For whitening of dark, dull or stained teeth, bleaching may be the simplest solution. Bleaching is performed by taking an impression of your teeth and making a model of them. From this model, a clear soft bleaching tray is made. Think of the tray as a "Jell-O mold" of your teeth. The tray is filled with bleaching gel and placed into the mouth directly over the teeth. This bleach filled tray may be worn during the day or while you sleep. Results can be seen daily. To obtain maximum results, most patients must wear the bleaching tray for about two weeks.

When teeth are chipped or slightly decayed, bonded plastic resins called composites may be the materials of choice. Bonding is hardened on the tooth using a light gun. First the tooth structure is cleaned and etched with a mild acid solution (exactly the same type and strength of acid for in sodas). Microscopically, the tooth surface resembles an English muffin with nooks and crannies. Then a clear adhesive liquid is painted onto the tooth and flows into the indentations. A putty-like tooth colored plastic filling material is applied to the tooth and shaped. It is permanently hardened and fused to the tooth with a handheld very bright blue light. This process is called photo curing. Bonding makes a great tooth colored filling for small cavities, chipped or broken surfaces, and for filling in small gaps. When the restoration reaches too large a size, the bonded material becomes too weak to withstand the forces placed upon it. If problems with bonding occur, the next choice for restorations would be porcelain laminate veneers or simply "veneers".

Example 1:

Before	After

Example 2:

Before	After

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Porcelain Laminate Veneers:

Many times the demands of cosmetic changes in the mouth are too great for simple bonding. This is when porcelain laminate veneers may be used. Porcelain veneers can dramatically change an entire smile. They can change the shape, color, size and arrangement of teeth or any combination of these factors. They can often be used as an alternative to orthodontic treatment. The technique consists of shaving a thin layer of outer tooth structure. An impression is then taken of the prepared teeth and is sent to a dental laboratory. In the lab, a ceramist will make very thin porcelain facings consisting of all the changes in shape, size, color and tooth arrangement that are needed to have a great looking smile. At the second visit, the laminates are bonded onto the prepared teeth with the blue light gun. The bonding material acts as an adhesive for the laminates. Porcelain laminates are the most popular technique used for dramatic smile makeovers.

Example 1:

Example 2:

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Porcelain Jackets (All Porcelain Crowns):

When there is not enough tooth structure left, or the chewing demands in the mouth are too great for laminates, a stronger, more extensive restoration is needed. Here we place porcelain jacket crowns. Porcelain Jackets are pure porcelain crowns placed on a fully prepared tooth. They are the most life-like of all full crown preparations. The technique consists of preparing the teeth and taking an impression. Temporary crowns are made while the permanent restorations are being fabricated in a dental lab. Within two weeks, the porcelain jackets are permanently bonded onto the patient’s teeth.

When biting pressure is too great for porcelain jackets or when gaps from missing teeth must be filled in, metal alloy must be placed under the porcelain for strength. This is the porcelain fused to metal crown technique. Again, the teeth are prepared for a full coverage restoration. After the impression is taken, a metal coping is made for the prepared tooth. This is then covered with porcelain. Porcelain fused to metal crowns do not have the translucency of pure porcelain crowns. Therefore, the esthetics may be slightly compromised in some situations. However, a talented ceramist with experience in custom staining can usually overcome the limitations, thereby creating lifelike restorations. When teeth are loose due to periodontal bone loss, this technique is used. Here the teeth are splinted together by joining the metal substructure of the crowns. The crowns are tied together like a small fence in the mouth.

When individual back teeth are broken down, but some good healthy tooth structure remains, gold onlays or crowns are used. These are the strongest and longest lasting of all the posterior restorations. These restorations are used when esthetic concerns are outweighed by the need for strength and longevity. Once the tooth is properly prepared, the technique is similar to the porcelain fused to metal crown technique. The benefit of this restoration is the advantage of the gold, which supports the tooth during heavy biting loads, thereby protecting the tooth and nerve.

NOTICE: ANY BEFORE OR AFTER PICTURES OR PHOTOGRAPHS ARE MERELY EDUCATIONAL AND ILLUSTRATIVE IN NATURE AND NOT MEANT TO PROMISE A PARTICULAR RESULT. 

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