COSMETIC DENTISTRY

+ Porcelain Veneers + Crowns & Bridges + Inlays & Onlays

Crowns: The outside of each tooth is made of enamel, which is extremely hard. Although teeth are strong and difficult to break, trauma (such as fall) may chip or break them.

Tooth decay may also severely weaken a tooth, with a high risk that the tooth may fall apart. Root canal treatment, where the pulp of the tooth containing nerves and blood vessels is removed, can also weaken a tooth, especially if it has large fillings. Teeth may also wear down over time.

In these cases, a crown is often the best way to save a tooth and it. A crown fits over the existing natural tooth and replaces the natural crown, the part of the tooth seen above the gums.

Bridges: Bridges replace one or more missing teeth. They consist of an artificial tooth anchored to the natural teeth on each side of the gap. If a tooth is lost through an accident, or is too badly decayed to save with a crown, a bridge may be the treatment of choice. You can also ask your dentist or prosthodontist about implants, which are another way of replacing missing teeth.
Crowns and bridges are usually made of porcelain and gold alloy. Porcelain is strong and can be made to match the colour of the natural teeth. It is resistant to staining and can be cleaned if it becomes stained.

Gold alloy is used for its strength hardness and durability. It is especially useful for molars which must withstand the forces of grinding and crushing. Gold alloy and porcelain are well tolerated by the gum and cheek. An allergic reaction to gold alloy or porcelain is rare.

Teeth have many functions apart from chewing and biting, so missing teeth should be replaced for the following reasons:
• to improve appearance.
• to prevent stresses causing damages to other teeth.
• to prevent the teeth near the gap from shifting.
• to maintain the natural bite.
• to improve chewing ability.

All general practitioner dentists are qualified to fit crowns and bridges. A dentist with specialist training in crown and bridge work is called a prosthodontist.

Based on your dental and medical history, X-ray examinations of your teeth and jaws, and an oral examination, your dentist or prosthodontist will recommend the treatment which is best for you. You will require at least two appointments for preparation and fitting of a crown or bridge. Sometimes a tooth will need a root canal filling and perhaps a post, before crown or bridge treatment.

Hygiene and Care: Crowns and bridges should last for many years. However, there is no lifetime guarantee. As with natural teeth, it depends on good dental hygiene and oral health. Therefore, regular dental check-ups are advisable. Crowns and bridges require regular flossing and brushing, with extra attention around the margins where decay is more likely. Special devices including floss threaders and “superfloss” are available for cleaning under the bridge.

Your dentist or prosthodontist will show you how to clean properly. 
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A combination of lifestyle and personal factors can result in teeth showing various faults or blemishes over the years. Your dentist can offer a variety of modern treatments to improve the appearance of your teeth and smile.

PROCEDURES
Veneers: These cover the front teeth and can significantly improve the appearance of your teeth and smile.
Bonding: Bonding can correct blemishes and irregularities of the front teeth without removing tooth structure.
Bleaching: This is a method used to whiten teeth.
Tooth-coloured composite fillings: These can be an alternative amalgam fillings in many cases.
Inlays and onlays: These repair larger cracks or cavities in the chewing surfaces of the back teeth, increasing their strength while maintaining their appearance.
 
PORCELAIN VENEERS
These are thin, tooth-coloured porcelain (ceramic) shells carefully crafted to bond to and cover the front of unsightly teeth. They are a more conservative treatment than a crown and can often be used an alternative if the underlying tooth is strong and healthy. 
Veneers are excellent for treating chipped, discoloured, slightly misaligned or misshapen teeth or gaps between the teeth, especially if these defects affect the front teeth. A tooth that is too small or has irregularities can be successfully treated with a veneer.
Two or three visits to your dentist will usually be required to prepare the teeth and fit the veneers. Your dentist will discuss your needs with you and plan the treatment that suits you best.     
  
The Care Of Veneers
Caring for your veneers will ensure that they last longer. Regular checks with the dentist who fitted them, or one who is experienced in the care of veneers, is recomended. During your visit, the veneers will be polished, and any irregularities will be trimmed. Mention to your dentist if you have noticed any problem during brushing or flossing.

Excessive chewing or biting, especially on foods like hard lollies, ice or bones may break the porcelain. Holding other hard objects in your teeth such as nails, pens or bottle tops may damage the veneers.

If they are struck by sharp objects, porcelain veneers can fracture, just like normal teeth. Wearing a mouthguard during sport is strongly recommended.
Good dental hygiene is important to extend the life of the veneers. Regular brushing with a fluoride toothpaste and flossing after meals will help to prevent decay.

Advantages of veneers
Application is relatively painless.
If the tooth underneath is strong enough, veneers can be a simpler and cheaper alternative to crowns.
Veneers are resistant to staining due to age, tea, coffee or smoking.
The porcelain and the cement used in the cementing process are strong, making veneers comparable in strength to normal teeth.
When applied professionally and cared for regularly, veneers can last for many years.
Porcelain will not decay.
 
BONDING 
Bonding is useful for improving small irregularities but is less successful than veneers in the treatment of some problems.
The tooth is prepared by etching its surface with gel. The surface is then painted with a bonding liquid that sets firmly when a special light is shone on it. A putty-like resin is moulded onto the tooth and shaped. The light is again used to harden it. Finally, the set resin is trimmed and polished.
 
Taking care of your bonding
Brush and floss regularly; avoid sweet or starchy foods.
Regular maintenance by a dentist is recommended. Rough or snagged areas can be smoothed if treated early.
Some commercially available toothbrushes and toothpastes are too hard on bonded teeth. Your dentist will discuss the best teeth-cleaning materials to purchase.
Stresses on bonded teeth (such as biting on hard foods, for example boiled lollies or carrots) may lead to breakages. If the front teeth have bonded edges, bite into foods using the side teeth.
As alcohol can cause deterioration of the resin, it should be taken in moderation.

Advantages of bonding
Binding is often satisfactory alternative for small blemishes.
Tooth preparation is not normally required.
Only one visit to the dentist is usually needed.
An excellent colour match can usually be achieved.
Bonding may be less expensive option than veneers in selected cases.
Bonding can be used as a conservative, temporary measure if more permanent treatment requiring tooth preparation is planned for a later stage.
A bonded surface can be repaired in the mouth and can be maintained as long as the person wants the dentist to look after it.

Composite Fillings and Glass Lonomer Cement Fillings
Composite fillings can be an alternative to amalgam fillings. They are made of a plastic material mixed with a small glass particles and are tooth coloured, rather than silver. They are suitable for repairing both the front and the back teeth.

After preparing the tooth, your dentist will place layers of the composite filling into the area to be repaired. Each layer of the composite material is hardened by exposure to a special light.
Once the cavity or defect is filled, your dentist can trim the composite to fit the tooth and then polished it to reduce discolouration or staining.

INLAYS & ONLAYS
Inlays
Inlays are fillings that were traditionally made of gold but now are often made out of porcelain, ceramic or composite material. They are used to repair moderately damaged back teeth and need to be extremely strong to withstand the grinding pressures of these teeth.

Inlays are glued into place and are contained within the cusp tips of the tooth. A special glue is used to increase the strength of the bond.
 
Onlays
Made of the same material as inlays, and onlay is a more extensive repair that covers the tooths cusps.
An onlay is much stronger than any other type of filling and actually increases the strength of the tooth.

Application of inlays and onlays
The fitting of inlays and onlays usually requires two dental dental visits.
The first visit involves removing the old filling or the decayed area and preparing the surface for the new filling. An impression is made of the area and sent to the dental laboratory so the inlay or onlay can be constructed. A temporary cover or filling is applied until the next visit.

At the second visit, the temporary cover or filling is removed and the new inlay or onlay is fitted. Your dentist will ensure that it is a perfect fit and does not interfere with your bite. It is then bonded into place with a powerful glue and polished.

Advantages of inlays and onlays
Strength is one of the major advantages of inlays and onlays. Fillings usually weaken a tooth, but because inlays and onlays are bonded directly into the tooth, they can increase the overall strength of the tooth.

Porcelains, ceramics and composite material can be made in colours to match natural teeth.

They are durable and may last 10 years or more, unless they get decay under them.

In some cases, they are a good alternative to the more complex crown.