These are just a few examples of what is important to not overlook. We encourage you to visit our office for a consult to see what sets us apart. We believe you’ll find us to be the right office for your cosmetic needs. We also encourage you to view our portfolio of before and after cases and to speak to our clients who have already had cosmetic dentistry done in our office.

I’m worried you’re going to cut my teeth to prepare for veneers.
Porcelain veneering is unlike preparing teeth for crowns. Only a thin layer of enamel, anywhere from .5-.8 mm is removed to make room for veneers. This small reduction of teeth allows us to create a smile that is natural and not too bulky and sticking out. You probably have seen people who have had bulky veneers placed and it looks like Chicklets. The genius of a beautiful smile design is that no one can tell what was done but they know your faces looks better. Many of our clients have told us their friends have noticed a change but are unable to determine what the change comes from. Their friends ask them “what did you have done, you look great?!”

I don’t want braces; can I still have a beautiful smile?
We get this question asked a lot. More than likely, yes. There are times where we had no choice but to resort to both options. If teeth are so misaligned we must first move them gently into position before veneering them. Only with careful analysis of tooth proportions and jaw dimensions are we able to determine that for certain. We have been able to help so many people who had absolutely refused braces without compromising the end result. Braces is not for everyone either. For various reasons sometimes braces would not even be the right choice to make a smile beautiful.

How many teeth need to be veneered for smile design?
A lot depends on how broad the arch is when smiling or how broad we would like the arch to appear to make a dramatic result. In this makeover design, at least 8-10 veneers need to be placed. Often times veneers are placed to correct a problem on one or two teeth and the rest of the teeth in the arch are absolutely perfect and all we need to do is match the new veneers to the existing smile. This is actually one of the most difficult tasks which require a high level of understanding of science and art to blend the two dissimilar situations seamlessly.

How will my teeth feel after I have porcelain veneers placed?
Normally, there is some sensitivity to be expects, hot and cold and biting pressure. This will be a short period of time when the teeth are adjusting to the new environment and it’s absolutely normal to feel that. After veneers are placed we have you come back in one week to make a few minor adjustments and finalize the polishing.

How do I take care of my veneers?
Porcelain veneers, when properly contoured feel so natural and smooth that most clients say that their teeth feel so much smoother. There is a good reason for that. Porcelain does not scratch very easily and the good part is that plaque does not adhere well to porcelain like it does to natural teeth, so the gums look and feel really great. As far as diet restriction, there are none. A normal diet poses no problem on veneers. It is important to avoid crushing ice between teeth or chewing hard candy as it would be with natural teeth. The gentler the chewing forces, the longer the veneers can last. As far as home care, we recommend Oxyfresh products to rinse and brush with. Oxyfresh is non-abrasive and effectively polishes the laminates, maintaining their luster and brilliance. We also recommend night guards after veneers are placed, especially if the bite forces are high or there is grinding of teeth at night.

What is the difference between bonding and a veneer?
Bonding is tooth colored plastic material that is placed over missing parts of teeth or when trying to close gaps on front teeth. A porcelain veneer is a strong porcelain lab fabricated restoration. Bonding is also an ideal filling material for back teeth for small cavities or replacing small metal fillings. One of the problems with bonding is that it can change color and requires more frequent replacement. Because bonding is a plastic material it is easier to break and chip. The advantage of bonding is that it can be done in one visit and is less costly than placing porcelain veneers. Veneers on the other hand never change color so it can permanently stay the same. They are extremely strong and durable. They become seamlessly integrated with the tooth. Porcelain veneers repel plaque better than natural teeth so the gums look extremely healthy. The whole make-up of the smile can be completely changed to enhance and complement the unique facial characteristics.

What can be done to fix rotated, misshapen or chipped teeth?
The long term restoration of choice is porcelain veneers. A less expensive but less dramatic option in certain cases may be bonding. Done properly, both veneers and bonding can be applied; color matched and shaped to make your teeth appear natural again. The shape of the face affects the shape of the teeth. For example, if a patient has a round face, we create long square-shaped teeth that give the illusion of a longer face, thus a slimming effect. Porcelain veneers are ideal for changing the shape of teeth, and you can lighten the color at the same time. If you have existing dental work or very misaligned teeth you can still change the shape of your teeth but you may need orthodontics, a reshaping of your gum line or crowns to achieve the desired results.

Is it possible to change the shape of my teeth without veneers or crowns?
Reshaping or cosmetic contouring is an ideal treatment for very small fractures or chips or to simply reshape what nature has given you to a more esthetically pleasing smile. Anesthesia is not necessary since we use sandpaper discs and polishing wheels to reshape teeth with a minimal loss of tooth structure. Contouring can change the smile line. If one front tooth is a little longer than the other, contouring can make them the same size. We can round off sharp corners of teeth or pointed canines, to soften their appearance. Smile symmetry can also be achieved with cosmetic contouring.

 

My teeth look short, they used to be longer when I was younger?
When teeth look short, it is often the gumline that is the problem. Gum quantity, shape and color greatly influence the cosmetics of your smile. Since your lips frame your smile they too play an important role in your smile's appearance. If they come up too much, it may give you a gummy smile making your teeth appear too short. We use something called the golden proportion to measure the ideal, more esthetic length your teeth should be. The solution is to reshape the gums to reveal more of your teeth. If the gumline is not the problem, porcelain veneers can add length to short worn teeth, making them look younger and stronger. The golden proportion is used to measure the ideal length your teeth should be made.

What really happens when we age?
Most people don't realize that teeth are so important to maintain a youthful look. The intricate and complex relationship (interplay) between teeth, bone and muscle tone is rarely discussed. Healthy long teeth have strong bone surrounding them and strong muscle tone and always maintain a youthful look at any age. Many people have had facelifts and other corrective facial surgery to help them look younger. But if the smile with a rejuvenated face reveals discolored, crooked, chipped or fractured teeth, the youthfulness created by the plastic surgeon will be lost. A well-maintained smile is a necessary part of a better, younger lo

As we age:

	Teeth get short.
	Teeth get crooked, especially on the bottom.
	Teeth get very dark and stained.
	Gums recede and, we start seeing spaces forming in between teeth.
	The amount of bone around teeth thins out.

With these changes to teeth we see important changes in muscle tone:

	The muscles around lips begin to sag, giving a sunken-in appearance.
	The skin around the lips begins to wrinkle since the support mechanism is lost.
	The lip tissue flattens out and may curl over shortened teeth.

What can be done:

	Wrinkles can be reduced if lips are plumped out with collagen, a procedure that must be repeated throughout your lifetime every few months if you wish to maintain a certain look.
	Wrinkles around the lips can also be reduced when the upper portion of a normally paper thin veneer is thickened. We build out the veneer and, as a result the facial area above the veneer is pushed out, thereby smoothing upper lip wrinkles while causing lips to appear more full and pouty and give a Kim Basinger pouty look.
	Longer veneers can be placed to lengthen teeth and give that youthful Halle Berry look and actually push out the lower lip, reducing the appearance of wrinkles.
	Teeth can be instantaneously straightened with paper thin veneers that will create symmetry to crowded and crooked teeth.
	Teeth can be permanently whitened to any shade you desire with shaded veneers that will never stain or darken with age.
	If you smile and all you see are your six front teeth, none of the back teeth, then your upper jaw is so narrow that back teeth are hidden. This of course can be corrected with invasive jaw expanding surgery or you can place veneers that widen the width of back teeth giving the appearance of an expanded jaw instantaneously and conservatively. This will improve the support and muscle tone of your cheeks and give you that Julia Roberts' smile.

All of this can be accomplished in 2 painless visits.

 

I don't like my crooked teeth, what are my options?
Orthodontics for adults is very common today. Approximately 30% of our adult patients are currently receiving orthodontic treatment. You can move teeth to align them with traditional metal braces, or ceramic braces or with the invisible Invisalign system. Removable orthodontics is also available for certain cases.

Another option for giving the appearance of straight aligned teeth is to use porcelain veneers or laminates. The veneers will fill in spaces, giving an impression of perfectly aligned teeth. We refer to this as instant orthodontics. Whereas traditional orthodontics may take 1-2 years to complete, instant orthodontics can take as little as 1-2 visits.

What is instant orthodontics? Is there pain involved?
With modern dental technology, uneven teeth can be reshaped and laminated with high tech ceramics. We call this instant orthodontics, using veneers or laminates instead of braces to make teeth look straight. It can close large gaps and correct overcrowding in as little as 1-2 days. It is typically a pain free procedure requiring only the use of local anesthetics. You are a candidate for this if you would like your teeth to look straighter and cannot commit to the time for conventional orthodontics. The extent to which this approach can be used depends on how crowded and crooked the teeth are to begin with. Sometimes a combination of limited traditional orthodontics and ceramic enhancement may be the best choice.

What are porcelain inlays/onlays? Do they replace a crown or cap?
Porcelain inlays and onlays are custom lab fabricated restorations that are placed in teeth that are too broken down for a filling to be placed. They are extremely esthetic and natural looking and help hold a badly broken down tooth together, actually strengthening it. In some cases they can be used instead of a crown or cap as a more conservative approach to restore a broken down tooth.

 

Can anything be done to correct a gummy smile or uneven gumline?
Gum quantity, shape, symmetry and color greatly influence the cosmetics of your smile. Since our lips frame the smile they too play an important role in your smile's appearance. The lips and gums should be in harmony. If your lip comes up too much it may give you a gummy smile. The solution is to reshape the gums to reveal more of your teeth. Artistic sculpting of gum tissue can make a dramatic improvement in one's smile. The healing time is very rapid and predictable.

 

What if I have missing teeth?
There is no reason to live with missing teeth. A full set of teeth improves self-esteem, speech, digestion, and sense of taste. It makes all the other teeth last longer by reducing the stress on the remaining natural teeth. Those patients who suffer from temperomandibular disorders (TMD) often are unable to become pain free without a full set of teeth to balance musculoskeltal and dental forces.

What is better, a bridge or an implant?
They each have advantages and disadvantages. We are not advocates of one treatment over another. Since any cosmetic situation that involves a missing tooth presents its own challenges and circumstances, careful and well thought out plans will give the best outcome. The advantage of an implant is that it will permanently replace a tooth since it’s anchored in the bone with a crown placed on top of it. A disadvantage of implants is that it can take at least 6-8 months to complete. Bridges are not anchored into the bone like implants are, but they are anchored to adjacent teeth. This will require preparation of teeth for crowns. If you have teeth that do not have any fillings in them or they are minimally restored you might not want to put crowns on them for a bridge. In this case it would be better to do an implant. But, the advantage of having a bridge as opposed to an implant is that it is fairly quick and can be completed in a few short weeks. Bridges can be done with an all porcelain system so that they can look beautiful. If the adjacent teeth are getting weak from poor bone support or excessively large fillings, having a bridge in place will give the teeth more support. With the all porcelain systems, teeth can be prepared for bridges more conservatively than before. Another disadvantage of having a bridge is that the teeth that are anchoring the bridge can no longer be flossed. An implant supported crown is a separate unit and is flossed like your own teeth.

 

What is the difference between porcelain fillings and composite fillings?
Porcelain fillings also known as inlays and onlays, are laboratory processed and therefore require two visits to complete. They are extremely strong and durable and they seamlessly blend with the tooth. Composite fillings on the other hand are placed directly over a tooth and won’t require a 2nd visit. They are the perfect filling material in a replacement of a small metal filling or small cavities. They are also less costly than porcelain inlays and onlays. However, since they are plastic mixture filled with small glass particles they cannot withstand heavy biting forces or in replacement of large metal fillings. They can chip or fracture in these situations. If this is the case the best filling material would be porcelain inlays and onlays since they have improved fracture toughness and are more capable of withstanding daily chewing forces.

What are a cap and a crown and what is the difference?
A cap or crown are they same thing. They refer to complete coverage of the tooth. They are generally necessary when teeth have gotten weak from previous large fillings to protect them from fracturing or teeth that have fractured and now they need support. Crowns are also placed on top of implants or on teeth that have had root canal treatment. Crowns are placed to make a bridge.

I have a crown that has a black line around it and it looks awful. Why is that?
This is caused by the underlying metal lining of the crown which makes the tooth look artificial and fake. Contemporary cosmetic dentistry affords us to completely avoid this unsightly problem. When it is absolutely unavoidable to use crowns we prefer to use all porcelain crowns. The strength of this crown is similar to the metal lined porcelain crowns and some even suppress that. All porcelain crowns allow light to pass through just like the enamel on teeth does. When the porcelain is artistically layered to fabricate a crown it will look natural and no one can tell a cap was placed over the tooth. When the tooth is prepared properly and the correct ceramic is used for the all porcelain crown, teeth will not only look real, they can actually look better than the original shape and color.

Whitening Questions

 

How can I make my teeth whiter?
We find that many of our patients are displeased with the color of their teeth. While enamel is the strongest substance in our body, it is porous and can stain. Culprits include coffee, tea, cranberry juice, red wine, soda, berries, soy sauce and smoking. Trauma to the teeth, tetracycline, nerve degeneration or simple aging can change the color of teeth.

Whitening toothpastes are effective surface stain removers but they won't brighten your teeth. Some contain titanium dioxide, a white pigment in paint, giving a temporary appearance of lightening. They also consist of abrasives and may wear down enamel and expose yellow dentin, the vital tooth structure that lies beneath the enamel. With long-term usage, this may actually then give the appearance of yellowing teeth.
Bleaching whitens teeth by placing a bleaching solution on the enamel to remove deep stains. If you have natural teeth and are pleased with their shape and position, bleaching may be your best option. The results are not permanent and depending on your diet and lifestyle habits may need touchups anywhere from 2-5 years. If you want to make a permanent change to the shape, position or color of your teeth, porcelain veneers can be ideal. If you have existing crowns that need to be whiter, you can upgrade to whiter, all-porcelain crowns. If you have bonding or tooth color fillings you may need to change them once you have completed bleaching.

How white should I make my teeth?
As we get older, our teeth pick up stain and become discolored. Many people are choosing shades that are whiter than in the past. Extremely white, opaque teeth on older individuals are a true sign they have undergone some type of cosmetic dentistry. In our office we strive to give you the look you want without looking “done”. You will attain a beautiful white esthetic outcome, but it will look real and complementary to your face.

How can I prevent discoloration?

	Have professional cleanings at the recommended time interval
	Drink beverages with high stain potential through a straw
	Avoid abrasive toothpastes, which can wear down enamel and expose yellow dentin below it
	Brush immediately after eating or drinking foods with a high stain potential
	If you aren't able to brush right away, rinse with lots of water or eat something crunchy like fruits or vegetables that will clean teeth naturally.

Which bleaching method is the most effective?
Our experience has proven that a combination of an in-office supercharged laser bleaching session along with take home bleaching trays to be most effective. We start with the in-office Zoom! or LaserSmile and power bleach for a quick change to the appearance and luster of the teeth, generally 6-9 -shades lighter. The longer the exposure of the teeth to the bleaching, the more dramatic the results. A true sign that someone has undergone some form of cosmetic dentistry is when you see very opaque white teeth. In our office we feel it is important to gain a sense of realism with every improvement and not artificiality.

Will bleaching hurt my teeth? Is it safe?
Studies have shown that bleaching gels cause no harm to teeth when used under direct dental supervision. Some people experience temporary minor sensitivity during the bleaching process but typically people do not experience any side effects. As with any cosmetic procedure, patients need to exercise judgment in how they go about whitening their teeth. Patients should avoid over the counter alternatives since these use trays that are ill-fitting and cannot be individually fitted, increasing the risk of burning gum tissue. They may also cause bite problems.