatment of choice is to use orthodontics (braces) to align the teeth. The advantage of doing this is that the black space will disappear without having to do any restorations on the teeth.
By Greggory Kinzer, DDS, MSD