Randall LaFrom, DDS
COSMETIC AND GENERAL DENTISTRY

(408) 996-8595 PH
randy@club2000.com


AESTHETIC DENTISTRY - The correction or improvement of the look, or shape of teeth and smile while including restorative dentistry, prosthetic dentistry, and preventive dental care.
Aesthetic Dentistry. This has almost become a specialty in itself. It includes the following procedures:
SMILE!

BLEACHING - TEETH WHITENING

There are two techniques which are commonly used to brighten teeth:
1) DENTIST SUPERVISED "AT-HOME" TECHNIQUE -
This technique is good for those people who simply need to lighten their teeth. When teeth have been discolored from smoking, coffee, tea, or simply due to aging, this is often a good option. [Often, if a single tooth has had a root canal treatment done, it can cause discoloration (darkening) of the tooth. If a crown is not placed to support the tooth right away, often the tooth may be bleached at a later time instead.]
First, an impression is taken of the patient's mouth and stone models are poured up. Then a precision fit splint is made (either by a lab or by the dental office) which has the facial surface of the teeth blocked out to allow room in the splint for the bleaching solution (typically 10% -15% carbamide peroxide) to stay on the teeth. This thin mouthpiece is then worn for one to three hours per night (or in the evening) daily, after the patient has carefully cleaned their teeth. It usually takes about two weeks to get to the desired results if worn every night.
Advantages include: This technique allows you to do this at your own home (or work) and on your own time. If you wish to lighten your teeth more in the future, you can simply purchase some more bleaching solution and use that. The cost for this procedure is generally a little less than the IN OFFICE TECHNIQUE.
2) "IN-OFFICE" TECHNIQUE -
First, the teeth are pumiced to clean them. Then an ointment is placed on the gums to protect them. A rubber dam (similar to a thin plastic square with holes in it to fit around the teeth) is placed over the teeth and the teeth are isolated to allow the bleaching solution to work. The patient then sits in front of a special bleaching light for approximately 30 minutes per arch. This technique usually works best after about three sessions.
Advantages include: This is better when you have streaks of darker colors on your teeth, or if you have crowns or other fillings on your front teeth. Since we are able to use a stronger solution using this technique, we feel it produces a more reliable result.
Disadvantages include: If you have sensitive teeth to begin with, this technique can cause them to be slightly more sensitive temporarily (typically for up to a day). In addition, occaisionally, the material can cause minor temporary irritation on the gums near the edges of the rubber dam.
OVERVIEW: Bleaching is a safe and effective way to whiten your teeth. For patients who are heavy smokers or coffee drinkers, the results may not be as long-lasting. The ADA has given it's approval on many of the products available for bleaching (specifically the ones used at our office.)


FOR MORE DETAILS ON DIFFERENT BLEACHING TECHNIQUES CLICK HERE!


BONDING -
BONDING is a generic term for the cosmetic procedures that we do when we add materials to the teeth to either fill in spaces between the teeth, to lengthen teeth, to reshape teeth, or to change the color of the teeth. It includes composites and porcelain veneers. These procedures can radically improve the overall smile of a person and improve self-esteem and self-confidence. They are more conservative than full coverage crowns.

COMPOSITES -
COMPOSITES are glass filled resins that are bonded to the teeth. The materials have improved dramatically in the past twenty years in terms of durability, esthetics, wear and use of placement. The newer light-cured type of composite materials allow us to place the filling in the tooth first to check the shade and then harden the material. There are generaly about ten different shades of white, yellow and grey that we can mix together to create a great shade match with your teeth. Most fillings that are placed in the front teeth are composites. Since these types of materials are bonded to your teeth and have better esthetics than metal type fillings, and they don't have the concern of mercury or putting extra stresses on the teeth, these are becoming more commonly done in the back teeth in smaller areas, when indicated. In the larger areas, porcelain inlays and onlys can be used to support the tooth surfaces and contact areas better.

CROWNS -
CROWNS - Typically porcelain crowns are placed when a significant amount of tooth structure is lost and when placing a filling would jeopardize the integrity of the tooth or compromise the aethetics or strength. Traditional crowns have gold inside of them with porcelain bonded to the outside for aethetics. These are sturdy and durable and hold up well to the 200 pounds of pressure put on them during chewing function. The newer porcelain crowns are called "second-generation" materials because they are stronger and more durable than the original porcelain type materials that were used thirty years ago. These new materials have more flex, better wear, more translucency to match the natural color of your teeth and they bond better to either the tooth or the metal underneath the porcelain on the porcelain/metal crowns. New materials, including the OPC crowns (Optimal Pressable Ceramic) are extrememly strong and durable crowns made completely of porcelain and bonded to the tooth. Another name for these is Empress Crowns. These types of crowns are becoming more and more popular because they are more aesthetic, and have NO metal underneath which can sometimes give a "grey" or "black" margin "shine-through" at the gumline.
Back to top

PORCELAIN INLAYS AND ONLAYS -
PORCELAIN INLAYS AND ONLAYS - In areas where strength and aesthetics are needed, porcelain inlays and onlays are an excellent option. In the contact areas, along the marginal ridge (the edge between the teeth), there is a fair amount of wear and tear. If a composite material is placed in an area of high stress, then it tends to wear down over time. In cases such as this, porcelain fillings are suggested due to their excellent aesthetics and durability. When part of a cusp of the tooth is missing, there may still enough tooth structure to support a large filling, or for a heavy chewing surface, then inlays and onlays can be considered. Just like the porcelain veneers, they are strong and they are bonded to the teeth using a thin layer of resin material. Porcelain restorations maintain their color better than do composites. They will restore 95% of the original tooth strength. With these newer materials available today, along with newer glass ionomer cements and techniques, these are almost invisible when they are placed.

PORCELAIN VENEERS -
PORCELAIN VENEERS - These new veneers are thin porcelain facings that cover the tooth and can be used to reshape, repair, or restore a tooth back to it's original size or even better! They are bonded to the tooth using a resin material and they are used to fill in spaces in teeth, large chips on the teeth, and cover up discolorations on teeth. Many people choose to have porcelain veneers placed on their teeth in cases where wearing braces (orthodontics) is not an option. Excellent results can be created from veneers in a matter of weeks, as opposed to wearing braces for months or years. We call it "instant orthodontics". Sometimes veneers are done to complete orthodontic cases where there simply isn't enough tooth structure to fill in the spaces needed due to a large arch. To see photos of porcelain veneers. New materials currently available allow the dentist to place porcelain veneers that have a very similar microscopic alignment of the crystals which allows it to mimic the reflective surfaces that our natural enamel offers, giving even more life-like appearance.
Back to top
[Photo at top courtesy of Visual Solutions in Vancouver Washington (800)691-9026.]
 

aesthetic children endodontics
hi-tech hygiene restorative
preventive prosthetics TMJ



HOME

Copyright©2007 Dr. Randall LaFrom ALL RIGHTS RESERVED
http://www.lafrom.com