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When dentistry becomes artistry

Everyone wants a set of pearly whites. Unfortunately, many of us learn to smile with our mouths closed.
For some, yellowed teeth, chipped teeth, crooked teeth, gap-toothed smiles and gummy smiles can be a source of embarrassment. Those who can’t live with their smiles can turn to cosmetic dentistry. As dental health has steadily improved over the years, this attention to aesthetics has become a new focus in the industry, "It is rare for people to have a lot of cavities now, and gum disease is under control," says Dr. Ed Philips, president-elect of the Central Dental Society and a private practitioner in Toronto.

Dr. Philips in the News…

Thanks to these factors, as well as new technology we can take dentistry to the next level!

Whitening and bonding are two of the most common procedures, but many adults are trying out orthodontics and the new alternative, porcelain laminate veneers, as well.

Dr. Philips says it is natural for people to want a beautiful smile, and the reasons can be found in the past. "The reasons people want a better smile are evolutionary," he says. "Sharp and uneven teeth used to signify the ability to tear and shred. Grinning and showing teeth used to scare away predators. But now grinning or smiling means, ‘I’m okay. I’m friendly. Come closer to me.’ It’s welcoming. Dark teeth or sharp, irregular teeth are still considered hostile and, because a smile now serves different social purposes, this isn’t desirable."

When people speak, the listener often focuses on their mouth as unwavering eye contact might be considered intimate or even aggressive. That means the mouth is one of the first things that is noticed. Now dentists and patients finally have the time and dental health to start thinking about procedures that are cosmetic rather than a requirement for health.

Dr. Philips says large numbers of dentists were enlisted during the Second World War, which resulted in a general decrease in dental care. Consequently, in the following years, many people’s mouths were filled with cavities.

By the I970s, the use of fluoride began improving dental health, but in the 1980s the baby boomers’ fillings started breaking down and had to be replaced. It is only since the 1990s that there has been time for the industry to move beyond damage control.

"Re-whitening is still the most popular procedure," says Dr. Philips. "Everyone wants clean, white teeth!’

Professional cleaning will remove surface stains such as those from coffee, tea, tobacco and plaque. But when teeth age, they tend to yellow. In these cases, an oxidizing agent must be used to break down the yellow pigments. I don’t like to call it whitening because we’re not adding colour," says Dr. Philips. We’re simply removing the yellow or darker pigments to re-whiten the teeth!" That means people’s teeth will never be whiter than their teeth are naturally.

Adult orthodontics are another popular choice in cosmetic dentistry. Straight, even teeth are an important factor in a nice smile, "If the teeth weren’t lined up properly to begin with, they will shift and drift throughout their life," says Dr. Philips. "So even if they had the smile of a cover model 10 years ago, they may not now. ‘Adults often think they’re too old for orthodontics, but it is actually quite common!’

According to the American Dental Association, about 20% of people who now get braces are adults. But this procedure takes patience, as adults often must wear them for two or three years, and afterward a retainer must be used.

Porcelain and laminate veneers are another option for those who want to improve their smiles. Thin, semi-translucent plates or shells can be used to cover discolouration, repair chipped or damaged teeth or change the look of teeth in terms of shape and size. Most of the time you can’t tell where the tooth and the veneer meet, eliminating shadow lines often associated with a crown. But because there must be a certain amount of tooth for the veneer to bond to, sometimes crowns are the only alternative.

‘Veneers are the number one choice for people who want to improve their smiles," says Dr. Philips. "It’s more expensive than bonding, but the results are often better!"

Bonding is another procedure people with chipped or discoloured teeth, or those with gaps between their teeth may choose. "Bonding is a bit of a misnomer as veneers are bonded as well as crowns," says Dr. Philips. "It’s the material we’re using that we’re referring to. With veneers, we’re using porcelain. With bonding, we’re using high-grade plastics!"

Often micro-abrasion is used to "roughen up" the surface of the tooth for bonding. "Drills create flatter surfaces that don’t bond as well," says Dr. Philips. "Abrasion, such as air abrasion, creates a honeycombed effect."

Some people don’t have a problem with their teeth, but they think their gums ruin their smiles. Dr. Philips says the remedy for a gummy smile is both simple and effective. "That tissue is very easily removed," he says. "It’s much like cutting cuticles, and we have had outstanding results!" Lasers or scalpels maybe used to remove the tissue.

And last but not least, there are people who have lost teeth. The answer is often implants. The solution used to be dental plates, but now dentists install teeth that are attached to the jawbone making them sturdy and realistic in appearance.

Of course, a good way to get a healthy smile is to maintain your teeth. Many of these procedures can be avoided if people take advantage of preventive treatments and care for their teeth by brushing and flossing.

But sometimes, the perfect smile still eludes us. In these cases, a cosmetic procedure may bring patients a great deal of confidence and comfort.

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