Years of bad habits and irregular visits to the dentist caused this patient’s teeth to deteriorate very quickly. Her top teeth were very uneven and heavily discoloured. Close friends and family always commented on how her teeth looked, which over time, caused the patient’s confidence to drop. She would never smile openly or laugh out loudly. Meeting new people was impossible and having photographs taken was never an option. This had a big impact on her life. She wanted to become the person she was, someone who was full of life and confidence.
After careful thought and planning, the best course of treatment recommended by Dr Dixit was to replace the existing crown and provide new porcelain crowns for the heavily filled and discoloured teeth. The teeth were prepared to the ideal shape for the crowns using custom-made templates to minimise drilling. A soft-tissue laser was used to painlessly recontour the gums enabling the final crowns to be of the ideal length for her face. The new colour was matched to perfection using a special hand-held shade taking device.
The patient was over whelmed with the results. Friends and family could not believe how confident it had made her. She was now able to hold her head up high and smile openly and laugh loudly.
We find that many people are looking for options to restore their smile but simply don’t know what those options are. This blog post has been written to allow you to understand what the options are available, possible prices, the procedures and what to expect from cosmetic dentistry.
Cosmetic dentistry is broadly broken down into 4 main areas.
Straightening crooked teeth.
Whitening dark teeth.
Restoring broken down teeth.
Replacing missing teeth.
Let’s look at each of these areas in turn.
Options to straighten crooked teeth.
As with many areas of dentistry there is in one simple way of doing this, which actually works as an advantage as it means that you can choose the best approach for you. We thought one of the easiest ways to break these treatments down Is to look at treatment time is and how quick you could have straight teeth again.
Straight teeth in around 2 to 3 weeks
If you’re looking to have straight teeth in the quickest time possible them possibly dental veneers are the way forwards. Dental veneers are a precision made thin-layer which fit over the surface of your existing teeth. They made from a high-strength dental ceramic by a highly skilled dental technician and so often come with a higher pricetag than many other options.
Dental veneers can also be used to restore broken down teeth and whiten dark teeth, so at the same time straightening them you could end up with a perfect Hollywood smile at the same time!
One of the big disadvantages with dental veneers are that they often require some form of reduction of your natural teeth underneath. Many dentists prefer to work on a minimally invasive nature, whilst dental veneers are relatively minimally invasive they do still often require drilling of your natural tooth.
If your natural tooth is otherwise healthy then you need to know that some of this may be reduced in order to accept the new dental veneer.
One of the disadvantages of dental veneers is the fact that they often require a small amount of reduction of your natural tooth. Whenever possible we prefer to keep your natural teeth fully intact and so this is where the next treatment to straighten teeth comes in, it involves moving them with orthodontics and the technique which is fastest is known as the Inman Aligner.
The Inman aligner is a revolutionary new technique whereby a removable orthodontic appliance is used to push and pull your teeth in the correct direction. You need to be committed with your Inman aligner and wear it for at least 20 hours per day, removing it only for cleaning and eating.
Here’s a video of how the Inman aligner works by pushing and pulling at the same time.
Many people dislike the fact that the Inman aligner, whilst being rapid, is a removable appliance. Some people prefer to have a fixed appliance. Fixed appliance orthodontics are generally able to move teeth slightly more than a removable appliance and the one that we prefer is Six Month Smiles.
This orthodontic system uses fixed, tooth coloured brackets to move your teeth around six months, this is much faster than conventional orthodontics which often takes between one and two years. The reason we can move the teeth quicker is down to a revolutionary type of bracket and the fact that we are often only moving the front teeth.
Teeth whitening is one of the most easily accessible treatments in dentistry as it can be offered to almost anyone. So long as you have natural teeth (dental veneers or crowns cannot be whitened) and you are in good dental health then you are more than likely candidate of teeth whitening.
As with any dental treatment it is absolutely vital that you are in good dental health before embarking on any programme of whitening. This is one of the reasons it is important to visit your dental practice to have your whitening treatment, if your gums are unhealthy or perhaps bleed on contact then this can affect the whitening process and inflame any gum disease you may already have.
The clear teeth whitening tray
Teeth whitening works by placing a small amount of peroxide gel in contact with your teeth. This peroxide whitening gel is held in place by close-fitting and precision made bleaching tray which is the spoke to you and cannot be used with anybody else. These trays need to be made with absolute precision.
They need to seal around the age of your tooth/gum margin to ensure that none of the peroxide gel touches your sensitive gums. This is another reason why we recommend going to see your dentist for whitening, they can accurately make sure that this tray fits precisely prior to beginning any treatment.
You will typically wear your teeth whitening bleaching trays overnight for approximately 2 weeks. The good thing with the treatment is that if you experience too much sensitivity or you reach your desired tooth colour then you can stop treatment immediately.
Dental veneers for whitening teeth
If your teeth are extremely dark, perhaps because they have died then we may find that whitening is not adequate to get them to the shade required. If this is the case then dental veneers can be used to cover up the dark teeth underneath.
Before restoration with veneers to whiten teeth
After restoration with dental veneers
Restoring broken down teeth in cosmetic dentistry
We’ve already discussed the ability for dental veneers to straighten crooked teeth and white and dark teeth, they can also be used to restore broken down teeth. Because we’ve already spoken about dental veneers we’re going to focus our attention now on dental crowns.
A dental crown is a precision made and highly aesthetic replacement for the natural crown of your tooth. The most aesthetic ones are made from pure high-strength dental great ceramic which is extremely long lasting and can withstand the force is exerted when you eat and chew.
Your dentist will remove any decayed area of tooth, prepare the remaining teeth and take an impression which will be sent off to the dental technician. The dental technician, who was a highly skilled member of the dental team will then make your new crown to fit exactly over the stump which the dentist has prepared.
This whole process takes approximately 2 weeks from start to finish, was the technician is making a new crown you will be supplied with a temporary crown.
Replacing missing teeth in cosmetic dentistry
We’ve written blog post in the past offering top tips for people wanting to replace missing teeth, so we’re not going to spend too much time here talking about this. What is important to know is that replacing missing teeth can also be done in conjunction with other forms of cosmetic dentistry.
If you have missing tooth it may be that in order to replace it we need to create more space, if this is true then we may use orthodontics to move the surrounding teeth around to create enough space. You may also want to restore broken down teeth and white and other teeth at the same time as replacing missing teeth. This then becomes a more complex form of cosmetic dentistry with complicated procedures.
If you’re going to have these more complex procedures we recommend you search for your cosmetic dentist on the British Academy of Cosmetic Dentistry website, in the search facility if you type in Nishan Dixit and enter the area as Harrow you will find that he is a full member of the Academy who has been qualified for more than three years, demonstrated a commitment cosmetic dentistry by fulfilling their strict requirements which include attendance at meetings and ongoing postgraduate education in subjects relevant to the practice of cosmetic dentistry.
Dr Nishan Dixit runs a dental practice in the heart of Harrow offering cosmetic dentistry to the local people. The practice offers a free cosmetic dentistry consultation with the treatment co-ordinator, please complete the relevant form here
As a board member and scientific director and education chair of the British Academy of Cosmetic Dentistry, our very own Dr Nishan Dixit is often asked to publish articles on successful cases so that others in the dental profession can learn from his successes. Here is one such article published in The Dentist, Issue 76, April 2014.
A Happy patient
Nishan Dixit describes a non-invasive composite restoration using a multi-layer technique.
67 year old male patient presented with a lingual cusp fracture in his lower right first pre-molar, which had an old amalgam restoration. He was not experiencing any pain, but was aware of the rough edge. Since the fracture had occurred, the patient had also become more self-conscious about the discolouration of the tooth.
The treatment options were discussed with the patient. The tooth could either be restored with a direct composite or an indirect laboratory-manufactured restoration. The patient decided on the composite option, as this would provide a more immediate and less disruptive solution. I prefer to offer composite treatment, rather than more invasive procedures, when the clinical situation allows. This is more affordable for the patient, and the durability of the material makes it a realistic long-term alternative.
Having been a provider of cosmetic dentistry for almost 20 years, I have observed a number of improvements in materials. Long-term studies have proved the reliability of modern composites. The latest developments have produced composites that are more resistant to wear and have better colour stability, combined with reduced polymerisation shrinkage rates.
For a number of years,I have used the Heraeus Venus range of composites exclusively, due to their handling properties and the results achievable. For this case, I chose to use Venus Pearl. It gives high aesthetic outcomes using a multi-layer technique, providing excellent colour adaptation and a natural finish. The material is easy to use, masks well and is highly sculptable and polishable. Compared with earlier technologies, the cured composite is more flexible under stress and more durable over time.
Venus Pearl includes super-fine nano-hybrid filler particles. This provides even more natural light refraction and supreme aesthetic appearance, combined with a creamy application.
Treatment and outcome
At the treatment appointment, local anaesthetic was administered and the tooth was isolated with rubber dam and a clamp system. The old amalgam restoration was removed and the cavity was rendered caries free. The preparation margins were smoothed and the enamel margins bevelled. A matrix band was then adapted to the tooth. The prepared cavity was etched with 37 per cent phosphoric acid using a total etch technique. The cavity was thoroughly washed, gently dried and primed. Then a bonding agent was placed and polymerised.
Venus Pearl OMC (Opaque Medium Chromatic) was applied to the cavity in 2mm increments. The composite was adapted to the cavity, using a microbrush in a ‘patting’ motion, then polymerised . Approximately 20 per cent of the cavity was filled with OMC and the remaining 80 percent was filled with the Venus Pearl A3 shade. The build-up of the composite was done on a cusp-by¬cusp basis, gradually creating the tooth shape and fissure pattern. During the incremental build-up a small amount of dark brown stain was applied in the fissure areas using an explorer.
Finally, the restoration was polished with Venus Supra discs and a silicone carbide brush. The outcome was a restoration with good aesthetics, achieved with minimum loss of tooth substance and completed in one short visit. The patient was extremely pleased with the end result, leaving him feeling like he had “a new, natural-looking tooth”. He had absolutely no post operative sensitivity or pain. Subsequent recall appointments have shown this has continued to be the case. The treatment has left a healthy tooth and a happy patient.
Dr Nishan Dixit recently attended The American Academy of Cosmetic Dentistry’s (AACD) annual meeting in Orlando, Florida, USA.
The conference, AACD 2014, took place April 30-May 3 and was the Academy’s 30th anniversary scientific session. Dr Nishan Dixit had access to multiple hands-on workshops and lectures during the conference, which was attended by an estimated 1,700 dental professionals.
The conference is cosmetic dentistry’s premier event, with some of the world’s most well-known dental educators, live dentistry, access to the latest cosmetic dentistry innovations in the AACD Exhibit Hall, and much more.
Dr James Hastings, the current AACD President said:
“By attending AACD 2014, Dr Dixit is not only showing his commitment to education and the cosmetic dentistry field, but to his patients, the education he received in Orlando will help him provide the best care to those he cares about the most.”
The team from Blue Court Dental enjoyed a golden hour of celebration last month when they attended an exclusive reception at the British Dental Conference and Exhibition in London. The reception was held to celebrate dental practices which had achieved at least ten years or more membership of the British Dental Association’s Good Practice Scheme, known as Gold Membership.
Blue Court Dental’s achievement has also been recognised in a celebratory publication that includes a profile of all practices with Gold Membership.
At the reception in London the practice teams were presented with a copy of the brochure by the President of the British Dental Association, Dr Barry McGonigle, and had the opportunity to meet fellow professionals from across the country.
Dr McGonigle said:
“A practice’s membership of the BDA’s Good Practice Scheme demonstrates its whole team’s commitment to high standards, delivering high-quality, patient-centred care and the pursuit of excellence.
“The practices that we are celebrating this year have not only achieved the required standards for membership of the Scheme, they have maintained them for at least ten years. This is a significant accomplishment and I offer my sincere congratulations to the teams at each of these practices.”
Dr Dixit said “We are very pleased and proud to be the only practice in Harrow and Middx to have achieved this standard, demonstrating our compliance with the Good Practice Scheme for 12 consecutive years.”