What are the characteristics of an attractive smile? While not every person is born with a perfect smile, qualities such as straightness, cleanliness or whiteness of teeth may come to mind. Thanks to developments in the field of cosmetic dentistry, people can change the smile they were born with into a smile they love.
General dentists are able to perform a variety of cosmetic procedures to improve patients' smiles. These procedures range from subtle changes to major repairs, fixing flaws such as discolored, chipped, misshapen or missing teeth.
Cosmetic procedures include bleaching, bonding, veneers, reshaping and contouring. Bleaching is a common and popular procedure that is used to whiten teeth and can be performed by a dentist in the office or under supervision at home. Dentists can also use a variety of methods to correct misshapen or crooked teeth. Veneers are thin shells of porcelain or plastic that are cemented over the front of teeth, and bonding is the use of tooth-colored material to fill in gaps or change the color of teeth. Tooth reshaping or contouring are used to alter the length, shape or position of teeth and are ideal for patients with normally healthy teeth seeking subtle changes in their smile.
Bleaching is a common and popular chemical process used to whiten teeth. Some people get their teeth bleached to make stains disappear, while other just want a whiter shade.
Discoloration occurs in the enamel and can be caused by medication, coffee, tea and cigarettes. Discoloration also can be hereditary or due simply to getting older.
Bleaching can be performed by your dentist in the office or, under dental supervision, at home. Many patients enjoy bleaching at home because it is more convenient. Treatment begins when your dentist creates a custom mouthpiece to ensure the correct amount of whitening solution is used and that your teeth are properly exposed. Typically, whitening at home takes two to four weeks, depending on the desired shade you wish to achieve. Whitening in the office may call for one or more 45-minute to one-hour visits to your dentist's office.
Tooth reshaping and contouring, is a procedure to correct crooked teeth, chipped or irregularly shaped teeth or even overlapping teeth in a single session. Tooth reshaping and contouring, is commonly used to alter the length, shape or position of your teeth. Contouring teeth may also help correct small problems with bite. It is common for bonding to be combined with tooth reshaping.
This procedure is ideal for candidates with normal, healthy teeth but who want subtle changes to their smile. Your dentist will take X-rays to evaluate the size and location of the pulp of each tooth to ensure that there's enough bone between the teeth to support them.
Veneers are thin pieces of porcelain or plastic placed over the front teeth to change the color or shape of your teeth. Veneers are used on teeth with uneven surfaces or are chipped, discolored, oddly shaped, unevenly spaced or crooked. Little or no anesthesia is needed. Veneers are used to treat some of the same problems as bonding.
This treatment is an alternative to crowns, which are more expensive. The procedure requires your dentist to take an impression of your tooth. Before the custom-made veneer is cemented directly onto the tooth, your dentist will lightly buff the tooth to compensate for the added thickness of the veneer. Once the cement is between the veneer and your tooth, a light beam is used to harden it. Porcelain veneers require more than one visit because they are fabricated in a laboratory. Veneers have a longer life expectancy and color stability than bonding.
Crowns, also known as caps, cover a tooth to restore it to its normal shape and appearance. Due to their cost, they are used in cases where other procedures will not be effective. Crowns have the longest life expectancy of all cosmetic restorations, but are the most time-consuming.
Bonding is tooth-colored material used to fill in gaps or change the color of teeth. Requiring a single office visit, bonding lasts several years. Bonding is more susceptible to staining or chipping than other forms of restoration. When teeth are chipped or slightly decayed, bonded composite resins may be the material of choice. Bonding also is used as a tooth-colored filling for small cavities. Additionally, it can be used to close spaces between teeth or cover the entire outside surface of a tooth to change its color and shape.
The relationship between maternal periodontitis and adverse pregnancy outcomes has been investigated in many studies in recent years. Periodontal disease is common during pregnancy and although it has been linked to adverse pregnancy outcomes such as low birthweight and pre-eclampsia, systematic reviews attempting to clarify these associations have reached mixed conclusions. Daalderop and colleagues1 performed a recent synthesis of findings from systematic reviews (“overview of reviews”) assessing the link between periodontal disease and a range of adverse pregnancy outcomes, focusing on interpretation of findings from high-quality reviews.The systematic review research protocol was peer-reviewed and published2 and had been registered with the PROSPERO international prospective register of systematic reviews (PROSPERO: CRD42015030132). Registration with PROSPERO helps to avoid research duplication and reduces opportunity for reporting bias by allowing a comparison of the completed review with what was planned in the protocol.Six online literature databases were electronically searched through November 2016; references and citations of eligible papers were manually searched. Systematic literature reviews comparing pregnancy outcomes among women with and without periodontal disease were considered eligible for inclusion. The primary health outcomes assessed were maternal mortality, preterm birth, and perinatal mortality; secondary outcomes included miscarriage, premature rupture of membranes, pre-eclampsia, and low birthweight. Two reviewers performed data abstraction and assessed the risk of bias of individual systematic reviews.Twenty-three systematic reviews (each including between 3 and 45 studies) were included in the overview. None of the systematic reviews reported the association between periodontal disease and maternal or perinatal mortality. Systematic reviews with the lowest risk of bias consistently demonstrated positive associations between periodontal disease and risk of preterm birth (relative risk [RR], 1.6; 95% confidence interval [CI], 1.3 to 2.0; 17 studies, N=6,741), low birthweight (RR, 1.7; 95% CI, 1.3 to 2.1; 10 studies, N=5,693), pre-eclampsia (odds ratio [OR], 2.2; 95% CI, 1.4 to 3.4; 15 studies, N=5,111), and preterm low birthweight (RR 3.4; 95% CI, 1.3 to 8.8; 4 studies, N=2,263). In terms of limitations, the authors noted that as several primary studies did not adjust for confounding, meta-analyses may have overestimated the strength of the associations being studied. Because of “substantial overlap” in the included primary studies, researchers were unable to aggregate results across reviews. They concluded, “Consistent evidence from systematic reviews with low risk of bias indicates that pregnant women with periodontal disease are at increased risk of developing preeclampsia and delivering a preterm and/or [low birthweight] baby,” and that “Research is needed to develop novel preventive and treatment strategies.
”ReferencesDaalderop LA, Wieland BV, Tomsin K, et al. Periodontal Disease and Pregnancy Outcomes: Overview of Systematic Reviews. JDR Clinical & Translational Research 2017;Online ahead of print.Vanterpool SF, Tomsin K, Reyes L, et al. Risk of adverse pregnancy outcomes in women with periodontal disease and the effectiveness of interventions in decreasing this risk: protocol for systematic overview of systematic reviews. Syst Rev 2016;5:16.Prepared by: Center for Scientific Information, ADA Science Institute
Several medications are available to help create more relaxed, comfortable dental visits. Some drugs control pain, some help you relax, and others put you into a deep sleep during dental treatment. You and your dentist can discuss a number of factors when deciding which drugs to use for your treatment. The type of procedure, your overall health, history of allergies and your anxiety level are considered when determining which approach is best for your particular case.
Your dentist might recommend that your child be administered anesthesia or sedation to relax them in order to safely complete some dental procedures.
Local anesthesia is a type of anesthetic used to prevent pain in a specific area of your mouth during treatment by blocking the nerves that sense or transmit pain, which numbs mouth tissues. Your dentist may apply a topical anesthetic to numb an area in preparation for administering an injectable local anesthetic. Topical anesthetics also may be used to soothe painful mouth sores. Injectable anesthetics may be used in such procedures as filling cavities, preparing teeth for crowns or treating gum disease.
Depending on the procedure, you may need a pain reliever after treatment. Analgesics are used to relieve pain and can be broken into two groups: non-narcotic and narcotic. Non-narcotic are the most commonly used drugs for relief of toothache or pain following dental treatment. They include aspirin, acetaminophen and non-steroidal, anti-inflammatory drugs such as ibuprofen. Narcotic analgesics, such as opioids, act on the central nervous system to relieve pain. They are used for more severe pain.
Be sure to talk with your dentist about how to properly secure and dispose of any unused, unwanted or expired medications, especially if there are any children in the household. Also, take the time to talk with your children about the dangers of using prescription drugs for non-medical purposes.
For some dental visits, your dentist may use a sedative, which can induce moderate sedation. Sedatives can be administered before or during dental procedures. Sedation methods include inhalation (using nitrous oxide), oral (by taking a pill) and intravenous (by injection). More complex treatments may require drugs that can induce deep sedation, reducing consciousness in order to relieve both pain and anxiety. On occasion, general anesthesia can be used, in which drugs cause a temporary loss of consciousness.
Dentists use the pain and anxiety control techniques mentioned above to treat millions of patients safely every year. Even so, taking any medication involves a certain amount of risk. That's why the ADA urges you to take an active role in your oral health care. This means understanding the risks and benefits involved in dental treatment, so that you and your dentist can make the best decisions about the treatment that is right for you. Working together, you and your dentist can choose the appropriate steps to make your dental visit as safe and comfortable as possible, and to help you keep a healthy smile.
Even though we’ve been brushing and flossing our teeth for years and years, many of us are surprised to learn that we’re not doing it properly. Case in point: Did you know that proper brushing takes at least two minutes? Most adults do not come close to brushing that long.
These four steps are the best and easiest ways to help you remember how to care for your mouth, teeth and gums: