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Issue Date: July 2008


All Smiles

 If you want a perfect smile, cosmetic dentistry can help you get it.
by Lynne Thompson
Brushing, flossing, regular checkups — they’re the keys to maintaining healthy teeth. But all too often, vigilant dental hygiene isn’t enough to produce a bright movie-star smile. Fortunately, cosmetic dentistry can correct flaws caused by heredity, injury, decay and aging. Following are some of the cosmetic procedures patients are requesting most.
In-office whitening
For those who don’t have the time or patience to mess around with those take-home tray systems, in-office whitening is truly a godsend. Dr. Gino DiGiannantonio of Dentistry Inc. in Willoughby Hills uses a laser to accelerate the action of a hydrogen-peroxide gel in three consecutive 20-minute sessions scheduled over two hours — a process that whitens teeth anywhere from five to 12 shades.

Dr. Scott L. Rose of the Center for Aesthetic & Restorative Dentistry in Solon uses a chemical whitening. “Without any light and heat, there’s less chance of damaging the nerves of the teeth,” he says. “And you’re still getting the same whitening effect.”

Porcelain veneers
The application involves removing a minimal amount of enamel from the tooth and bonding a veneer to the front of it to close gaps and correct the appearance of chipped, crooked or discolored teeth.

Modern technology in the form of a Cerec machine allows dentists to make porcelain restorations — veneers as well as crowns — while patients are in the office, eliminating repeat visits and weeks-long waits for dental labs to produce the same thing. The dentist uses an optical camera to take images of the teeth, which are fed into a computer that designs the restoration. The resulting design is then sent to a milling machine containing a small block of porcelain the dentist has matched to the patient’s teeth.

“In about 20 minutes, a brand-new veneer or crown rolls out,” Rose says. “It just has to be polished and cemented in.”

Replacement of metal fillings
Replacing metal fillings with porcelain-bonded counterparts does more than make teeth look better, DiGiannantonio says. Metal fillings wear down and leak, eventually resulting in additional decay, even tooth breakage.

“A porcelain-bonded restoration glues the tooth together,” he says. “It’s a lot stronger.”


Dental implants
The best way to replace a missing or irreparable tooth is a two-step process. First, an oral surgeon places a titanium implant in the jawbone — a relatively simple procedure if the bone is healthy. Then a cosmetic dentist puts a porcelain restoration, or crown, on top of the post. In some cases, DiGiannantonio says, the restoration can be installed the same day as the surgery. And Rose notes that unlike a bridge, an implant requires no reduction of neighboring teeth. “They don’t decay, they don’t break down,” he adds. The same concept can be used to secure dentures.
Neuromuscular dentistry
A newer field of dentistry, it determines the patient’s optimal jaw and biting position using advanced techniques such as three-dimensional jaw tracking, joint stenography (listening to the jaw joints with special microphones) and electromiography (taking electrical readings of the facial muscles to see if they’re firing properly), Rose says. “Your teeth have to come together to function,” he explains. “But where your teeth come together and what makes the muscles happy can be two totally different things.” The optimal jaw position is then attained by wearing an appliance and/or rebuilding the mouth with crowns, bridges and veneers — treatments that are used to alleviate everything from jaw-joint problems to head, neck and back pain to ringing in the ears.

“As the muscles begin to relax,” he says, “the symptoms go away.”

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