Dental braces (also known as braces, orthodontic cases, or cases) are devices used in orthodontics that align and straighten teeth and help position them with regard to a person's bite, while also aiming to improve dental health. They are often used to correct underbites, as well as malocclusions, overbites, open bites, gaps, deep bites, cross bites, crooked teeth, and various other flaws of the teeth and jaw. Braces can be either cosmetic or structural. Dental braces are often used in conjunction with other orthodontic appliances to help widen the palate or jaws and to otherwise assist in shaping the teeth and jaws.
Traditional metal wired braces are stainless-steel and are sometimes used in combination with titanium. Traditional metal braces are the most common type of braces. These braces have a metal bracket with elastic (rubber band) ties holding the wire onto the metal brackets. The second-most common type of braces is self-ligating braces that do not require elastic ties. Instead, the wire goes through the bracket. Often with this type of braces, treatment time is reduced, there is less pain on the teeth, and fewer adjustments are required than with traditional braces.
Gold-plated stainless steel braces are often employed for patients allergic to nickel (a basic and important component of stainless steel), but may also be chosen because some people simply prefer the look of gold over the traditional silver-coloured braces.
Lingual braces are a cosmetic alternative in which custom-made braces are bonded to the back of the teeth making them externally invisible.
Titanium braces resemble stainless-steel braces but are lighter and just as strong. People with allergies to the nickel in steel often choose titanium braces, but they are more expensive than stainless steel braces.
Customized orthodontic treatment systems combine high-technology including 3-D imaging, treatment planning software and a robot to custom bend the wire. Customized systems such as this offer faster treatment times and more efficient results.
Progressive, clear removable aligners may be used to gradually move teeth into their final positions. Aligners are generally not used for complex orthodontic cases, such as when extractions, jaw surgery, or palate expansion are necessary.
Aligners are a series of tight-fitting custom-made mouthpieces that slip over the teeth. Invisalign is the largest producer of clear aligners, but it’s not the only brand. Others include Clear Correct, Inman Aligner, and Smart Moves.
Clear (or "invisible") aligners aren't for everyone. Your orthodontist or dentist will help you decide what’s best for you.
Because the invisible aligners are custom-built for a tight fit, they are best for adults or teens. Straightening a child’s teeth is more complicated. Young people, and their mouths, are still growing and developing; the doctor must think about this when setting up treatment.
Clear orthodontic aligners are typically used for patients who have mild or moderately crowded teeth, or have minor spacing issues. Patients who have severe crowding or spacing problems or severe underbites, overbites, or crossbites may need more complex treatment.
Crowns & Bridges
A crown is a dental treatment in which a cap is placed over your existing tooth. The cap is either made of porcelain or porcelain fused to metal. Each crown is custom made to fit your tooth, and it is tinted to match your other teeth.
Crowns can be used as a dental treatment to:
Correct misshapen or small teeth
Cover up discolorations
Protect and restore chipped or cracked teeth
Reinforce teeth that have had a root canal
Replace missing teeth
Support teeth with large fillings
Bridge When you have lost one or more teeth, it is crucial to replace them for the health of your other teeth and your jaw. A bridge is a dental treatment that is used to replace missing teeth. They are called bridges because they form a bridge over the space created by the missing tooth or teeth.
Dental bridges have the following benefits:
Fill in gaps in your smile
Allow you to chew and speak normally
Support the position of remaining teeth
Prevent further tooth loss
Reduce boss loss to the jaw
The bridge process consists of making impressions of your teeth to create the crowns needed for the neighboring teeth and the artificial tooth, known as a pontic, fills in the gap.
Dental implants are artificial tooth roots used to support a restoration for a missing tooth or teeth, helping to stop or prevent jaw bone loss. The implantation procedure is categorized as a form of prosthetic (artificial replacement) dentistry, but also is considered a form of cosmetic dentistry.
People who have lost teeth might feel too self-conscious to smile or talk. Additionally, biting irregularities caused by tooth loss can have a negative effect on eating habits, leading to secondary health problems like malnutrition.
By replacing missing tooth roots, dental implants provide people with the strength and stability required to eat all the foods they love, without struggling to chew. Additionally, they help to stimulate and maintain jaw bone, preventing bone loss and helping to support facial features.
Healing from the surgical procedure to place the implant(s) takes up to six months, while the fitting and seating of the crown(s) can take up to two months. Again, this timeframe depends on individual cases and treatments. Follow-up appointments with your treatment coordinators are essential for monitoring your progress.
Implants also may be categorized based on the shape/type of their head. All implants require the restoration and abutment to be attached or screwed to the head. For this purpose, there are three main connector types:
Internal Hex Connectors: Shaped like a hexagon, an internal hex connector is an opening in the implant head into which the restoration/abutment is screwed.
External Hex Connectors: Also shaped like a hexagon, these connectors are atop the implant head.
Internal Octagon Connectors: Shaped like an octagon, an internal octagon connector has an opening in the implant head into which the restoration/abutment is screwed.
After the required healing period, the dental implant is tested to determine whether it was successfully taken up by the surrounding bone. Once this has been confirmed, a prosthetic component is connected to the dental implant via a screw. This component is called an "abutment." It will serve to hold the replacement tooth or "crown." The dentist will take an impression (mold) of this abutment in the mouth and have the implant crown custom-made to fit. The implant crown is either cemented on or secured with a screw to the abutment.
A denture is a removable replacement for missing teeth and surrounding tissues. Two types of dentures are available -- complete and partial dentures. Complete dentures are used when all the teeth are missing, while partial dentures are used when some natural teeth remain.
Complete dentures can be either "conventional" or "immediate." Made after the teeth have been removed and the gum tissue has begun to heal, a conventional denture is ready for placement in the mouth about eight to 12 weeks after the teeth have been removed.
Unlike conventional dentures, immediate dentures are made in advance and can be positioned as soon as the teeth are removed. As a result, the wearer does not have to be without teeth during the healing period. However, bones and gums shrink over time, especially during the healing period following tooth removal. Therefore a disadvantage of immediate dentures compared with conventional dentures is that they require more adjustments to fit properly during the healing process and generally should only be considered a temporary solution until conventional dentures can be made.
A removable partial denture or bridge usually consists of replacement teeth attached to a pink or gum-colored plastic base, which is sometimes connected by metal framework that holds the denture in place in the mouth. Partial dentures are used when one or more natural teeth remain in the upper or lower jaw. A fixed bridge replaces one or more teeth by placing crowns on the teeth on either side of the space and attaching artificial teeth to them. This "bridge" is then cemented into place. Not only does a partial denture fill in the spaces created by missing teeth, it prevents other teeth from changing position. A precision partial denture is removable and has internal attachments rather than clasps that attach to the adjacent crowns. This is a more natural-looking appliance.
A smile makeover is the process of improving the appearance of the smile through one or more cosmetic dentistry procedures, such as:
Some of the components taken into consideration include your facial appearance, skin tone, hair color, teeth (color, width, length, shape and tooth display), gum tissue and lips. Smile makeovers are performed for many reasons and customized according to your unique considerations.
What is it that you like or dislike about your smile or your teeth? Some aspects of your smile that your cosmetic dentist will review with you and that could be improved include the following:
Image courtesy of Larry Addleson, DDS, FAACD
Tooth Color: Silver or amalgam dental fillings can be replaced with natural, tooth-colored composite restorations, while teeth whitening can improve the color of stained or dulled teeth. Tooth color and shading are important considerations during the evaluation of and preparation for various procedures, including porcelain veneers, crowns, bridges, composite bonding and dental implants.
When considering the color of your teeth, keep in mind that dark or discolored teeth may suggest an aged mouth. A well-shaped smile comprised of bright, white teeth lends to a youthful appearance. The shade your dentist selects for teeth whitening and veneers is carefully evaluated with special consideration given to the tone and color of your face and hair. Cosmetic dentists are skilled at finding the right balance between providing you with a brighter, whiter smile and maintaining a natural tooth color.
Alignment and Spacing: Teeth that are crooked, overlapping or have gaps between them can be straightened and aligned when necessary through orthodontics or Invisalign and improved with veneers.
Missing Teeth: One or more missing teeth can negatively affect the appearance of your smile – as well as affect your bite and increase your risk for tooth decay – making replacement an integral part of oral health and facial esthetics. Missing teeth can be replaced by dental implants, bridges or partial dentures.
Harmony and Balance: Uneven, chipped and cracked teeth can be cosmetically bonded for an improved appearance, and a gummy smile can be re-contoured to help improve the overall look of the smile.
Fuller Lips, Smile and Cheeks: An unshapely or aging face can be improved or rejuvenated with certain procedures in the smile makeover category, including orthodontics and/or oral maxillofacial surgery.
A cosmetic dentist will work closely with you to develop a treatment plan designed to achieve exactly what you want from your makeover. This treatment plan may consist of many cosmetic and functionally restorative procedures, potentially including teeth whitening, composite bonding, veneers, dental crowns, orthodontics (braces), oral maxillofacial surgery and gummy smile reduction.
Aesthetic Components of a Smile Makeover
In addition to the color, alignment and balance of your teeth in the aesthetic zone of your smile (the section of upper and lower teeth that show when you smile), there are several attributes of your teeth and smile that your cosmetic dentist will evaluate with you when planning your makeover. These include:
Tooth Length: Long teeth lend a youthful appearance. Aging produces wear and tear that often results in shorter teeth, and a gummy smile also can make teeth appear shorter. A treatment for shorter teeth may include reshaping and lengthening the two front central teeth with composite bonding or porcelain veneers. If you have a gummy smile, your cosmetic dentist may provide treatment to modify the gum line and lengthen the appearance of the teeth using laser dentistry procedures. You may also be referred to a periodontist for crown lengthening if necessary.
Teeth lengthening may also impact your overall facial appearance. For example, shapely, long, square teeth on a round-faced individual can provide a slimming effect.
Smile Line: The smile line is an imaginary line that follows the edges of your upper teeth from side to side, which ideally should be the same as the curve of your lower lip when you smile. This standard point of reference may be used to help determine how long your new teeth should be.
Tooth Proportions: Your cosmetic dentist will examine your teeth to determine if they are in correct proportion with each other. Most people recognize a pleasing smile as one in which the two central front teeth are dominant and have a width-to-length ratio of 4-to-5. This proportion guides the length and width of other teeth in the aesthetic zone so that the smile line appears balanced.
Tooth Texture and Characterization: An artistic dentist can characterize your crowns or veneers to create a more feminine or a more masculine appearance, in addition to matching the look and feel of natural teeth or those you’ve seen in photographs.
Teeth whitening is one of the most popular cosmetic dentistry treatments offering a quick, non-invasive and affordable way to enhance a smile. Universally valued by men and women alike, whitening (or bleaching) treatments are available to satisfy every budget, time frame and temperament. Whether in the form of professionally administered one-hour whitening sessions at a dental office or cosmetic spa, or home-use bleaching kits purchased at your local drugstore, solutions abound.
Virtually everyone who opts for a teeth whitening solution sees moderate to substantial improvement in the brightness and whiteness of their smile. That said, it’s not a permanent solution to discoloration and requires maintenance or “touch-ups” for a prolonged effect.
There are two categories of staining as it relates to the teeth: extrinsic and intrinsic.
Extrinsic stains are those that appear on the surface of the teeth as a result of exposure to dark-colored beverages, foods and tobacco, and routine wear and tear. Superficial extrinsic stains are minor and can be removed with brushing and prophylactic dental cleaning. Stubborn extrinsic stains can be removed with more involved efforts, like teeth whitening. Persistent extrinsic stains can penetrate into the dentin and become ingrained if they are not dealt with early.
Intrinsic stains are those that form on the interior of teeth. Intrinsic stains result from trauma, aging, exposure to minerals (like tetracycline) during tooth formation and/or excessive ingestion of fluoride. In the past, it was thought that intrinsic stains were too resistant to be corrected by bleaching. Today, cosmetic dentistry experts believe that even deep-set intrinsic stains can be removed with supervised take-home teeth whitening that is maintained over a matter of months or even a year. If all else fails, there are alternative cosmetic solutions to treat intrinsic staining, such as dental veneers.
Despite achieving the results of treatment, stains can return within an initial couple of months of treatment. Various methods may be employed to prolong the treatment results, such as:
Brush or flush out mouth with water after eating and drinking
Floss to remove plaque and biofilms between the teeth
Take special care during the first 2 days – the first 24–48 hours after the whitening procedure is seen as the most crucial period in which you must protect for your teeth the most. Hence, it is vital that non-staining drinks or foods are eaten during this time as enamel is prone to adhere to stains.
Drink fluids that may cause staining through a straw
Depending on the method used to whiten the teeth, re-treatment every six months or after a year may be required. If an individual is a smoker or they consume beverages with the capacity to stain, regular re-treatments would be required.