What is Digital Smile Design?
Digital Smile Design (DSD) is the use of digital images and computer-based manipulation to demonstrate possible changes to the smile and specifically to the position, size, shape and colour of the teeth and gums. It is a comprehensive cosmetic dental planning tool that uses digital calibration to known dimensions in the mouth in order to guide the placement of wax during the planning/blueprint or diagnostic wax-up stage. It is then this diagnostic wax-up that is “test-driven” in your mouth before the final smile is delivered.
This is a technique coined and pioneered by Dr. Christian Coachman, DDS, CDT.
Read more here: http://digitalsmiledesign.com
Note: page is in Portuguese, but do look at the photographs!
What is Cosmetic Dentistry?
Cosmetic dentistry is the branch of restorative dentistry that strives to improve teeth and smiles to a level reflecting beauty, harmony, and natural symmetry. It is the art of designing a tooth or smile to mimic nature. The sine qua non of cosmetic dentistry is to produce restorations not noticed by the eye.
Success in cosmetic dentistry is achieved not only by modifying the white esthetics (i.e. the teeth), but sometimes also the pink esthetics (i.e. the gums). Cosmetic dentistry sometimes conducts the coordinated dance between dental specialties in the reconstruction of a case. Often, bone grafting and gum grafting are prescribed in conjunction with implants to replace a missing tooth. Orthodontics or braces are often needed to move teeth to better positions for more predictable esthetics and function before veneers, crowns, or bridges are added to the mix.
The key to smile design lies in the understanding of the patient’s personality and desires. It is possible to produce a smile in a patient that seems to not belong there at all. Cosmetic dentistry therefore requires artistic perception to successfully emulate nature.
The difference between cosmetic dentistry and esthetic dentistry is simple. Cosmetic dentistry strives to improve the appearance of teeth and smiles. Esthetic dentistry represents the final subjective result: a smile that looks good. What looks good to one may not look good to another. However, what is certain, is that esthetic success is often attained if nature is reproduced.
My teeth are stained and yellow. Can they be safely whitened? Is whitening safe?
Yes, dental whitening is used now and is widely effective. Most people can achieve a white, bright smile in 1 day using an in-office technique, or 2-3 weeks using custom home bleaching trays. The level of maximum whitening is greater using custom home bleaching trays. In some cases, patients report transient sensitivity during the whitening procedure, and most report none at all. Any sensitivity does dissipate after the whitening is completed. Research has found that the whitening agents used do not damage tooth enamel or cause nerve damage. Ten year studies have proven the safety of prescribed custom home whitening regimens.
Can I see a preview of my new smile before I decide if I want to go ahead and start work?
Yes, you can. Communication with your cosmetic dentist is key to designing a predictable outcome. Normally, a wax model (diagnostic wax-up) would be made of your mouth to show you the proposed changes and improvements the veneers and/or crowns would make. You would be able to critique this and communicate any desired changes back to your dentist so that a clear understanding of the objectives is gained before you even start. On occasion, the dentist may have digital software that can also show you the proposed result. In some cases, your dentist can do a “trial smile” directly in your mouth based on the wax model without touching a dental bur to your teeth. This will give you a good preview of how you might look afterwards.
I have some silver mercury amalgam fillings. Are these bad for my health?
Silver amalgam has served dentistry well for the last 150 years. There is currently no definitive research that directly links silver amalgam fillings to systemic ailments and diseases. Silver amalgam has been continuously classed as safe as a dental restorative material by the Food and Drug Administration (FDA). Whilst high levels of mercury can be found in seafood, mercury levels in old amalgam fillings stay at a very low level in the mouth. The highest levels of mercury exposure are noted when the amalgam filling is first placed, and when the amalgam filling is drilled out/removed. Some patients want the amalgam fillings replaced just because they are an eye-sore. This will be an individual decision after considering the risk:benefit ratio.
What is the difference between composite and porcelain veneers?
Porcelain veneers take 1-2 weeks to make and are typically made by a dental ceramist in conjunction with your cosmetic dentist. They have better colour stability over time, but are harder to repair and require more tooth recontouring or preparation. Composite veneers are artistically-layered directly on your tooth by your cosmetic dentist and typically utilize between 2-5 colours to achieve a natural result that blends into your smile. Composite veneers attract stain more easily, but can be easily polished and repaired, and most importantly require minimal tooth recontouring or preparation. Composite veneers are significantly less expensive than porcelain veneers.
My teeth are chipped. What can be done?
Chipped and ragged teeth these days can be repaired using a simple bonding technique. A small amount of tooth-coloured composite resin material is shaped to recreate the lost part of your tooth. If done correctly, the result should be virtually undetectable. Larger fractures may necessitate a composite or porcelain veneer.
Can dental implants be used to restore many missing teeth?
Yes, dental implants can be used singly or in multiples. For individuals who have lost all their teeth and desire better function of their wobbly dentures, implants placed strategically around the mouth can hold their false teeth securely, increasing their chewing confidence and efficiency. For those who are just sick and tired of wearing dentures, dental implants can also be used to support long-span and cross-arch porcelain bridges that stay in the mouth and effectively replace their teeth. For ideal candidates, our team offers an innovative technique known as All-on-4®.
What is a dental implant?
A dental implant is made from Grade 4 titanium and is compatible with your body. It is shaped like a tooth root form, and is expertly placed into the missing tooth site by your dentist or specialist. After it heals there for three to six months, it will have likely integrated with bone (fused to bone). When your dentist or specialist confirms the tightness of the implant, they will take special dental impressions (molds) to design the implant crown. After the implant crown is cemented or secured in place, it will look like a normal tooth and you can use it like a normal tooth. You can floss around it, brush it and bite on it. Essentially, you will have regained your lost tooth. This is the most predictable and successful method of replacing missing teeth in dentistry and is always the recommended-first option.
What is a bridge?
A bridge is one option used to permanently fill a missing tooth space. If you are only missing one tooth, the teeth on either side of the gap will act as supports or abutments. These teeth will be prepared for crowns. The two crowns on either side will be fused to a dummy crown “pontic” in the missing tooth gap. This resulting 3-tooth unit will be cemented on your support teeth, instantly filling your missing tooth space with a porcelain tooth. Bridges should only be prescribed if the root support of the abutment teeth is ideal. The support teeth should be moderately-to-heavily-filled to warrant crown preparations. If the abutment teeth are not suitable in any way, look to restore your missing tooth space with an dental implant.
What is a veneer?
A veneer is a delicately-made shell of porcelain that is cemented onto the front (facial surface) of your tooth permanently. It requires slight contouring of the tooth beforehand (tooth preparation) in most cases so the final veneer result does not look bulky. In select cases, no reduction of tooth structure is necessary for the proposed result. A veneer or set of veneers can transform your smile within a week or two. An old, discoloured and misshapen tooth can be made to look perfectly straight and harmonious with your smile. Material choices for veneers include porcelain and composite resin. A successful veneer case depends on the artistic orchestration between your cosmetic dentist and dental ceramist.
What is a crown?
A crown is a “cap” of handmade porcelain art that reproduces the lost contours of your tooth. After cementing the crown on your tooth, often the crown lends strength to the remaining structure and revitalizes its appearance simultaneously. A crown is only indicated when there is sufficient weakness of the tooth due to very large fillings or if a root canal has been done on the tooth. A crown requires more tooth recontouring or reduction than a veneer and should only be prescribed if needed.