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Section Questions and Answers

Cosmetic Dentistry

  1. What is the purpose of cosmetic dentistry?
  2. Can cosmetic dentistry improve the appearance of teeth?
  3. Why should I improve my appearance?
  4. What are aesthetic principles?
  5. Where do I start?
  6. What first steps will my dentist take?
  7. What is "smile analysis"?
  8. How can I be sure that I will like my changed smile?
  9. My teeth seem too big for my face. What can be done?
  10. What is a dental restoration?
  11. How are crowns, veneers and bonding used in cosmetic dentistry?
  12. What is available for whitening my teeth?
  13. Can anything be done about unattractive, discoloured fillings?
  14. How can crowded, rotated and misshapen teeth be improved?
  15. Too much gum shows when I smile. What can be done?
  16. What is the treatment for an uneven gum line?
  17. How can receding gums be treated?
  18. Can the appearance of my red, swollen gums be improved?
  19. My jaw structure spoils my looks. Can anything be done?
  20. Is cosmetic dental treatment painful?

 
1. What is the purpose of cosmetic dentistry?

  • Cosmetic dentistry aims to improve the aesthetics of the teeth and face.
    The term "aesthetics" refers to beauty, and the factors that make something beautiful or attractive.

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2. Can cosmetic dentistry improve the appearance of teeth?

  • Yes, it can. Cosmetic dentistry can enhance the appearance of teeth.
    It can renew and improve the appearance of teeth that are stained, discoloured, or damaged by decay or injury.

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Before
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Treatment

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After

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3. Why should I improve my appearance?

  • It is important to like yourself and the way you look.
    • Physical appearance matters to us. Most of us want to look as good as possible.
    • Modern medicine and dentistry make it possible for us to improve the way we look.
    • Looking and feeling more attractive can lead to an improved self-image, greater self-confidence and a sense of well-being.

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4. What are aesthetic principles?

  • Aesthetic principles are the criteria we use to assess the harmony and attractiveness of the teeth, smile and face.
    • These aesthetic principles are based on size, shape, colour, proportion, and alignment.
    • Teeth must not only have a pleasing shape, colour and size, but also a correct proportion of width to height.
    • They should also match the surrounding teeth in size, shape, colour, and be in proper alignment with them.
    • The proportion of tooth to gum that shows when a person smiles, is also important to the aesthetic quality of the mouth and face.
    • These aesthetic "principles" are not rules imposed by some know-all authority.
      We all recognise when a tooth is too long or if it doesn't "fit in" in some way or another.
      These are not hard and fast rules. A smile that is imperfect can still be acceptable or even attractive.

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Aesthetic mouth
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Teeth in harmony

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5. Where do I start?

  • Have a discussion with your dentist and explain exactly what it is that you don't like about your teeth, mouth and gums.
    Ask your dentist what changes can be made.

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6. What first steps will my dentist take?

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7. What is a smile analysis?

  • The dentist will evaluate all the factors that affect your smile. The following will be considered:
    • How much tooth shows when you smile.
    • The size, colour, shape and position of the teeth.
    • Spaces between the teeth.
    • The condition of the teeth.
    • The amount of gum revealed when you smile.
    • The evenness or unevenness of the gum line.
    • The colour and texture of the gums.
    • The way the lips are supported by the teeth and gums.
    • The way the upper and lower jaws relate to each other.

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Smile and teeth
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Size, colour and shape of teeth

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Bad dental condition

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Spacing
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Uneven gum line

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8. How can I be sure I will like my changed smile?

  • Some cosmetic dentists have a computer-imaging programme.
    • This enables them to project the proposed changes onto your own photograph.
    • This will give you a good idea of how you will look when the changes have been made.
  • The dentist can also show you "before and after" photographs of other patients who have been successfully treated.

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9. My teeth seem too big for my face. What can be done?

  • Teeth that are disproportionately large can be pared down and fitted with new crowns.
    This will make the teeth smaller, and more in proportion to the rest of your mouth and face.

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10. What is a dental restoration?

  • In order to repair or improve the appearance of a tooth, it may be necessary to remove some of the tooth and replace it with a filling, replacement crown, or a veneer.
    This process is called tooth restoration.
  • Natural looking, tooth-coloured restorations are used in cosmetic dentistry.
Restorations used in Cosmetic Dentistry
Crowns - Veneers - Bonding

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Crown + veneer preparations
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Porcelain veneers and a crown

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Aesthetic result

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Before bonding
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After bonding repair

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11. How are crowns, veneers and bonding used in cosmetic dentistry?

  • The restorations used most in cosmetic dentistry are:
    Replacement crowns (caps)
    Veneers
    Bonding
    Porcelain inlays and onlays

  • Replacement Crowns
    Replacement crowns look attractive and natural, and match the adjacent teeth.
    • The visible part of the tooth above the gum line is called "the crown".
    • If the natural crown is unattractive, decayed or damaged, it can be aesthetically repaired with a "replacement crown".
    • The dentist pares down the original tooth, takes an impression of it, and sends it to a dental technician.
    • The technician uses the impression to make a cast of the prepared tooth.
    • A plaster cast is an exact copy of the prepared tooth and the adjoining teeth.
    • A replacement crown is made to fit the cast, and is sent back to the dentist.
    • The dentist then cements the replacement crown onto the prepared tooth.
    • Replacement crowns are usually made of porcelain, or porcelain fused to metal.
    • A temporary plastic replacement crown will cover and protect the pared down tooth until the permanent crown is ready to be cemented onto it.

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Before
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Preparation
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After

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Before
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After

See Replacement Crowns

  • Veneer Restoration
    The appearance of a tooth can be dramatically improved by replacing only the front visible surface of the natural crown. This procedure is called a veneer restoration.
    • The dentist trims down the front surface of the tooth, and takes an impression of the prepared tooth.
    • The impression is sent to the dental technician who makes a thin porcelain veneer, similar to a false fingernail.
    • As very little tooth material is removed in the preparation for a veneer, a temporary veneer may not be necessary while the porcelain veneer is being made.
    • However, a temporary plastic veneer will be needed to protect the trimmed down tooth if it is sensitive to hot and cold.
    • Finally, the dentist will bond the attractive, natural-looking porcelain veneer to the tooth.

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Before
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After
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Upper teeth veneered
Lower teeth not veneered

See Veneers

  • Bonding
    Bonding is a method of replacing an unattractive tooth surface with a more aesthetic tooth-coloured material.
    • This material is applied in layers to the tooth surface, fused to the tooth with a special ultra violet light, and then shaped appropriately.
    • The procedure is painless, and can be used to repair damage to front teeth, or to replace old, discoloured or unattractive fillings.
    • Bonding can reduce spacing between teeth by increasing the width of the teeth.

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Before
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After bonding
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Before
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After bonding

See Bonding

  • Porcelain inlays and onlays
    An inlay or onlay is a solid filling made outside the mouth, and then cemented into the tooth.
    • It is long lasting and made of porcelain bonded to metal, or of pure porcelain.
    • This is a superior type of restoration that is used to replace unsightly, discoloured fillings.
    • The dentist removes the unattractive filling, and takes an impression, which is sent to the dental technician.
    • A natural looking replacement filling is then made.
    • A temporary filling will be placed in the tooth to protect it while the restoration is being made.
    • The filling is then placed into the prepared cavity and held in place by cement.

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Before
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Preparation
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After

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12. What is available for whitening my teeth?

A few whitening procedures are available to lighten the colour of teeth.
  • Professionally carried out whitening by bleaching can lighten the colour, and improve the appearance of discoloured teeth.
    • The dentist applies the bleaching material to the teeth in trays that fit around the teeth.
    • The patient then continues with the applications at home.
    • Laser treatment for tooth whitening is very successful. A noticeable change of colour can be achieved in a short time.
  • Home whitening can be achieved by using whitening toothpastes and whitening kits.
    • The toothpastes can lighten tooth colour and maintain the lighter colour of teeth that have been whitened by other means.
    • Whitening kits are available from drug stores and pharmacies for home use. Some are claimed to be very successful.
    • Home whitening is likely to be more gradual than the professional treatment.

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Before
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After

See Whitening for more information

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13. Can anything be done about unattractive, discoloured fillings?

  • Unattractive fillings that have discoloured can be replaced by other more natural looking fillings, veneers or replacement crowns.

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Before
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After replacement crowns

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14. How can crowded, rotated or misshapen teeth be improved?

  • Replacement crowns are the best way to reshape and change the size of teeth.
  • Crowding will require orthodontic treatment for moving teeth. Braces and other appliances are used.
    Orthodontics has become quite common to correct uneven, crowded teeth for adults

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Before
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After

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15. Too much gum shows when I smile. What can be done?

  • The gum can be surgically reduced to the acceptable level.

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Before
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After gum surgery
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After replacement crowns
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Final result

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16. What is the treatment for an uneven gum line?

  • Surgery can correct an uneven gum line.
    The gum line is the scalloped line formed by the gum where it meets the tooth.
  • The corrective surgery can be followed by the fitting of replacement crowns or veneers.

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Before
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After surgery
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Final result

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17. How can receding gums be treated?

  • Receding gums can leave the roots of teeth exposed. This looks very unattractive and can also be painful as sensitive root areas become exposed.
  • Periodontists can create new gum to cover the exposed roots by using a variety of grafting techniques.
    This improves the proportion of tooth to gum.

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Before graft
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After graft

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18. Can the appearance of my red, swollen gums be improved?

  • Infection is the main cause of red, swollen gums.
    • Treatment by your dentist will restore the gums to a healthy pink colour, reduce the swelling, and improve their appearance.
    • If this condition is related to poorly fitting crowns, they can be replaced with new ones to correct the problem.

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Before
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After treatment

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19. My jaw structure spoils my looks. Can anything be done?

  • A combination of orthodontics (moving teeth with braces), jaw surgery, gum treatments and replacement crowns, can correct this problem.

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Before
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After

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Before
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Treatment
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After

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20. Is cosmetic dental treatment painful?

  • Dental treatments for the cosmetic improvement of teeth are generally not painful. They may be uncomfortable if long sessions are necessary.
    • Tooth whitening is completely painless.
    • The preparation and fitting of crowns or inlays, are all carried out with the use of a local anaesthetic, and are usually painless.
    • Preparation and fitting of veneers is a quick and painless procedure.
    • Pain relief is seldom needed after treatment.

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