"If a patient cannot clean his teeth, no dentist can clean them for him."

Martin H. Fischer

The visible part of a tooth, otherwise known as the crown, is only a small portion of the living system. The crown is made up of enamel, the hardest substance found within the body. It is bone that has been enriched with large percentages of calcium. That's why people who drink lots of milk or take calcium supplements have strong bones and teeth. The enamel is thickest at the crown, and thinnest near the roots of the teeth.

Excellent crowns and bridges were made by the Etruscans in the 7th cent. B.C. At about that time, teeth were being extracted in Asia Minor as a cure for bodily ills and diseases. Skills achieved by the Etruscans, Phoenicians, Egyptians, Greeks, and Romans were largely lost during the Middle Ages, when barbers and roving bands of charlatans practiced unskilled dentistry at marketplaces and fairs. Abulcasis, a Spanish Moor, was one of the few in his time who studied dental surgery.

New developments include the implantation of artificial teeth or binding posts into the gums or jawbone; antibiotic fiber for periodontal disease; root canal surgery, a procedure that ameliorates pain while permitting teeth to remain in place; and nearly painless lasers to repair dental cavities, usually making local anesthesia unnecessary.

The classic metal orthodontic braces are the most familiar method of teeth straightening. Consisting of a bracket glued to the front of each tooth and a metal wire connecting them, orthodontic braces usually require several years of wear for effective teeth straightening. They can be uncomfortable, expensive, and embarrassing for older patients. However, they are still the most effective method of teeth straightening and can correct overbites and underbites as well as individual teeth alignment.

The most common method of teeth straightening remains standard orthodontic braces. Archwires, springs, and rubberbands apply pressure to the individual teeth by means of brackets that are glued onto their surface. Regular visits are required to the orthodontist in order to tighten wires as needed and make other adjustments. At each visit, the wires will be tightened slightly to renew pressure and push them toward their intended position. Additional wires, rubberbands, and headgear may be prescribed to help move the teeth into their ideal position as quickly as possible. When the teeth have all been repositioned, the brackets will be removed and a retainer must be worn to prevent relapse for some period of time.

Tooth reshaping, or contouring, is one of few instant treatments now available in cosmetic dentistry. Dental reshaping and contouring is a procedure to correct crooked teeth, chipped teeth, cracked teeth or even overlapping teeth in just one session.

Dental reshaping and contouring is a procedure to correct crooked teeth, chipped teeth, cracked teeth or even overlapping teeth in just one session. This procedure is even a substitute for braces under certain circumstances. This is also a procedure of subtle changes. A few millimeters of reduction and a few millimeters of tooth-colored can create a beautiful smile when performed by a cosmetic dentist, with no discomfort to you. Tooth reshaping, or dental contouring, is commonly used to alter the length, shape or position of your teeth.

The cosmetic dentist will mark your teeth with a pencil prior to performing the procedure. This helps the cosmetic dentist in their sculpting process. As your cosmetic dentist sculpts the tooth, imperfections are artfully eliminating or minimized. A sanding drill or laser may be used to remove small amounts of surface enamel gradually. Abrasive strips are then moved back and forth between your teeth to shape the actual sides of your teeth. Then the teeth are smoothed and polished. Usually anesthetic is not needed. Teeth contouring and reshaping usually takes one to three visits.

Tooth loss is something no one looks forward to. If you lose one or more teeth, you have a number of options, one of which is dental implants. You owe it to yourself to be informed as possible about these options. With this in mind, we've created this section on dental implants. Begin learning more about dental implants for tooth replacement exacltly now!

Implants are great for replacing missing teeth. It is important that you have enough bone in the area of the missing teeth for the implants to be attached to. Implants are not only used to replace one tooth, but rather people missing most, if not all, of their teeth benefit greatly as well. Implants are increasingly being used to replace certain types of bridges and removable partial dentures.

If you're missing one tooth or all of your teeth, implants may well be for you. So long as you have enough bone in the area of the missing tooth to facilitate the anchorage of the implants, this procedure can yield terrific results. If you don't have enough bone for this purpose, a bone graft may be necessary. A procedure of building up the bone is known as Bone Grafting. Bone grafting is common with dental implants. The bone that is used is one of three types. The preferred bone to use is taken from other areas of your mouth or collected in a suction device as the drilling of the sites for dental implants occurs. Sometimes bone is taken from areas such as a hip (this requires an orthopedic surgeon and an operating room). The third source for needed bone is a synthetic type. This is the least preferred type of bone to be used for this procedure.

Veneers provide a durable solution to the color and shape problems that are common to so many people. Veneers are applied to fronts or visible areas of the teeth. The enamel (outside layer of the tooth) is ground down or reduced by just fractions of a milimeter in order to allow for the thin (contact lense thickness) veneer to be permanently attached to the tooth.

Dental veneers (sometimes called porcelain veneers or dental porcelain laminates) are wafer-thin, custom-made shells of tooth-colored materials designed to cover the front surface of teeth. These shells are bonded to the front of the teeth changing their color, shape, size or length and resulting in an improved appearance.

Dental veneers can be made from porcelain or from resin composite materials. Porcelain veneers resist stains better than resin veneers and better mimic the light reflecting properties of natural teeth. Resin veneers are thinner and require removal of less of the tooth surface before placement. You will need to discuss the best choice of veneer material for you with your dentist.

A very mild etching solution is applied to your teeth to create very small crevices in the tooth's enamel structure. These small crevices provide a slightly rough surface permitting a durable resin to bond materials to your teeth. The resin is then placed on your tooth and high-intensity light cures the resins onto your tooth's surface - with each individual layer of resin hardening in just minutes. When the last coat has been applied to your tooth, the bonded material is then sculpted to fit your tooth and finely polished.

The resin comes in many shades so that we can match it to your natural teeth. Due to the layers involved, this procedure will take slightly longer than traditional silver fillings because multiple layers of the bonding material are applied. Typically bonding takes an hour to two hours depending on your particular case.

The simplest type of teeth whitening is the use of products that can be picked up from the drugstore. These products, which use a very mild bleaching solution, usually require extended use over a period of several weeks. They may be brushed on, squeezed into one-size-fits-all trays, applied as strips, or used in conjunction with normal toothpaste and mouthwash. While these products are very popular, their mildness makes them less effective.

Dentists are able to provide much more dramatic teeth whitening. Some patients opt for a take-home kit that provides results in a few days, while others choose a one-hour procedure that uses advanced technologies to immediately bleach teeth several shades lighter. Take-home kits usually involve custom-fit trays with a whitening gel of carbamide peroxide, to be worn for several hours at a time over some number of weeks as determined by the dentist. These kits are usually less expensive than the one-visit whitening procedures.

Some types of tooth discoloration are difficult to whiten and treat. Teeth that have been subjected to trauma may darken significantly, and resist any bleaching procedure. Some medications affect young children when their teeth are first forming and may also be nearly impossible to treat. Dentists will be able to tell what situations may result in bleach-resistant discoloration, and provide advice on how effective various treatments may be. In cases of extreme discoloration that cannot be subjected to common teeth whitening procedures, porcelain veneers applied to the teeth may be an alternative solution.

Mild side effects are to be expected with any teeth whitening procedure, and may range from slight discomfort to sensitivity to hot and cold. While serious side effects are extremely rare, any extended sensations of pain should immediately be reported to a dentist. Irritation to the gums and mouth tissues should also be watched for and reported if persistent.

Grinding your teeth, an improper bite, age, fillings and tooth decay can all be contributing factors in the wearing down, cracking or breakage of your teeth. Dental crowns cover the entire visible surface of your affected tooth and add strength, durability and tooth stability.

Your cosmetic dentist will usually be able to spot problem areas in your mouth that might lead to tooth damage and a need for crowns. Chewing patterns play a big role as well. By selectively grinding the tips of your middle and back teeth (called cusps) will alter your bite to reduce the stress on at-risk teeth.

In some cases your cosmetic dentist may choose to use a Flipper instead of a temporary crown. A Flipper is a false tooth to temporarily take the place of a missing tooth before the permanent crown is placed. A Flipper can be attached via either a wire or a plastic piece that fits in the roof of your mouth. Flippers are meant to be a temporary solution while awaiting the permanent crown.

Your cosmetic dentist will prepare your teeth on either side of the space for the false tooth. You will be given a mild anesthetic to numb the area, and the cosmetic dentist will remove the an area of each abutment (teeth on either side of the space) to accommodate for the thickness of the crown. When these teeth already have fillings, part of the filling may be left in place to help as a foundation for the crown.

The dentist will then make an impression, which will serve as the model from which the bridge, false tooth and crowns will be made by a dental laboratory. A temporary bridge will be placed for you to wear while your bridge is being made until your next visit. This temporary bridge will serve to protect your teeth and gums.

Your cosmetic dentist may have you use a Flipper appliance. A Flipper is a false tooth to temporarily take the place of a missing tooth before the permanent bridge is placed. A Flipper can be attached via either a wire or a plastic piece that fits in the roof of your mouth. Flippers are meant to be a temporary solution while awaiting the permanent bridge.

Terms explaining

Dental fillings

• Dental fillings are inserted as restorations in the treatment of dental cavities, after drilling out the cavities.

Dental implants

• Dental implants are surgically fixed substitutes for roots of missing teeth. Embedded in the jawbone, they act as anchors for a replacement tooth, also known as a crown, or a full set of replacement teeth.

Dentures

• Removable complete dentures are full-mouth false teeth, which are used when a patient has no teeth left on either the mandibular arch, the maxillary arch, or both.

Veneer

• A layer of tooth-colored material, usually porcelain or acrylic resin, attached to and covering the surface of a metal crown or natural tooth structure.

Anesthesia

• Total or partial loss of sensation, especially tactile sensibility, induced by disease, injury, acupuncture, or an anesthetic, such as chloroform or nitrous oxide.


• Local or general insensibility to pain with or without the loss of consciousness, induced by an anesthetic.


• A drug, administered for medical or surgical purposes, that induces partial or total loss of sensation and may be topical, local, regional, or general, depending on the method of administration and area of the body affected.

Bridge

• A dental bridge is a prosthesis used in place of missing teeth and may be removable or permanently attached.

Dental cavities

• The formation of cavities in the teeth by the action of bacteria; tooth decay.


• Also known colloquially as tooth decay.

Dental crown

• Full-coverage restoration (sometimes incorrectly called a cap) is a prosthetic tooth designed by a dentist and usually created by a lab technician.

Porcelain

• A hard, white, translucent ceramic made by firing a pure clay and then glazing it with variously colored fusible materials.

Stomatology

• The medical study of the mouth and its diseases.

Tooth bleaching

• Also known as tooth whitening.

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