Cosmetic Dentistry (Aesthetic Dentistry)
A cosmetic consultation is done when we focus mainly on your smile, and ways to enhance it aesthetically. The consultation includes the following:
- A thorough examination and diagnosis of all the teeth, gums, tongue, cheeks, temperomandibular joints, and extra oral tissue.
- Intra-oral photos
- Extra-oral photos of the face and smile
- Impressions for study models
- Study model analysis and wax-up
- Digital x-rays were needed
- Digital manipulation of the photographs to determine the treatment possibilities
- Comprehensive treatment plan and cost estimate
The need for a smile makeover is generally indicated when you don’t feel confident when you smile. In many cases people are just not aware of the available treatments to enhance their smile, and could be self conscious and shy about their smile for many years. Some of the treatments are very easy, non-invasive, and not expensive, but sometimes more invasive treatments are needed.
The most important step is correct diagnosis, and a lot of time is spent on identifying the specific areas that you are not happy with. We use digital smile design to diagnose and treat your smile with the following considerations:
- Facial appearance
- Skin tone
- Hair colour
- Teeth (colour, width, length, shape and tooth display)
- Gum tissue
Different treatment options can be done on their own or in combination when a smile make over is done:
- Bleaching / Whitening
- Orthodontic treatment
- Cosmetic bonding and shaping
- Crowns and bridges
- Gingival contouring (gingivectomy)
The perfect smile
The perfect smile is simply defined as the smile that perfectly suits you.
Everyone’s teeth are unique so there isn’t one particular type of smile that is perfect to everyone. Our teeth are different shapes and sizes and what looks perfect on one person may look strange on another due to the way the smile suits particular facial features. There are, however, some general factors that make a smile perfect in a broader sense.
Firstly, the perfect smile looks natural. Teeth that are too white or look artificially shaped aren’t as appealing as a smile that looks healthy and natural.
Are you a candidate for smile make over?
If you are not 100% happy with your smile, you are a candidate for smile design and possibly a smile make over. We are able to assist anyone, from minor corrections to comprehensive treatments.
What to Expect when you have a smile make over
Step one: Consultation and diagnosis
A Comprehensive consultation is done where you point out areas of concern, expectations and treatment preferences.
- Digital photos of your teeth and face
- X-rays if needed
- Impressions for study models
Step two: Treatment discussion
During this appointment, various treatment options and their costs are discussed.
We will also look at photos of what we can achieve, as well as a mock-ups of the new smile.
Step three: Treatment
The different treatment options can be done on their own or in combination:
- Bleaching / Whitening
- Orthodontic treatment
- Cosmetic bonding and shaping
- Crowns and bridges
- Gingival contouring (gingivectomy)
Orthodontic treatment as part of smile make over
Orthodontic treatment is a wonderful way to conservatively correct your smile. Once your teeth are moved with orthodontics, the amount of restorative treatment needed is much less. Using orthodontics in combination with veneers or crowns can often extend the lifetime of the restorations, and also allows for more conservative preparation of the teeth.
Orthodontic treatment is ideal where all the teeth visible in the smile are healthy and would otherwise not need any treatment, except for cosmetic reasons. In this instance, we can correct your smile by simply straightening and aligning the teeth. This will give you a lifetime of healthy smiles.
Veneers as part of the smile make over
Veneers are porcelain coverings cemented onto the natural tooth structure. We use minimally invasive preparation techniques to ensure the conservation of the natural tooth structure. Veneers can be very thin but are extremely durable. The laboratory technician, or ceramic artist, creates the veneers to appear completely natural.
There are two main types of material used to fabricate a veneer: composite and dental porcelain. A composite veneer may be directly placed in the mouth or indirectly fabricated by a dental technician in a dental laboratory, and later bonded to the tooth, typically using a resin cement. In contrast, a porcelain veneer may only be indirectly fabricated.
Whitening as part of the smile make over
Whitening lightens the teeth and helps to remove stains and discoloration. Whitening in conjunction with a smile makeover ensures that the remaining untreated teeth are as healthy looking as the new veneers or composite bonded teeth.
Cosmetic Bonding as part of the smile make over
Bonding is the application of a tooth-coloured composite resin (plastic) to repair a decayed, chipped, fractured or discoloured tooth. Unlike veneers, which are manufactured in a laboratory and require a customized mould to achieve a proper fit, bonding can be done in a single visit. The procedure is called bonding because the material bond to the tooth.
A veneer is a thin layer of material placed over a tooth, either to improve the aesthetics of a tooth or to protect the tooth's surface from damage. There are two main types of material used to fabricate a veneer; composite and porcelain.
Composite is directly placed in the mouth with bonding techniques. The composite used is a resin based material. Composite veneers are placed in one appointment and is minimally invasive. This treatment is generally done in people with small imperfections, and can be very quick and effective.
It is important to remember that composite will stain with coffee, tea and smoking. It also has a shorter lifespan than porcelain veneers, and will last around 5 to 7 years. Staining might occur earlier than that, but can be polished off as part of the maintenance.
One of the main differences between composite and porcelain veneers is that composite is generally much cheaper than porcelain veneers.
A Porcelain veneer may only be indirectly fabricated. A Laboratory technician fabricates the veneer out of porcelain, and then stains and glazes the porcelain for a natural looking appearance.
The material we use to fabricate porcelain veneers is called E-max. This is a very durable material and allows for maximum aesthetics.
Porcelain veneers can be done without removing much of the tooth structure underneath, and at times we can even cement the veneers without doing any drilling on the tooth.
One of the benefits of porcelain veneers are that they don’t discolour with time. They maintain the bright white colour for much longer than normal teeth or composite veneers.
Whitening / Bleaching
Dental bleaching, also known as tooth whitening, is a common procedure in general dentistry. Whitening restores natural tooth colour and bleaching whitens beyond the natural colour.
The dentist will photograph your teeth first and then he will examine your teeth and ask you questions in order to determine what caused your teeth to become stained.
The next step is that the dentist/oral hygienist will clean your teeth. This will remove the build-up of bacteria, food and other substances which contribute to staining. The dentist will then apply a substance that covers and protects the gums around the teeth. After this is done, hydrogen peroxide will be applied to the teeth.
If you have tooth decay or receding gums, whitening may make your teeth sensitive.
Different ways to whiten your teeth:
In the dental chair (Power Whitening)
This procedure is done by the oral hygienist in one session of usually an hour to an hour and a half. Results are instantly visible and long lasting.
Home whitening kit
Custom made trays are used at home for 30 minutes a day to whiten your teeth. The whitening gel is put into the custom trays, which fits onto your teeth. This is a very safe and economical way to whiten your teeth and results can usually be seen after the third day. A Home kit can be used to do touch up treatments as well.
Combination Power whitening and home whitening
The most predictable way of whitening your teeth is to combine the procedures. Firstly the power in-chair whitening is done at the dental office, and there after the home kit is used for two weeks.
Excellent results can be achieved, and the results are even longer lasting.
Home whitening instructions
Follow your dentist’s instructions on how to load gel into your custom bleaching tray. Use no more than 1/3 to 1/2 of a syringe.
Brush teeth before inserting tray.
Lightly tap tray to adapt tray sides to teeth.
Timing is as follows:
- Opalescence 10% for 8-10 hours or overnight
- Opalescence 15% for 4-6 hours
- Opalescence 20% for 2-4 hours
- Opalescence 35% for 30 minutes.
Remove excess gel with clean fingers or a soft toothbrush. Rinse twice; do not swallow rinsed gel.
If significant sensitivity occurs, stop treatment and consult your dentist.
Clean the tray with soft brush and cool tap water.
Store tray in case provided.
Home whitening Precautions:
- Do not use household bleach to whiten teeth.
- Pregnant women should not bleach their teeth.
- If you have any questions regarding the appropriate use of this product, including how long it will take to bleach your teeth, please consult CSD as soon as possible.
- Do not use tobacco products or eat while bleaching.
- White spots on the enamel or that appear during bleaching may blend during continued bleaching process.
- Teeth are naturally darker along the gum line. These areas may require more time to lighten than the rest of the tooth surface and Usually remain slightly darker.
- A small percentage of patients experience sensitivity with bleaching. Should this occur, remove the tray and contact your dentist.
- Foods and juices high in citric acid can cause sensitivity to the teeth.
- Some patients have noticed temporary discomfort of the gums, lips, throat, or tongue. Should any of these symptoms persist for more than two days or progressively worsen, call your dentist. These side effects will usually subside within 1-3 days after treatment is discontinued.
- Coffee, tobacco, and other products can restain your teeth over time. Should this occur, the teeth can be rewhitened within a few nights using Opalescence.
- Regular dental check-ups and cleanings are important before and after bleaching to maintain a healthy smile.
- Some old amalgam or “silver” fillings may leave a dark purple colour in your bleaching tray; this is normal.
- Crowns, bridges, partial dentures, veneers, and composite fillings will not bleach.
- Store bleach out of the sun and heat. Refrigeration is recommended, but do not freeze.
- Discard any unused bleaching gel after treatment is completed.
- Keep Opalescence out of reach of small children.
- Do not swallow gel or rinsed gel. Product contains peroxide and may contain fluoride; swallowing large amounts can be harmful.
We use opalescence whitening products. The Opalescence range has more than 20 years of scientific evidence backing the system. It is completely safe to use, and does not damage the tooth structure at all.
Research articles available on opalescence whitening:
- Basting RT, Rodrigues AL Jr, Serra MC. The effects of seven carbamide peroxide bleaching agents on enamel microhardness over time. J Am Dent Assoc. 2003;134(10):1335-42.
- Al-Qunaian TA. The effect of whitening agents on caries susceptibility of human enamel. Oper Dent. 2005;30(2):265-70.
- Clark LM, Barghi N, Summitt JB, Amaechi BT. Influence of fluoridated carbamide peroxide bleaching gel on enamel demineralization. J Dent Res 85(Spec Iss A): 0497, 2006 (www.dentalresarch.org).
- Amaechi BT, Clark LM, Barghi N, Summitt JB. Enamel fluoride uptake from fluoridated carbamide peroxide bleaching gel. J Dent Res 85(Spec Iss A): 0498, 2006 (www.dentalresarch.org).
- Browning WD, Myers M, Downey M, Pohjola RM, Brackett WW. Report on low sensitivity whiteners. J Dent Res 85(Spec Iss A): 1650, 2006 ( www.dentalresearch.org).
Before & After
Please view our smile gallery
Safety in Whitening
All professional whitening products should be applied by a dental professional. The whitening gel contains peroxide and can be damaging if it comes in contact with the gum tissue. The whitening instructions should be followed carefully. If any adverse effects occur please contact us.
1. How does whitening work?
Working from the inside out, the active ingredients in Opalescence gel penetrates your teeth to break down the discoloured molecules, removing stains and whitening your smile. Opalescence gels contain potassium nitrate and fluoride which have been shown to strengthen enamel, decrease sensitivity, and help prevent cavities!
2. Is whitening for everyone?
Whitening is a safe, comfortable way to get a bright, white smile. Results and treatment time may vary depending on the level of staining and whiteness desired. Crowns, bridges, fillings, and veneers will not whiten. We recommend visiting your dentist for a pre-whitening consult so that they can help you choose the professional option that best fits your needs.
3. How long do the Whitening results last?
Whitening results are very stable, leaving you with a stunning smile long after treatment is over. However, there are a few factors that can make teeth lose their luster. Things like genetics, diet, age, some medications (like tetracycline), and certain habits (like smoking) may affect the length of your whitening results. Fortunately, touch-up treatments are quick and easy, helping you get that bright, white smile back.
4. Will whitening cause tooth sensitivity?
Tooth sensitivity is a relatively common side effect of whitening. If sensitivity occurs, it is often temporary and will go away once you've completed the whitening process. Opalescence products include desensitizing ingredients like potassium nitrate and fluoride to help reduce sensitivity and provide additional comfort.
5. Will whitening weaken my teeth?
Opalescence products include potassium nitrate and fluoride. Potassium nitrate has been shown to help reduce sensitivity. Fluoride has been shown to help reduce caries and strengthen enamel.
6. I've heard of some whitening treatments that require a bright light to be shined on my teeth. Are these lights really effective?
Lots of other in-office whitening treatments use a light or a laser during the whitening process. You've probably seen commercials for these kinds of teeth whiteners. Or maybe you've even seen kiosks in the mall where they'll use a light to whiten your teeth. Are these lights and lasers really effective, though?
The answer is no. Current research shows that hydrogen peroxide alone (the whitening agent used in Opalescence Boost) is effective in whitening teeth, and that light activation adds no additional benefit.
We offer a free consultation with our whitening specialist at our practice. Please contact us to set up an appointment.
Bonding & Shaping
Bonding is the application of a tooth-coloured composite resin (plastic) to repair a decayed, chipped, fractured or discoloured tooth. Unlike veneers,
which are manufactured in a laboratory and require a customized mould to achieve a proper fit, bonding can be done in a single visit. The procedure is
called bonding because the material bonds to the tooth.
Bonding is among the easiest and least expensive of cosmetic dental procedures. The composite resin used in bonding can be shaped and polished to match the surrounding teeth. Most often, bonding is used for cosmetic purposes to improve the appearance of a discoloured or chipped tooth. It also can be used to close spaces between teeth, to make teeth look longer or to change the shape or colour of teeth.
Sometimes, bonding also is used as a cosmetic alternative to amalgam fillings, or to protect a portion of the tooth's root that has been exposed when gums recede.
Your dentist will use a shade guide to select the composite resin colour that will match the colour of the tooth most.
Once your dentist has chosen the colour, he or she will slightly abrade or etch the surface of the tooth to roughen it. The tooth will be coated lightly with a conditioning liquid, which helps the bonding material adhere.
When the tooth is prepared, your dentist will apply the tooth-coloured, putty-like resin. The resin is moulded and smoothed until it's the proper shape. Then the material is hardened with an ultraviolet light or laser.
After the bonding material hardens, your dentist will further trim and shape it. Then he or she will polish the material until it matches the sheen of the rest of the tooth surface.
It usually takes about 30 minutes to an hour to complete the procedure. If you're having more than one tooth done, you may need to schedule several visits.
Tea, coffee, cigarette smoke and other substances can stain the resin. To prevent or minimize stains, it's essential to avoid eating or drinking foods that can stain for the first 48 hours following any composite procedure. In addition, brush your teeth often and have them cleaned regularly by a dental hygienist.