Dr. Tara Sexton, joining us this month as one of the MLT's panel of reader service experts, last appeared on our January cover for the Class of '98
Designing Your Smile
by Tara Sexton
Believe it or not, even smiles go in and out of style! The mouth is a focal point in facial aesthetics, receiving a lot of attention from others we interact with daily. As a powerful communication tool, an engaging smile can sometimes mean the difference between success or failure. Therefore, the high visibility of the smile makes the condition of the teeth a vital component of our self-esteem and the overall first impression we make.
American culture of the 90s advocates the pursuit of beauty and fitness as a measure of self- respect and total health. Endorsed by the advertising industry, this perspective has sent dental consumers in search of the "perfect smile". All who seek cosmetic treatment are looking for a change in their appearance, usually based on some personal image of the ideal. Cindy Crawford , Tom Cruise and Robert Redford are recognized as having some to the most desirable smiles in the entertainment business.
Over the past decade, material and technique advances have made the field of aesthetics one of the most dynamic and appealing areas of dentistry. These procedures are indicated for aesthetic changes in terms of both color and shape, to mask defects, to restore fractures and alignment and to fill unnatural gaps in the teeth. Often they can be accomplished in relatively few dental visits and with minimal discomfort.
The most common aesthetic complaint is the desire for whiter, brighter teeth. Surface stains are often the result of age, tarter deposits and certain foods or beverages (coffee, tea, tobacco, berries). Internal discoloration can be the result of injury, illness or tetracycline or excess fluoride ingestion as a child. If carefully selected and supervised, whitening can produce substantially lighter teeth in most cases. Presently, the most common method involves wearing a custom made splint that contains a whitening solution. Depending on the severity of the stain, the length of treatment may be one to two weeks.
Designing Your Smile
by Tara Sexton
Believe it or not, even smiles go in and out of style! The mouth is a focal point in facial aesthetics, receiving a lot of attention from others we interact with daily. As a powerful communication tool, an engaging smile can sometimes mean the difference between success or failure. Therefore, the high visibility of the smile makes the condition of the teeth a vital component of our self-esteem and the overall first impression we make.
American culture of the 90s advocates the pursuit of beauty and fitness as a measure of self- respect and total health. Endorsed by the advertising industry, this perspective has sent dental consumers in search of the "perfect smile". All who seek cosmetic treatment are looking for a change in their appearance, usually based on some personal image of the ideal. Cindy Crawford , Tom Cruise and Robert Redford are recognized as having some to the most desirable smiles in the entertainment business.
Over the past decade, material and technique advances have made the field of aesthetics one of the most dynamic and appealing areas of dentistry. These procedures are indicated for aesthetic changes in terms of both color and shape, to mask defects, to restore fractures and alignment and to fill unnatural gaps in the teeth. Often they can be accomplished in relatively few dental visits and with minimal discomfort.
The most common aesthetic complaint is the desire for whiter, brighter teeth. Surface stains are often the result of age, tarter deposits and certain foods or beverages (coffee, tea, tobacco, berries). Internal discoloration can be the result of injury, illness or tetracycline or excess fluoride ingestion as a child. If carefully selected and supervised, whitening can produce substantially lighter teeth in most cases. Presently, the most common method involves wearing a custom made splint that contains a whitening solution. Depending on the severity of the stain, the length of treatment may be one to two weeks.
Bonding is a versatile term used to describe a variety of techniques. One method involves molding a tooth-colored-composite resin to any portion of a given tooth. It can be used to replace old fillings, to widen or lengthen, to repair chips and fractures, to mask and isolated stain and to chance tooth color. Many times, this procedure can be completed in one office visit and requires no local anesthetic.
Porcelain veneers are the answer for more severely discolored or misshapen teeth. They are thin, hand-sculpted pieces of dental porcelain that fit as a facing over the front surfaces of prepared teeth. They are fabricated by a laboratory technician, from a mold of your teeth, and fired in a ceramic oven to a glossy natural finish. Finally, the veneers are attached to the teeth using a bonding cement.
Veneers provide for a much more conservative treatment option than crowns, often referred to as "caps", because only a tiny amount of enamel is removed for their fitting. Crowns, albeit more aggressive, remain the treatment of choice for badly broken-down teeth and a variety of more complicated problems. Although they were once made from gold and porcelain exclusively, recent advances permit all-ceramic crowns for optimal esthetics.
Tooth-colored inlays and onlays are increasingly popular alternatives to traditional silver fillings. For large-sized fillings, previous options included a silver replacement or a crown. These newer restorations function physiologically most closely to a natural tooth and, like veneers, chemically adhere to the teeth for additional strength. Since inlays and onlays preserve as much tooth structure as possible, the need for a crown in postponed.
What about a missing tooth or teeth? A bridge is a series of inter-connected crowns used to replace teeth lost as a result of infection or trauma. A newer treatment involves placing a titanium implant in the jaw to replace the lost tooth. After healing, an implant crown, shaped and colored to match the adjacent teeth, can be attached to the implant. Implants require two stages: initial placement by a periodontist or an oral sergeon, then completion by an aesthetic restorative dentist.
Porcelain veneers are the answer for more severely discolored or misshapen teeth. They are thin, hand-sculpted pieces of dental porcelain that fit as a facing over the front surfaces of prepared teeth. They are fabricated by a laboratory technician, from a mold of your teeth, and fired in a ceramic oven to a glossy natural finish. Finally, the veneers are attached to the teeth using a bonding cement.
Veneers provide for a much more conservative treatment option than crowns, often referred to as "caps", because only a tiny amount of enamel is removed for their fitting. Crowns, albeit more aggressive, remain the treatment of choice for badly broken-down teeth and a variety of more complicated problems. Although they were once made from gold and porcelain exclusively, recent advances permit all-ceramic crowns for optimal esthetics.
Tooth-colored inlays and onlays are increasingly popular alternatives to traditional silver fillings. For large-sized fillings, previous options included a silver replacement or a crown. These newer restorations function physiologically most closely to a natural tooth and, like veneers, chemically adhere to the teeth for additional strength. Since inlays and onlays preserve as much tooth structure as possible, the need for a crown in postponed.
What about a missing tooth or teeth? A bridge is a series of inter-connected crowns used to replace teeth lost as a result of infection or trauma. A newer treatment involves placing a titanium implant in the jaw to replace the lost tooth. After healing, an implant crown, shaped and colored to match the adjacent teeth, can be attached to the implant. Implants require two stages: initial placement by a periodontist or an oral sergeon, then completion by an aesthetic restorative dentist.
Orthodontics is still the recommended therapy for severely crooked teeth or a "bad bite". Transparent brakers and invisible braces, which are attached to the backs of teeth, are two state-of-the-art advances in this area. Beautifully shaped and shaded teeth can often be perfectly realigned without the use of the aesthetic procedures discussed above. Your aesthetic restorative dentist is an ideal source for this specialty referral.
How does one find a dentist who had dedicated a substantial effort to developing and utilizing aesthetic techniques in his/her practice? For convenience, many people select a neighborhood dentist, but location should not be a determining factor. Call the local dental schools or societies; they keep current on who excels in this discipline. Also, question other appearance- related specialist (orthodontist, plastic surgeon) as to whom they recommend. If friends have had aesthetic enhancements, find out who they used and their level of satisfaction.
A skilled dentist with expertise in aesthetics will assess the general health and appearance of the teeth and gums. A thorough history and x-ray evaluation are a must to ensure that enhancements are build to a solid foundation. Those treatment options best suited to the individual's case will be discussed. Be prepared to discuss the advantages and disadvantages such as: cost, durability and special care. The dentist should supply a portfolio of treated cases (before and after photos) for education and review. Good communication and realistic expectations are paramount in obtaining patient satisfaction.
As dentistry approaches the 21st century, more and more procedures are becoming elective. Aesthetic dentistry is an art form devoted to the beautification of smiles. How would you rate your smile on a scale form one to 10? If the answer is not a resounding " 10" maybe it's time to investigate your smile's shortcomings.
Editor's Note:
Dr. Tara Sexton is an aesthetic restorative dentist who maintains a private practice in Bala Cynwyd. She is a graduate of the University of Pennsylvania School of Dental Medicine and has contributed to numerous scientific journals and lay publications. Dr. Sexton can be reached by telephone at 610-664-8466.
How does one find a dentist who had dedicated a substantial effort to developing and utilizing aesthetic techniques in his/her practice? For convenience, many people select a neighborhood dentist, but location should not be a determining factor. Call the local dental schools or societies; they keep current on who excels in this discipline. Also, question other appearance- related specialist (orthodontist, plastic surgeon) as to whom they recommend. If friends have had aesthetic enhancements, find out who they used and their level of satisfaction.
A skilled dentist with expertise in aesthetics will assess the general health and appearance of the teeth and gums. A thorough history and x-ray evaluation are a must to ensure that enhancements are build to a solid foundation. Those treatment options best suited to the individual's case will be discussed. Be prepared to discuss the advantages and disadvantages such as: cost, durability and special care. The dentist should supply a portfolio of treated cases (before and after photos) for education and review. Good communication and realistic expectations are paramount in obtaining patient satisfaction.
As dentistry approaches the 21st century, more and more procedures are becoming elective. Aesthetic dentistry is an art form devoted to the beautification of smiles. How would you rate your smile on a scale form one to 10? If the answer is not a resounding " 10" maybe it's time to investigate your smile's shortcomings.
Editor's Note:
Dr. Tara Sexton is an aesthetic restorative dentist who maintains a private practice in Bala Cynwyd. She is a graduate of the University of Pennsylvania School of Dental Medicine and has contributed to numerous scientific journals and lay publications. Dr. Sexton can be reached by telephone at 610-664-8466.