Table of Contents
What is Cosmetic Dentistry?
What is the difference between Cosmetic and Restorative dentistry?
What dental work is considered to be unique to Cosmetic Dentistry?
Dental Techniques used in Cosmetic Dentistry.
Teeth Whitening.
Reshaping.
Composite Bonding .
Bridges.
Table of Contents
Implants.
Gum Lifts.
Straightening.
Bite reclamation.
Inlays - Onlays – Overlays.
Veneers.
Conclusion.
What is Cosmetic Dentistry?
The simple answer to this question is that Cosmetic Dentistry is about improving the appearance of a person’s smile through aesthetic improvements to their teeth or gums such as adjusting the colour, position, alignment, shape or size of the teeth in order to improve a person’s smile. Therefore Cosmetic Dentistry - as the name suggests - is about improvements to appearance and less concerned with the functionality or overall health of the teeth. As such it can be viewed as being a vanity service which is more art than science as the dental work undertaken has often little health or medical value. Indeed Cosmetic Dentistry despite being in huge demand is not actually a recognized world-wide specialty of the dentistry profession. This leads us on to the trickier definition of Cosmetic Dentistry because despite not being recognized as a profession cosmetic dentists must have some sort of highly specialized training. The answer to that riddle is that cosmetic dentistry is actually skills built upon a professional specialty called restorative dentistry. As a result cosmetic dentistry and restorative dentistry overlap, as both use the same general techniques such as crowns and implants.
What is the difference between Cosmetic and Restorative dentistry? The main difference being that restorative dentistry has a focus on functionality and the goal of providing a patient with a full set of functioning teeth. A restorative dentist will fix structural damage to teeth or replace missing teeth so they will use dentures, crowns, implants, bridges and overlays to restore the patient’s teeth to be in good working order. Whereas, cosmetic dentistry goes a step further and not only provides the patient with functioning teeth but will strive to improve the appearance so that they have a perfect smile. Therefore, despite not being recognized as a dental profession cosmetic dentists are actually restorative dentists who have undertaken additional extensive training on smile design and in the use of many of the specialist techniques and materials unique to cosmetic practice.
What dental work is considered to be unique to Cosmetic Dentistry? Cosmetic dentistry uses the same techniques as in restorative work such as dentures, crowns, implants, veneers, and onlays and overlays in order to repair the structure of the teeth prior to performing cosmetic procedures. However cosmetic dentists also undertake non-structural work such as teeth whitening using bleaching or lasers and gum depigmentation. Indeed prior to any cosmetic work being undertaken the cosmetic dentist will ensure that there is no decay to the teeth or that there are other oral health issues that need to be remedied before work takes place. So for example the patient will typically undergo an x-ray to determine that no root canal work is required on the tooth or teeth that are to be worked on. As a result most cosmetic dental work although being predominantly about appearance does require a sound and healthy basis of standard oral health to begin with. Therefore the patient will typically undergo a full dental checkup, diagnosis and repair of any outstanding issues before the cosmetic procedures take place. In short it is only the dental treatment which is concerned with the appearance of the teeth and the enhancement of the patient’s smile, which are deemed to be cosmetic.
Dental Techniques used in Cosmetic Dentistry As we have already covered cosmetic dentists undertake and use many of the techniques and practices used in restorative dentistry. In general a cosmetic dentist’s procedures can be classified as the addition or removal of dental material such as when using implants, crowns, bridges or veneers. They also use non-intrusive treatments such as teeth whitening. However cosmetic dentists are also skilled in orthodontics which involves teeth alignment such in designing and using braces to straighten or bring the teeth into a straight line. However, this is where cosmetic and orthodontic procedures can converge and the boundaries blur because what is considered to be purely a cosmetic treatment will vary dependent on who is footing the bill i.e. the health care or insurance company. Nonetheless, even though many of the treatments overlap with restorative or orthodontics the common cosmetic procedures and treatments used to enhance the appearance of teeth and the patient’s smile is still quite extensive.
Teeth Whitening
Teeth whitening techniques are the most common cosmetic dentistry treatment. Over time teeth become stained by food, coffee, tea, smoking amongst other things. Whitening the teeth involves bleaching the enamel after all the plaque, tartar and other debris have been removed in order to lighten the colour. There are many options including over-thecounter methods but the most effective appears to be laser whitening. In this technique bleach is applied to the surface of the teeth and then subjected to a laser that accelerates the bleaches action in whitening the enamel.
Reshaping
This is a technique used to remove enamel from the tooth in order to correct some problem with its shape. For example the tooth may be too long or be chipped leaving it out of line with the other teeth. In this procedure the dentist will sculpture the tooth by removing enamel and reshaping the tooth to their design. This procedure is effective in adjusting over large teeth or repairing damaged or chipped teeth. It is also a valuable technique in aligning the teeth vertically so that they all have the same uniform height.
Composite Bonding This technique is used to accomplish the same purpose as reshaping but it takes a different approach. In Composite bonding an additional dental compound is applied to the tooth to mold it into shape thereby increasing or adding volume to the shape or size of the tooth. In bonding the dentist will drill out the decay or reshape the damaged area before applying the composite. The composite material is selected to match the colour of the tooth and once the material is set using a high intensity light the composite material is indistinguishable from the tooth surface. Composite bonding is an inexpensive cosmetic procedure and commonly used where a tooth is decayed, damaged or badly discoloured it is also often used where standard fillings would be visible.
Bridges
In both reconstructive and cosmetic dentistry missing teeth can be replace quite effectively using a technique called bridging. In this practice teeth either side of the missing tooth are crowned and they are used to bridge the gap using a false tooth which they hold in place. Bridges are typically permanent structures and cannot be removed like dentures. Traditional bridges are by far the most common type of bridge fitted and they are made from usually porcelain fused to a metal bridge. Bridges replace missing teeth and are an alternative to implants so have structural as well as cosmetic functions. For example they can improve the patients bite and stop other teeth from drifting out of position so are not purely cosmetic as they do serve real structural purpose.
Implants Implants are dental prosthetics used to replace missing teeth and are an alternative to the traditional bridge. The advantage of an implant is that it does not require the presence of other teeth or implants to form a bridge so can be inserted on its own. An implant is however a surgical procedure where a metal post or frame is inserted into the jawbone to provide a foundation for the dentists to attach a false tooth. An implant typically has three components a base made of titanium which is inserted into the jaw bone, an abutment and a dental crown. Implants are expensive but provide structural support to the crown which many patients find far more satisfying to use for example when chewing than dentures. Implants like bridges are used extensively in restorative dentistry and not just for cosmetic value. However to be able to have implants fitted you must have healthy gums and sufficient bone available for the surgical procedure.
Gum Lifts
A gummy smile is often found to be unattractive by patients as they feel that too much of their gums and too little of their teeth are shown when they smile. Gum lifts are an aesthetic procedure whereby the gum line is usually raised to remove it from view when smiling. This also has the effect of elongating the teeth making them look larger. Gum lifts or 'gingivectomy’ as it is technically termed involves the dentist cutting away the excess gum tissue while the patient is under a local anaesthetic.
Straightening
Teeth straightening or alignment was typically used in orthodontic treatments to bring teeth into alignment to correct issues with overcrowding or poor bite. However straightening and aligning the teeth is a major attraction of cosmetic dentistry as it is fundamental in producing that perfect smile. Previously metal braces were used to force the teeth into the desired position but these were often obtrusive, uncomfortable and embarrassing for the patients to wear. However over the last decade a new type of aligner has become popular that is made of transparent plastic and practically invisible. These clear-aligners have become very popular over the last decade but so ironically have the metal brace as it is making a come-back as a fashion accessory.
Bite reclamation
Chipped, broken or worn teeth can cause issues where the teeth no longer meet correctly. This condition can make chewing or even just biting difficult. Bite reclamation is therefore more a restoration procedure than a cosmetic one as it is focused on restructuring the teeth to reclaim their bite function. In bite reclamation the teeth will be sculpted by the dentist to even them up do that they no longer inhibit a good bite function. The individual techniques used by the dentist for example whether he grinds the teeth or uses onlays or overlays will likely determine whether it is restorative or cosmetic procedure.
Inlays - Onlays – Overlays These are dental prosthetics that are somewhere between a filling and a crown. The difference between each other though is basically the amount of damage that they cover. In all cases these are techniques typically used on the rear teeth to assist with chewing. An inlay for example is a positioning in the centre of the tooth and does not extend over the edges of the top of the tooth. An on-lay will be positioned on top of the tooth and the overlay acts something like a cap cover both the top and the sides of the tooth. As these are a non-invasive procedure they are very popular in cosmetic dentistry with all three being made of ceramics they very effectively reduce chewing load on the underlying damaged tooth.
Veneers Dental laminates are ultra-thin veneers of tooth like material that is used to cover the front surfaces of one or more teeth. The porcelain veneer is applied like a thin cap that serves two purposes in so much as it both protects the tooth and when used in conjunction with others it also whitens and reshapes the smile. However, a veneer is a non-reversible procedure because when the dentist applies the veneer they will typically shape down the original enamel from the tooth and that is irreplaceable. Despite this porcelain veneers are often used to close gaps between teeth, cover damaged or chipped teeth, reshape or elongate teeth or simply to hide discoloured or badly stained teeth.
Conclusion
Many of the procedures used by cosmetic dentists are based but tried and tested techniques used in both reconstructive dentistry and orthodontic treatment. The term cosmetic dentistry may in comparison seem frivolous and vain as the intention is to enhance the appearance rather than address structural or medical issues. However, patients do find that cosmetic dentistry can do wonders for their self-confidence as they can now smile with confidence. As a result we must not underplay the important role that cosmetic dentistry plays in improving the lives of many patients that have previously had to live with bad teeth. Indeed cosmetic dentistry is now hugely popular as patients feel that although the techniques and skills mentioned in this article may be expensive the improvements to their self-esteem makes them ultimately well worth the cost.
The End
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