"The man with a toothache thinks everyone happy whose teeth are sound."

George Bernard Shaw

The visible part of a tooth, otherwise known as the crown, is only a small portion of the living system. The crown is made up of enamel, the hardest substance found within the body. It is bone that has been enriched with large percentages of calcium. That's why people who drink lots of milk or take calcium supplements have strong bones and teeth. The enamel is thickest at the crown, and thinnest near the roots of the teeth.

Excellent crowns and bridges were made by the Etruscans in the 7th cent. B.C. At about that time, teeth were being extracted in Asia Minor as a cure for bodily ills and diseases. Skills achieved by the Etruscans, Phoenicians, Egyptians, Greeks, and Romans were largely lost during the Middle Ages, when barbers and roving bands of charlatans practiced unskilled dentistry at marketplaces and fairs. Abulcasis, a Spanish Moor, was one of the few in his time who studied dental surgery.

New developments include the implantation of artificial teeth or binding posts into the gums or jawbone; antibiotic fiber for periodontal disease; root canal surgery, a procedure that ameliorates pain while permitting teeth to remain in place; and nearly painless lasers to repair dental cavities, usually making local anesthesia unnecessary.

Composite resins may also be used to enhance the appearance of any tooth, which is a tooth bonding procedure. The composite resin will strengthen and enhance the natural tooth structure as it does with use as a dental filling.

A special dental material is then used to open up the pores of your tooth's dentin and roughens up the surface of the exposed enamel. This achieves better and stronger bond. The bond resin is applied to stick the composite to your tooth. This material is made of the same dental resin as the composite however it is much more fluid. This layer is then hardened and cured with a very bright light.

If over half of your molar tooth's biting surface is decayed an inlay or onlay may be a better option than a filling. These options are basically for when more than a filling is needed but less than a crown will do. An inlay is placed in between the cusps of the tooth, whereas an only will cover one or more of the cusps. They can be made of a gold alloy, porcelain or tooth-colored resin and are cemented into place.

This section of our cosmetic dentistry information site provides you with some background into dental veneers, both composite veneers and porcelain veneers. Dental veneers, sometimes called tooth veneers, can be used to correct both color and shape problems.

Dental veneers can be made from porcelain or from resin composite materials. Porcelain veneers resist stains better than resin veneers and better mimic the light reflecting properties of natural teeth. Resin veneers are thinner and require removal of less of the tooth surface before placement. You will need to discuss the best choice of veneer material for you with your dentist.

Veneers, porcelain or plastic, are placed over the front teeth to change color shape of the teeth. Veneers are ideal for teeth that are too small, too big, or have uneven surfaces. It is very common for people to have imperfect teeth, either oddly shaped teeth, chipped teeth, crooked teeth, teeth with small holes in them, or an inappropriate sized tooth or teeth that have an odd appearance. Veneers solve such irregularities and create a durable and pleasing smile.

While no alternative to veneers will create the exact same effect, there are some popular procedures that may seem worthwhile. Crowns, while more expensive, also act to cover the tooth with a protective coating. For individuals who simply want to brighten their teeth, many clinics now offer tooth bleaching, though this is a much less permanent procedure.

Bonding is a composite resin filling placed in the back teeth as well as the front teeth. Composites are the solution for restoring decayed teeth, making cosmetic improvements and even changing the color of your teeth or the reshaping of teeth. Bonding will lighten any stains you may have, close up minor gaps and can be used to correct crooked teeth.

A very mild etching solution is applied to your teeth to create very small crevices in the tooth's enamel structure. These small crevices provide a slightly rough surface permitting a durable resin to bond materials to your teeth. The resin is then placed on your tooth and high-intensity light cures the resins onto your tooth's surface - with each individual layer of resin hardening in just minutes. When the last coat has been applied to your tooth, the bonded material is then sculpted to fit your tooth and finely polished.

The resin comes in many shades so that we can match it to your natural teeth. Due to the layers involved, this procedure will take slightly longer than traditional silver fillings because multiple layers of the bonding material are applied. Typically bonding takes an hour to two hours depending on your particular case.

A dental bridge is a false tooth, known as a pontic, which is fused between two porcelain crowns to fill in the area left by a missing tooth. The two crowns holding it in place that are attached onto your teeth on each side of the false tooth. This is known as a fixed bridge. This procedure is used to replace one or more missing teeth. Fixed bridges cannot be taken out of your mouth as you might do with removable partial dentures.

Your cosmetic dentist will prepare your teeth on either side of the space for the false tooth. You will be given a mild anesthetic to numb the area, and the cosmetic dentist will remove the an area of each abutment (teeth on either side of the space) to accommodate for the thickness of the crown. When these teeth already have fillings, part of the filling may be left in place to help as a foundation for the crown.

Your cosmetic dentist may have you use a Flipper appliance. A Flipper is a false tooth to temporarily take the place of a missing tooth before the permanent bridge is placed. A Flipper can be attached via either a wire or a plastic piece that fits in the roof of your mouth. Flippers are meant to be a temporary solution while awaiting the permanent bridge.

For individuals who have chipped, cracked or irregularly shaped teeth, dental contouring and reshaping can be just the ticket for a more beautiful smile.

You maybe candidate for tooth contouring and reshaping, if you want your teeth to appear less crowded, lack chips and fractures, have decreased overlaps or to be without pits or grooves in the enamel, this procedure should be discussed with your cosmetic dentist.

The cosmetic dentist will mark your teeth with a pencil prior to performing the procedure. This helps the cosmetic dentist in their sculpting process. As your cosmetic dentist sculpts the tooth, imperfections are artfully eliminating or minimized. A sanding drill or laser may be used to remove small amounts of surface enamel gradually. Abrasive strips are then moved back and forth between your teeth to shape the actual sides of your teeth. Then the teeth are smoothed and polished. Usually anesthetic is not needed. Teeth contouring and reshaping usually takes one to three visits.

Contouring teeth may also help correct small problems with bite. It is common for bonding to be combined with tooth reshaping to achieve a beautiful smile. There are actually several ways to change the appearance of your teeth. Many times these various procedures are combined in different ways to deliver that smile of your dreams.

Your cosmetic dentist will usually be able to spot problem areas in your mouth that might lead to tooth damage and a need for crowns. Chewing patterns play a big role as well. By selectively grinding the tips of your middle and back teeth (called cusps) will alter your bite to reduce the stress on at-risk teeth.

In some cases your cosmetic dentist may choose to use a Flipper instead of a temporary crown. A Flipper is a false tooth to temporarily take the place of a missing tooth before the permanent crown is placed. A Flipper can be attached via either a wire or a plastic piece that fits in the roof of your mouth. Flippers are meant to be a temporary solution while awaiting the permanent crown.

There are basically three types of crowns, those made of gold, ceramic crowns and ceramic-veneered gold crowns. Gold and metal-ceramic crowns are extremely durable and are normally used in molars, where the forces from chewing and grinding are most prevalent. Ceramic crowns are used primarily for front teeth, since they can best resemble the natural tooth color.

Teeth straightening is accomplished with a number of different procedures and is usually done on children and adolescents when their permanent teeth begin growing in. Crooked teeth, crowded teeth, and even overbites and underbites can be treated with various teeth straightening techniques. While considered a cosmetic procedure, some people require teeth straightening in order for their teeth to be aligned in such a way that chewing is possible. Severe overbites and underbites can result in serious consequences over time, and even overly crowded teeth can mean health problems for the mouth.

Some tenderness and soreness is to be expected with any method of teeth straightening, especially soon after an adjustment is made. The bone on one side of each tooth socket will be compressed, and the other side must be filled in with new bone as the tooth moves through the jaw. Standard orthodontic braces may cause superficial irritation to the interior of the mouth, a symptom that can be reduced with salt water gargles and a soft wax on the surface of the brackets. Severe side effects to teeth straightening are nearly unheard of, and the process is considered very safe.

Terms used on this page

Dental fillings

• Dental fillings are inserted as restorations in the treatment of dental cavities, after drilling out the cavities.

Dental implants

• Dental implants are surgically fixed substitutes for roots of missing teeth. Embedded in the jawbone, they act as anchors for a replacement tooth, also known as a crown, or a full set of replacement teeth.

Dentures

• Removable complete dentures are full-mouth false teeth, which are used when a patient has no teeth left on either the mandibular arch, the maxillary arch, or both.

Veneer

• A layer of tooth-colored material, usually porcelain or acrylic resin, attached to and covering the surface of a metal crown or natural tooth structure.

Anesthesia

• Total or partial loss of sensation, especially tactile sensibility, induced by disease, injury, acupuncture, or an anesthetic, such as chloroform or nitrous oxide.


• Local or general insensibility to pain with or without the loss of consciousness, induced by an anesthetic.


• A drug, administered for medical or surgical purposes, that induces partial or total loss of sensation and may be topical, local, regional, or general, depending on the method of administration and area of the body affected.

Bridge

• A dental bridge is a prosthesis used in place of missing teeth and may be removable or permanently attached.

Dental cavities

• The formation of cavities in the teeth by the action of bacteria; tooth decay.


• Also known colloquially as tooth decay.

Dental crown

• Full-coverage restoration (sometimes incorrectly called a cap) is a prosthetic tooth designed by a dentist and usually created by a lab technician.

Porcelain

• A hard, white, translucent ceramic made by firing a pure clay and then glazing it with variously colored fusible materials.

Stomatology

• The medical study of the mouth and its diseases.

Tooth bleaching

• Also known as tooth whitening.

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