Cosmetic Dentist Lee’s Summit, MO
Here at dental expressions we offer a multitude of cosmetic services for you and your family. Some of these procedures include tooth whitening, metal-free fillings, porcelain crowns, porcelain inlays / onlays, and bonding.
There are many options available for tooth whitening depending on the health of your teeth and the degree of patient motivation. Patients may choose to whiten both the upper and lower arches as well as just individual teeth that appear in the smile zone. Whitening can be used to correct many tooth discolorations which may have been caused by staining, chemical damage to the teeth, or simply by aging. Certain teeth may not lighten if there is extreme discoloration. They may require veneers or porcelain crowns. The main advantage to whitening is that it corrects brown, yellow, and mottled tooth staining. It is a long lasting solution for restoring brightness to a smile, and it does work on people of all ages.
Take home whitening is a method by which custom trays are fabricated specifically for the patient based on impressions in the mouth. This is a very quick appointment at the dentist where impressions are taken. Within a few days, trays are ready for pick up along with the whitening material to take home. The whitening material is then applied to the tray at home and applied over a short period of time. Amount of time may vary but generally is 3-4 hours every night for a week. These trays are clear and can be applied even during daytime. With time, the whitening material takes the stain out of the enamel without altering tooth structure or any dental work. Once a brilliant shade has been reached, photos are then taken to compare before and after results.
In office whitening is a nice alternative for patients that do not want to wear whitening trays at home. This procedure takes a little over an hour in office. A special light accelerates the whitening process. The results are excellent!
Many of the products over the counter can be harmful if not applied properly or may not be approved by the ADA. They may be used with caution.
Inlay / Onlay
When more than half of the tooth’s biting surface is damaged, Dr. Bhoot will often use an inlay or onlay. This is recommended in teeth where the size of the filling is too large to place a regular tooth colored filling, but smaller than that which would necessitate a crown. Traditional fillings can decrease the strength of a natural tooth by up to 50%.
As an alternative, inlays and onlays, which are bonded directly onto the tooth can actually increase the strength of a tooth by up to 75 percent. As a result, they can last from 10 to 30 years.
What are inlays and onlays made of?
Inlays and onlays can be made of porcelain, gold, or composite resin. These pieces are bonded to the damaged area of the tooth. An inlay, which is similar to a filling, is used inside the cusp tips of the tooth. An onlay is a more substantial reconstruction, similar to the inlay but extending out over one or more of the cusps of the tooth.
In our office, inlays/onlays are milled in one visit through our virtual CAD/CAM technology called CEREC. It is a porcelain milled piece which has shown to provide significant strength due to new bonding technologies and a high level of aesthetics.
Metal Free Dentistry
If you had cavities as a child or a young adult more than likely the material used was amalgam which appears silver in color and contains a mixture of alloys. Amalgams contain 50% mercury which over time can corrode, leak, and cause stains to the existing teeth. The crowns that were made were metal-lined. Although they were the best materials back then, advances in technology have proven to increase the strength, function, and appearance of these restorations.
Why are my old metal fillings defective?
It has been discovered that the mercury fillings in your mouth function similarly to metal outside the mouth. When exposed to cold and hot temperatures, such as cold ice cream or hot coffee, the silver fillings in your mouth expand and contract. As they move, they eventually weaken the teeth and may cause the tooth to crack. This shifting also creates space between the filling and the tooth allowing bacteria to get in under the filling, causing decay underneath.
What material will you use to fill my cavity?
If your cavity is small and caught early, chances are Dr. Bhoot will use a tooth-colored composite resin to restore the tooth. This composite is stronger and lasts longer than silver-mercury fillings and is far more attractive. Also this resin contains fluoride which can prevent decay. In effect, the tooth remains intact and stronger.
If the cavity is large or if Dr. Bhoot is replacing older fillings, she will use an inlay or onlay to restore the health and function of the tooth.
The overall result is excellent.
This procedure is commonly performed to mend chips, cracks, discolorations, or misarranged teeth. It also is an alternative to veneers. This is a beautiful restoration that can be completed in a single office visit and can improve the overall look of a tooth tremendously. It is a tooth colored plastic resin similar to the tooth colored filling material placed in teeth. It can be smoothed and polished to the desired shape that is needed. The longevity of this restoration is 3-5 years. These restorations can stain, wear, and chip as its strength is not the same as natural enamel. It is a very convenient procedure in that it can be completed in a single office visit, and the results can be seen instantly. These restorations can be repaired and repeated over time as needed.
A bridge attaches artificial teeth to adjacent natural teeth, called abutment teeth. Bridges are either permanently attached (fixed partial denture), or they can be removable (removable partial denture).
Fixed bridges are applied by either placing crowns on the abutment teeth or by bonding the artificial teeth directly to the abutment teeth. Removable bridges are attached to the teeth with metal clasps or by precision attachments.
A bridge is recommended when there is a missing tooth and on either side of the missing tooth there exists natural teeth. The natural teeth on either side serve as anchors (abutments) which attach the missing tooth in the center. A traditional bridge is a 3 unit piece and there are a total of 3 crowns. However, there are many instances where there is more than one tooth missing in between the natural teeth. In that case, a bridge can still be fabricated. Fixed bridges are bonded into place and can only be removed by a dental professional. Removable bridges (partials) can be taken out and cleaned. Fixed bridges offer more stability than their removable counterparts.
There are many reasons why patients choose a bridge. A bridge helps support the lips and cheeks. The loss of a back tooth may cause your mouth to sink and your face to look older. However, the most important reason for a bride is to replace the missing tooth or teeth so that unusual stresses are not placed on the other teeth which can cause a number of harmful disorders. An increased risk of gum disease has shown to be a major side effect of missing teeth.
What Is Involved With The Bridge Procedure?
If takes two or three appointments to complete. At the first appointment Dr. Bhoot will prepare the teeth on either side of the missing tooth by reducing a portion of the enamel and dentin.
Since the bridge must be prepared very accurately to ensure correct bite and to match the opposing tooth, impressions of the teeth are taken and sent to a lab where the bridge will be constructed.
The bridge is permanently cemented to the abutment teeth. The tooth in the center (missing tooth) is called a pontic. The pontic is the replacement tooth.
What Types Of Bridges Can Be Fabricated?
There are many different materials used to construct a bridge. They are usually made from gold alloys, semiprecious alloys, and or porcelain.
What Type Of Maintenance Needs To Be Done For A Bridge?
A strong oral hygiene program needs to be in effect to up keep the health and function of a bridge. Home care involves brushing and flossing thoroughly to keep the surrounding teeth clean. This is important because it is the adjacent teeth which support the bridge.
Removable Partial Dentures
This is an alternative for replacement teeth when 3 or more teeth are missing in the upper or lower arch. This appliance is removable in that you can remove it at night or after meals to clean it. It consists of an underlying metal framework to which a plastic gum colored base is attached on which the replacement teeth sit. The partial has metal clasps which hook to the remaining teeth. Partial dentures come in different varieties including a metal-free flexible denture with metal free clasps as well. Precision attached partials are one of the more esthetic partials in that no clasps exist. Instead special attachments are placed on the crowns which anchor the partial in place. Dr. Bhoot can evaluate the type of partial which is best suited for each individual patient.
There are many questions that may come up with wearing a partial denture. Below are frequently asked questions.
Will I Be Able To Eat With The Denture?
Having replacement teeth should make it easier to chew evenly on both sides of your mouth. The recommendation is to start with eating soft foods, non-sticky foods until your mouth adjusts to the change.
How Do I Take Care Of The Denture?
Initially it is best to take the denture out in an area where it will not break upon removing it. Use a mirror to help you. Brush the denture after eating to remove plaque build up. The recommendation is a soft bristled brush specially designed for partials where the bristles are shaped to clean the denture. There are many denture cleansers available on the market.
Will I Be Able To Speak Clearly?
With missing teeth it is often difficult to enunciate words because of loss of lip support. A partial often helps with that. However, initially it may feel bulky and therefore may alter your normal speech. In due time, your mouth will adjust.
Will My Partial Need Adjustments?
After the initial delivery of the partial one may develop some minor sore spots which require adjustments by the dentist. This may involve adjustments to the bite or areas of the partial which are impinging on the soft tissue. Also over a period of time the gums and bone may shrink affecting the overall fit of the partial. It may become loose and may require a refitting to accommodate those changes in the mouth. It is strongly recommended that no adjustments be made at home as permanent damage can occur to the partial.
This type of prosthesis is necessary when all of the natural teeth have been lost due to periodontal disease, tooth decay, or trauma. With the aid of a denture, improvement of one’s facial profile, musculature, and overall speech is highly improved as well as the support of the TMJ joint. There are various types of complete dentures.
A conventional full complete denture is placed only after the teeth have been removed and the tissues have healed over 6-8 weeks following the tooth extractions. If one already wears a complete denture and would like a replacement than there is no waiting period involved. It normally takes several short appointments to fabricate a precise fitting denture. Over that process the patient can take part in selecting the shape of the tooth as well as the shade.
An immediate denture is a type of denture in which the patient is not without teeth during the healing period. The back teeth are generally removed and the teeth in the anterior are preserved until the denture is ready to be delivered. That is the main advantage with this type of denture. Some of the negatives are the patient is unable to view their denture until it is delivered. Also the denture fit may change within 6 months as the gums have healed and may have shrunk. A refitting is normally required at this point.
An implant supported denture is one in which the denture is not retained solely by the anatomy of the ridge and the soft tissue. In many patients where the ridge especially in the mandible is not sufficient to hold a denture properly, implants are placed to anchor the denture and provide extra retention. These may also be placed in the maxilla if needed.
There are many instances where a tooth may necessitate a crown. This type of restoration is a long term solution in which the crown is permanently cemented to the tooth. Some of these factors which warrant a crown are fractures in teeth, root canalled teeth, trauma, disease, wear, and oversized failing fillings. There are situations where biting on a tooth may generate radiating pain due to hairline fractures. Also in a root canalled teeth the vitality is lost and the tooth is greatly weakened. Therefore, a crown helps to support the existing tooth structure. Further, malpositioned teeth may pose a great challenge to restore with simple bonding. In this instance a crown may rebuild the tooth in its most normal anatomical position and alignment. Moreover, certain teeth may appear more natural looking with a porcelain crown due to heavy discoloration. Crowns have a longevity of 10-20 years depending on the maintenance. In general the goal of a crown is for added support to the tooth with an extremely natural look that is durable, biocompatible, and beautiful.
A crown is fabricated in different types of materials based on the bite, esthetics, etc. Some of the materials used in our office are high grade porcelain, porcelain fused to metal, or all gold.
The traditional process by which a crown is fabricated is a 2 step process. On the first visit the tooth is prepared such that it is reduced to a specific size and shape. An impression is taken of this tooth and a shade is selected. A bite is taken. This is then sent off to a dental lab. In the mean time the patient is sent home with a temporary crown that is cemented in the mouth with temporary cement. This crown mimics a natural appearance of the crown to come. The 2nd appointment is for the cementation of the permanent crown. This appointment is usually made 2-3 weeks from the initial appointment.
Latest technology has introduced an all porcelain crown which can be fabricated in office called a CEREC crown.
This is single-visit CAD/Cam restoration technology. We offer our patients a service for obtaining a crown on 1 appointment. CEREC crowns enable us to provide you with high quality ceramic crowns (metal-free) with outstanding marginal fit. This procedure does not involve impressions or temporaries. This is a computer simulated program which enables us to capture a picture of your tooth after it has been prepared. From that picture, Dr. Bhoot designs your crown chair-side with a computer program so that you can see the shape and anatomy that is being created in your tooth. The crown is then milled in office and it is cemented on that appointment. Most of our patients appreciate this service!
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