WHITENING

How can you brighten your smile

Your wedding is coming up and you want your smile to be it's brightest. Or maybe you have an important speaking engagement. Whatever the reason, tooth bleaching isn't just for the movie stars, and it isn't just for one day. Many people have had their teeth bleached, and probably millions more are thinking about it. The desire for a brighter smile with whiter teeth is very strong, and tooth bleaching safely lightens the colour of the teeth, lasting for up to five years. The most effective and safest method of tooth bleaching is dentist-supervised.

Is bleaching for you?
Generally, bleaching is successful in at least 90 percent of patients, though it may not be an option for everyone. Consider tooth bleaching if your teeth are darkened from age, coffee, tea or smoking. Teeth darkened with the colour yellow, brown or orange respond better to lightening. Other types of grey stains caused by fluorosis, smoking or tetracycline are lightened, but results are not as dramatic. If you have very sensitive teeth, periodontal disease, or teeth with worn enamel, your dentist may discourage you from bleaching.

What's involved?
First, the dentist will determine whether you are a candidate for tooth bleaching and what type of bleaching system would provide the best results. If you're in a hurry for whiter teeth, you may decide to have your teeth lightened immediately. Your dentist will use either an in-office bleaching system or laser bleaching while you sit in the dental chair. However, most patients choose dentist-supervised at-home bleaching, which is more economical and provides the same results. At the next appointment if you don't choose laser bleaching, the dentist or hygienist will make impressions of your teeth to fabricate a mouth guard appliance for you. The mouth guard is custom made for your mouth and is lightweight so that it can be worn comfortably while you are awake or asleep. The mouth guard is so thin that you should even be able to talk and work while wearing your mouth guard. Along with the mouth guard, you'll receive the bleaching materials. You'll be given instructions on how to wear the mouth guard. Some bleaching systems recommend bleaching your teeth from two to four hours a day. Generally this type of system requires three to six weeks to complete, and works best on patients with sensitive teeth. Other systems recommend bleaching at night while you sleep. This type of system usually requires only 10-14 days to complete.

VENEERS

What are porcelain veneers?

Porcelain veneers are ultra-thin shells of ceramic material, which are bonded to the front of teeth. This procedure requires little or no anesthesia, and can be the ideal choice for improving the appearance of the front teeth. Porcelain veneers are placed to mask discolourations, to brighten teeth, and to improve a smile. Highly resistant to permanent staining from coffee, tea, or even cigarette smoking, the wafer-thin porcelain veneers can achieve a tenacious bond to the tooth, resulting in an esthetically pleasing naturalness that is unsurpassed by other restorative options.

Why a porcelain veneer?
Porcelain veneers are an excellent alternative to crowns in many situations. They provide a much more conservative approach to changing a tooth's colour, size, or shape. Porcelain veneers can mask undesirable defects, such as teeth stained by tetracycline, by an injury, or as a result of a root-canal procedure, and are ideal for masking discoloured fillings in front teeth. Patients with gaps between their front teeth or teeth that are chipped or worn may consider porcelain veneers. Generally, veneers will last for many years, and the technique has shown remarkable longevity when properly performed.

What happens during the procedure?
Patients need three appointments for the entire procedure: diagnosis and treatment planning, preparation, and bonding.

1) Diagnosis and treatment planning: It's critical that you take an active role in the smile design. Spend time in the decision-making and planning of the smile. Understand the corrective limitations of the procedure. Have more than one consultation, if necessary, to feel comfortable that your dentist understands your objectives.

2) Preparation of teeth: This appointment will take from one to two hours. To prepare the teeth for the porcelain veneers, the teeth are lightly buffed to allow for the small added thickness of the veneer. Usually, about a half a millimetre of the tooth is removed, which may require a local anesthetic. At this appointment, a mold is taken of the teeth, which is sent to the laboratory for the fabrication of the veneers. This can take about one to two weeks. If the teeth are too unsightly a temporary veneer can be placed, at an additional cost.

3) Bonding of Veneers: This appointment will take about one or two hours. First, the dentist places the veneers with water or glycerine on the teeth to check their fit and get a sense of the shade or colour. While the veneers are resting on your teeth, view the esthetic results, and pay particular attention to the colour. At this point, the colour of the veneers can still be adjusted with the shade of the cement to be used. The colour cannot be altered after veneers are cemented. To apply the veneer, the tooth is cleansed with specific chemicals to achieve the bond. Once a special cement is sandwiched between the veneer and tooth, a visible light beam indicated the release of a catalyst to harden the cement.

How about maintenance?
For about a week or two, you will go through a period of adjustment as you get used to your "new" teeth that have been changed in size and shape. Brush and floss daily. After one or two weeks, you'll return for a follow-up appointment.

Have realistic expectations
Porcelain veneers are reasonable facsimiles of natural teeth, not perfect replacements. It's not uncommon to see slight variations in the colour of porcelain veneers upon close inspection, as this occurs even in natural teeth. Nevertheless, this procedure can greatly enhance your smile, and can heighten inner satisfaction and self-esteem.

PORCELAIN CROWNS

What are Crowns?

A crown is a restoration that covers, or "caps," a tooth to restore it to its normal shape and size, strengthening and improving the appearance of a tooth. Crowns are necessary when a tooth is generally broken down and fillings won't solve the problem. If a tooth is cracked, a crown holds the tooth together to seal the cracks so the damage doesn't get worse. Crowns are also used to support a large filling when there isn't enough of the tooth remaining, attach a bridge, protect weak teeth from fracturing, restore fractured teeth, or cover badly shaped or discoloured teeth.

How is a crown placed?
To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of teeth and gums is made and sent to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown is made. On the next visit, the dentist removes the temporary crown and cements the permanent crown onto the tooth.

Will it look natural?
Yes. The dentist's main goal is to create crowns that look like natural teeth. That is why dentists take and impression. To achieve a certain look, a number of factors are considered, such as the colour, bite, shape and length or your natural teeth. Any one of these factors alone can affect your appearance. If you have a certain cosmetic look in mind for your crown, discuss it with your dentist at your initial visit. When the procedure is complete, your teeth will not only be stronger, but they may be more attractive.

Why crowns and not veneers?
Crowns require more tooth structure removal; hence, they cover more of the tooth than veneers. Crowns are stationary and are customarily indicated for teeth that have sustained significant loss of structure, or to replace missing teeth. Crowns may be placed on natural teeth or dental implants.

What is the difference between a cap and a crown?
There is no difference between a cap and a crown.

How long do crowns last?
Crowns should last approximately 5-8 years. However, with good oral hygiene and supervision most crowns will last for a much longer period of time. Some damaging habits like grinding your teeth, chewing ice, or fingernail biting may cause this period of time to decrease significantly.

How should I take care of my crowns?
To prevent damaging or fracturing the crowns, avoid chewing hard foods, ice or other hard objects. You also want to avoid teeth grinding. Besides visiting your dentist and brushing twice a day, cleaning between your teeth is vital with crowns. Floss of interdental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown area where the gum meets the tooth. Plaque in that area can cause dental decay and gum disease.

CONTACT US FOR A CONSULTATION
Dr.A.J. Johnston Dentistry
Phone: 416-242-2518
E-mail: office@drjohnston.ca