Cosmetic Dentistry

Treatments, Trends and Cosmetic Dentists

While traditional dentistry focuses on oral hygiene and preventing, diagnosing and treating oral disease, cosmetic dentistry focuses on improving the appearance of a person's teeth, mouth and smile. In other words restorative, general and/or family dental practices address dental problems that require necessary treatment, whereas cosmetic dentistry provides elective – or desired – treatments or services.

Cosmetic dentistry may also provide restorative benefits. For example, dental fillings are a common procedure used to treat decayed teeth. Previously, most dental fillings were composed primarily of gold, amalgam and other materials that left visible dark spots on the teeth.

Today, dental fillings may fall into the category of cosmetic dentistry, because you can select fillings made of porcelain or composite materials that closely match the color of your teeth, thus maintaining the natural appearance of your teeth and smile. Many people may choose to have their older fillings replaced with newer, tooth-colored fillings to enhance their oral appearance.

Cosmetic Dentistry Trends

Technological advancements in natural-looking, tooth-colored dental materials make today's cosmetic dental treatments more durable and predictable than in years past. Additionally, dentists are now using more conservative cosmetic dentistry techniques to preserve as much of your natural tooth structure as possible, depending upon your specific clinical situation.

Cosmetic dentists may also use such technologies as lasers in order to perform some procedures necessary for cosmetic treatments in their own offices – without the need for referrals to specialists. This makes cosmetic dental procedures such as smile makeovers more comfortable and convenient for patients, as well as helps to reduce recovery time.

Cosmetic Dentistry Treatments

Cosmetic dentistry treatments currently in use include:

Inlays/Onlays: Also known as indirect fillings, inlays and onlays made from porcelain or composite materials are a long-lasting yet cosmetic way to provide a “filling” to teeth with tooth decay or similar structural damage. Whereas dental fillings are molded into place within the mouth during a dental visit, inlays and onlays are created in a dental laboratory before being fitted and adhesively bonded into place by your dentist.
Composite Bonding: Chipped, broken, discolored or decayed teeth may be repaired or have their appearance corrected using a procedure called composite bonding. A dental composite material with the look of enamel and dentin is applied into the cavity or onto the surface of a tooth, where it is then sculpted into shape, contoured and hardened with a high-intensity light. The result is a restoration that blends invisibly with the remainder of the surrounding tooth structure and the rest of your natural teeth to create a healthy, bright smile.
Teeth Whitening: Teeth whitening is perhaps the most commonly recommended cosmetic dentistry procedure. Teeth are often stained from smoking, food, drink (coffee, tea or red wine) or poor oral hygiene. Bleaching the teeth can enhance the appearance of your smile.
Dental Veneers: Composite or porcelain laminates that are adhesively bonded to the surface of a tooth to correct and repair chips and cracks will improve a worn appearance or severe tooth discoloration. Veneers may also be recommended if you have gaps in your teeth or if you have not had success with teeth whitening.
Dental Implants: Dental implants are artificial tooth root replacements that are used as a part of prosthetic (artificial replacement) dentistry in order to compensate for tooth loss. Often the result is not only an enhanced smile, but also a more youthful appearance, since missing teeth cause the face to collapse, making you look older.
Smile Makeover: Smile makeovers involve a comprehensive assessment of your smile esthetics in order to improve its overall appearance. Typically one or more cosmetic dentistry procedures, such as dental veneers, dental implants, gingival sculpting and teeth whitening, will be required for several teeth in both the upper and lower arches in order to achieve the look you want.
Full mouth reconstruction: While consulting with you about a smile makeover to primarily improve the esthetic appearance of your smile, your dentist may discover that there is a need to provide necessary treatment to correct functional problems with your bite, muscles, teeth and bone structure. If you need full mouth reconstruction, the materials available today make it possible for your dentist to provide you with durable, functional and clinically sound treatments that also look natural.

Cosmetic dentistry offers many options for people who are unhappy with their smile. If you are one of these people, we encourage you to read our comprehensive cosmetic procedure articles to learn about the various treatments available to beautify your smile.

Cosmetic Dentistry Costs
and FAQ

Cosmetic dentistry costs vary widely, but you'll find approximate costs in our articles on particular procedures. For example, professional in-office teeth whitening costs approximately $450 to $650, whereas over-the-counter whiteners range in cost from $4 to $100.

Usually dental insurance doesn't cover cosmetic dentistry. But some dental plans may cover part of the cost of certain procedures, such as crowns, especially when the main purpose is to repair a structural problem that could affect the overall health of your mouth. Usually, functional and restorative dentistry is covered in part by insurance, while cosmetic dentistry is seldom covered.

Cosmetic Dentistry FAQ

Q. What causes the discoloration of a tooth?

A. Tooth discoloration is a normal part of aging. As people age, enamel wears down, and teeth take on a duller appearance. Teeth can also become discolored from smoking and heavy consumption of coffee or tea. Other causes of tooth discoloration include side effects of medications (specifically certain antibiotics) used during the developmental phase of the teeth, an individual's genetic makeup, and excessive fluoride consumption (fluorosis, seen in both children and adults). Teeth whitening and veneers offer a cosmetic dentistry solution for people with discolored or dull-looking teeth.

Q. Are any side effects associated with teeth whitening?

A. Dentists take protective measures to prevent discomfort during teeth whitening procedures. Typically, a protective gel or rubber shield is used to prevent bleaching agents from damaging gum tissue. The most common bleaching agents used by dentists are approved for use by the American Dental Association, ensuring safety and effectiveness. After the whitening procedure, you may experience minimal tooth sensitivity for a short period of time.

Q. Does teeth whitening work for everyone?

A. No. In cases involving severe discoloration, teeth whitening may not result in a bright, white smile. Individuals with severe tooth discoloration should consider other options, such as porcelain veneers or composite bonding.

Q. Are there special considerations for dental veneers?

A. The factors to consider when evaluating a veneer procedure from an esthetic point of view include:

Your goals.
The color of your teeth. For example, most veneers are ultra-thin and therefore translucent, so discolored teeth underneath may show through. Your dentist may recommend teeth whitening first to reduce discoloration. Veneers are fabricated to have a natural tooth-like appearance. Veneer color must match that of any remaining teeth, and texturing may be applied to veneer surfaces for a natural look.
The impact of your lifestyle and habits. For example, teeth grinding and clenching may make the veneer more susceptible to chips, cracks, and breaking.

You should also consider the artistry of the dentist who designs the specifications and ultimately places the veneers. Veneer materials are universal, but the artistic skill of the dentist, as well as that of the lab technician who crafts the veneers, plays a major role in the esthetic appeal of the final product.

Q. How do I know whether a cosmetic dentist is good or not?

A. One of the first questions you should ask is what type of training he or she has for the particular procedures you're interested in. Not all dentists know and perform all cosmetic dentistry procedures. As such, cosmetic dentists often involve other specialists (orthodontist, endodontist, lab techs, etc.) in treatment planning and execution. It is important to know exactly who will be involved in your treatment and what they will be doing.

You should also ask to see before-and-after photos of patients who underwent those procedures. Ask questions about their cases and the strategies the dentist used to improve their smiles.

Additionally, ask if the dentist is an accredited member of the American Academy of Cosmetic Dentistry (AACD). Accredited members undergo extensive continuing education and rigorous testing to ensure that their skills using composite bonding, porcelain veneers and other cosmetic restorations and procedures are exemplary and worthy of accreditation status.

Q. What cosmetic dentistry procedures are available for people who are missing teeth?

A. Although dentures are not considered a cosmetic dentistry procedure, they provide a cosmetic benefit for people who have lost all or some of their teeth. People who are missing only certain teeth, or rows of teeth, may be better served by a dental bridge or dental implants. It is best to have your situation evaluated by a dental professional in order to establish candidacy for any of these procedures.

Q. May I choose to be sedated during cosmetic dentistry procedures?

A. Yes. The level of sedation necessary for cosmetic dentistry procedures depends on several factors, including:

Your health and medical history.
The procedure being performed.
Your dentist's familiarity with sedation modalities.

Most people do not require a high level of sedation during cosmetic dental procedures.

Q. Why can't smokers undergo certain cosmetic dentistry procedures?

A. Smoking is a leading cause of tooth loss. Smokers also have an increased risk for periodontal disease (gum disease), leukoplakia, loss of bone structure, inflammation of the salivary gland, and development of lung, throat, or oral cancer. Smokers therefore face an additional set of considerations when exploring cosmetic dentistry treatment.

One restriction for smokers involves dental implants. Smoking increases the risk that a dental implant will fail to integrate with bone tissue (osseointegration). Smoking also affects gum health, and unhealthy gums can lead to dental implant failure. If you smoke, you need to quit before having an implant.

Another restriction involves teeth whitening. If you whiten your teeth but continue to smoke, the whitening effect will not last as long, because smoking stains the teeth.

Q. Are dental implants suitable for children?

A. Dentists indicate that implants cannot be considered until bone growth has completed. This typically occurs during adolescence, but may vary from one child to the next. Implants placed prior to bone growth completion may shift out of place and cause severe problems. If a child loses a tooth before bone growth has completed, an orthodontic device called a “space maintainer” may be used to prevent an abnormal growth of surrounding teeth. Once bone growth has completed, the space maintainer can be removed and the missing tooth restored using an implant or bridge.

Q. Are veneers my only option if I want a smile makeover?

A. No. Your cosmetic dentist will determine the cosmetic dentistry procedures that would be the best for you. The dentist's suggestions will be based on your desires and a thorough examination to determine the condition of your teeth and what problems, if any, may require dental treatment. Therefore, your smile makeover could involve teeth whitening, crowns, composite bonding, gingival sculpting, inlays and onlays or any other combination of cosmetic dental procedures that your dentist determines is right for your cosmetic treatment plan.

Q. I want a smile makeover because I think I have ugly teeth, but I don't have any cavities or anything else wrong that needs to be fixed. Can something be done to make my smile look better?

A. If you are unhappy with the appearance of your smile, the first step is to do your homework and investigate the level of cosmetic dentistry experience for each cosmetic dentist you consider before setting up a consultation appointment. We suggest that you read How to Choose a Cosmetic Dentist for information about questions to ask and other criteria that can help you in selecting the cosmetic dentist that is right for you.

The cosmetic dentist will help you discuss what it is about your smile that you don't like. Then, based on your needs, your cosmetic dentist will develop a cosmetic treatment plan that is right for you.

If you are concerned about the removal of healthy tooth structure, the good news is that dentists have conservative techniques available to enhance the look of your smile, including teeth whitening and composite bonding, as well as minimal and no-prep veneers.

Q. Are there cosmetic dentistry procedures that can be performed on children or teenagers?

A. There are many reasons why children and adolescents may want a better looking or prettier smile, such as for better socialization, enhanced self-esteem and greater confidence. Depending on your child's age and where he or she is in the development of his or her teeth and dental arches, some cosmetic dental procedures may be suitable if there is a specific problem that needs correcting.

For example, some children and adolescents may have severely discolored teeth as a result of taking certain medications. Or, the front teeth may have been fractured due to an accident or sports injury and require composite bonding or veneers. In other instances, there still may be slight gaps or spaces between the teeth even after orthodontics, so perhaps composite bonding would enhance the look of the smile.

If your child or teenager is concerned about the appearance of his or her smile, make an appointment to see your dentist. He or she will suggest the most appropriate course of action based on your child's age, oral condition and desires, as well as possibly refer you to a cosmetic dentist for consultation.