Frequently Asked Questions
Simple, detailed answers to cosmetic and restorative dentistry questions
- Our Office
- Cosmetic Dentistry
- Common Cosmetic Smile Problem
- Porcelain Veneers
- Full Mouth Restoration
- Cosmetic Dental Bonding
- Dental Fillings
- Cosmetic Gum Lift
Q: Do you perform general dentistry or only cosmetic dentistry?
A: Our primary focus is on cosmetic dental procedures such as porcelain veneers, crowns, bridges, inlays, onlays, and whitening. We also perform general dental procedures including hygienic cleanings, fillings, etc. The difference is that we practice dentistry with the aesthetics of the final result in mind, so we place a special emphasis on making you look great.
Q: I would like my smile improved, but I am simply fearful of going to the dentist. Can you do anything to make me feel better?
A: Fortunately, many dental procedures do not have to be uncomfortable anymore, or certainly not as uncomfortable as when you were a child. A great deal has changed in the past 10 years. Our office uses new, more effective types of anesthetic to numb the teeth than in earlier years, and we have many amenities and alternatives designed to distract you from the dental procedure and to help you with the psychological discomfort you may associate with visiting a dentist. Our office offers nitrous oxide gas, DVD movies, music CDs, anti-anxiety medication (when appropriate), in-house massage therapist along with a heavy dose of good ol’ TLC.
Q: Are you more expensive than other cosmetic dentists?
A: Our fees are comparable to those at premier cosmetic dental boutiques nationally. If you are price shopping for cosmetic dental care, bear this in mind — just like all restaurants, cars, or hotel rooms are not the same and you would never purchase one because it was the cheapest one you could find – all cosmetic dental offices are not alike. With such a high level of artistry, technology, and science needed for optimal results, there are at least two healthcare professionals you should not skimp on- your brain surgeon and your cosmetic dentist. This is not to say that our office is necessarily higher on the specific treatment you may need. In fact, depending on the procedure, our fees may be lower than other cosmetic dental practices. We encourage you to experience what separates us from other cosmetic dental practices, before making a life-altering decision based on price alone. We are confident you will agree that our services are value-priced.
Q: Will my dental insurance cover cosmetic dental treatment?
A: Like plastic surgery, insurance does not usually cover treatment done for purely cosmetic reasons. However, treatment that is needed to repair broken or decayed teeth or to replace existing restorations that are defective may qualify for some insurance reimbursement.
Q: Is there any advantage to using a cosmetic dentist that is accredited or a fellow in the American Academy of Cosmetic Dentistry?
A: An AACD fellow or accredited dentist has presented a number of specific but different cosmetic cases to their peers and have been found to demonstrate a high level of dental excellence in cosmetic dentistry. They have earned their distinction not only by passing an exam, and attending many hours of continuing education in cosmetic dentistry, but also by presenting close-up photos of individual cases that have been closely scrutinized by international experts in cosmetic dentistry.
Q: What is cosmetic dentistry?
A: Cosmetic dentistry is dental treatment that improves the beauty and health of one’s smile. Nearly every dental procedure has 2 elements: Aesthetics and function. Quality cosmetic dentistry takes both of these elements into consideration; so that one may rest assured they will not only look great, but enjoy hassle free long-term results.
Q: What are some examples of cosmetic dentistry procedures?
A: Cosmetic dentistry covers a multitude of procedures from smile teeth whitening to repairing, straightening, replacing or enhancing the appearance of one’s teeth and smile. Most common is the use of Cosmetic Veneers or Laminates. These thin, but durable restorations are much more conservative to the natural tooth than traditional crowns, and have become a very popular way to enhance a smile. In certain procedures dental bonding can be a way to shape teeth as well.
Q: Why would someone need or be interested in cosmetic dentistry?
A: Cosmetic dentistry provides more than just a beautiful smile and a healthy mouth. According to the American Academy of Cosmetic Dentistry (AACD), cosmetic dentistry has also been shown to improve a person’s overall health and emotional well-being. An improved smile can boost a person’s self-image, making them more confident in their daily lives.
Q: How has technology improved in cosmetic dentistry?
A: Cosmetic dental techniques have advanced dramatically over the last decade. The qualities of materials such as porcelain and composite resins have improved, giving a more lifelike appearance. And, where gum-tissue surgery and contouring was once performed with scalpels, lasers now provide fast, non-surgical results.
Q: How Do I Choose A Cosmetic Dentist?
A: A very important question. For the best results, it is important to know the qualifications and experience of the treating cosmetic dentist. The term “cosmetic dentistry” has become trendy and many dentists are promoting themselves as cosmetic dentists. At this time, cosmetic dentistry is not a recognized specialty (like orthodontics, for example). However, it is a discipline of dentistry that requires a thorough knowledge of science and an artistic eye. Ask your cosmetic dentist about his or her training, credentials, and experience in this area. A very effective way to understand your dentist’s skills is asking to see their portfolio of before and after photographs. Dentists who are dedicated to the art of cosmetic dentistry always take photographs of their cases.
Q: Is there a standard beautiful smile for all people?
A: No. Each person is different and each case is different, and has to be planned very carefully. There are many differences between male and female teeth and between all people. The design of the teeth has to be in proportion with the gum line, the lips, and the construction of the face of each individual to achieve a beautiful and natural smile.
Q: How white should I get my teeth?
A: In adolescence we generally have a white, bright smile but over the years our teeth pick up stain and become discolored. When undergoing cosmetic dental procedures the question then is how pearly white do we want to make your teeth? Many people are choosing shades that are whiter than in years past. Brilliantly white, opaque teeth on older individuals are a true sign they have undergone some type of cosmetic dentistry. In our office we strive to give your smile a sense of realism, we call it perfect imperfections. You will attain a beautiful white esthetic outcome, but there will still be a sense of realism.
Q: How can I get an idea of how I would look with an improved smile?
A: The first thing we do is listen – to what your desires are for your smile. We then can perform computerized cosmetic imaging. We simply take a number of photos showing different views of your face with a digital camera. We then use graphic artist software to generate a computerized image showing you with various smile enhancements. We work with you to determine things like how white you would like your smile, the shape of your teeth, and other aspects of your smile. Cosmetic imaging, although an artificial rendering, can assist in giving you a better idea of what you can look like after cosmetic dental improvements. We also may want to have our in-house dental lab perform a “wax-up” of your new smile, which would show in life-like, tangible form the proposed treatment.
Q: How long do your cosmetic dental procedures take?
A: In most cases, bonding can be completed in one visit. Accelerated whitening can be completed in one visit. At-home whitening requires an initial visit to be fitted for the splint. You need to return in a few days to pick-up your splint and we make sure it is fitted properly. Then depending on how often you wear the splint, you should see results from the first wearing to a few weeks or more. Porcelain veneers require two visits, about 10 days apart for fitting and application. Since each person’s cosmetic dental needs are unique, the above time guidelines are only an estimate. When we develop your customized treatment plan, we can give you a more precise schedule based on your cosmetic dental needs.
Q: How long will cosmetic dental treatment last?
A: There are too many factors to accurately predict how long any cosmetic dental treatment will last. The longevity of cosmetic treatment varies from procedure to procedure and person to person. The condition of the teeth prior to treatment influences the longevity of the restorations. Home care (hygiene) and eating habits are part of the equation. Of course, the quality of the treatment itself influences the long-term outcome as well. And, we do our best to deliver high-quality treatment that will last many years. Regular visits to the cosmetic dentist can help insure that your dental treatment is being maintained. While there is nothing we can do to render a tooth completely immune to future problems, preventive maintenance will prolong the life of your cosmetic dental treatment for many years. For estimated time frames for specific procedures, look at the treatment sections on this website or come in for a consultation for a more personalized estimate.
Q: Are there cosmetic dentistry procedures that can be performed on children or teenagers?
A: There are many reasons why children and adolescents may want a better looking or prettier smile, such as for better socialization, enhanced self-esteem and greater confidence. Depending on your child’s age and where he or she is in the development of his or her teeth and dental arches, some cosmetic dental procedures may be suitable if there is a specific problem that needs correcting. For example, some children and adolescents may have severely discolored teeth as a result of taking certain medications. Or, the front teeth may have been fractured due to an accident or sports injury and require composite bonding or veneers. In other instances, there still may be slight gaps or spaces between the teeth even after orthodontics, so perhaps composite bonding would enhance the look of the smile. If your child or teenager is concerned about the appearance of his or her smile, make an appointment to see your dentist. He or she will suggest the most appropriate course of action based on your child’s age, oral condition and desires, as well as possibly refer you to a cosmetic dentist for consultation.
Common Cosmetic Smile Problems
Q: What can be done to fix rotated, misshapen, or chipped teeth?
A: Chipped or misshapen teeth can ruin an otherwise pleasing smile. The long-term restoration of choice is porcelain veneers. A less expensive (but less durable) option may be a bonding, which can usually be performed in one visit. Done properly, both porcelain veneers and bonding can be applied, color-matched and shaped to make your teeth appear natural again. Check out our Before & After Photo Gallery for examples of these cosmetic dental procedures.
Q: What can I do about my uneven teeth?
A: Cosmetic contouring, porcelain veneers, orthodontics, bonding or crowns can be used to correct this. We usually recommend porcelain veneers to get the best aesthetic results. The best way to determine the best option for you is through a cosmetic consultation, and we have a couple of ways to do them. One option is that we can do just a smile analysis, but this has its pros and cons. Essentially what we do is perform a “look see” to see what the general situation is with your smile and our first impressions of what may work for you (whether it be whitening, bonding, veneers, etc.). We necessarily cannot get very specific with this approach though because we have not performed a cosmetic dental examination of you, determined if you have gum or bone loss, looked at x-rays, etc. — one or more of which may reveal a number of material issues that could affect our preliminary cosmetic treatment thoughts for you.
The second option, and our recommended approach, is our more detailed cosmetic consultation. This consult comes after you have had us perform a full exam, x-rays, cleaning, and a number of other diagnostic procedures. At that point, through computerized cosmetic imaging, etc. we can develop a customized smile design that is very detailed and specific for you. To get to that point, it takes 2 visits and an investment on your part of about $310 for the detailed cosmetic initial exam, full series of x-rays, cleaning, etc.
Q: I have a “gummy” smile. Can anything be done about that?
A: For most people the answer is, “absolutely!” Gum sculpting or “gingival contouring” as it is sometimes called, is one of the most common cosmetic procedures we perform. A symmetrical and even gum line is one of the most important aspects of getting a beautiful smile. We use an electrosurge unit or a laser to contour the gum tissue and place it in the position that “Mother Nature intended. Most people report that after the procedure is performed it feels like a “pizza burn” – like when you have eaten pizza that may have been a bit too hot. Usually, we can do other work like bonding or veneers on the same day.
Q: How can I correct severely discolored teeth from tetracycline?
A: Tetracycline is an antibiotic used to treat a number of illnesses. One of its major drawbacks is that it causes severe staining in teeth if it is used in growing children. These teeth have a gray or dark brown appearance to them. Such discolored teeth may not satisfactorily respond to whitening treatments. Porcelain veneers can be a miraculous answer for those patients who thought that nothing could be done for their teeth.
Q: I have a gap between my two front teeth. How can it be closed?
A: There are a number of options to correct this problem, which may include one or more of the following: porcelain veneers, crowns, bonding, and orthodontics. Click on our Before & After Photo Gallery for examples of patients with gaps in their teeth that we corrected.
Q: What can I do to change my teeth that are too small to make them bigger?
A: There are a number of options including porcelain veneers, crowns, and bonding.
Q: What can be done to correct cracked teeth?
A: Translumination or an intraoral camera can be used to help determine the extent of the cracks. Some of the possible choices to correct the problem would be porcelain veneers, crowns, or bonding. Look at our Before & After Photo Gallery for examples of these procedures.
Q: What can I do about my “buck teeth” that stick out in front?
A: Many times other options can be suggested after a cosmetic consultation, including porcelain veneers, crowns, bonding, orthodontics or simply cosmetic contouring of the teeth.
Q: My teeth have presented nothing but problems over the years. Should I just have one or more of them pulled?
A: Once your natural teeth are gone – they’re gone. That’s why we encourage patients to try and save their teeth for a number of reasons. If a tooth that can and should be saved is pulled, it will lead to overstressing the other teeth and can result in their loss as well. Tooth loss can cause ineffective chewing and this can result in the swallowing of large chunks of food. This overworks the digestive system and can even lead to digestive disorders. People who don’t have their own teeth have a difficult time consuming a high fiber diet. A high fiber diet has been recommended by the American Cancer Society for the prevention of cancer. Dentures don’t chew food efficiently. Tooth loss leads to bone loss in jaws. Many young denture patients appear prematurely aged due to the bone loss they experience after having their teeth pulled. With today’s great emphasis on having a youthful appearance, regardless of one’s age, saving your teeth is indeed a wise investment. Dentures are colonized by mouth bacteria and pick up odors and stains. They must be taken out at night or they can lead to a yeast infection of the gums. Dentures are a good choice for patients who have no hope of saving their teeth. Without natural teeth, a denture, implants or bridges are the most common options. To be able to wear a denture comfortably requires sufficient retention. Bone is invariably lost when teeth are pulled and then continues to reabsorb and shrink back, resulting in poor fitting loose dentures. These consistently require reapplication and never function as effectively as natural teeth. Today, dental implants used to anchor a tooth restoration add stability and provide a better choice for patients that have missing teeth. Most times, in partnership with our patients, we can establish good functioning, aesthetically pleasing, and long-lasting teeth.
Q: I want a smile makeover because I think I have ugly teeth, but I don’t have any cavities or anything else wrong that needs to be fixed. Can something be done to make my smile look better?
A: If you are unhappy with the appearance of your smile, the first step is to do your homework and investigate the level of cosmetic dentistry experience for each cosmetic dentist you consider before setting up a consultation appointment. We suggest that you read How to Choose a Cosmetic Dentist for information about questions to ask and other criteria that can help you in selecting the cosmetic dentist that is right for you. The cosmetic dentist will help you discuss what it is about your smile that you don’t like. Then, based on your needs, your cosmetic dentist will develop a cosmetic treatment plan that is right for you. If you are concerned about the removal of healthy tooth structure, the good news is that dentists have conservative techniques available to enhance the look of your smile, including teeth whitening and composite bonding, as well as minimal and no-prep veneers.
Q: What are porcelain veneers?
A: These are also called “porcelain laminates,” “porcelain laminate veneers,” and just “veneers,” For our purposes, we will just call them veneers. Veneers are formed porcelain shells that are used to create a new front surface to a tooth. These are thin sculpted pieces of tooth-shaped porcelain that fit over the front of the teeth and are the premier standard of care in cosmetic dentistry. Permanently bonded to the front surface of a tooth, to restore or improve position, shape and tooth color, they can make a dramatic, immediate difference to one’s smile and overall facial appearance. Veneers are wonderful for fixing common problems such as midline spaces (the gap-toothed look of the two front upper teeth) or chipped, crooked, missing, discolored, pitted, malformed or improperly positioned teeth. Once only accessible to the wealthy and top Hollywood stars and models, veneers are now a popular way for many people to obtain the smile of their dreams.
Q: Is there really a difference between the porcelain veneers you can get from one cosmetic dental office and another?
A: Yes, there is a real blend of art and science behind high-end aesthetic dentistry. All veneers are not created equal. Our cosmetic dentists have extensive training in the art of smile design, which determines the colors, line angles, shapes, thickness, translucency, occlusion, and many other factors that our cosmetic dentists prescribe to our in-house laboratory. Our lab then hand makes the veneers to our specifications. Veneers should be custom-designed to fit your face, smile, gender and personality. Done correctly, they look and feel like real teeth. You can be as much a part of the selection process as you wish, but part of why you select a cosmetic dentist is his or her experience and artistry in what looks great. Computer imaging as well as before and after photos of other cases will help you decide on the style, shape and color that work best for you. Veneers are bonded in place with a high intensity curing light. You can tell the quality by the photos of the work you see in our office.
Q: How are porcelain veneers made?
A: Veneers are made from a thin shell of porcelain and are permanently bonded to the teeth. Our selected, world-class dental ceramists fabricate the veneers from our impressions and color mapping specifications. Each veneer is custom-designed to fit naturally and comfortably over each tooth like a ballet slipper. After placement, these veneers are designed to look like beautiful, natural teeth.
Q: What are porcelain veneers used for?
A: Veneers can be used to correct the size, shape, color and alignment of teeth. So if your smile suffers from teeth that are stained, crooked or malformed for any reason (cracks, chips, fractures, spaces, smoking or tetracycline stains, etc.), then you may be a great candidate for porcelain veneers. Many people want straighter teeth without the hassle and time orthodontic braces require. Now teeth can be straightened with porcelain veneers and crowns. Most people can get the shape, length and degree of whiteness they want, and they don’t stain!
But what many people don’t realize is that the shape of veneers in combination with occlusal adjustments, such as opening the bite, can also have profound impact on the entire face. This can result in giving the appearance of a face-lift or elimination of wrinkles without any plastic surgery. So in developing your personalized Smile Design, we take into account building out certain teeth or reduce others to achieve such desired objectives. This is why for a number of our quests, they actually look 10 years younger after our Smile Designs and just imagine their rejuvenated spirit!
Q: What’s the difference between plastic veneers, bonding and porcelain veneers?
A: Composite bonding (also sometimes called “direct veneers” or “plastic veneers”) is a tooth-colored plastic resin material. Bonding can usually be placed in one visit and is used many times to repair a smaller chip in a tooth or to make aesthetic improvements in more than one tooth. Bonding usually requires little to no tooth reduction or anesthesia. Because they are made out of porcelain in a lab, porcelain veneers are usually more aesthetic in terms of the spectrum of colors, realism and translucency. Porcelain veneers are also more of a long-term solution than bonding, as they do not stain, discolor, and are stronger than bonding. Porcelain veneers usually require only a couple of office visits – the first visit to prepare the teeth and the second to seat the veneers.
Q: How quick can porcelain veneers give me a gorgeous smile?
A: Our quests can usually get the smile of their dreams in a couple of visits. At the first veneer appointment, your teeth are prepared, impressions are taken, and you will walk out of the office with custom temporary veneers. In the second appointment, we permanently seat the veneers. Imagine getting a new smile within one month — one that actually fits your face and personality and gives you the confidence to express the real you!
Q: I’m an adult, and don’t want to go through braces. Can veneers help correct my crooked teeth faster than orthodontics?
A: Porcelain veneers are a perfect alternative to braces for many adults. Veneers can correct the shape of teeth that are not aligned correctly, have gaps and spaces. Older patients, who have always wanted straighter teeth but no desire to undergo years of treatment with braces, usually love this new technique. Instead of months and years in braces, crooked teeth can usually be corrected in as little as two weeks with veneers. In fact, even if you have had braces in the past but the size and shape of your teeth is not pleasing to you, veneers may be the perfect solution. See our Before & After photo gallery for amazing examples of what “instant ortho” looks like.
Q: What are the pros and cons of braces vs. veneers?
A: Braces are most desirable for people under the age of 18. At this stage in life, the bone is more malleable, teeth move easier and are more likely to stay once the bone “remodels” around the newly positioned teeth. Many adults also wear braces, but for a longer duration and almost always need a permanent retainer to hold the new positioning. There are numerous office visits in addition to the general hassles of wearing braces. Also, teeth may be repositioned, but continue to be the same shape and color which may or may not be desirable. Orthodontic braces, however, do not require the teeth to be reshaped or restructured in any way. Sometimes called, “instant ortho,” veneers can give the appearance of straightening teeth, closing gaps, and changing the shape of teeth to give a perfect smile. A veneer is a thin shell of porcelain. After the enamel on teeth is reduced, usually only slightly, the veneers are bonded in place covering the visible part of a tooth. Seated correctly, they are strong and should last a very long time. The bite is most often enhanced and veneers do not stain or discolor.
Q: How are the teeth prepared for porcelain veneers?
A: Unlike crowns, usually only a thin layer of enamel is removed from the teeth to make room for the veneers. Usually, only about 5/10 to 8/10 of a millimeter is removed from the outer surface. This small amount of reduction is required to make room for the porcelain. This allows us to make the veneers to the proper contour without them appearing to be bulky or unnatural. Some teeth on some individuals may not need any tooth reduction, and some may require a lot.
Q: How are porcelain veneers placed on the teeth?
A: New advances in bonding technology allow us to create an extremely strong bond between your teeth and the veneers. The teeth are first prepared with a bonding adhesive and special resin cement is used as the “glue.” The resin cement is available in a number of different colors to give the best possible aesthetic result. After approval, resins are then used to permanently bond the veneers to the teeth using a special dental curing light, which helps to create a stronger, longer-lasting bond between the veneer and your tooth. The durability, look and simplicity of application make it easy to see why veneers have become one of the most popular cosmetic dental treatments available today.
Q: How many porcelain veneers are needed for a new Smile Design?
A: This depends entirely on the desired result. If there is only one tooth that is discolored or malformed, then a single veneer may be able to be used. To get a more balanced and even looking result, many times it is recommended that several veneers (from 4 to 8) be done at the same time. This allows us to get the most beautiful result possible. When closing large gaps between teeth, 6 to 10 veneers may be necessary to get a proper aesthetic result.
Q: How long will porcelain veneers last?
A: There are no hard and fast rules about how long porcelain veneers will last. While you can certainly expect your veneers to last many years (some patients have had them for 20 or more years), it is unrealistic to expect them to last forever. With good home care and by exercising good judgment, it seems likely that a porcelain veneer could last well in excess of 10 to 15 years. Ask about our limited warranty.
Q: Will my teeth be sensitive after I get porcelain veneers?
A: Some people experience sensitivity (to hot and cold or pressure, etc.) after the placement of veneers. Some sensitivity is absolutely normal and usually dissipates spontaneously from a day or so to a couple of weeks. The reason for the sensitivity can arise from the amount of enamel left on your tooth after preparation, the proximity of the nerve, as well as several other factors. If this sensitivity remains or concerns you at all, please contact your cosmetic dentist.
Q: Will I need to change my diet after getting porcelain veneers?
A: Once placed, your veneers are very strong and will resist most of the forces placed upon them by a normal diet, so a normal diet should pose no problem at all. Porcelain has great crushing strength but poor tensile strength. Therefore, you should avoid anything that will bend or twist the veneers. As with your regular teeth, opening bottle caps with your teeth or crunching on hard candy or ice is not a good idea.
Q: How do you maintain new porcelain veneers and what follow-up care is recommended?
A: With proper home care and scheduled dental visits, veneers can provide you with a beautiful smile for many years. A week or two after the placement of your veneers, we ask that you return to our office for a cosmetic polish and treatment evaluation. This visit is extremely important. It gives us the opportunity to evaluate the placement of the veneers, the tissue response and to answer any questions you might have regarding your new smile design. For example, if you grind or clench your teeth, please let us know. We can fabricate a soft night guard for you to wear to minimize the stresses placed upon your teeth while you sleep. The maintenance of your porcelain veneers is relatively simple. Brush and floss as you normally would to prevent oral hygiene problems. Once placed, veneers are typically the kindest restoration to the gum tissues that we currently have available. Don’t be afraid that you’ll damage your veneers by either flossing or brushing. Any non-abrasive toothpaste is acceptable. A good home care regimen will help ensure the aesthetic success of your veneers.
Q: When would porcelain veneers maybe not be right for me?
A: 1. If you have unhealthy teeth. Porcelain veneers cannot be placed on teeth where there is decay or active periodontal disease (gum disease). These conditions must be treated by your dentist before porcelain veneers can be successfully fabricated and placed. 2. If you have weakened teeth. If a significant amount of tooth structure has been lost as a result of decay or fracture, or else already replaced by a dental filling, the tooth may not be a good candidate for a porcelain veneer. Porcelain veneers do not significantly strengthen the teeth on which they are placed. Teeth that have, or have had, a history of a loss of a significant amount of tooth structure are usually better treated by placing a dental crown on them, not a porcelain veneer. 3. If you have an inadequate amount of tooth structure. Some teeth, as a result of excessive wear or previous attempts at dental work, may have inadequate tooth structure. These teeth do not make good candidates for porcelain veneers. 4. If you clench or grind your teeth. Persons who clench and grind their teeth can make poor candidates for porcelain veneers. The forces created by these activities, termed bruxism by dentists, can easily chip or break porcelain veneers. Possibly a person can successfully control their bruxing habits during their waking hours, but during sleep a bruxer has essentially no control over this activity. If a person who bruxes does have veneers placed, they must be committed to wearing an acrylic dental night guard when they sleep so to minimize the amount of stress placed on their veneers.
Q: Are veneers my only option if I want a smile makeover?
A: Not necessarily. Our cosmetic dentist will determine the cosmetic dentistry procedures that would be the best for you and give your options. The dentist’s suggestions will be based on your desires and a thorough examination to determine the condition of your teeth and what problems, if any, may require dental treatment. Therefore, your smile makeover could involve teeth whitening, crowns, composite bonding, gingival sculpting, inlays and onlays or any other combination of cosmetic dental procedures that your dentist determines is right for your cosmetic treatment plan.
Q: What is a crown?
A: A crown is a restoration that covers, or “caps,” a tooth to restore it to its normal shape and size, strengthening and improving the appearance of a tooth. Crowns are necessary when a tooth is generally broken down and fillings won’t solve the problem. If a tooth is cracked a crown holds the tooth together to seal the cracks so the damage doesn’t get worse. Crowns are also used to support a large filling when there isn’t enough of the tooth remaining, attach a bridge, protect weak teeth from fracturing, restore fractured teeth, or cover badly shaped or discolored teeth.
Q: How does a cosmetic dentist place a crown?
A: To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of the teeth and gums are made and sent off to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown in made. On the next visit, the cosmetic dentist removes the temporary crown and cements the permanent crown onto the tooth.
Q: I have seen people with crowns that look “fake” or that have a dark line at the gum line of the crowns. What causes that?
A: This is usually caused by the metal margin of a porcelain fused to metal (or PFM) crown. In the “old days,” many dentists used PFM crown, but now in most cases, cosmetic dentists use all porcelain crowns, which provide virtually the same strength but are highly superior in their aesthetic result.
Q: Why would someone want an all-porcelain crown?
A: Some restorations are designed with a metal lining, covered with porcelain (porcelain- fused-to-metal or PFM). At one point in time, most restorations were made this way. When placed, they usually look opaque or “flat” because they do not let light pass through like a natural tooth. There is often a noticeable dark line next to the gum-line that is undesirable (often the darkness invades the adjacent gum tissue as an adverse reaction). All-porcelain restorations are what we chose to use unless there is a compelling reason otherwise. Again, when properly seated, they are as strong or stronger than their metal predecessor. And the appearance can be identical to a natural tooth, allowing light to pass through (referred to as translucency).
Q: Why would the cosmetic dentist recommend crowns instead of veneers?
A: Crowns require more tooth structure removal; hence, they cover more of the tooth than veneers. Crowns are stationary and are customarily indicated for teeth that have sustained significant loss of structure, or to replace missing teeth. Crowns may be placed on natural teeth or dental implants.
Q: What can be done to replace a missing tooth?
A: Cosmetic dentistry now offers options beyond having a partial denture. One option is to have an implant and crown placed. An implant is a titanium cylinder that is placed in the bone (under the tissue) and functions to replace what was once the root of the tooth. After a period of 5-6 months a stress or load can be placed into this implant and then the crown is placed over the abutment. This tooth is now cared for like all the other teeth in your mouth. Another option is a bridge. A bridge is like a crown that is bonded to the teeth on either side of the missing tooth. Some people prefer to not go through the surgical procedure of having the implant placed. Others prefer to have a quick fix and to not go through the waiting period of 5-6 months before a crown can be placed on the implant.
Q: What can I expect on my first visit for the crown procedure?
A: As soon as you are seated, we will numb the area to be worked on using a local anesthetic. Depending upon the type of local anesthetic used, you can expect to feel numb for one to four hours. If your anesthesia should last longer, do not be concerned. Individuals react differently to anesthesia. While the area is numb, please be careful not to bite your lip or tongue. You may want to consider a soft diet or no meal at all while until your sensation returns in the affected area. Once the appropriate area is numb, one of our cosmetic dentists will prepare the tooth to maximize the function, retention and aesthetics of your new crown. After the tooth is fully prepared, we proceed to the impression stage where we create a model of your prepared tooth for our in-house lab to custom-fabricate your crown. Should you experience any discomfort you can take a mild analgesic (Tylenol, Advil, or aspirin, etc.) as long as there is no medical contraindication based upon your medical history. Typically, you can take anything you would normally take for a headache. If the discomfort persists, please call our office.
Q: How should I care for my crowns?
A: To prevent damaging or fracturing the crowns, avoid chewing hard foods, ice or other hard objects – just like you should avoid for your natural teeth. You also want to avoid teeth grinding. Besides visiting our office, and brushing twice a day, cleaning between your teeth is vital with crowns. Floss or interdental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown area where the gum meets the tooth. Plaque in that area can cause dental decay and gum disease.
Q: What is a bridge?
A: A dental bridge is a false tooth, known as a pontic, which is usually fused between two porcelain crowns to fill in the area left by a missing tooth. The two crowns holding it in place are attached onto your teeth on each side of the false tooth. This is known as a fixed bridge. This cosmetic is used to replace one or more missing teeth. Fixed bridges cannot be taken out of your mouth as you might do with removable partial dentures. Bridges can reduce your risk of gum disease, help correct some bite issues and even improve your speech. Bridges require your commitment to serious oral hygiene, but can last as many ten years or more.
Q: Is it possible to have a porcelain bridge affixed to your teeth without having any clasps or metal appearing?
A: Yes. If you are an appropriate candidate, a porcelain bridge can look as natural as (or in many cases better than) your own teeth, in color and shape, in proportion and alignment, with no clasps or metal appearance. Some bridges are designed with a metal support structure or a metal lining, covered with porcelain (porcelain-fused-to-metal or PFM). At one point in time, most restorations were made this way. When placed, they usually can often look opaque or “flat” because they do not let light pass through like a natural tooth. There can also be a noticeable dark band showing through the teeth or showing next to the gum-line that is undesirable (often the darkness invades the adjacent gum tissue as an adverse reaction). All-porcelain bridge restorations are what we chose to use unless there is a compelling reason otherwise. Again, when properly seated, they are virtually as strong or stronger than their metal predecessor. And the appearance can be identical to a natural tooth, allowing light to pass through (referred to as translucency).
Q: Who is a candidate for a bridge?
A: If you have one or more missing teeth and have good oral hygiene practices, you should discuss this procedure with your cosmetic dentist. If spaces are left unfilled, they may cause the surrounding teeth to drift out of position. Additionally, spaces from missing teeth can cause your other teeth and your gums to become far more susceptible to tooth decay and gum disease.
Q: How is a dental bridge placed?
A: We prepare your teeth on either side of the space for the false tooth. You will be given a mild anesthetic to numb the area, and then remove an area from each abutment (teeth on either side of the space) to accommodate for the thickness of the crown. When these teeth already have fillings, part of the filling may be left in place to help as a foundation for the crown. We will then make an impression, which will serve as the model from which the bridge, false tooth, and crowns will be made by our dental laboratory. A temporary bridge will be placed for you to wear while your bridge is being made until your next visit. This temporary bridge will serve to protect your teeth and gums. On your second appointment, the temporary bridge will be removed. Your new permanent bridge will be fitted and checked and adjusted for any bite discrepancies. Your new bridge will then be cemented to your teeth.
Q: Are there different types of bridges?
A: Yes. There are three main types of dental bridges:
1. Traditional Fixed Bridge — A dental bridge is a false tooth, known as a pontic, which is fused between two porcelain crowns to fill in the area left by a missing tooth. There are two crowns holding it in place that are attached onto your teeth on each side of the false tooth. This is known as a fixed bridge. This procedure is used to replace one or more missing teeth. Fixed bridges cannot be taken out of your mouth as you might do with removable partial dentures. 2. Resin Bonded Bridges — The resin bonded is primarily used for your front teeth. Less expensive, this bridge is best used when the abutment teeth are healthy and don’t have large fillings. The false tooth is fused to metal bands that are bonded to the abutment teeth with a resin, which is hidden from view. This type of bridge reduces the amount of preparation on the adjacent teeth. 3. Cantilever Bridges — In areas of your mouth that are under less stress, such as your front teeth, a cantilever bridge may be used. Cantilever bridges are used when there are teeth on only one side of the open space. This procedure involves anchoring the false tooth to one side over one or more natural and adjacent teeth.
Q: What are the pros and cons of a bridge?
A: Some of the main advantages include that bridges are natural in appearance, and usually require only two visits to place. If you maintain good oral hygiene, your fixed bridge should last as many as ten years or more. Some of the disadvantages of having a bridge include that it is common for your teeth to be mildly sensitive to extreme temperatures for a few weeks after the treatment. The buildup of bacteria formed from food acids on your teeth and gums can become infected in proper oral hygiene is not followed.
Q: What is meant by a “full-mouth restoration”?
A: In short, a full-mouth restoration (or sometimes called reconstruction or rehabilitation) is the individual restructuring of each and every tooth in a mouth. FMR is called for where the teeth are worn down, broken down or missing, causing problems in both the bite and appearance of the mouth. The most common solutions to these problems are crown, veneers, onlays, and bridge work. FMR in the hands of a highly skilled dentist is usually so successful that others cannot discern the real teeth from the restoration. This technique involves some easy preliminary information gathering. Reconstruction is completed in just two appointments – a preparation appointment and a seating appointment. During the preparation appointment all old restorations and any decay are removed, impressions are made of the underlying healthy tooth structure and beautiful temporary teeth are made. These temporaries are worn until the seat appointment, about three weeks later. This appointment involves removing the temporaries and bonding on the final restorations.
Q: My teeth are really broken down and worn. Can the youthful smile I had years ago be recreated?
A: In many cases, the answer is, “yes.” If you have teeth that are worn, shifted, missing, broken, or a combination of these, then FMR may be the answer. FMR is designed to restore your smile and, at the same time, make eating easier and more comfortable. Cosmetic dentistry has evolved dramatically in recent years. Many people have old dentistry that was done in bits and pieces. Much of it has worn resulting in collapsed bites and difficulty with chewing. This wear and patchwork quilt of old dental work creates an appearance that can age you beyond how you feel. Furthermore, a poor bite can cause jaw joint problems, muscle tenderness, and even headaches. Chewing and speech may be affected, as well.
Q: How do I know whether I am a candidate for full-mouth restoration?
A: If you have teeth that are in very poor health or those who have worn them excessively over time, you should consider this procedure. You probably have lost vertical dimension if your teeth appear short, show signs of wear, or if your top teeth nearly or completely overlap your lower teeth. This “vertical dimension” is typically lost from decay or from teeth “grinding” (often from stress and/or misalignment of teeth). Other signs of lost vertical dimension are pains in the joints located near your ears, headaches, back pain, muscle pain, clicking and or popping of the jaw joints. Vertical dimension is restored by physically adding to the biting surfaces of all teeth. A material similar to porcelain is used to enhance the height of teeth in the form of a typical crown. It has been estimated that approximately 80% of the general population have lost some Vertical Dimension.
Q: Why should you choose Cosmetic Dentists at the Atlanta Center for Cosmetic Dentistry for Full Mouth Restoration?
A: Full mouth reconstruction is a demanding area of dentistry that often requires a combination of many disciplines. Most importantly, it requires planning and advanced skills on part of the cosmetic dentist. Our cosmetic dentists have had extensive training in Full Mouth Restoration. In addition to the training and passion for this technique, Dr. King instructs other dentists from around the world on the technique. “Every time I teach I come back home with something new that augments my skills and therefore our client’s end result,” says Dr. King. Most cosmetics dentists, who do FMRs for their clientele, do this over a period of time, say several years. The advantage to our technique is that we complete it usually in a couple of appointments. Because of this efficiency we are able to increase the vertical dimension all at once. Vertical dimension cannot be increased when a cosmetic dentist is restructuring a mouth one or even several teeth at a time. To see photographs of full mouth reconstruction cases performed by our cosmetic dentists, click on our before and after Photo Gallery.
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- Teeth Whitening
- Root Canal Therapy
- Home Dental Care
- Teeth Grinding
- Gum Disease
- Emergency Dental Care
- Dental Implants
- Restorative Dentistry
- Dental Hygiene
- Dental X-rays
Cosmetic Dental Bonding
Q: What is bonding and how is it different than veneers?
A: Bonding is done by placing tooth-like material onto the tooth to both build and alter its shape. Because natural tooth structure is usually not removed, its best use is somewhat limited to broken or chipped teeth. The advantage of bonding is that it is a relatively inexpensive and conservative way to restore a tooth. One disadvantage is that over time, the bonded portion of a tooth may change color as compared to the natural, un-bonded portion of the tooth. Another disadvantage is that it is more prone to breakage. A porcelain veneer or crown on the other hand, will not discolor and will be far stronger in the long run. This may cost more and the preparation of the affected tooth will be more extensive, but may be necessary in order to get a smooth, natural appearance. A veneer covers the front, sides, and biting surface of the tooth. Once properly “seated,” it becomes your tooth. It should be seamless. They are very strong and durable and are no more likely to break than a real tooth. And like a real tooth, the veneer is repairable if it were ever to chip or break.
Q: What are the different types of fillings?
A: The three most common types of filling materials are amalgam, composite, and porcelain.
1. Amalgam Fillings — Amalgam fillings (sometimes called “silver fillings”) are a mixture of mercury liquid and small pieces of silver and other metals such as copper, tin and zinc. 2. Composite Resin Fillings — A composite resin is a tooth-colored plastic mixture filled with glass (silicon dioxide). Introduced in the 1960s, dental composites were confined to the front teeth because they were not strong enough to withstand the pressure and wear generated by the back teeth. Since then, composites have been significantly improved and can be successfully placed in the back teeth as well. Composites are not only used for restoring decay, but are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth. Composite resin dental fillings were created as an alternative to traditional metal dental fillings. Tooth fillings colored to look like a natural tooth are known as composite resin fillings and are made of a plastic dental resin. Composite resin fillings are strong, durable, and make for a very natural looking smile. Many dental insurance plans cover their use. 3. Porcelain Inlays and Onlays — The real advances have been made in laboratory processed white porcelain fillings called “inlays” and “onlays”. They are beautiful, strong, and usually long lasting. The cost is similar to a gold “inlay” or “onlay”.
Q: My old fillings in the front have turned dark. Can they be bleached?
A: Amalgam fillings, bonding and composite resin fillings do not bleach. If you are unhappy with the look, it is time to replace those. There are now many ways to restore teeth with materials that virtually disappear and blend with the natural color of your teeth. Remember, only replace these fillings and bonding after whitening in order to match the new improved color of your own natural tooth.
Q: How are composite fillings placed?
A: Following preparation, we place the composite in layers using a light specialized to harden each layer. When the process is finished, we will shape the composite to fit the tooth. We then polish the composite to prevent staining and early wear.
Q: Why are porcelain inlays/onlays used for larger cavities or restorations?
A: In cases with larger cavities or broken down areas, an inlay or onlay to cover more of the tooth’s surface may be indicated. These restorations are indirect because they require two visits and fabrication by our dental laboratory. The ceramic restorations are considerably more expensive and therefore simple, one-visit composite fillings are typically used instead for small fillings. Ceramic restorations are much more durable and will not stain. Naturally speaking, the final result with ceramics is spectacular. White inlays or onlays are actually glued into the tooth and there is now a body of research that claims that because of this the tooth ends up stronger after such a procedure, less prone to problems down the road.
Q: Do cavity fillings need to be obvious?
A: New advances in tooth-colored porcelain and composite materials not only allow fillings to go unnoticed, but in many cases are stronger and more wear-resistant than amalgam (silver fillings).
Cosmetic Tooth Contouring
Q: What is tooth contouring and reshaping?
A: Tooth reshaping, or contouring, is one of few “instant” treatments now available in cosmetic dentistry. Dental reshaping and contouring is a procedure that can aesthetically improve certain crooked teeth, chipped teeth, cracked teeth or even overlapping teeth in just one session. Tooth reshaping and dental contouring, is commonly used to alter the length, shape or position of your teeth. Contouring teeth may also help correct small problems with bite. It is common for bonding to be combined with tooth reshaping. This procedure is ideal for candidates with normal healthy teeth, but who want subtle changes to their smile. The dental contouring procedure can even be a substitute for braces under certain circumstances. It is also a procedure of subtle changes. A few millimeters of reduction and a few millimeters of tooth-colored veneer can create a beautiful smile when performed by a cosmetic dentist, with no discomfort to you.
Q: How do I know whether I am a candidate for tooth contouring and reshaping?
A: If you want your teeth to appear less crowded, and not have chips, fractures, overlaps, pits or grooves in the enamel, this procedure should be discussed with your cosmetic dentist. With a little dental contouring, you can make a huge difference in the way you feel about your smile. Good cosmetic dentistry can give you a smile that is the envy of others. Tooth contouring by a cosmetic dentist does require that you have normal, healthy teeth. Done right, tooth reshaping, or tooth sculpting, is a safe and conservative way to improve your smile. Teeth may become weaker if large amounts of enamel are removed, tooth reshaping should be limited to minor changes or combined with veneers or bonding for the best smile.
Q: How is the tooth contouring and reshaping procedure performed?
A: Preparation for dental contouring and reshaping is a team effort. Our cosmetic dentists even use computer imaging to show you how you will look after the procedure. We will usually mark your teeth with a pen prior to performing the procedure. This helps us in the sculpting process. As our cosmetic dentist sculpts the tooth, imperfections are artfully eliminated or minimized. A sanding drill may be used to remove small amounts of surface enamel gradually. Abrasive strips are then moved back and forth between your teeth to shape the actual sides of your teeth. Then the teeth are smoothed and polished. Usually anesthetic is not needed. Teeth contouring and reshaping usually can be done in one visit.
Cosmetic Gum Lifts
Q: I have a “gummy” smile. Is there anything that can be done about it?
A: Absolutely! A beautiful smile is like a work of art – the smile is the frame, the gums are the matting, and the teeth are the featured subject. Much like the cuticles on your fingernail, the gums can cover your tooth structure, making your teeth appear short and fat instead of the shape that “Mother Nature” intended. We routinely correct this in most of our smile designs. Gum contouring can be done to reduce the excess gum. The removal of this excess tissue allows for normal sized teeth and for a normal gum line appearance by using an electrosurge or laser to remove the undesirable tissue.
Q: Is a gum lift painful? Will I have a long recovery period?
A: Typically our patients describe the procedure as feeling like a mild pizza burn – like when you eat pizza that is too hot and it burns the roof of your mouth. They typically report that they are fine within a day or so.
A: Preparation for dental contouring and reshaping is a team effort. Our cosmetic dentists even use computer imaging to show you how you will look after the procedure. We will usually mark your teeth with a pen prior to performing the procedure. This helps us in the sculpting process. As our cosmetic dentist sculpts the tooth, imperfections are artfully eliminated or minimized. A sanding drill may be used to remove small amounts of surface enamel gradually. Abrasive strips are then moved back and forth between your teeth to shape the actual sides of your teeth. Then the teeth are smoothed and polished. Usually anesthetic is not needed. Teeth contouring and reshaping usually can be done in one visit.
Q: What is whitening?
A: Dental Whitening (sometimes called “bleaching”) is a popular dental procedure used to whiten teeth. Some people get their teeth bleached to make stains disappear, while other just want a whiter shade.
Q: How does teeth whitening work?
A: The active ingredient in most of the whitening agents is 10 percent carbamide peroxide, also known as urea peroxide; when water contacts this white crystal, the release of hydrogen peroxide lightens the teeth.
Q: What are the different ways to whiten teeth?
A: There are a number of different ways to whiten teeth. There are accelerated in-office approaches using a light activated technique with the peroxide gel. There are also at-home whitening kits used with a peroxide gel. Also, porcelain veneers can have the effect of whitening teeth to the shade determined by you and your cosmetic dentist.
Q: Is whitening safe? Are there side effects?
A: A number of different studies have been performed over the years showing this method of whitening to be safe and effective. The American Dental Association has granted its seal of approval to a number of teeth whitening products. Some patients may experience slight gum irritation or tooth sensitivity, which will resolve when the treatment ends.
Q: Why do teeth discolor?
A: Discoloration occurs in the enamel and can be caused by medication, coffee, tea and cigarettes. Discoloration also can be caused by your genetic make-up or simply getting older.
Q: How is whitening performed?
A: Whitening can be performed by our cosmetic dentist in the office or, under dental supervision, at home. Many patients enjoy whitening at home because it is more convenient. Treatment in our office begins when we create a custom mouthpiece to ensure the correct amount of whitening solution (composed of carbamide peroxide) is used and that your teeth are properly exposed. Typically, whitening at home takes two or three weeks, depending on the desired shade you wish to achieve. Whitening in the office may call for one hour and ½ visit to our office.
Q: How do I know if I am a candidate for whitening?
A: Generally, whitening is successful in at least 90 percent of patients though it may not be an option for everyone. Consider tooth whitening if your teeth are darkened from age, coffee, tea, or smoking. Teeth darkened with the color of yellow, brown, or orange respond better to whitening. Other types of gray stains caused by fluorosis, smoking or tetracycline are lightened, but results are not as dramatic. If you have very sensitive teeth, periodontal disease, or teeth with worn enamel, we may discourage whitening.
Q: How long does whitening last?
A: Like skin tone, each person is different. In addition to genetics, it depends on how many cups of coffee, glasses of cola, red wine and other staining drinks and food you have cross your teeth. Many people can go from one to three years without significant need for touch-ups in whitening. The ultimate whitening is through porcelain veneers, which can last much longer.
Q: What are realistic expectations with whitening?
A: No one can really predict how much lighter your teeth will become. Every case is different. Typically, there is a two-shade improvement as seen on a dentist’s shade guide. The success rate depends upon the type of stain involved and your compliance. Whitening can only provide a shift in color from gray to a lighter shade of gray, for example. Whitening does not lighten artificial materials such as resin, composite, or porcelain.
Q: What if I have tetracycline stained teeth?
A: The difficulty presented by staining that results from tetracycline use is that it is not uniform, but usually presents as horizontal light and dark bands. For such teeth, the banding effect will remain after whitening, albeit in a lighter color. The only practical way of eliminating the staining you describe is by covering it up. This can be done by the placement of crowns, or more conservatively by placing porcelain veneers.
Q: My teeth have turned yellow. What can I do?
A: A good cleaning in our dental office with a prophy jet using baking soda spray is a good start. Professional in-office whitening using a light activated technique, especially when combined with take-home whitening can also help.
Q: My teeth have really dark stains, what can be done?
A: First, get a hygienic cleaning with a prophy jet, which uses a baking soda spray followed by tooth polishing. This will help determine the type and amount of real discoloration present in the enamel of your teeth. Then, you can either opt for professional in-office whitening using a light activated approach, take-home whitening, or porcelain veneers to get a more permanent whiteness.
Q: Do over-the-counter whitening products work?
A: Frequently, we hear from people who have not gotten the results they wanted through over-the-counter whiteners. Several factors can contribute to the darkening of teeth, including the effects of age, foods and drinks, smoking and some medications. Darkened teeth caused by oral supplements or medications pose more of a challenge. The whitening process involves placing a whitening solution in contact with the teeth, causing oxidation of stains and subsequent lightening. There are a variety of systems available, ranging from those done in the dental office to dentist supervised at-home systems.
Q: I have heard about laser whitening. Would that help someone with really dark teeth?
A: Laser whitening is a procedure that is becoming less popular and is being replaced by professional light-activated, in-office whitening systems. For a high percentage of our patients, this whitening technique has been very successful. It usually takes a couple of hours and usually costs about $650 and includes take-home whitening trays as well. Many times, the laser whitening used to cost from $1,200 to $2,000. A smile darkened with the color of yellow, brown or orange responds better to whitening than brown or white spots caused by fluorosis, smoking or tetracycline (grayed teeth). If you have very sensitive teeth or teeth with worn enamel, we can use whitening materials that are designed specifically for sensitive teeth. The more traditional take-home whitening takes a little longer to complete. Tray whitening is accomplished by wearing a form-fitted tray containing a whitening or whitening agent at home for two to four weeks. The professional take-home systems tend to cost a little less than in-office systems, at around $450. In the take-home system, we mold your teeth and make the trays to fit snugly to your teeth to prevent spillage of the whitening gel. Usually you place these trays over your teeth before going to sleep and take them out in the morning. With tray whitening most people will notice a change in the color of their teeth the first night they bleach. Often tray whitening takes about seven to ten days to complete.
Root Canal Therapy
Q: What Is It and Why Do I Need A Root Canal?
A: A badly infected tooth or one that just had significant decay can sometimes be salvaged through procedures utilized by both the general dentist and the root canal specialist, the endodontist. Extraction is truly our last resort!
Q: How do I know if I need a root canal?
A: Some indications of the need for root canal treatment may be:
- Spontaneous pain or throbbing while biting.
- Sensitivity to hot and cold foods.
- Severe decay or an injury that creates an abscess (infection) in the bone.
Q: Why should I spend a lot of money on a root canal? Why not just pull the tooth?
A: Losing a tooth can precipitate further teeth loss. Saving the tooth maintains space, keeps other teeth from shifting, and eliminates the need and cost of a bridge or implant and crown. Although seemingly expensive, it is actually quite cost effective. Remember, once your teeth are gone, they’re gone!
Q: How is a root canal performed?
A: A root canal is really not as bad as it is sometimes made out to be and in our office, we try to make it as pleasant as possible. Here’s how it works. Root canal treatment consists of the removal of the infected or irritated nerve tissue that lies within the root of the tooth. It is this infected pulp tissue that causes an eventual abscess. The first step in a root canal is to obtain access to the nerve. This is accomplished by establishing a small access opening in the top of the tooth. It will be done under a local anesthetic. The length of the root canals is determined and the infected pulp is removed. Usually at the same visit, the canal where the nerve is located will be reshaped and prepared to accept a special root canal filling material. This filling procedure will probably not occur until your next visit. The number of visits necessary to complete your root canal will depend upon several factors including the number of nerves in the tooth, the infected state of the nerve and the complexity of the procedure. The final step in your root canal will be the sealing of the root canal with a sterile, plastic material, called gutta percha. This is done in order to prevent possible future infection. The tooth will then possibly need a post and core and a crown in order to re-establish normal form and function. This decision will be based upon several additional factors. If treated early, root canal therapy need not be uncomfortable. Another “Old Wives’ Tale” is that by removing the nerve the tooth becomes “dead.” This is not true. The tooth is very much alive and functioning because it receives a source of blood supply and nerve supply from the surrounding tissues that hold it in place in your jaw bone. The tooth will have no sense of feeling too hot, cold or sweets but will be responsive to biting pressures etc. With the proper restoration the tooth should last as long as your other teeth and can even be used as an anchor tooth for a partial denture or cemented bridge. Sometimes when there has been long-standing infection or abscess, there may be some soreness associated with the first or second root canal visit. If this should be true, you will be given specific instructions to follow to minimize the discomfort. When an infection is present, it may be necessary to take an antibiotic. If pain should be present, analgesics may need to be prescribed. In either case, be sure to call your dental office if either of these problems should arise.
FAQs About Home Dental Care
Q: How do I select the right toothbrush for me?
A: The brand of the toothbrush is not nearly as critical as the type of bristle, the size and shape of the head and how frequently you replace your brush. We recommend a soft bristled brush with a small head. The soft bristles are most important for the health of your gums. A small head allows you to get around each tooth more completely and is less likely to injure your gums. Daily frequency of brushing and replacement with a new brush are much more important issues than the brand you choose. We recommend replacing your brush at least once a month. We recommend brushing twice a day at a bare minimum.
Q: What is the proper way to brush my teeth?
A: Thorough brushing twice a day, and cleaning between the teeth daily with floss or other interdental cleaners, usually helps remove normal levels of plaque. Keep these tips in mind when brushing your teeth. Place the brush at a 45-degree angle to the teeth and use a gentle tooth-wide, back-and-forth motion. Remember to clean the inside teeth surfaces where plaque deposits are heavy, and clean the back teeth and tongue.
Q: Can I damage my teeth if I brush improperly?
A: Yes. Even though teeth are protected by a hard layer of enamel, they can become worn out from improper tooth brushing. Toothbrush abrasion can occur on the crown of the teeth as well as in the softer cementum that covers the tooth roots, which can be exposed by receding gums. These exposed surfaces can become more prone to decay. When you brush, be sure to use gentle, short, tooth-wide strokes.
Q: How do I clean between teeth?
A: Floss and other interdental cleaners remove plaque from between the teeth and under the gum line, areas where the toothbrush can’t reach. If you haven’t been in the habit, it’s never too late to start. When flossing, keep in mind these tips. Gently ease the floss between the teeth and gum line; never snap it. Form a “c” against the sides of both teeth and gently rub the floss up and down the tooth, moving it from under the gum line to the top of the tooth. Establish a regular pattern of flossing and remember to floss the backside of the last teeth. If you use interdental cleaners, ask your dentist how to use them properly, to avoid injuring your gums.
Q: Are the newer toothbrushes a replacement for flossing?
A: The newer toothbrushes such as Sonicare, Rotadent, Braun are all probably more effective in removing plaque than a manual toothbrush. They are still not a substitute for flossing which eliminates the plaque from the surfaces between the teeth.
Q: Why is brushing with toothpaste important?
A: Brushing with toothpaste (also called a “dentifrice”) is important for several reasons. First, a toothpaste and a correct brushing action work to remove plaque, a sticky, harmful film of bacteria that grows on your teeth that causes caries, gum disease, and eventual tooth loss if not controlled. Second, the toothpaste contains fluoride, which makes the entire tooth structure more resistant to decay and promotes remineralization, which aids in repairing early decay before the damage can even be seen. Third, special ingredients in the dentifrice help to clean and polish the teeth and remove stains over time. Fourth, toothpastes help freshen breath and leave your mouth with a clean feeling.
Q: What type of toothpaste should I use?
A: As long as your toothpaste contains fluoride, the brand you buy really does not matter, whether or not it is in paste, gel, or even powder form, or containing a certain flavor. All fluoride dentifrices work effectively to fight plaque and cavities and clean and polish tooth enamel. Your dentifrice brand should also bear the ADA (American Dental Association) seal of approval on the container, which means that adequate evidence of safety and efficacy have been demonstrated in controlled clinical trials. If your teeth are hypersensitive to hot or cold, consider trying a dentifrice designed for sensitive teeth dentifrices containing baking soda and/or hydrogen peroxide (which are both good cleansing agents) give the teeth and mouth a clean, fresh, pleasant feeling that can offer an incentive to brush more, but fluoride is the true active ingredient at work protecting your teeth. Some prefer a tartar control toothpaste containing pyrophosphates to prevent the buildup of soft calculus deposits on their teeth. New pastes offer advanced whitening formulas aimed at safely removing stains to make teeth brighter and shinier, although they can’t nearly match the effectiveness of a professional whitening formula administered or prescribed by a dentist.
Q: How much toothpaste should I use?
A: Contrary to what toothpaste commercials show, the amount of paste or gel needed on your brush for effective cleaning does not have to be a heaping amount. Simply squeeze on a pea-sized dab of paste on the top half of your brush. If you brush correctly holding the toothbrush at a 45-degree angle and brush inside, outside and between your teeth, the paste should foam enough to cover all of your teeth. Children under 6, however, should only be given a very small, baby pea-sized dab of dentifrice on their brush.
Q: Is brushing with toothpaste enough to fight cavities and tooth disease?
A: No. Although brushing thoroughly after each meal helps, flossing your teeth every day to remove plaque and food particles between teeth and at the gum line is just as important. Studies show that plaque will re-grow on teeth that are completely clean within 3 to 4 hours of brushing. You also need to maintain regular dental hygienic cleanings at your dental office – at least every 6 months (or sooner if recommended).
Q: What is bruxism?
A: If you wake up with dull headaches or vise-like pain, you may be one of many people who grind their teeth at night. Many people are unaware they even have the disorder (called bruxism) because it often occurs at night during sleep. Your dentist can usually detect the telltale signs of wear on your teeth. Bruxism is the technical term for grinding and clenching that abrades teeth and may cause facial pain. People who grind and clench, called bruxers, unintentionally bite down too hard at inappropriate times, such as in their sleep. In addition to grinding teeth, bruxers also may bite their fingernails, pencils and chew the inside of their cheek. People usually aren’t diagnosed with bruxism until it is too late because so many people don’t realize they have the habit. Others mistakenly believe that their teeth must touch at all times. About one in four people suffer from bruxism, which may be able to be treated by our dentists.
Q: Can bruxism cause harm?
A: Bruxism can either directly or indirectly cause many problems. Grinding can cause teeth to become painful or loose. Patients can literally grind away parts of their teeth, leaving them with worn surfaces or fractured enamel. People who have otherwise healthy teeth and gums can clench so often and so hard that over time their teeth become sensitive and they experience jaw pain and headaches. Forceful biting when not eating may cause the jaw to move out of proper balance.
Q: What are the signs of bruxism?
A: Grinding is a common occurrence among many people at some time or another. If you develop facial pain, fatigue or other problems, treatment may be needed. Talk with your dentist if you suspect that you are grinding your teeth. During regular dental visits, we usually check for physical signs of bruxism. If we notice signs of bruxism, the condition may be observed over several visits to be sure of the problem before recommending and starting therapy. When a person has bruxism, the tips of the teeth look flat. Teeth are worn down so much that the enamel is rubbed off, exposing the inside of the tooth, which is called dentin. When exposed, dentin may become sensitive. Bruxers may experience pain in their temporomandibular joint (TMJ)-the jaw-which may manifest itself as popping and clicking. Women, who are more susceptible to TMD, also have a higher prevalence of bruxism possibly because they are more likely to experience tissue alterations in the jaw resulting from clenching and grinding. Tongue indentations are another sign of clenching. Stress and certain personality types are at the root of bruxism. For as long as humankind has existed, bruxism has affected people with nervous tension. Anger, pain and frustration can trigger bruxing. People who are aggressive, competitive and hurried also may be at greater risk for bruxism.
Q: What causes bruxism?
A: More research is needed to determine the exact cause of bruxism, but it is thought that both emotional and physical factors are involved. Some of the contributing factors may be stress or sleep disorders, an abnormal bite or crooked or missing teeth.
Q: What can be done about bruxism?
A: There are a number of ways to treat bruxism. Our cosmetic dentists will determine which single treatment or combination of treatments is right for you. When stress is the major cause of bruxism, people need to find ways to relax. People who have difficulty handling stress may need to seek counseling or our dentist may prescribe muscle relaxants to relax jaw muscles. We many times can prescribe a night guard, which prevents grinding from occurring during sleep. To help alleviate muscle pain, physical therapy may be needed. The objective of therapy is to get the bruxer to change behavior by learning how to rest the tongue, teeth and lips properly. When some people become aware of their problem, simply advising them to rest their tongue upward with teeth apart and lips shut may be enough to change their behavior and relieve discomfort. However, the dentist can make a plastic mouth appliance, such as a night guard that’s worn to absorb the force of biting which causes damage and pain and also helps to change patient behavior.
Q: Why might a night guard or other protective appliance be advisable?
A: If designed correctly, protective bite appliances help keep teeth from moving, protect ceramic restorations, and protect teeth from wear damage caused by grinding or clenching. A night guard is a plastic mouth guard worn at night to prevent tooth grinding. A bite plate is a removable plastic device, which prevents teeth from coming together. In some cases, such as with an overbite, it may eventually improve the bite. A method used to treat the damage caused by more serious cases of grinding involves reshaping or reconstruction of the biting surfaces with crowns or inlays or a full mouth restoration.
Q: What is periodontal or gum disease?
A: Periodontal or gum disease is the leading cause of tooth loss in adults. Why? Because it occurs at an age when cavities are usually a thing of the past, and the initial symptoms often go unnoticed.
Q: What causes gum disease? Does it hurt? Wouldn’t I know if I had it?
A: Gum disease is bacterial infection that attacks the gums and bone supporting the teeth. In its early stages gum disease is not apparent to the patient. Just as high blood pressure is called the silent killer, so is gum disease the silent killer of teeth. We’ve learned a great deal about gum disease in recent years. We are now able to diagnose it earlier and help patients get it under control much better than in the past. The earlier we detect it the sooner we can get it under control. If your gums are bleeding, even slightly, it is a sign of gum disease. When patients wait until teeth are loose and painful and their gums are oozing it is much more difficult and costly, if at all possible, to get the disease under control.
Q: What are the signs of gum disease?
A: You should watch for gums that bleed when brushing; red, swollen or tender gums; and/or persistent bad breath.
Q: How can gum disease be prevented?
A: Gum disease can be prevented by brushing at least twice a day, flossing daily, eating a balanced diet, and visiting your dentist regularly — ideally every six months (or more if recommended) — for a preventive checkup and professional cleaning.
Emergency Dental Care
Q: What should I do if my porcelain veneer pops off?
A: If your porcelain veneer comes off, carefully remove the veneer from your mouth without damaging it further. If you have found only one piece then the veneer may not have broken but instead may have just become dislodged from your tooth, fully intact. If the veneer is whole, our cosmetic dentists, your dentist may be able to re-bond it to your tooth so place it in a protective container. Even if the veneer is broken it’s not a bad idea to save the parts and show them to our cosmetic dentists. They could possibly be of interest. Then, give us a call to schedule a repair.
Q: Can a veneer coming off cause more serious problems? Will I be in pain?
A: Ask our cosmetic dentists for specific instructions but, in general, if a porcelain veneer where only a minimal amount of tooth structure has been removed to make the veneer has simply broken or come off there is little potential for a serious tooth problem developing. Remember, in many cases teeth in the process of being veneered are left uncovered for the entire one to two weeks during which their veneers are being fabricated. Since all or part of the veneer is missing you can expect that your tooth’s shape might be rough or irritating to your lip or tongue. The tooth itself could be expected to have a heightened sensitivity to hot or cold foods and beverages because the veneer is no longer there to cover and protect the tooth’s front surface.
Q: What do I do if a temporary crown comes off?
A: If your temporary dental crown does happen to come off give our office a call so we can provide you with specific instructions and also make arrangements for you to come in and have it re-cemented. In regards to that time period before you can get in to see our cosmetic dentists, we will usually suggest that you simply place the temporary crown right back on your tooth. Doing so will protect the tooth from irritating stimuli such as hot or cold foods and liquids. Wearing the temporary crown will also hold the tooth in place and keep it from shifting position (an important factor in how well or how easily your permanent dental crown can be fitted). If the bite on your temporary crown seems incorrect when it is placed back on your tooth then it might be advisable to leave the temporary crown off. If your temporary dental crown doesn’t seem to stay in place very well many dentists will suggest that you fill it with toothpaste, Vaseline, or denture adhesive before you place it over your tooth (this technique should only be used for a few days). You will need to be careful with your temporary crown in this state. So you don’t end up swallowing or biting on it unexpectedly, your temporary crown should be removed when you sleep and eat. Anytime your crown is not in your mouth you should keep it wet. Put it in a glass of water or close it up in a baggie containing a moist paper towel.
Q: What is a dental implant?
A: This is a surgical procedure designed to replace a missing tooth. A dental implant is a titanium cylinder that is placed in the bone and replaces what was once the root of the tooth. A crown is attached to the implant to simulate an individual tooth.
A dental implant literally replaces a missing tooth. A dental implant simulates the root of a tooth to which the cosmetic dentist attaches a cosmetic tooth. A dental bridge, on the other hand, is non-surgical and uses the adjacent teeth to support a new cosmetic tooth. A dental implant is not invasive to surrounding teeth (especially desirable if they are healthy and in good condition). By simulating the root, it engages the bone and keeps it healthy. Because a dental implant is an individual tooth it is also easier to floss. A dental bridge can be a good choice if the adjacent teeth are in need of restoration. However, there are other subtle factors such as age, timing and bone health that you should discuss with Dr. King when deciding which options may be best for you.
Q: How long does the Dental Implant process take?
A: Once a person is deemed a good candidate for dental implants, then there is one visit to surgically place the implant. Some applications are ready for immediate restoration, others may be required to wait anywhere from 3 to 6 months for bone growth to solidify around the implant to anchor it. At this point the implant can be restored to completion.
Q: Why can’t smokers undergo certain cosmetic dentistry procedures, such as dental implants?
A: Smoking is a leading cause of tooth loss. Smokers also have an increased risk for periodontal disease (gum disease), leukoplakia, loss of bone structure, inflammation of the salivary gland, and development of lung, throat, or oral cancer. Smokers therefore face an additional set of considerations when exploring cosmetic dentistry treatment.
One restriction for smokers involves dental implants. Smoking increases the risk that a dental implant will fail to integrate with bone tissue (osseointegration). Smoking also affects gum health, and unhealthy gums can lead to dental implant failure. If you smoke, you need to quit before having an implant. Another restriction involves teeth whitening. If you whiten your teeth but continue to smoke, the whitening effect will not last as long, because smoking stains the teeth.
Q: Are dental implants suitable for children?
A: Dentists indicate that implants cannot be considered until bone growth has completed. This typically occurs during adolescence, but may vary from one child to the next. Implants placed prior to bone growth completion may shift out of place and cause severe problems. If a child loses a tooth before bone growth has completed, an orthodontic device called a “space maintainer” may be used to prevent an abnormal growth of surrounding teeth. Once bone growth has completed, the space maintainer can be removed and the missing tooth restored using an implant or bridge.
Q: What is restorative dentistry?
A: Restorative dentistry replaces old mercury fillings, old ugly crowns and composites that have become discolored. Restorative dentistry repairs cracked teeth and/or missing teeth. We are renewing the teeth that need help in a comprehensive (all inclusive) manner, which is an investment that saves time and money.
Q: Who would benefit from restorative dentistry?
A: Restorative Dentistry is ideal for an individual wanting to renew restorations in a couple easy visits to ensure overall oral health and a beautiful smile that feels good. He or she may be tired of “piece-meal” dentistry that never seems to quite solve a problem with a tooth. They may feel that their bite is always just a little bit “off.” By comprehensively addressing numerous teeth all at once (in some cases an entire upper or lower arch) then length shape and health can be restored to a more ideal state.
Q: Can I still get tooth decay after?
A: Any place where there is an actual porcelain restoration – whether it is a veneer or a crown, will not be susceptible to decay. However, any uncovered area of the natural tooth structure (including the root surface and area under gum tissue) is vulnerable to decay. Continuing with regular dental/hygiene visits (as well as good home care) will help preserve the integrity and health of your teeth and preserve your investment.
Q: Why do I need to have my teeth cleaned and how often?
A: There is more happening than just “cleaning your teeth” at an advanced dental office. The primary aspect of the visit is to remove tarter and calculus (hardened prolonged buildup) from around the teeth and under the gum where floss and a tooth brush do not reach. The hygienist will measure the depth of the “pocket,” or space, between the tooth and gum. These measurements should be taken at least once a year. Up to three millimeters is considered healthy, as this is the barrier between the exposed part of your tooth and the inner workings of your body. Three millimeters is also the maximum depth that floss will reach. When people don’t floss as often as necessary, dental cleaning visits are even more important. A visit every six months is recommended for people in good oral health who floss and take good care of their teeth and gums. For some people, more frequent visits may be necessary as recommended by the hygienist.
Q: What is the cosmetic maintenance required for my Atlanta Center for Cosmetic Dentistry Veneers?
A: You should be able to stay on regular dental cleaning visits. Cosmetic restorations do not stain and they are unlikely to have any buildup over time. But the natural tooth adjacent to the restoration and the area under the gum needs the regular attention of an aesthetic hygienist. With good personal and professional care, cosmetic restorations can last a lifetime.
Once a guest in our practice receives the benefits of cosmetic dentistry, they may return for follow-up care because of our attention to detail and our expertise with leading-edge materials and cosmetic dental techniques. We would be happy to provide you with information regarding the care of your cosmetic dentistry should you choose to return to your general dental office.
Q: Are X-Rays really necessary?
A: X-rays are necessary to detect decay between teeth and areas not visible to the naked eye. Since gum and bone problems happen slowly over time, they are often not felt or detected from the surface. X rays are also necessary for detecting bone loss and infections at root surfaces. Dental X-Rays are a key element in a good diagnosis and hence, proper treatment of your teeth and surrounding areas.
Q: How about radiation?
A: Many people are understandably concerned about excessive radiation. Atlanta Center for Cosmetic Dentistry takes digital radiographs, which use approximately 80% less radiation than conventional techniques.
Q: What is Invisalign?
A: Invisalign is the advanced way to straighten teeth and improve smiles. Using the latest medical imaging technologies, Invisalign manufactures precision polymer aligners that rapidly straighten teeth. Using a precise 3-dimensional analysis of your teeth and adjacent tissue, Invisalign crafts personalized aligners for our guests. Each aligner is worn for approximately two weeks, and can be removed to eat, brush, floss, and on special occasions. During wear, the teeth are gently moved to their ideal position. The length of the process depends on the specific situation and the results each person wants to achieve.
Q: Why are straight teeth important?
A: Never underestimate the power of a nice smile. A nice smile is not only beautiful, it also promotes good health:
Q: Why Invisalign?
A: When it comes to creating beautiful smiles, Invisalign is the clear winner. Invisalign aligners: