Aesthetic Dentistry

One of the primary aims of dental treatment is to mimic teeth and design smiles in the most natural and appealing way possible, based on the patient's particular and special demands. Possibilities for achieving that aim have greatly increased over the previous decade as a result of new and particular treatment modalities, continually improving and more aesthetically pleasing dental materials, and revolutionary procedures and technology.

Among the most noteworthy development over the past decade are the establishment of universal aesthetic rules and guidelines based on the assessment of natural aesthetic parameters, anatomy, and physiognomy; the development of tooth whitening and advanced restorative as well as prosthetic materials and techniques, supported by the pioneering discovery of dental adhesion; the significant progress in orthodontics and periodontal as well as oral and maxillofacial surgery; and, most recently, the implementation of digital technologies in the 3-dimensional planning and realization of truly natural, individual, and aesthetic smiles.

Artificial intelligence and machine learning will most likely lead to the automation of aesthetic evaluation, smile design, and treatment-planning procedures in the future.

Common Aesthetic Dentistry Procedures

Whitening

The most frequent cosmetic dentistry procedure is whitening, sometimes known as "tooth bleaching." Whitening is a safe and successful procedure for the majority of patients. There are several whitening solutions available, including over-the-counter items like as Crest Whitestrips and dentist-supervised techniques such as in-office treatments or at-home treatments using trays with peroxide gel.

Laser whitening is a teeth whitening treatment that involves covering the gums with a rubber dam and applying a bleaching solution to the teeth. The teeth are subsequently exposed to an argon laser beam, which is meant to speed up the whitening process. This laser activates the bleaching chemical, lightening the color of the teeth. When compared to other tooth whitening techniques, laser whitening is believed to be six times more effective.

Reshaping by dental braces

Tooth reshaping involves the removal of portions of the enamel in order to improve the look of the tooth. It can be used to remedy a minor chip, change the length, shape, or location of teeth, and correct tooth size discrepancies; it can also be used to treat crooked or abnormally long teeth. The enamel that has been removed is irreplaceable and may occasionally show dentin. Enameloplasty, odontoplasty, contouring, recontouring, cosmetic contouring, slenderizing, and stripping are some other terms for it.

Dental braces (also known as braces, orthodontic cases) are orthodontic devices that align and straighten teeth and assist place them in relation to a person's bite, with the goal of improving dental health. They are frequently used to repair underbites, as well as malocclusions, overbites, open bites, gaps, deep bites, cross bites, crooked teeth, and other dental and jaw abnormalities. Braces can be aesthetic or structural in nature.

Dental braces are frequently used in combination with other orthodontic appliances to help broaden the palate or jaws and shape the teeth and jaws.

Traditional metal wiring braces are made of stainless steel and are occasionally combined with titanium. The most frequent form of braces are traditional metal braces. These braces contain a metal bracket with elastic (rubber band) ties that hold the wire in place. Self-ligating braces, which do not require elastic ties, are the second most prevalent form of braces. Rather, the wire is routed via the bracket. Treatment time is often decreased with this form of braces, there is less discomfort on the teeth, and less adjustments are necessary than with traditional braces.

Gold-plated stainless steel braces are frequently used for individuals who are sensitive to nickel (a fundamental and significant component of stainless steel), but they may also be selected because some people prefer the look of gold over silver-colored braces.

Lingual braces are a cosmetic option in which custom-made braces are bonded to the back of the teeth, making them completely undetectable from the outside.

Titanium braces are similar to stainless steel braces, yet they are lighter and just as strong. People who are allergic to nickel in steel frequently opt for titanium braces, which are more costly than stainless steel braces.

Customized orthodontic treatment systems use cutting-edge technology such as 3-D imaging, treatment planning software, and a robot to bend the wire to the patient's specifications. Customized solutions like this one provide speedier treatment times and more efficient outcomes.

Clear removable aligners that are progressive in nature can be used to progressively shift teeth towards their ultimate placements. Aligners are not often employed in complicated orthodontic patients, such as those requiring extractions, jaw surgery, or palate extension.

Teeth bonding

Adhesive dentistry is a field of dentistry that deals with the adhesion or bonding of dental materials to the natural substance of teeth, enamel, and dentin. It investigates the nature and strength of adhesion to dental hard tissues, the characteristics of adhesive materials, the causes and processes of bond failure, clinical bonding procedures, and emerging bonding applications like as bonding to soft tissue.

Direct composite bonding, which employs tooth-colored direct dental composites to treat different tooth defects such as cracks or gaps, is also available.

Dental bonding is a dental technique in which a dentist applies a tooth-colored resin substance (a durable plastic material) to the tooth and cures it using a visible, blue light. This "bonds" the substance to the tooth and enhances the overall look of the teeth. Tooth bonding procedures are used in a variety of therapeutic settings, including operative and preventative dentistry, aesthetic and pediatric dentistry, prosthodontics, and orthodontics.

Teeth bridging

Dental bridges are used to replace a lost tooth or teeth. Teeth are prepared on both sides of the gap created by the lost teeth. A bridge is composed of abutments, prepped teeth, and pontics, which are missing, false teeth.

This technique, which is cemented in, is used to replace one or more missing teeth. Bridges can be made up of more than three teeth, and the feasibility of any bridge is typically established by following Ante's Law and assessing where the teeth are in the mouth.

The majority of bridges are permanent and cannot be removed. Fixed bridges are not removable in the same way that partial dentures can. A cantilever bridge may be utilized in parts of the mouth that are less stressed, such as the front teeth. Maryland bridges or cantilever bridges are used to replace lost anterior or front teeth. They are minimally invasive but have a high failure rate. Bridges need a considerable commitment to dental hygiene and are risky. Bridges have an average life of approximately 10 years, similar to crowns.

Veneers

Veneers are custom-made, ultra-thin porcelain laminates that are attached directly to the teeth. They can be used to close gaps, improve the shape, or modify the color of teeth that do not react well to whitening therapies. In the vast majority of situations, some degree of tooth reduction is required for excellent outcomes. To achieve a pleasing smile, dentists create diagnostic mock-ups, which serve as a tooth preparation guide prior to the fabrication of veneers.

This allows the dentist to visualize the changes that need to be made to the patient's teeth in terms of size, shape, and proportion, as well as their relationship with gingival contour, lip contour, and smile line. Mock ups may be a huge help in creating preevaluation temporaries, which can provide a preliminary evaluation of the esthetics, phonetics, and teeth occlusion. It also allows physicians to determine if any modifications are required.

A veneer is made from two sorts of materials: composite and dental porcelain. A composite veneer can be directly inserted or indirectly created in a dental lab by a dental technician and afterwards glued to the tooth, often with a resin cement. They are often used to treat teenage patients who will require a more permanent design once they reach adulthood. A composite veneer has a lifetime of around 4 years.

A porcelain veneer, on the other hand, may only be made indirectly. A complete veneer crown is defined as "a restoration that covers all coronal tooth surfaces. In contrast, a laminate veneer is a thin coating that covers only the surface of the tooth and is typically used for cosmetic purposes. These often have improved performance and aesthetics, as well as being less plaque retentive.

Contraindications for veneer

Veneers are not suitable for everyone. Dentists warn that using veneers for 'instant orthodontics' or simulated teeth straightening might be dangerous, especially for younger persons with good teeth. Leading dentists warn that small surface damage or regular tooth wear does not justify porcelain or ceramic veneers.

This is because, if performed by an untrained dentist, the preparation required to place a veneer may ruin 3–30% of the tooth's surface. After ten years, it has been discovered that half of the veneers are either misplaced, require re-treatment, or are no longer in excellent condition.

Some aesthetic dentists may over-promote prosthodontic therapy in teenagers or young to middle-aged people who have generally healthy teeth that simply require whitening or more frequent cleaning. Because veneer preparation may need cutting down the tooth in some situations, sensitivity and decay will be an issue even if the treatment is carried out correctly.

Furthermore, the cost of maintaining a veneer might be prohibitively expensive for many people. Individuals with substantial cosmetic concerns, such as significantly cracked or fractured teeth, who do not fulfill the standards for a crown or full replacement, should be considered for veneer installation.

Poor dental hygiene, uncontrolled gingival disease, a high caries rate, parafunction, no enamel, excessive patient expectations, and massive existing restorations are all contraindications.

Dental implants

Dental implant surgery is a treatment that replaces tooth roots with metal screw-like posts and replaces damaged or missing teeth with artificial teeth that appear and function similarly to natural teeth. Dental implant surgery can be a welcome alternative to ill-fitting dentures or bridgework, as well as an option when a lack of natural tooth roots prevents the construction of denture or bridgework tooth replacements.

The type of implant used and the health of your jawbone determine how dental implant surgery is conducted. Several treatments may be required during dental implant surgery. The main advantage of implants is that they provide firm support for your new teeth, a procedure that needs the bone to mend securely around the implant. Because bone regeneration takes time, the procedure might take months.

Risks of dental implant:

Dental implant surgery, like any other operation, carries some health concerns. However, problems are uncommon, and when they do arise, they are usually minor and readily remedied. Among the risks are:

Infection at the location of the implant.
Injuries or damage to nearby structures, such as other teeth or blood vessels.
Nerve damage can result in discomfort, numbness, or tingling in your natural teeth, gums, lips, or chin.
Sinus problems, when dental implants placed in the upper jaw protrude into one of the sinus cavities.

When bone graft is required?

If the jawbone isn't thick enough or is too soft, the patients may need bone grafting before they can have dental implant surgery. That's because the powerful chewing action of mouth exerts great pressure on your bone, and if it can't support the implant, the surgery likely would fail. A bone graft can create a more solid base for the implant.

There are several bone graft materials that can be used to rebuild a jawbone. Options may include a natural bone graft, such as from another location in your body, or a synthetic bone graft, such as bone-substitute material that can provide support structures for new bone growth.

It may take several months for the transplanted bone to grow enough new bone to support a dental implant. In some cases, the patient may need only minor bone grafting, which can be done at the same time as the implant surgery.

Gum lift

A gum lift (also known as gingivectomy) is a cosmetic dentistry surgery that elevates and shapes the gum line. This surgery includes modifying the tissue and/or underlying bones to provide the illusion of larger or more symmetrical teeth, making the smile more aesthetically attractive. This operation is often used to eliminate overly gummy smiles or to balance out an asymmetrical gum line. The treatment, also known as crown lengthening, has historically been used to treat gum disease.

Only in the last three to five years have dentists begun to employ this technique for cosmetic objectives. Cosmetic gum lifts were initially performed in the late 1980s, but there were few oral surgeons and dental practitioners accessible to perform the procedures. Gum lifts may also comprise bone contouring to minimize the prominence of the upper jaw and balance the tooth-to-gum ratio. This procedure produces lasting effects, whereas basic gum contouring may result in gingiva recurrence or regrowth.

What causes a gummy smile?

The size and form of your teeth, your facial muscles, your gum tissue, and the shape and size of your lips all influence our smile line–the teeth that show when we smile. The same variables can contribute to a gummy smile. Gummy smiles are caused by:

Abnormal tooth eruption: The teeth are normal length, but because of their abnormal eruption they appear shorter.
Altered active eruption: The teeth erupt correctly, but are covered with too much bone and gum tissue.
Altered passive eruption: The teeth and bone are within normal parameters, but the teeth are covered with excessive gum tissue.
Upper jaw protrusion: During development of the jaw, the bone protrudes into the gum tissue, creating a gummy smile.
Hyperactive upper lip: The upper lip is higher than normal revealing too much gum.
Hypermobile upper lip: When smiling, the facial muscles pull the top lip up too high, revealing too much gum.
Short upper lip: The upper lip is too short, revealing too much gum.
Vertical maxillary access: The vertical dimension of the upper jaw is longer than it should be.
Super-eruption of the top front teeth: When the lower jaw is smaller than the upper jaw, the top teeth drift lower, pulling the gum tissue with them.

Advantages of gum lifting:

Improves aesthetics of anterior teeth.
Requires minimal removal of soft tissue.
Does not compromise the periodontal structures.
Can lengthen clinical crown height (which is important in tooth wear cases).
Reduces the amount of maxillary gingiva on display.
Can allow for both sub- and supra- gingival restorations.
Allows for additional tooth structure to withstand the mechanical needs during restorative procedures.

Disadvantages of gum lifting:

The morphological characteristics of the dentition and gingiva influence a patient’s smile greatly. This should be used in order to predict how a patient’s smile should be restored.
A bony defect which cannot be corrected. If it can be corrected, this surgery must be carried out prior to the gum lift.
If the gingiva is fragile.
If the location of the base of the pocket is apical to the mucogingival junction. This would cause problems with healing.
If the patient is not affected by the aesthetics.
Depending on the shape of the anterior teeth, “black triangles” may develop in the area where there is labial or interproximal soft tissue recession following the gum lift. This leads to an undesired outcome.
A gum lift is not available on the NHS and so would need to be obtained privately, where the charge is variable.

Straightening

Metal braces are typically used to correct overcrowding or mismatched teeth. While the primary goal is to remedy concerns such as jaw alignment, they can also enhance appearances.

As an alternative to traditional metal braces, clear aligners are employed. Clear aligners give outcomes equivalent to metal braces and are chosen by some patients since they are less visible to others than traditional braces.

Bite reclamation

Bite reclamation is for patients who have had years of significant wear to their teeth as a result of grinding or acid reflux, which can change their vertical dimension. This gives them a closed or shorter smile and a closed or shorter aspect to their face. A competent professional can regain their vertical dimension by opening up their bite.

How Much Does Cosmetic Dentistry Cost?

While prices will fluctuate on a case-by-case basis, each procedure typically falls within a certain range of cost. These are the average costs you can expect from some of the most popular cosmetic dentistry treatments:

Invisalign: $3,000 – $8,000
Teeth Whitening: $189 – $1,200
Dental Implants: $1,900 – $7,500
Porcelain Veneers: $1,800 – $2,200
Crowns: $500 – $1,500

Conclusion

Some individuals wrongly assume that the primary goal of aesthetic dentistry is to get a beautiful smile. However, while increasing the appearance and brilliance of your smile is important, it is not the final aim. Instead, this approach of care focuses on the natural health and function of your mouth.

A purely cosmetic technique may result in a celebrity-status, Chiclet-white smile that is symmetrical and visually pleasing (if not a little fake looking). The smile is right, but it does not appear natural or real.

An aesthetic approach, on the other hand, aims to achieve more than simply a lovely smile. It combines a variety of scientific approaches and creative abilities to guarantee you create a smile that complements and suits your natural characteristics and personality, therefore assisting you in achieving oral wellness.

Aesthetic dentistry may be as basic as replacing an old discolored and broken filling with a more natural-looking filling that blends in with your natural tooth. More complex operations, such as replacing a rotting or broken tooth with a dental implant and a natural-looking crown, may also be included.

This method does more than simply improve the appearance of your smile. In reality, a cosmetic restoration is typically founded in the correction of a significant tooth disease that may be causing you dental and entire health problems. Many cosmetic options, such as veneers, dental crowns, dental implants, aesthetic bonding, teeth whitening, gum lift, and dental bridging, are now accessible.

Finally, every procedure is designed to make you feel more comfortable. The physician will provide a pleasant setting as well as sedative choices to make you feel comfortable and at peace.