"I find that most men would rather have their bellies opened for five hundred dollars than have a tooth pulled for five."

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.

The permanent teeth are the second set of teeth that will last the rest of your life. They tend to be more yellow (and not just because of coffee) and are extremely hard. The final set of teeth is made up of 32 teeth, or 16 on each jaw. There are two central incisors for biting, two lateral incisors for biting, two canines for tearing and cutting, four premolars for chewing, and six molars for chewing.

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.

Most of us have had amalgam fillings (silver) or gold filling restorations. Some amalgam fillings were what we have called mercury fillings, as some amalgam fillings contained mercury. Metal fillings were effective, but very conspicuous and tended to blacken in color over time.

Composite resins may also be used to enhance the appearance of any tooth, which is a tooth bonding procedure. The composite resin will strengthen and enhance the natural tooth structure as it does with use as a dental filling.

A special dental material is then used to open up the pores of your tooth's dentin and roughens up the surface of the exposed enamel. This achieves better and stronger bond. The bond resin is applied to stick the composite to your tooth. This material is made of the same dental resin as the composite however it is much more fluid. This layer is then hardened and cured with a very bright light.

There are no known health risks of receiving composite fillings. If such a filling is not going to be enough to protect your damaged tooth, or if your tooth enamel is thin and will easily fracture, or if your tooth has had a root canal that weakened your tooth condition, your tooth may require additional protection such as a crown.

A dental bridge is a false tooth, known as a pontic, which is fused between two porcelain crowns to fill in the area left by a missing tooth. The two crowns holding it in place that are attached onto your teeth on each side of the false tooth. This is known as a fixed bridge. This procedure is used to replace one or more missing teeth. Fixed bridges cannot be taken out of your mouth as you might do with removable partial dentures.

In areas of your mouth that are under less stress, such as your front teeth, a cantilever bridge may be used. Cantilever bridges are used when there are teeth on only one side of the open space. Bridges can reduce your risk of gum disease, help correct some bite issues and even improve your speech. Bridges require your commitment to serious oral hygiene, but will last as many ten years or more.

You maybe candidate for dental bridges, if you have missing teeth and have good oral hygiene practices, you should discuss this procedure with your cosmetic dentist. If spaces are left unfilled, they may cause the surrounding teeth to drift out of position. Additionally, spaces from missing teeth can cause your other teeth and your gums to become far more susceptible to tooth decay and gum disease.

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 other instances, crowns are used to replace a actual missing tooth. These crowns are anchored to the teeth on either side, with a bridge section connecting the two crowns. Instead of bridges, single tooth dental implants may be used that eliminate the need for supporting the crowns.

Be sure to discuss with your cosmetic dentist that the cement color used for your permanent crown will be the same as used for your temporary crown. A try in paste is used for this purpose. The color of the cement does affect the overall color of a porcelain crown, so this needs to be discussed long before your temporary crown is placed.

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.

Teeth straightening is accomplished with a number of different procedures and is usually done on children and adolescents when their permanent teeth begin growing in. Crooked teeth, crowded teeth, and even overbites and underbites can be treated with various teeth straightening techniques. While considered a cosmetic procedure, some people require teeth straightening in order for their teeth to be aligned in such a way that chewing is possible. Severe overbites and underbites can result in serious consequences over time, and even overly crowded teeth can mean health problems for the mouth.

Invisalign is one of the newest methods of teeth straightening and is extremely popular with adults. Consisting of a clear mold that is nearly invisible when worn, Invisalign uses a series of molds that gradually push the teeth into the desired shape. Invisalign does not cost significantly more than standard orthodontic braces, but cannot correct an overbite or underbite and is only a good choice for minor straightening. Invisalign is not as effective on major problems, which may require standard braces.

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.

For individuals who are looking for a fast way to achieve dramatic teeth whitening results, in-office whitening is the way to go. Protective gel is applied to the gums, lips and other tissue around the teeth, and then a bleaching solution is applied to the tooth enamel. A high intensity laser or other type of light catalyzes the bleach, and the teeth are treated for one to two hours.

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.

Definitions and terms on this page

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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