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Cosmetic Dentistry Examined
By REBECCA WATTS


More information on cosmetic dental procedures can be found at the AACD website and the ADA website.

Sam Harrison's smile never prevented him from doing anything he set his mind to, but it was in the back of his mind growing up. “I’ve basically been a gregarious person my whole life. My smile never bothered me, but I was always aware of it,” Harrison said.

Harrison, a retired urologist, investor and local businessman, took the antibiotic tetracycline as a child, which caused severe staining of his teeth. He also chipped and broke several teeth during athletic endeavors as a young man. About four years ago, Harrison paid a visit to local dentist Dr. Bill Birdwell and found he had several other teeth that were in need of work. Rather than undergo several dental procedures, Dr. Birdwell explained to Harrison he was the perfect candidate for cosmetic dentistry, specifically, porcelain veneers. Two office visits later, Harrison had the smile he had always wanted.

“Having that procedure done has really allowed me to have a brighter smile and a brighter outlook on life,” Harrison said. “The interesting thing is that people have come up to me and said how nice my smile is now. It’s hard to conceal my happiness with such a good result.”

Harrison is just one of millions that have opted to use cosmetic dentistry to correct their teeth problems. The American Academy of Cosmetic Dentistry reports a 50 percent increase each year since 2005 in the amount of cosmetic dental procedures performed. Public Relations director for the AACD, Eric Nelson, said the members of the Academy anticipated at least a 10 percent increase in cosmetic procedures this year. The scope of cosmetic dentistry encompasses dental work as simple as tooth-colored fillings to complex full mouth restoration combining several procedures. Teeth whitening, veneers, and implants are the most common cosmetic procedures.

Tooth Whitening

Teeth whitening can be done in several ways. Over-the-counter whitening products approved by the America Dental Association contain a 10 percent concentration of carbamide peroxide to whiten teeth and are a convenient, cost-effective way of bleaching teeth. Local dentists differ as to whether over-the-counter whiteners really work. Some have said they are as good as in-office whitening, while others believe they are an effective maintenance tool after receiving an in-office whitening. Cosmetic dentist Michael K. Reece said, “Whitening is just bleach. Bleach is bleach. The stronger the concentration of bleach, the better the teeth are going to whiten. The things you buy over the counter are the same as what we use in the office, just a lower concentration because you can’t control as well where the bleach goes.”

Dentists offer two methods of whitening: customized trays that are worn at least seven to ten days and an in-office procedure using a special light that activates ingredients in a translucent gel. Both procedures are equally effective, the difference is in how long whitening takes. With trays, both customizable and over-the-counter, whitening can take several days to several weeks; the result of laser bleaching is seen immediately. The cost of each procedure varies by the product and by the dentist. Teeth should be healthy to begin with before being whitened. Bryan dentist Robert Hall said, the darker teeth are, the more dramatic whitening results will be, but he added that results for each procedure differ and some teeth may not respond to whitening. Stains from tetracycline, such as Harrison experienced, do not respond to whitening treatments and other factors can sometimes affect results.

Porcelain Veneers and Bonding

Porcelain is modern dentistry’s answer to tooth enamel. Porcelain is stronger than enamel and is more resistant to staining because it is less porous. Porcelain veneers are similar to artificial fingernails in size and shape and the method by which they are applied. A dentist shapes and prepares the original tooth so the veneer fits like a cap over the tooth. The veneer should fit seamlessly against a ledge on the back of the tooth. Dentists typically work with 6 to 10 veneers that can be applied all at once or over a series of visits. When done by a skilled dentist, veneers drastically transform a person’s smile. The porcelain can be adjusted in thickness and can sometimes be applied with very little tooth preparation.

Veneers are the number one cosmetic procedure performed by Reece at his office. “People start out asking to get their teeth whiter just because they don’t know what to ask for,” Reece said. “They are like artificial nails we can glue on the outside of teeth. We can make them longer; we can make them shorter -- any of that kind of stuff.” Veneers are used to correct teeth issues such as gapping, excessive wearing, coloring not affected by whitening, and smile adjustments. Contrary to popular belief, applying veneers is not a painful process. Soreness or tenderness can sometimes occur, but most dentists offer anesthesia options. Veneers range in price from $700 to $1500 per veneer depending on the dentist used and special certifications earned.

Implants

Implants are much more effective and aesthetically pleasing than traditional bridge or other tooth replacement techniques. Implants use a tiny titanium coated screw that is available in a variety of diameters, depending on the tooth being replaced. The first step for an implant is to surgically place the screw in the jawbone. The screw has a tiny hole in the top that accommodates the second step of an implant, the replacement tooth. The replacement tooth has a small rod that is inserted into the hole in the screw. Both sections are bonded together and through a process called osteointegration, attaches to the jawbone. Implants can be combined with any number of procedures to create a drastically different smile.

Most local dentists begin the cosmetic process by identifying what a patient wants, how much it costs to make those wants possible, and what, if any, alternatives are available. Software programs are available that can show how the finished procedure would look on a person. Birdwell recommends shopping around for a cosmetic dentist. “I love second opinions,” Birdwell said. “Cosmetic dentistry is an elective procedure, so there’s no hurry. It always amazes me that patients get second opinions for cancer or other health issues, but not for this.” All dentists work to make their services affordable. Most accept CareCredit, Capitol One financing, insurance and, of course, major credit cards and cash.