Cosmetic Dentistry

• Veneers & Laminates
• Porcelain Crowns
• Teeth Whitening
• Crowns & Bridges
• Air Abrasion
• Oral Jewellery

Veneers & Laminates

Ceramic laminate veneers are all white, thin ceramic shells, which fit precisely onto the faces of prepared anterior teeth. Like bonding, veneers are used to cover up discoloration, cracks and chipping, and to change the shape or size of your teeth. Veneers outperform bonding with greater resilience and a greater resistance to stains and dulling.

Most veneer procedures require two appointments to complete, the first of which is dedicated to preparing and taking an impression of the teeth. Veneers are minimally invasive restorations. Therefore,we need to remove only a small portion of the face and top edge of a tooth to achieve a proper preparation design. After the tooth or teeth are prepared, an impression is taken, which, along with accompanying photos and models, is sent to the lab. The lab fabricates porcelain shells, which, not unlike false fingernails on your fingertips, fit onto your teeth. These are your veneers.

During your second appointment,we will cement your veneers onto your teeth. Be sure to leave plenty of time for this appointment, since placing veneers is a meticulous and delicate procedure. Each veneer must be trial fitted and assessed for aesthetic and functional success before final cementation. If required, fine adjustments are made prior to or immediately after final cementation.

Ceramic laminate veneer procedures are exacting, but their results can be extremely worthwhile. Stronger and longer lasting than composite resin restorations, they are the current state-of-the-art procedure to restore and beautify your smile.

This patient has tetracycline staining which occurs when a patient is exposed to the drug while the teeth are developing. The stain is all the way through the tooth (we call it Intrinsic).To hide the stain, we can remove about 0.5mm of tooth structure and replace it will porcelain or composite. The same technique is seen in the before and after pictures below.We closed the space between the two front teeth (a diastema) with the veneers and also recontoured the other teeth to make up for missing lateral incisors.

What are porcelain veneers?

Porcelain veneers are ultra-thin shells of ceramic material,which are bonded to the front of teeth. This procedure requires little or no anesthesia, and can be the ideal choice for improving the appearance of the front teeth. Porcelain veneers are placed to mask discolorations, to brighten teeth, and to improve a smile. Highly resistant to permanent staining from coffee, tea, or even cigarette smoking, the wafer-thin porcelain veneers can achieve a tenacious bond to the tooth,resulting in an esthetically pleasing naturalness that is unsurpassed by other restorative options.

Why would you recommend a porcelain veneer?

Porcelain veneers are an excellent alternative to crowns in many situations. They provide a much more conservative approach to changing a tooth's colour, size, or shape. Porcelain veneers can mask undesirable defects, such as teeth stained by tetracycline, by an injury, or as a result of a root-canal procedure, and are ideal for masking discolored fillings in front teeth. Patients with gaps between their front teeth or teeth that are chipped or worn may consider porcelain veneers.

What happens during the procedure?

The patient should spend time in the decision-making and planning of the smile and understand the corrective limitations of the procedure.

To prepare the teeth for the porcelain veneers, the teeth are lightly buffed to allow for the small added thickness of the veneer. Usually, about a half a millimeter of the tooth is removed, which may required a local anesthetic. At this appointment, a mould is taken of the teeth, which is sent to the laboratory for the fabrication of the veneers. This can take about a week. Because the teeth are buffed or reduced, they will look a little different until the next appointment when the veneers will be placed. If the teeth are too unsightly you, a temporary veneer can be placed, at an additional cost.

Bonding of veneers: First, the dentist places the veneers with water or glycerine on the teeth to check their fit and get a sense of the shade or colour. While the veneers are resting on the teeth, the aesthetic results are viewed with particular attention to the colour. At this point, the colour of the veneers can still be adjusted with the shade of the cement to be used. The colour cannot be altered after veneers are cemented. To apply the veneer, the tooth is cleansed with specific chemicals to achieve a bond. Once a special cement is sandwiched between the veneer and tooth, a light beam initiates the release of a catalyst to harden the cement.

For about a week or two, the patient will go through a period of adjustment as he/she gets used to the "new" teeth that have been changed in size and shape. Brushing and flossing is to be carried on daily, as usual. After one or two weeks,there is a follow-up appointment.

Have realistic expectations

Porcelain veneers are reasonable facsimiles of natural teeth, not perfect replacements. It's not uncommon to see slight variations in the colour of porcelain veneers upon close inspection, as this occurs even in natural teeth. Nevertheless, this procedure can greatly enhance the smile, and can heighten inner satisfaction and self-esteem.

 

Teeth Whitening

What Is Teeth Whitening

What Is Discoloration

Types Of Whitening

Home, Professional

In-Office, Professional

Who May Benefit From Teeth Whitening

During The Process

Is The Process Safe

Products And Methods

Over-The-Counter

What Is Teeth Whitening?

It's a bleaching process that lightens discolorations and removes stains from the enamel and dentin of the teeth.

What Is Tooth Discoloration?

There are many causes, and there is a distinction between internal and external stains.

• Internal Stains: aging, trauma, tetracycline (while teeth are forming), excessive fluoride (while teeth are forming), nerve degeneration
• External Stains: coffee, tea, tobacco, some juices (grape, apple) - over years these can also get into the enamel crystals and become internal stains

Types Of Whitening

• home, professional
• in-office, professional
• over-the-counter

Home, Professional

Professional home bleaching is very effective and has long lasting results. It most often utilizes custom mouth trays and viscous bleaching gels. Typically the gel is a carbamide peroxide (10-30%), but can be a hydrogen peroxide (7.5-9.5%).

In-Office, Professional

In-office professional whitening is the fastest method. To have long-lasting results it must include home bleaching as a follow-up (which I recommend and include with each in-office procedure). Current in-office whitening typically uses bleaching gels that are light activated. The two most common in-office systems are Zoom and BrightSmile.

Who May Benefit From Teeth Whitening?

Almost everyone. However there are some cases where the treatment may be less effective. The most difficult situations to whiten are those teeth with tetracycline staining. Also, and this is important, teeth whiten; however, crowns (caps), fillings, and veneers do not. If you are planning any crowns, fillings and/or veneers as part of your overall treatment, you may want to whiten your teeth first.

During The Process

Sometimes the biting edges and the sides of the teeth whiten more quickly than the rest of the teeth. This occurs because your enamel is thicker in these areas and responds faster to the whitening process. As you continue to use the whitening gel, the rest of your teeth will catch up and the color will even out.

Is The Process Safe?

Yes, extensive research and clinical studies indicate that whitening teeth under the supervision of a dentist is safe. In fact, many dentists consider whitening the safest cosmetic dental procedure available. Tooth whitening product is not recommended for children under 13 years of age and pregnant or lactating women.

The whitening process does not damage enamel or weaken a tooth. For some people, teeth become more sensitive during the process, but this always goes away when you stop the whitening process. The bleaching gel can be quite irritating if it gets on the gums.

Evaluation (before whitening)

• no cavities (examination and x-rays required)
• all fillings, crowns, etc. sealed tightly
• not recommended during pregnancy or nursing
• 13 years or older

Note

• fillings, veneers, crowns, bonding (i.e. restorative materials) will not whiten
• teeth may become more sensitive during whitening - reversible when stopped

Products And Methods

I use two methods, both with the same result, but different length of time to achieve results:

• in-office whitening (ZoomT), and
• home bleaching

I always recommend and include home bleaching with in-office whitening.

The home professional whitening I prefer utilizes concentrated 30% carbamide peroxide Life-LikeT whitening gel in custom mouth trays (custom whitening trays are critical to making the process effective). 30-minute* treatments for 10-14 days typically complete the process; however, the final result is something you determine.

* 30% carbamide peroxide gel is the most concentrated gel available for home use. At this concentration the maximum wear time is 30 minutes. If desired, two 30-minute sessions can be used with a minimum 4 hour interval between sessions (no more than 2 sessions per day).

Home professional bleaching requires two short office visits:

• Find out what you want to accomplish and evaluate your teeth (color, shape, etc.), make the molds of your teeth for the custom whitening tray
• Try-in and deliver the custom whitening tray, answer your questions, and review instructions

NOTE: Some professional home bleaching products still have directions for night time or extended (2 or more hours) wear, but current research shows that effective whitening does not occur after the first hour. What will occur with longer wear is an increase in sensitivity.

Over-The-Counter

Whitening toothpastes and related over-the-counter products are for external stains. Until recently professional whitening has been the only way to actually make the teeth themselves whiter. Crest WhiteStrips and Colgate Simply White can whiten teeth slowly, AND require reapplication at least every 6 months. Professional whitening is far more effective for darker colored teeth, easier to use, and faster.