Article by Benjamin S. Fiss, DDS
Chicago Cosmetic Dentist
Technology triggers new age in dentistry
By Douglas Perry
Strong, healthy-looking teeth promote self-confidence and a sound attitude toward overall health and fitness. Yet many people don't put much thought into how they care for their smile; they run a toothbrush over their teeth every day and leave it at that.
Diligent home care (de: regular and proper brushing and flossing) and bi-annual visits to the dentist for check-ups remain the easiest and most effective methods of maintaining a set of healthy-looking teeth. They look healthy because they are healthy.
Some people's strong, well-tended teeth, however, do not look particularly healthy. There can be many reasons for this. Enamel that is wrinkled, discolored, pitted or thin can be the result of premature birth, the use of common antibiotics during infancy or by the mother during pregnancy, high fever during infancy, nutritional deficiencies or congenital diseases. Healthy teeth, which are normally a light yellow or dull white color, also can be stained by tea, tobacco, cola and other foods and beverages.
But with modern dental technology, discolored teeth no longer need to stay that way. For whiter teeth, there are a handful of cosmetic treatments available. The three most common treatments are bleaching, bonding and laminate veneer application.
With bleaching, stains are lifted from teeth by the application of a peroxide solution along with an activating heat. This in-office process, although usually effective. has some drawbacks. The treatment is rather expensive, and teeth may need to be bleached several times before they reach the desired whiteness. Also, despite the application of a sealant to protect against stains, bleached teeth often need to be touched up approximately once every year. Another drawback is the harshness of the bleaching chemicals, which sometimes irritates the gums.
But the conventional in-office bleaching techniques of the past 20 years are becoming obsolete. Relatively new and affordable take-home procedures, such as White & Brite TM, are proving to be remarkably successful and popular. Although many dentists still do not offer the take-home bleaching option, the procedure's success is rapidly making it commonplace. "The take-home procedure doesn't have any of the negatives [of the older bleaching techniques]," says Dr. Benjamin Fiss, who has offered the take-home process for two years.
According to Fiss, the White & Brite? procedure requires an initial in-office appointment to begin treatment. After the office visit, patients complete the mild treatment at home, which includes wearing a custom-made X-Cell? tray. Teeth-whitening is usually completed within two weeks. Follow-up visits to the dentist are necessary.
Bonding, instead of lightening discoloration, covers it. This procedure is also used to restore chipped and cracked teeth. Plastic resin is used to rebuild damaged teeth or cover stains or pits.
The resin. once applied and shaped. is exposed for 20 to 60 seconds to a bonding light that cements it to the tooth. Although Fiss says bonding usually produces excellent results, particularly with chips and cracks, it has some drawbacks as a tooth whitener. "It lacks both the depth of color and the iridescence of enamel," Fiss says. Also, especially dark teeth some times cannot be masked by bonding because the necessary thickness of the material results in teeth that look bulky or plump. Bonding covers usually last four to seven years before the plastic resin breaks down.
Laminate veneers, like plastic-resin bonding, cover stained and damaged teeth. Usually made of porcelain, laminate veneers are cemented onto the surface of teeth to give the tooth a smooth, complete surface and a natural shine. The material used for laminate veneers is extremely thin, preventing the bulkiness that can be a problem with plastic resin. Significantly stronger than plastic bonding resin, laminate veneers last approximately 10 to 15 years.
Not everyone, unfortunately, has the luxury to consider dental work that is merely cosmetic. But thanks to modern dental science, even people with missing teeth, significant tooth decay or gum disease can often have a set of strong, healthy-looking, permanent teeth.
The loss of teeth due to injury or disease is a traumatic experience that necessitates an often discouraging lifestyle adjustment. Even with well-constructed dentures, basic everyday actions such as eating and speaking can be difficult. With dental implants, however, the loss of teeth need not restrict one's ability to chew hard or soft foods or hinder one's appearance, speaking ability or self-confidence.
Although dental implants have been available for more than 30 years, removable dentures have been the most-widely utilized method of tooth replacement until recently. Now, modern technology has made implants a preferable option for most patients with tooth loss. "In many cases, implants are without a doubt the best way to restore proper contour, comfort, function, aesthetics, speech and overall dental health," says Dr. Peter M. Tomaselli, who has been placing implants since 1986.
Yet Tomaselli points out that implants are not for everyone who has missing teeth.