Smile Designing

A smile makeover is the process of improving the appearance of the smile through one or more cosmetic dentistry procedures, such as dental veneers, composite bonding, tooth implants and teeth whitening.

Essentially, a smile makeover is something that you choose to have performed, while a full mouth reconstruction is something that you need to have performed.

Smile Makeover Considerations

A smile makeover takes into consideration your facial appearance, skin tone, hair color, teeth (color, width, length, shape and tooth display), gum tissue and lips to develop your ideal smile. Smile makeovers are performed for many reasons and customized according to your unique considerations.

What is it that you like or dislike about your smile or your teeth? Some aspects of your smile that your cosmetic dentist will review with you and that could be improved with a smile makeover include the following:

Tooth Color: Silver or amalgam dental fillings can be replaced with natural, tooth-colored composite restorations, while teeth whitening can improve the color of stained or dulled teeth. Tooth color and shading are important considerations during the evaluation of and preparation for various procedures, including porcelain veneers, crowns, bridges, composite bonding and dental implants.

When considering the color of your teeth, keep in mind that dark or discolored teeth may suggest an aged mouth. A well-shaped smile comprised of bright, white teeth lends to a youthful appearance. The shade your dentist selects for teeth whitening and veneers is carefully evaluated with special consideration given to the tone and color of your face and hair. Cosmetic dentists are skilled at finding the right balance between providing you with a brighter, whiter smile and maintaining a natural tooth color.

Alignment and Spacing: Teeth that are crooked, overlapping or have gaps between them can be straightened and aligned when necessary through orthodontics or Invisalign and improved with veneers.

Missing Teeth: One or more missing teeth can negatively affect the appearance of your smile – as well as affect your bite and increase your risk for tooth decay – making replacement an integral part of oral health and facial esthetics. Missing teeth can be replaced by dental implants, bridges or partial dentures.

Harmony and Balance: Uneven, chipped and cracked teeth can be cosmetically bonded for an improved appearance, and a gummy smile can be re-contoured to help improve the overall look of the smile.

Fuller Lips, Smile and Cheeks: An unshapely or aging face can be improved or rejuvenated with certain procedures in the smile makeover category, including orthodontics and/or oral maxillofacial surgery.

A cosmetic dentist will work closely with you to develop a treatment plan designed to achieve exactly what you want from your makeover. This treatment plan may consist of many cosmetic and functionally restorative procedures, potentially including teeth whitening, composite bonding, veneers, dental crowns, orthodontics (braces), oral maxillofacial surgery and gummy smile reduction.

Esthetic Components of a Smile Makeover

In addition to the color, alignment and balance of your teeth in the esthetic zone of your smile (the section of upper and lower teeth that show when you smile), there are several attributes of your teeth and smile that your cosmetic dentist will evaluate with you when planning your smile makeover. These include:

Tooth Length: Long teeth lend a youthful appearance. Aging produces wear and tear that often results in shorter teeth, and a gummy smile also can make teeth appear shorter. A smile makeover treatment for shorter teeth may include reshaping and lengthening the two front central teeth with composite bonding or porcelain veneers. If you have a gummy smile, your cosmetic dentist may provide treatment to modify the gum line and lengthen the appearance of the teeth using laser dentistry procedures. You may also be referred to a periodontist for crown lengthening if necessary.

Teeth lengthening may also impact your overall facial appearance. For example, shapely, long, square teeth on a round-faced individual can provide a slimming effect.

Smile Line: The smile line is an imaginary line that follows the edges of your upper teeth from side to side, which ideally should be the same as the curve of your lower lip when you smile. This standard point of reference for smile makeovers may be used to help determine how long your new teeth should be.

Tooth Proportions: Your cosmetic dentist will examine your teeth to determine if they are in correct proportion with each other. Most people recognize a pleasing smile as one in which the two central front teeth are dominant and have a width-to-length ratio of 4-to-5. This proportion guides the length and width of other teeth in the esthetic zone so that the smile line appears balanced.

Tooth Texture and Characterization: Cosmetic dentists performing smile makeovers are adept at blending functionality and esthetics. An artistic dentist can characterize your crowns or veneers to create a more feminine or a more masculine appearance, in addition to matching the look and feel of natural teeth or those you've seen in photographs.

The Life of Your Smile Makeover

Cosmetic dentistry procedures require regular oral hygiene care and may require maintenance over time. For example, teeth whitening must be repeated on occasion in order to maintain brightness. Porcelain veneers may chip or break off and need replacement. Permanent composite bonding may stain and require enhancement or replacement. Dental crowns typically require replacement after 10 to 15 years. Gummy smile improvements may also require enhancement over time.

 

Dental Implants

Coming Soon

Single Sitting Root Canals

A root canal is the space within the root of a tooth. It is part of a naturally occurring space within a tooth that consists of the pulp chamber (within the coronal part of the tooth), the main canal(s), and more intricate anatomical branches that may connect the root canals to each other or to the surface of the root. The smaller branches, referred to as accessory canals, are most frequently found near the root end (apex) but may be encountered anywhere along the root length. There may be one or two main canals within each root. Some teeth have more variable internal anatomy than others. This space is filled with a highly vascularized, loose connective tissue, the dental pulp.

The dental pulp is the tissue of which the dentin portion of the tooth is composed. The formation of secondary teeth (adult teeth) is completed by 1-2 years after eruption into the mouth. Once the tooth has reached its final size and shape, the dental pulp's original function ceases for all practical purposes]. It takes on a secondary role as a sensory organ. Root canal is also a colloquial term for a dental operation, endodontic therapy, wherein the pulp is cleaned out, the space disinfected and then filled.

Cosmetic Dentistry

Today, cosmetic dentistry is more popular than ever, from whitening and shaping to closing spaces and replacing teeth. And dentists have a wide array of tools and techniques at their disposal for improving the look of your smile.
The various cosmetic procedures are as follows

Teeth Whitening

Over time, teeth can become stained or discolored, especially after smoking, taking certain medications, or consuming foods and beverages such as coffee and tea. Using a chemical process, the dentist can bleach your teeth in one of two ways. He can either do an in-office procedure, or provide a system that can be used at home.
 Dentist can create a custom mouthpiece tray that ensures the right amount of whitening solution reaches your teeth. Whitening at home may be more convenient. But it can take two to four weeks or longer depending on the strength of peroxide used. In-office whitening can take place in one or more 1- to 2-hour visits.
Keep in mind, your teeth can become stained again if you continue exposing them to the same substances that originally stained them. Because whitening products are not meant to clean teeth, it is still important to continue practicing daily oral hygiene by brushing twice a day and flossing at least once a day.

Bonding

Bonding may improve how your teeth look if they have excess space between them, or if they are chipped, broken, stained, or cracked.
Dentists also use bonding materials to fill small cavities or to protect the exposed root of a tooth.
The dentist can usually do this procedure in a single office visit by applying an etching solution followed by tooth-colored materials -- sometimes composite resins -- directly to the tooth's surface where needed.
Although bonding can last for several years, it is more likely than other types of restorations to chip or become stained or just wear down.

Veneers

These custom shells, typically made of porcelain (sometimes plastic), cover the front sides of the teeth to change their color and/or shape. Veneers last longer than bonding and provide a superior appearance. They are less expensive than crowns. Veneers can improve teeth that:

• Have spaces between them
• Have become chipped or worn
• Are permanently stained
• Are poorly shaped
• Are slightly crooked

Before inserting veneers, the dentist first takes an impression of your tooth, then buffs the tooth before cementing the veneer in place. A beam of light helps harden the cement, which secures the veneer to your tooth.
Porcelain veneers are made in a laboratory, so you need a second visit to the dentist to have them inserted.

Crowns

Sometimes called caps, crowns completely cover a tooth, restoring a normal shape and appearance. You may need a crown to:

• Cover a misshapen or discolored tooth
• Protect a weak tooth
• Restore a broken or worn tooth
• Cover a tooth with a large filling
• Hold a dental bridge in place
• Cover a dental implant
• Cover a tooth that's had a root canal procedure

Crowns can be made from metal, porcelain fused to metal, resin, or ceramic materials. Because crowns are costly, dentists usually suggest them only when other procedures can't produce a pleasing result.
Sometimes, a dentist can make an in-office same-day crown, or a temporary crown.  Some offices can mill a crown in the same day. The dentist prepares the tooth for the crown, makes molds of the tooth or takes a digital impression, provides you with a temporary crown if sending it to a lab, and then places the permanent crown at a separate time.
Permanent crowns can have a long life if you take good care of them.

Enamel Shaping and Contouring

Enamel shaping and contouring involves removing or contouring dental enamel to improve the appearance of your teeth. Dentists may combine this process with bonding.
Often used to alter the length, shape, or position of teeth, reshaping and contouring can correct:

• Crooked or overlapping teeth
• Chipped and irregular teeth
• Minor bite problems

A  good candidate for reshaping and contouring if they have normal, healthy teeth, and there's still adequate bone between your teeth to support them.

Braces

Today, people of almost all ages are benefiting from braces. Braces not only improve the look of teeth that are crooked or crowded. They can improve an irregular bite and correct jaw positioning and jaw joint disorders.
Braces are worn to apply pressure to and reposition the teeth, usually over the a few months to longer for more advanced cases.
To place braces, the dentist or orthodontist bonds brackets made of metal, ceramic, or plastic to your teeth. Then they places wires through the brackets, which guide the teeth into their correct positions. Sometimes, dentists can attach lingual braces to the backs of teeth, hiding them from view.
After the braces are attached -- and after each visit in which your dentist tightens your braces -- some discomfort for a few days is expected. Also, regular oral hygiene becomes especially important while wearing braces.
Risks with braces are minimal. But people with allergies to metal or latex, or those who have periodontal disease, are at greater risk for problems during treatment. Root shortening is also a problem if teeth are moved too quickly.
An alternative for correcting minor spacing problems involves wearing a series of clear, customized appliances called aligners, or invisible braces. Your dentist will reshape and replace them about every two weeks to progressively move your teeth. Unlike traditional braces, aligners can be removed while eating, brushing, and flossing.
Often there are two phases to treatment with braces: wearing braces, and then using a retainer to hold your teeth in their new position. Retainers can be removable or permanently bonded in behind your teeth.

Bridges

Sometimes called a fixed partial denture, bridges are used to replace missing teeth with artificial teeth. Bridges can be made of gold, alloys, porcelain, or a combination. Dentists anchor them onto surrounding teeth after preparing them for crowns. Then a false tooth joins to the crowns and the bridge is cemented onto the prepared teeth. Only the dentist can remove a fixed bridge.
The success of the bridge depends upon its foundation. So, remember that oral hygiene to keep remaining teeth healthy is particularly important if there is  a bridge.

Implants

Implants require an involved and expensive cosmetic dentistry procedure but are a long-term solution for replacing missing teeth. They are an alternative to bridges -- which use adjacent teeth as anchors -- and to removable dentures, which rest on the gums. A surgeon implants them surgically into the jawbone.
Implants have three parts:

• Titanium metal, which fuses to the jawbone
• An abutment, which fits over the part of the implant that sticks out from the gums
• The crown, which a special restorative dentist creates for a natural, tooth-like appearance

An implant is done to replace a tooth. Or two or more implants can provide a stable support for replacing several teeth. If there is bone loss from periodontal disease or lost teeth, the surgeon will likely need to first graft bone so the implant has something to secure to.
Having implants requires several steps, including:

• A comprehensive exam, X-rays, and consultation
• Surgical implantation of the titanium screws
• Taking impressions of the upper and lower jaws
• Making a model for the creation of the dentures or crowns
• Placement of the crown
• Follow-up exams with the Implantologist

Other Periodontal Plastic Procedures

An array of other procedures can also improve the smile. They include procedures to help with:

• An uneven gum line
• Teeth that look too short or too long
• Exposed roots
• Indentations in the gums or jawbone

If problems like these are a concern for you, ask your dentist about your best options for correcting them and creating a smile that you can be proud of.

Periodontal & Gum Care

Coming Soon

Preventive Child Dental Care

Coming Soon

Tooth Whitening / Bleaching

Dental bleaching, also known as tooth whitening, is a common procedure ingeneral dentistry but most especially in the field of cosmetic dentistry. A child's deciduous teeth are generally whiter than the adult teeth that follow. As a person ages the adult teeth often become darker due to changes in the mineral structure of the tooth, as the enamel becomes less porous [citation needed]. Teeth can also become stained by bacterial pigments, foodstuffs and tobacco. Certain antibiotic medications (like tetracycline) can also lead to teeth stains or a reduction in the brilliance of the enamel. There are many methods to whiten teeth: bleaching strips, bleaching pen, bleaching gel, laser bleaching, and natural bleaching. Traditionally, at-home whitening is done with bleaching gel which is applied to the teeth using thin guard trays. At-home whitening can also be done by applying small strips that go over the front teeth. Oxidizing agents such as hydrogen peroxide or carbamide peroxide are used to lighten the shade of the tooth. The oxidizing agent penetrates the porosities in the rod-like crystal structure of enamel and oxidizes interprismatic stain deposits; over a period of time, the dentin layer, lying underneath the enamel, is also bleached. Power bleaching uses light energy to accelerate the process of bleaching in a dental surgery. The effects of bleaching can last for several months, but may vary depending on the lifestyle of the patient. Factors which will decrease whitening include smoking and the ingestion of dark colored liquids like coffee, tea and red wine.

Internal staining of dentine can discolor the teeth from inside out. Internal bleaching can remedy this. If heavy staining or tetracycline damage is present on a patient's teeth, and whitening is ineffective, there are other methods of whitening teeth. Bonding, when a thin coating of composite material is applied to the front of a person's teeth and then cured with a blue light can be performed to mask the staining. A veneercan also mask tooth discoloration.

Dental Braces

Dental braces (also known as orthodontic braces, or simply braces) are a device used in orthodontics to align teeth and their position with regard to a person's bite. They are often used to correct malocclusions such as under bites, overbites, cross bite and open bites, or crooked teeth and various other flaws of teeth and jaws, whether cosmetic or structural. Orthodontic braces are often used in conjunction with other orthodontic appliances to widen the palate or jaws or otherwise shape the teeth and jaws. While they are mainly used on children and teenagers, adults can also use them.

Crown, Bridges & Dentures

A crown (or cap) is a covering that encases the entire tooth surface restoring it to its original shape and size. A crown protects and strengthens tooth structure that cannot be restored with fillings or other types of restorations.

Although there are several types of crowns, ceramic/porcelain (tooth colored) are the most popular because they resemble your natural teeth. They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced. Porcelain and ceramic crowns are made to match the shape, size, and color or your teeth giving you a natural, long-lasting beautiful smile.

Reasons for crowns:

• Broken or fractured teeth
• Cosmetic enhancement
• Decayed teeth
• Fractured fillings
• Large fillings
• Tooth has a root canal

What does getting a crown/onlay involve?

A crown procedure usually requires two appointments. Your first appointment will include taking several highly accurate molds (or impressions) that will be used to create your custom crown. A mold will also be used to create a temporary crown which will stay on your tooth for approximately two weeks until your new crown is fabricated by a dental laboratory and ready to be placed. Our CEREC technology allows this procedure to be accomplished, typically, the same day.

If CEREC cannot be used, While the tooth is numb, the dentist will prepare the tooth by removing any decay and shaping the surface to properly fit the crown. Once these details are accomplished, your temporary crown will be placed with temporary cement and your bite will be checked to ensure you are biting properly.

At your second appointment your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite are accurate.

You will be given care instructions and encouraged to have regular dental visits to check your new crown.

Dental Surgeries

Tooth extraction can be performed with local anesthesia if the tooth is exposed and appears to be easily removable in one piece. An instrument called an elevator is used to loosen (luxate) the tooth, widen the space in the bone, and break the tiny elastic fibers that attach the tooth to the bone. Once the tooth is dislocated from the bone, it can be lifted and removed with forceps.

If the extraction is likely to be difficult, the dentist may refer the patient to an oral surgeon. Oral surgeons are specialists who are trained to give nitrous oxide, an intravenous sedative, or a general anesthetic to relieve pain. Extracting an impacted tooth or a tooth with curved roots typically requires cutting through gum tissue to expose the tooth. It may also require removing portions of bone to free the tooth. Some teeth must be cut and removed in sections. The extraction site may or may not require one or more stitches to close the cut (incision).

General Dental Diseases

In health, the gum and bone tissues that surround teeth are attached to the root surface by connective tissue fibers called the gingivo-dental fibers. This functional unit, called the periodontium, is comprised of four types of tissue:

• Cementum, which exists on the tooth root surface.
• Alveolar bone, which surrounds and supports the teeth in the jaw.
• Gingiva, or gum tissue, which is comprised of epithelium and a lamina propria of connective tissue.
• Periodontal ligament fibers, which run from the alveolar bone and insert into the cementum.

In addition to the periodontal fibers that attach the tooth to the surrounding bone, there are also two types of connection between the tooth and the surrounding gum tissue. There is the more apical gingival fiber attachment and the more coronal junctional epithelium attachment. Together, these two are referred to as the gingival attachment apparatus and, in health, they keep the gingival tissue snug around the necks of the teeth. In gingivitis), an inflammatory process in the gum tissue may cause a transient loss of this gingival attachment apparatus that is completely reversible if the inflammatory process is reversed.

Replacement of Missing Tooth

Reasons for replacing a missing tooth (or teeth) vary and should be weighed against the risks of leaving the space, as well as resultant changes that may take place in the rest of your dentition.

Bone Loss

When teeth are removed from the jaw, the bone that supports the teeth tends to shrink over time. This process is called resorption and is a natural consequence of the loss of stimulation to the bone from the forces placed on the teeth. Resorption of the alveolar bone (bone that supports the teeth) begins almost as soon as the tooth is removed and proceeds over time. The bone will lose both height and width from resorption.

When multiple teeth are lost, with or without a prosthesis to replace them, significant loss of jaw bone can take place. This sometimes leads to difficulty wearing a removable denture due to lack of an adequate "ridge" upon which the denture can obtain stability. In the so-called "esthetic zone" of the mouth, where loss of ridge volume can be visibly apparent to the naked eye, this can lead to a cosmetic defect. As the bone resorbs, the gum which covers it also shrinks away, creating a concavity (depression in height and width) that can be unsightly as well as possibly promote food impaction under adjacent teeth.

Drifting

Loss of one or two teeth in a segment of your mouth can lead to drifting of neighboring teeth, whereby the adjacent teeth lean over into the vacant space where the teeth have been lost. Similarly, loss of a tooth or teeth can lead to shifting of opposing teeth as they drift down into the open space (super-erupt).

In general, our teeth have a constant tendency to move both towards the front of our mouths and towards the opposing jaw, unless they are stopped by something in their way, usually the adjacent or opposing teeth. Loss of teeth allows this to proceed in a pathologic way. As teeth drift, they create discrepancies in the height and contours of the gum tissue that predispose adjacent teeth to periodontal disease progression and/or dental decay from accumulation of food and plaque and difficulty in cleaning these areas from "piled-up" gum tissue. Drifting teeth can also adversely affect the occlusion (bite), as well as cosmetics of your face and smile.

Composites

A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a composite filling.

There are many types of filling materials available, each with their own advantages and disadvantages. The dentist will give the best options for restoring your teeth. Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth, and are more aesthetically suited for use in front teeth or the more visible areas of the teeth.

As with most dental restorations, composite fillings are not permanent and may someday have to be replaced. They are very durable, and will last many years, giving you a long lasting, beautiful smile.

Reasons for composite fillings:

• Chipped teeth
• Closing a space between two or more teeth
• Cracked or broken teeth
• Decayed teeth
• Worn teeth

How are composite fillings placed?

Composite fillings are usually placed in one appointment. While the tooth is numb, your dentist will remove decay as necessary. The space will then be thoroughly cleaned and carefully prepared before the new filling is placed. If the decay is near the nerve of the tooth, a special medication will be applied for added comfort and protection. The composite filling will then be precisely placed, shaped, and polished, restoring your tooth to its original shape and function.

It is possible to experience slight sensitivity to cold when composite fillings are first placed, however this will subside shortly after your tooth acclimates to the new filling. You may eat right after the composite is place.

Good oral hygiene practices, eating habits, and regular dental visits will aid in the life of your new fillings.