"A man loses his illusions first, his teeth second, and his follies last."

Helen Rowland

Our teeth

Throughout your life you end up having 2 completely different sets of teeth. The initial set is the baby teeth (deciduous teeth) that eventually fall out. They are whiter, softer, and less sturdy than adult teeth. Hence, they tend to wear out much faster than permanent teeth, but they also fall out to make room for them. Making sure that there's enough space in the vacancy caused by a lost baby tooth is important for healthy adult 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.

Your teeth are by far one of the most important things you use every day. Many people end up neglecting their teeth with improper oral hygiene. You should take care of them by brushing at least twice a day, flossing once per day, and going for regular dental checkups at least twice per year.

The need for teeth whitening

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.

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.

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.

Tooth replacement

Dental implants are fixtures of titanium which are surgically screwed into your jaw bone. The implant is an anchor for a naturally-appearing false tooth or a set of false teeth. The success rate of dental implants depends on where the implants are placed and their purpose. They are typically best placed in the front portion of your lower jaw.

The implant procedure is a surgical placement of the implant or implants in your jaw bone which requires a three to six month healing period before the implant restoration to replace the missing tooth or teeth. During this healing time, the bone grows in and around the titanium implant creating a very strong support. Dental implants can be rejected. Usually they are replaced with another implant of a slightly larger size. The rejection or "failure" rate is minimal, only 1 to 2% of all implant procedures. You must go without wearing your dentures for one day to two weeks after an implant placement. After the implant has "taken" and you have sufficiently healed, a very natural crown is placed on the implant.

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.

Tooth fillings

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.

Your dentist will give you a local anesthetic to numb the area. The dentist then prepares an access to the decayed area of the tooth and removes the decayed portions. This is accomplished with traditional drills, micro air abrasion or even with a dental laser. With a composite filling, your dentist will preserve more of the natural tooth as the composite resin can be bonded to the tooth in thin layers. If your tooth's decayed area is close to a nerve, a special liner will be used to protect the nerve.

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.

If over half of your molar tooth's biting surface is decayed an inlay or onlay may be a better option than a filling. These options are basically for when more than a filling is needed but less than a crown will do. An inlay is placed in between the cusps of the tooth, whereas an only will cover one or more of the cusps. They can be made of a gold alloy, porcelain or tooth-colored resin and are cemented into place.

Dental bonding

Bonding is a composite resin filling placed in the back teeth as well as the front teeth. Composites are the solution for restoring decayed teeth, making cosmetic improvements and even changing the color of your teeth or the reshaping of teeth. Bonding will lighten any stains you may have, close up minor gaps and can be used to correct crooked teeth.

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.

You are good candidate for tooth bonding, if you have close, small gaps between your front teeth, or if you have chipped or cracked teeth, you may be a candidate for bonding. Bonding is also used for patients who have discolored teeth, uneven teeth, gum recession or tooth decay. Bonding material is porous, so smokers will find that their bonding will yellow. If you think you are a candidate for bonding, discuss it with your dentist.

Teeth contouring and reshaping

Tooth reshaping, or tooth sculpting, is a safe and conservative way to improve your smile. Teeth may become weaker if large amounts of enamel are removed, tooth reshaping should be limited to minor changes or combined with veneers or bonding for the best smile.

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.

Contouring teeth may also help correct small problems with bite. It is common for bonding to be combined with tooth reshaping to achieve a beautiful smile. There are actually several ways to change the appearance of your teeth. Many times these various procedures are combined in different ways to deliver that smile of your dreams.

Dental bridges

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 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.

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.

Teeth straightening

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.

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.

Terms and definitions 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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