Straight & Pearly Whites 101
A beautiful smile is
definitely an enviable asset to have. Unfortunately
a set of crooked, yellowed and chipped teeth will certainly
subtract from a face no matter how attractive or sensual.
Today's cosmetic dental technology can transform a less than
attractive mouth into a true, beaming Hollywood
smile. From straightening to whitening to lessening
or increasing tooth and gum show, cosmetic dental can surely
help you acquire a sensational set of pearly whites. This
isn't exactly considered facial plastic surgery, but it can add
to your appearance.
There are many procedures to
improve the appearance of your mouth, even if you are missing
several teeth. We will discuss the various options and
cover the costs involved as well...
According to the American Association of Orthodontics,
"Orthodontics is the branch of dentistry that specializes in the
diagnosis, prevention and treatment of dental and facial irregularities.
The technical term for these problems is malocclusion, which
means "bad bite." The practice of orthodontics requires
professional skill in the design, application and control of corrective
appliances, such as braces, to bring teeth, lips and jaws into proper
alignment and to achieve facial balance."
Association of Orthodontists - FAQ about Orthodontics 2001
The general attitude towards braces is
usually very negative, thankfully orthodontics have advanced
significantly. Granted, patients needing extensive
straightening may not benefit from the newer techniques but usually all
complaints can be remedied. Not only do orthodontics improve
your smile but they improve dental health, in general. Dental
problems which are not necessarily cosmetic such as gum disease and
tooth decay are more likely to happen in individuals with orthodontic
I am personally going to try the Invisalign®
brand and cannot wait!! Marc (my partner) had braces for about 3 years and
it certainly helped his teeth so very much -- however his teeth have moved back since his braces so instead of a repeat of braces he
got Veneers for his his uppers and about 7 crowns. He is planning on
for his lowers next year if he is a candidate. He has also had tooth bleaching done (Professional
Nite-White® brand). BUT! Ha! Mine are
whiter!! and all I have used are Crest Whitestrips and IGIA! Finally White Gel.
& Reasons for Orthodontics
- Crooked Teeth
- Teeth that are too
- an overbite
- protruding teeth
- misalignment where the
front teeth make no contact
- an underbite
- widely spaced teeth
Your Options In
Today's options are not like the train tracks of yesteryear.
Many new materials decrease the wear time for many patients and there
are even clear or colored brackets like hot pink or neon green,
invisible trays and invisible types which are placed behind
the teeth, called lingual braces.
- Standard metal braces:
Such as Titanium alloy set ups with or without colored or clear
brackets may take anywhere from 1 to 3 years on average and are
costly to the patient.
- Non-invasive Straightening
Products: There are even non-metal, removable trays
which can effectively move the teeth as long as they are worn for
the recommended amount of time. Such a product is Invisalign®
which is available for as little as $129.00US a month. (www.invisalign.com)
. Results have been seen from 6 months to 1.5 years in average
- Orthognathic surgery/Surgical
Alignment: This is reserved for misalignment of the jaw and
other types of maxillofacial and mandible dysfunctions.
Tooth Bleaching & Whitening
Whiter, brighter, cavity-free teeth are a sure sign of good hygiene and vitality!
Although some us may
brush and brush and brush some more but never are able to retain that sparkling white
smile. Even if your teeth yellowed from age or stained from your little habits
(smoking, drinking tea, juice and coffee, etc.). Even if your teeth are stained due to medical
reasons you can find a dental specialist who whitens teeth and walk out of
there smiling -- flashing your beautiful white teeth to the masses!
There are quite
a few ways to bleach the teeth so let's start with the professional in-office types and
work our way down.
Reasons Why Teeth May
Appear Stained or Darkened
These reasons do vary so be sure to review the below causes to determine
if they apply to you. Even if your teeth are successfully
whitened, retaining habits or exposing your teeth to these
variables will only darken your teeth once again if you choose to
continue. There are quite a few ways to bleach the teeth -- some
inexpensive, some very expensive.
- aging certainly has an effect on tooth
color and brightness (from yellow to brown)
- beverages such as coffee, tea, grape
juice, dark sodas such as Coca-Cola® or Pepsi-Cola® (dark brown
- dark fruits such as black and/or
blueberries (dark bluish hues)
- excessive fluoride can cause darkening
- genetics can play a significant part
in tooth color and brightness
- smoking can cause significant
- medications such as tetracycline
[: a yellow crystalline broad-spectrum antibiotic produced by a
soil actinomycete of the genus Streptomyces (S. virdifaciens) or
synthetically; also : any of various derivatives of tetracycline]
can cause yellowing.
Over the Counter
There are many types of bleaching pastes, gels and strips available either at your pharmacy or at through the
Internet. But remember, it is possible. Some of these
Use Crest Whitestrips every six months or as needed to maintain
whiteness. If your teeth are significantly discolored, you may
need to use 2 boxes of Crest Whitestrips initially to get the desired
result. We recommend using a Crest whitening toothpaste to gently
polish away surface stains daily.
What you get with a box of Crest White strips:
- 56 Tooth Whitening Strips
- 28 for Upper Teeth, 28 for Lower Teeth
- Noticeably Whiter Teeth Guaranteed in Just 14 Days
- White Teeth for At Least 6 Months
Review: They work -- although don't expect
miracles if you have seriously stained teeth. Interesting
information is that although Crest instructs that you do not brush your
teeth beforehand, it WAS proven that pre-brushing significantly improved
whiteness. The downfall was that it
increased tissue sensitivity:
to applying Crest Whitestrips significantly improves product
efficacy in terms of reduction of the yellowness from the teeth
measured. Elimination of the pre-brushing step may improve soft tissue
tolerability with only a modest reduction in product efficacy.
Research presented at the
30th Annual Meeting of the AADR, March 7-10, 2001
YTF! Tip: Don't
let your box of strips get super warm because the gel will stick to the
hard plastic backing and not come off on the strips.
Colgate Simply White Clear Whitening Gel
.34 fl oz $14.99
Dreaming of a white...set of teeth?
Colgate knows how to make your dream come true. With Simply White, just
follow three easy steps, and in 14 days sport a sparkling smile.
Until now, whitening your teeth meant
expensive trips to the dentist or struggling at home with messy, complicated or
expensive products. Colgate® Simply White™ is an EASY, affordable way to
sparkling white teeth... and it really works, in just three easy steps.
Whitens In 14 Days.
The Easy Way to Sparkling White Teeth - Enough product for 14 days of use.
Money Back Guarantee
If not satisfied with results, send proof of purchase from box and original cash
register receipt to: Colgate-Palmolive, Consumer Affairs, 300 Park Avenue, New
York, NY 10022
Review: I think it is a
waste of money, just like the commercial shows, as soon as you close your mouth
the gel gets washed away.
Mentadent Tooth Whitening System
on years of global research, Mentadent delivers a whitening system that
is safe to use. The unique delivery system pioneered in the oral
care marketplace keeps Mentadent's ingredients separate until use.
Upon contact, the combination of the activator paste and the peroxide
gel forms a powerful whitening agent with a low peroxide level that is
safe for the enamel of your teeth. You get an effective level of
whitening and fast results that you desire while not exposing your teeth
to high levels of peroxide.
Your Mentadent™ kit
- Dual Chambered Pump with
equal amounts of activator paste and bleaching gel that combine to
create a powerful whitening agent - 3.5 oz/99.2 g.
- Oral Rinse - 4 fl oz/118.3 ml.
- 1 Dosing Paddle - Exclusive
dosing paddle takes the guesswork out of how much to use.
- 2 Custom Designed Mouthtrays.
- Instruction guide with a shade
guide to monitor your progress.
Activator Paste Boosts Whitening
by over 40%*
Toothpastes: These are generally called pellicle
[(b) : a thin
layer of salivary glycoproteins coating the surface of the teeth]
removers. Many times the pellicle is stained due to
products consumed or smoking. The pellicle is removed and the
teeth appear somewhat brighter. The pellicle does return
rather quickly so be sure not to eat or drink any staining foods or
beverages to retain the whiteness achieved. Also you should
not eat or drink and staining foods or beverages soon after the
pellicle is removed due to the staining to the actual enamel which
can happen without the protective pellicle coating present. Such a
SuperSmile® Pellicle Remover
($15. for 4.2 oz, $10. for 1.75 oz)
Carbamide Peroxide Gels (trays
needed): These products are very common and very popular. They
provide simple whitening without exorbitant prices with the use of
an ingredient called carbamide peroxide. The gel is
placed within the tray and the carbamide peroxide is placed all
around the teeth. After the carbamide peroxide begins breaking
down it introduces oxygen into the enamel of your teeth - thereby
literally bleaching any staining element present. Only natural or
enamel can be whitened, veneers, crowns and fillings cannot be
lightened. Many of these were generally available only to
dentists, the Internet has brought these professional strength
formulations to your door without a dentist's prices. Such products
by IGIA: (I got
it for $36.90 (29.95 + shipping/handling); it seems to bounce around from $36.90 to $39.95 to $59.95,
If you find it for over $40.00 - NOT WORTH
IT! But if you can catch it on sale, go for it! The prices go up
and down. I tried it right after
the Crest strips and obtained very white teeth with both systems
combined and I didn't even have to use all the syringes nor use
it for the suggested amount of time. The photo to the left is very misleading because the little syringes do
NOT look like this. In the photo it looks like the professional syringes
when in fact it looks more like some Cracker Jack toy syringes (like in
the photo of the IGIA FinallyWhite PRO kit photo.. The IGIA
Finally White Plus kit came with:
3 "Custom Moldable Trays"
which had to be further customized by trimming excess silicone rubber
1 Blue "Tray Storage Case" That honestly had a hard time
fitting BOTH upper and lower trays, together.
"1 oz. Whitening Gel"
"Instruction Booklet with Step by Step Directions"
I did experience tissue sensitivity and tooth sensitivity
as well and had to skip a few days and resume after the sensitivity went
away, IT HURT!
Update: 9/9/01: I checked
tonight and there was
a Pro version -- same as what I bought for
but with an extra syringe, a robe, a magnifying mirror, an extra tray and a neutralizing mouth rinse!!
What the?? Actually, I saw the deal and well, I couldn't resist.
it, I bought it. I needed some more gel anyway -- who was I to pass up
PRO by IGIA: I received my kit with the promised lighted
magnifying mirror, the extra tray, the extra gel and mouth rinse plus
the official IGIA robe !
Well, the mirror is something I will never use hahaha! The robe I use
when I apply my sunless tanning lotion and the gel is the same good gel
as in the other kit. I really like it and it doesn't cost a fortune. Although
I couldn't stand wearing those huge trays longer than the minimum amount of time
(3 hours). If I had custom trays that are very thin plastic I'd be a
happy camper. The IGIA
Finally White PRO kit came with:
- 7 Syringes of Carbamide
- 3 "boil and
mold" customizable trays
- mouth rise (what's the
- a carrying tray
- plus the other
- the lighted
- the IGIA robe
It works though, I'd try it before spending
the big bucks on professional treatments if you don't have the cash to spend.
doesn't really taste too nasty and if you place the gel in the tray correctly
you shouldn't have over spilling of the gel on to the gum line.
Makes me salivate like Pavlov's dog though.
Other Over The
- PowerWhite® Professional Tooth
Whitening System with SofTray™ (patent pending) ($124.95)
- Nupro Gold®
- Rembrandt® Gel
Whitening Systems & Procedures
Many times the same Carbamide Peroxide that are available on the internet
are also what your dentist will provide you. Check around and
compare strengths. Many of the over the counter brands are
actually one level below the professionally available strengths.
Usually the difference is less wear time, custom trays and decreased
Carbamide Peroxide Gels (trays
needed): These products are inexpensive in comparison to laser whitening
but are sufficient in whitening usually all levels of staining.
The gel is placed within a custom tray and the carbamide peroxide is
placed all around the teeth. Just as with the over the counter
brands the carbamide peroxide begins breaking down it introduces oxygen
into the enamel of your teeth -- thereby literally bleaching any staining
element present. Only natural enamel can be whitened, veneers, crowns
and fillings cannot be lightened. Such products are:
- Nupro Gold®
- Rembrandt XTRA-Comfort® ($250. -
$350. for product)
- There are more Whitening Systems,
please check with your dentist for other options.
Laser Tooth Whitening Systems
These systems generally require an application of gel which is activated
by either light, a single or even two different types of lasers. Such
- LaserSmile™ Laser Whitening
System (Biolase): A purple gel is applied to one to several
teeth at a time, then the dental damn gel which will protect your
gums is applied. After these applications are complete, laser
light is then applied to the teeth for as little as 2 minutes collectively
for the average whitening cases. Most visits require 2 hours
of treatment time.
- PEARLINBRITE™ Laser Whitening
System: This system utilizes Energy Transfer Crystals , or ETC's.
ETC's actually absorb the laser's energy and transfers the energy to
the hydrogen peroxide molecules of the gel. This whitens the
stains in your teeth with oxygen on a much higher level that typical
carbamide peroxide gels. Usually several applications, lasting
up to 30 seconds, per each tooth is needed per session.
However, only one session is usually sufficient in most whitening
cases. Most visits require 30 minutes of treatment time.
- BriteSmile™ 3000 Laser Whitening
System: This system uses a 15% hydrogen peroxide gel application
in conjunction with gel plasma light technology.
Application may take up to 20 minutes on average, the gel is then
exposed to the light which speeds the whitening process by exciting
the hydrogen peroxide molecules. After the light
exposure, the gel is left on the teeth for a little over an hour.
- There are more Laser Whitening
Systems, please check with your dentist for other options.
How long does whitening last? Well,
that depends upon you and your habits. It also depends
upon which option you chose. Typically carbamide peroxide gels can
last anywhere from 6 - 12 months whereas professional laser whitening
can last up to a year and a half.
Porcelain (or Composite) Veneers
A very popular procedure for restoring chipped, worn and discolored
teeth is by the use of Cosmetic Porcelain (or Composite) Veneers.
Even teeth which are crooked and spaced too far apart (these spaces are
called called a diastemas) or too close together may benefit from
veneers. They can also help those who may have permanently stained
or discolored teeth which cannot be helped with professional whitening
Porcelain (or Composite) Veneers are
approximately 0.3mm to 0.5mm in thickness but once bonded to your
natural teeth become very strong and instantly change your smile from
drab to fabulous. They require removal (usually .5mm/grinding
down) of the surface of the natural tooth which is why this procedure is
not reversible. Take this into consideration before choosing
to undergo cosmetic porcelain (or composite) veneers. You may need
anesthetic so request it if you find the grinding
intolerable. Although .5mm does not normally necessitate a
temporary cap to wear for a week until your veneer is
delivered by the dental lab, you can request one if you have sensitive
teeth or find that your teeth look "odd".
When you return a week later for your
veneer insertion you will not usually need any anesthetic -- although you
may request it. After your fit is ascertained and your veneer
verified for color-match, your teeth are cleaned, the pellicle removed
and the veneer laminate is applied to your teeth with a light-activated
binding agent. After your veneer is exposed to the white light,
your veneer should be permanently adhered. Your veneers should
last you many, many years as they are very strong. Just be sure to
watch what you eat - opening things with your teeth or eating very
chewy candies like cold caramels or toffee is not recommended.
Also known as "caps" Cosmetic Porcelain Crowns are very
attractive looking and provide a more natural look as compared to
amalgam or gold crowns. Although there are of
course the metal crowns as previously said, there are porcelain-covered
metal crowns and full porcelain crowns. There are several reasons
for which you may need or benefit from a crown:
- excessive decay
- excessive decay which has been
- root canal, which will of course need
a crown or cap of some sort
- permanently stained or discolored
teeth which cannot be helped with professional whitening systems
- fractures or large breaks (crumbling)
Your initial appointment requires tooth
preparation which will involve and removal of decay and grinding down of
the tooth. You will then have an impression made of your teeth.
A temporary crown will also be made which will somewhat resemble your
tooth. Your impression and requirements are sent to the lab where
they will construct your porcelain crown.
Within 2 weeks or more it is sent back to
your dentist's office. When you return your dentist will remove
your temporary crown and ascertain your permanent crown fits well.
Any adjustments are made to either your teeth or the crown and your
crown is then permanently cemented over your natural tooth. Your
dentist will then have you bite down on what looks like thick carbon
paper to check your bite. If proper contacts are made you will
need no further tooth surface adjustment. If contacts are not
being made correctly or your bite is uncomfortable your dentists
will lightly drill or sand parts of your crown until the correct
contacts are made.
I have 2 crowns, one which is a porcelain-covered
metal crown with a portion of the metal showing through on one corner and
the other is a standard cosmetic porcelain-covered
metal crown. The metal cornered crown was from a place I call
"Western Teefus" which is a ghetto place that reminds me of a dental
assembly line. It is really named Western Dental and anyone who has gone
there knows what I mean. I kid you not it took me 6.5 hours for a root canal
(and many shots later) because the dentist would work on me, then on someone
else, then someone else, then yet another patients THEN on me again. This
repeated aaaalllll day. That was just the root canal procedure -- I still
had to go back for the post placement and then the fitting and final placement
of the crown. Thankfully those didn't take too incredibly long.
Anyway! I was told that the metal cornered one was the only type of crown there
was because the fully porcelain-covered crowns would break if you chewed
something hard. Well me not knowing any better, accepted that. When I went
in for the fitting (after the post placement), he put my new crown on with
petroleum to check the fit and told me to bite down, I did and the bite wasn't
right. So he proceeded to drill it down a bit with the electric drill to fix the bite instead of ordering me a knew crown and it
cracked! Do you know he had the absolute nerve to write in my file that my
biting down cracked it!!
Two years later I go to a REAL dentist (with real
exorbitant prices, joy.) and he tells me that the dentist at Western
Teefus lied to me about the metal cornered crown and preceded to show me his on
full porcelain-covered crown! He also pointed out the dark metal under the
porcelain showed through at my gum line, ugh! I knew that already, thanks for
He then further inspected my crown and said,
"they even have "WD" stamped in the metal!
Look!" Well I turned WHITE and grabbed the mirror to see for myself.
Well, he started laughing so hard! I finally realized he was kidding. That certainly
broke the ice for us. Well that same
"high-priced" dentist gave me a 45 minute root canal (woo hoo!) and I
was going to get a full porcelain covered crown! Which I did and it is
SO much better looking.
Cosmetic Dental Bonding
Cosmetic Dental Bonding (also known as composite or
composite fillings) is the act of using a natural-colored
light-sensitive composite resin filling to fill in cavities, gaps (diastemas), cracks and general flaws. Teeth can be
reshaped, repaired (filled), straightened, made whiter, made
brighter, made simply more attractive with a few thin coats of composite
resin. It is less invasive and less expensive than crowns or
veneers and more attractive than typical amalgam (silver)
fillings. Unfortunately Cosmetic Dental Bonding doesn't
last as long as Porcelain Veneers or Crowns and will need to be replaced
within 10 years. However, it is better for your teeth than amalgam
fillings as it will expand and act like natural enamel as opposed to the
unyielding metal fillings.
You may wish to have your teeth whitened
before your bonding to color-match the composite to a nicer, whiter
shade. After your teeth have been bonded Your teeth must
first be marred or abraded to create a surface which the
composite can adhere to easily. After a thin coat of color-matched
resin is applied, your dentists will cure (harden) it with a
special light. You will have several layers applied as needed and
then your new teeth will be sculpted into an aesthetically
pleasing form. You can significantly build up several layers to
sculpt an entirely different-looking tooth. Filling in gaps and enlarging teeth which are too-small is very effective with
Cosmetic Dental Bonding.
I have this in/on several teeth -- instead of
keeping the silver fillings, I had them all removed and had them filled with
composite -- more expensive but worth it!! I also had my two canines
bonded after Invisalign failed to correct it adequately. I cannot tell you
the difference this has made in my smile..
Surgery & Upper Lip Retraction
Many of you may have heard of a gummy smile. This can either be from literally excess gum (and teeth which appear too short) or retraction of the columella (segment of skin which divides the nostrils) and upper lip. And also may need excision for placement of veneers and crowns.
Gum surgery itself involves the removal of this excess gum either manually, or more commonly, with a lasing device (laser). It is actually a very simple surgery but can cause discomfort due to the rawness of the gums post-laser treatment.
When the upper lip is too short it does not adequately cover the upper
gums of the maxilla and can be literally released for
more gum coverage. This can be done by releasing some muscle
fibers above the upper lip which will lower the upper lip to lessen gum
show. Be careful when choosing a surgeon to perform this as too
much of release can severely elongate the upper lip and increase
your subnasale to lip ratio. This area naturally elongates in
average individuals with age and muscle laxity.
Prices of Cosmetic Dental Procedures
$1,200. - $10,000.
Over The Counter Tooth Whitening Pastes
||$6. - $40.
Over The Counter (OTC) Whitening Systems (gels, liquids, etc.)
|| (w/o root
canal: $600. - $800.; w/ root canal: $750. - $1,200.)
$1,800. per veneer
|| $175. -
$750. per tooth
$10. - 250. for the trays; $35 - $200. for the bleach
|| $500. - $2,500.
Cosmetic Gum Surgery:
$500. - $2,000.
Lip Retraction Surgery:
|| $2,000. - $4,000.
American Association of
Removable, Clear & Effective
American Dental Association
International Association for Dental
Finally White $29.95 (with trays & 6 syringes of gel)
SuperSmile - Pellicle Remover in a Tube
($15. for 4.2 oz, $10. for 1.75 oz)
BriteSmile Professional Teeth Whitening
Dentistry Network Discussion Forum
30th Annual Meeting of the AADR, March 7-10, 2001" 922 Impact of
Prior Tooth Brushing on Whitening Strip Clinical Response