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Improve Your Smile: Cosmetic Dentistry 101

Medically Reviewed by Brunilda Nazario, MD on April 19, 2021
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Cosmetic dentistry is more popular than ever, from whitening and shaping to closing spaces and replacing teeth. And dentists have a large selection of tools and techniques for improving the look of your smile.

Before deciding to undergo any cosmetic procedure, it's important to know the benefits and risks and what you can expect during the process. Make sure you're clear about what it will cost, how much experience your dentist has with the procedure, and whether any special maintenance will be needed afterward.

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, your dentist can bleach your teeth in one of two ways. They can do an in-office procedure, or provide you with a system to use at home.

Your dentist can create a custom mouthpiece tray that ensures the right amount of whitening solution reaches your teeth. You may find whitening at home more convenient. But it can take 2 to 4 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, flossing at least once a day, and rinsing with an antiseptic mouthwash daily.

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. 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 on 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 Recontouring

Enamel shaping and recontouring (also called odontoplasty, enameloplasty, stripping, or slenderizing) involves removing or contouring dental enamel. The procedure is usually done to improve the appearance of teeth by creating more balance in the look of the smile. Recontouring is the most conservative cosmetic treatment. It’s a quick and painless procedure and the results can be seen right away.

  • Reshaping and recontouring can be used to improve:
  • Crooked or overlapping teeth
  • Chipped and irregular teeth
  • Minor bite problems
  • Bulges or pits in a tooth's enamel
  • The length of the canines (the pointed teeth on the side of your mouth)

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Recontouring can also improve dental health by removing crevices or overlaps between teeth in which plaque or tartar can accumulate.

You may be a good candidate for reshaping and recontouring if you have normal, healthy teeth, and there's still enough bone between them.

Because enamel can’t be replaced, recontouring should be carefully considered. The risk involves the thickness of the enamel. If the enamel of the tooth that has been recontoured becomes too thin sensitivity to heat, cold, and sweets could result.

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Recontouring isn’t recommended if your teeth have substantial imperfections, such as a large chip or deep fracture. It’s not a substitute for veneers or bonding; but is often used in combination with these procedures.

If you want to recountour your teeth, your dentist may first take an X-ray to see the size and location of the tooth's pulp (the center of the tooth that contains the nerves and blood vessels). If the tooth's enamel layer is too thin or if the pulp lies too close to the tooth's surface, recontouring may not be possible.

At your appointment, your dentist will use a sanding disc or a fine diamond bur to remove small amounts of tooth enamel. To reach imperfections between teeth, your dentist may use a strip of sandpaper to shape and smooth the sides. Once shaped, your dentist will finish the process by polishing your tooth or teeth. Since recontouring doesn’t affect the pulp of the tooth, you typically don’t need an anesthetic.

A recontouring procedure that isn’t combined with other cosmetic procedures (such as bonding or veneer placement) doesn’t need follow-up.

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 a few months to longer for more advanced cases.

To place braces, your dentist or orthodontist bonds brackets made of metal, ceramic, or plastic to your teeth. Then they place 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.

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After your braces are attached -- and after each visit in which your dentist tightens your braces -- expect some discomfort for a few days. Also, regular oral hygiene becomes especially important while you are 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.

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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 2 weeks to progressively move your teeth. Unlike traditional braces, aligners can be removed while eating, brushing, and flossing. They’re also more discreet. Learn more about how invisible aligners help solve the problem of “ugly braces."

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. Find more information on how much dental aligners cost.

Bridges

Sometimes called a fixed partial denture, bridges 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 the crowns, and the bridge is cemented onto the prepared teeth. Only your dentist can remove a fixed bridge.

The success of your bridge depends upon its foundation. So, remember that oral hygiene to keep remaining teeth healthy is particularly important if you wear 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 your 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

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You can get an implant to replace a tooth. Or two or more implants can provide a stable support for replacing several teeth. If you have 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:

  1. A comprehensive exam, X-rays, and consultation
  2. Surgical implantation of the titanium screws
  3. Taking impressions of the upper and lower jaws
  4. Making a model for the creation of the dentures or crowns
  5. Placement of the crown
  6. Follow-up exams with members of your implant team

Other Periodontal Plastic Procedures

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

  • An uneven gum line
  • Teeth that look too short or too long
  • Exposed roots
  • Indentations in your 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.

WebMD Medical Reference

Sources

SOURCES:

Academy of General Dentistry: "How Can My Dentist Improve My Smile?"

American Dental Association: "Cosmetic Dentistry" and "Bridges."

Cleveland Clinic: "Dental Crowns."

American Association of Oral and Maxillofacial Surgeons: "Dental Implants."

American Academy of Periodontology: "Periodontal Plastic Procedures."

American Dental Association: "Dental Minutes: Tooth Whitening Is Not Equal to Tooth Brushing."

Columbia University College of Dental Medicine.

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