February 2, 2009

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Article

Smile Makeovers

Dental Procedures Improve Looks and Health

Carolyn Campbell

February 2, 2009

The head fashion stylist at Salt Lake’s apparel store Jealousy Boutique believes belts, scarves and jewelry aside, she has the perfect makeover: a new smile. Sandra Roskiewich underwent a dental transformation that included bonding, a series of teeth whitening treatments and filling replacements, exchanging silver for white ones. “My teeth never looked so great before,” she says. “It’s amazing how a smile makeover can make you feel better about yourself—not just in your smile, but in your self-confidence. I notice the difference every morning when I get ready for work.” Roskiewich’s makeover included several elective dental processes (described as aesthetic procedures by dental physicians), which may not be necessarily relative to treating tooth decay or gum disease. Rather, they are principally used to enhance a patient’s smile and are usually not covered by insurance. Tooth whitening is the most common elective dental procedure and the most conservative, affordable and minimally invasive way to address cosmetic dental needs, says Dr. Jaimee Morgan, Roskiewich’s dentist. Morgan practices cosmetic and restorative dentistry in Midvale and lectures internationally about elective dentistry. She describes bleaching as the very foundation of elective dentistry and advises patients who have decided to pursue other elective procedures, such as composite bonding or porcelain veneers, to ask their dentist whether he or she plans to whiten their teeth before the other procedures. “Teeth whitening doesn’t adversely affect the hardness of the tooth enamel, yet makes a huge difference in appearance,” says Morgan. “Only 3 percent of those who bleach don’t get successful results. I would venture to say that some of those didn’t continue to bleach long enough.” Patients who visit a dentist for whitening can make sure they are getting a formula that will not harm the teeth and can avoid putting bleach over active decay, trying to bleach out darkness when the tooth is basically sick, says Morgan, adding that while many over- the-counter products are effective, they aren’t regulated. “Some of them are reported to have an etching solution that makes the teeth rough. Then the consumer is instructed to brush over that with a paste that contains titanium oxide, as does latex paint,” Morgan explains. “This creates a situation where a white substance is being held onto the teeth, not in a permanent fashion.” Cosmetic tooth bonding is also a conservative procedure that addresses small tooth defects like chips, spots and gaps between the teeth with tooth reshaping. It is a technique that the dentist applies directly to the tooth and is usually a one-appointment procedure. “It doesn’t require a drill to reduce the size of the tooth to accommodate the material and can address aesthetic challenges when there is no time to have orthodontics done,” Morgan explains. “Cosmetic tooth bonding can be left as a permanent change or may also be considered a temporary situation, in that it can be modified or removed without harming the natural teeth. I’ve had patients take care of these bonded composites so that they look beautiful for years. Touch-ups and repairs on them take only minutes in the chair.” Dr. Jaleena Jessop, a dentist who lectures nationwide about cosmetic dental procedures, explains that porcelain veneers or crowns, are used by dentists as a way to make cosmetic changes to teeth that are discolored, worn, chipped, or misaligned. Alternatively termed dental veneers or dental porcelain laminates, some dentists have cut down teeth to make them, then bond them onto the front side of teeth to create a cosmetic improvement. She says this has been a popular option for patients wanting the “Hollywood” smile. But now, she says, tooth bleaching and esthetic composites provide healthier alternatives. “Although veneers are necessary at times, we are able to provide more conservative options, helping us to avoid some of the potential negatives of the more invasive procedures.” Jessop adds that when a dentist cuts down a tooth in preparation for a crown and then hollows it out later to treat it for a root canal, the chances of a resultant fracture in the anterior region are much higher. There are additional options for patients trying to achieve a brighter smile, such as ultrasonic scalers, which Jessop says can make a big difference in removing surface stains. Also, endo bleaching can help lighten a tooth that has had a root canal if the patient does not want a crown. “Tissue grafting in areas where there is a lot of gum recession is another option,” says Jessop. “We can make a big difference in appearance by finding a point where the patient is happy with their appearance with little invasiveness.”
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