Cosmetic dentistry

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Cosmetic dentistry is generally used to refer to any dental work that improves the appearance (though not necessarily the functionality) of teeth, gums and/or bite. It primarily focuses on improvement in dental aesthetics in color, position, shape, size, alignment and overall smile appearance. [1] Many dentists refer to themselves as "cosmetic dentists" regardless of their specific education, specialty, training, and experience in this field. This has been considered unethical with a predominant objective of marketing to patients. [2] The American Dental Association does not recognize cosmetic dentistry as a formal specialty area of dentistry. [3] However, there are still dentists that promote themselves as cosmetic dentists.

Contents

Fields

There are primarily two dental specialties that predominantly focus on dental aesthetics. They are:

  1. Prosthodontics [4] and
  2. Orthodontics [5]

Common cosmetic dentistry options

Types

Cosmetic dentistry may involve:

  1. the addition of a dental material to teeth or gums – examples: bonding, porcelain veneers (laminates), crowns (caps), gum grafts
  2. the removal of tooth structure or gums – examples: enameloplasty, gingivectomy
  3. neither adding nor removing dental materials, tooth structure, or gums – examples: teeth whitening (bleaching), laser whitening, gum depigmentation
  4. straightening of teeth accompanied by improvement in appearance of face [6] – orthodontics
  5. veneers, dental laminates - conservative
  6. scaling
Teeth reshaping (sculpting) and bonding performed in one office visit. Sculpting1.jpg
Teeth reshaping (sculpting) and bonding performed in one office visit.

Whitening

Whitening, or "tooth bleaching", is the most common cosmetic dental procedure. Whitening is a safe process that is effective for most patients. Multiple whitening options are available, including over the counter products such as Crest Whitestrips, as well as dentist-supervised methods such as in-office treatments or at-home treatments involving trays with a peroxide gel.

Laser whitening is a teeth whitening technique in which gums are covered with a rubber dam and a bleaching chemical is applied on the teeth. A beam of argon laser, which is intended to accelerate the process of bleaching, is then projected upon the teeth. This laser activates the bleaching chemical and lightens the teeth color. [7] Laser whitening is said to be six times more effective in teeth whitening compared to other procedures.

Reshaping

Tooth reshaping removes parts of the enamel to improve the appearance of the tooth. It may be used to correct a small chip, or to alter the length, shape or position of teeth, as well as when there is tooth size discrepancy; [8] [9] it can be used to correct crooked or excessively long teeth. The removed enamel is irreplaceable, and may sometimes expose dentin. It is also known as enameloplasty, odontoplasty, contouring, recontouring, cosmetic contouring, slenderizing, stripping. This procedure offers fast results and can even be a substitute for braces under certain circumstances. [10]

Bonding

Bonding is a process in which an enamel-like dental composite material is color matched, applied to a tooth's surface, sculpted into proper tooth contour, hardened and then polished. This process utilizes dental adhesives, which are solutions of resin monomers that make the resin dental substrate interaction possible. They are mainly classified into two techniques: self-etch or etch-and-rinse. [11] An examples of a bonded restorations are inlays and onlays, which are used to repair decayed & cracked teeth. Teeth damaged by small to moderate decay, erosion, or small fractures can be repaired with direct composite restorations bonded to the teeth. Aesthetics are especially critical in anterior composite restorations.

Bridging

Dental bridges are used to replace one or more missing teeth. Teeth on both sides of the space left by the missing teeth are prepared. [12] A bridge is made up of abutments, the teeth that are prepped, and the missing, false teeth, which are called pontics. [13] This procedure is used to replace one or more missing teeth and is cemented in. Bridges can consist of more than three teeth in total and the viability of any bridge is usually determined by applying Ante's Law and assessing where in the mouth the teeth are.[ citation needed ] Most bridges are fixed, they can not be removed. Fixed bridges cannot be taken out in the same way that partial dentures can. In areas of the mouth that are under less stress, such as the front teeth, a cantilever bridge may be used. Cantilever bridges or Maryland Bridges are used to replace anterior or front missing teeth, are minimally invasive but do have a reputation for failure. [14] Bridges require commitment to serious oral hygiene and carry risk. [15] The average life of bridges is similar to that of crowns which is nearly ten years. [16]

Veneers

Anatomic wax mock-up fabricated to guide the dentist before tooth preparation Wax mock up.jpg
Anatomic wax mock-up fabricated to guide the dentist before tooth preparation

Veneers are ultra-thin, custom-made porcelain laminates that are bonded directly to the teeth. They are an option for closing gaps, enhance the shape, or change the color of teeth that do not respond well to whitening procedures. In the majority of the cases, some level of tooth reduction is necessary for optimal results. To achieve a pleasing smile, dentists fabricate diagnostic mock-ups, which act as a tooth preparation guide before the fabrication of veneers, [17] it allows the dentist to visualize the changes needed to be done on the patient's teeth with respect to size, shape and proportion, its relation with gingival-contour, lip contour and smile line. [18] Mock ups can be a great aid in fabricating pre-evaluation temporaries, which can give a preliminary evaluation to the esthetics, phonetics and teeth occlusion, in addition, it gives an opportunity to the clinicians to check if they need to do any corrections.

Implants

Dental implants are prosthetic replacements for missing teeth. According to ICOI (International Congress of Oral Implantologists) there are commonly three parts to what it is described as an implant: the implant device which is predominantly made of titanium (which is inserted into the bone), the abutment, and a dental crown or a denture which are connected to the implant through the abutment.

Gum lifts

A gum lift is a cosmetic dental procedure that raises and sculpts the gum line. The procedure involves reshaping the tissue and/or underlying bones to create the appearance of longer or more symmetrical teeth. [19]

Straightening

Metal braces are used primarily to correct crowded or misaligned teeth. While correcting issues such as jaw alignment are the primary purpose, they can also improve aesthetics. [20]

Clear aligners are used as an alternative to traditional metal braces. Clear aligners produce comparable results to metal braces and are preferred by some patients as they are less noticeable to others than traditional braces. [20]

Bite reclamation

Bite reclamation is for patients who have had years of excessive wear to their teeth due to grinding or acid reflux can alter their vertical dimension. This gives them a closed or shorter look to their face and smile. By opening up their bite, a qualified professional can reclaim their vertical dimension.

Materials

In the past, dental fillings and other tooth restorations were made of gold, amalgam and other metals—some of which were veneered with porcelain.[ citation needed ] Now, dental work can be made entirely of porcelain or composite materials that more closely mimic the appearance of natural tooth structure. These tooth-colored materials are bonded to the underlying tooth structure with resin adhesives. Unlike silver fillings (amalgams) they are entirely free of mercury. Cosmetic dentistry has evolved to cover many new procedures and new dental materials are constantly introduced.

Training

The American Dental Association does not recognize cosmetic dentistry as a specialty. [21] Prosthodontics is the only dental specialty under which the concentration of cosmetic/esthetic dentistry falls. General dentists may perform some simple cosmetic procedures. Consequently, there are questions regarding whether it is ethical for general dentists to treat "smile makeovers" or complex cosmetic and full-mouth reconstruction cases, as they are not qualified to address the complex needs of the patient. [21] [22]

American College of Prosthodontists

The American College of Prosthodontists is a not-for-profit organization representing prosthodontists within organized dentistry and to the public, with more than 3,700 members worldwide. Prosthodontics is one of the twelve dental specialties defined by the American Dental Association, which recognizes the American College of Prosthodontists as the national organization representing the prosthodontic specialty- the dental specialty of cosmetic / esthetic dentistry, implant dentistry and reconstructive dentistry.

Membership is open to individuals who have graduated from or are currently enrolled in an ADA-accredited advanced prosthodontics program. The ACP is the only prosthodontic specialty association where membership is based solely on education credentials. Certified dental laboratory technician and members of the prosthodontic academic community may become Alliance members of the College.

American Academy of Cosmetic Dentistry

The American Academy of Cosmetic Dentistry (AACD) is the largest international dental organization in the world, composed of general dentists, specialists, and lab technicians focused on the art and science of cosmetic dentistry. Founded in 1984, the AACD has over 7,000 members in the United States and more than 70 countries around the globe. Members of the Academy include dentists, dental laboratory technicians, educators, researchers, students, hygienists, corporations and dental auxiliaries. AACD members seek out continuing education through lectures, workshops, and publications in order to keep up-to-date with all of the advancements in cosmetic dental techniques and technology. In 1984, the AACD was formed and has filled the dire need for credentialing in cosmetic dentistry. The purpose of the American Board of Cosmetic Dentistry (ABCD) is the testing, analyzing, and evaluation of the services of dentists and laboratory technicians for the purpose of awarding AACD Accreditation in cosmetic dentistry. [23] However, this certification is not approved or recognized by the American Dental Association.

American Society For Dental Aesthetics: Conceived in 1976, the American Society for Dental Aesthetics was developed with a single purpose in mind: continuing dental education to teach dental health professionals the most advanced aesthetic and restorative techniques available. To become a member of the ASDA, a dentist must show a minimum of five years in dental practice, or postgraduate training of two years in an approved program; attendance to at least two ASDA sponsored continuing dental education seminars; nomination by a member accompanied by two letters of recommendation by Society members; presentation of five (5) cases illustrating the concepts of aesthetic dentistry. [24]

History

Newell Sill Jenkins (1840–1919) was an American dentist who practiced most of his life in Dresden, Germany. [25] He developed the Jenkins porcelain enamel and improved, thus making a composition of the porcelain paste, porcelain inlays, dental crowns and bridges. Hence, he is regarded as the founder of aesthetic dentistry.

Related Research Articles

<span class="mw-page-title-main">Dentistry</span> Branch of medicine

Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions of the mouth, most commonly focused on dentition as well as the oral mucosa. Dentistry may also encompass other aspects of the craniofacial complex including the temporomandibular joint. The practitioner is called a dentist.

<span class="mw-page-title-main">Dentist</span> Health care occupations caring for the mouth and teeth

A dentist, also known as a dental surgeon, is a health care professional who specializes in dentistry, the branch of medicine focused on the teeth, gums, and mouth. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.

<span class="mw-page-title-main">Orthodontics</span> Correctional branch of dentistry

Orthodontics is a dentistry specialty that addresses the diagnosis, prevention, management, and correction of mal-positioned teeth and jaws, as well as misaligned bite patterns. It may also address the modification of facial growth, known as dentofacial orthopedics.

<span class="mw-page-title-main">Dental braces</span> Form of orthodontics

Dental braces 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.

<span class="mw-page-title-main">Bridge (dentistry)</span> Dental restoration for missing teeth

A bridge is a fixed dental restoration used to replace one or more missing teeth by joining an artificial tooth definitively to adjacent teeth or dental implants.

Dental restoration, dental fillings, or simply fillings are treatments used to restore the function, integrity, and morphology of missing tooth structure resulting from caries or external trauma as well as to the replacement of such structure supported by dental implants. They are of two broad types—direct and indirect—and are further classified by location and size. A root canal filling, for example, is a restorative technique used to fill the space where the dental pulp normally resides.

Tooth whitening or tooth bleaching is the process of lightening the color of human teeth. Whitening is often desirable when teeth become yellowed over time for a number of reasons, and can be achieved by changing the intrinsic or extrinsic color of the tooth enamel. The chemical degradation of the chromogens within or on the tooth is termed as bleaching.

<span class="mw-page-title-main">Crown (dental restoration)</span> Dental prosthetic that recreates the visible portion of a tooth

In dentistry, a crown or a dental cap is a type of dental restoration that completely caps or encircles a tooth or dental implant. A crown may be needed when a large dental cavity threatens the health of a tooth. Some dentists will also finish root canal treatment by covering the exposed tooth with a crown. A crown is typically bonded to the tooth by dental cement. They can be made from various materials, which are usually fabricated using indirect methods. Crowns are used to improve the strength or appearance of teeth and to halt deterioration. While beneficial to dental health, the procedure and materials can be costly.

Prosthodontics, also known as dental prosthetics or prosthetic dentistry, is the area of dentistry that focuses on dental prostheses. It is one of 12 dental specialties recognized by the American Dental Association (ADA), Royal College of Surgeons of England, Royal College of Surgeons of Edinburgh, Royal College of Surgeons of Ireland, Royal College of Surgeons of Glasgow, Royal College of Dentists of Canada, and Royal Australasian College of Dental Surgeons. The ADA defines it as "the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth or oral and maxillofacial tissues using biocompatible substitutes."

<span class="mw-page-title-main">Clear aligners</span> Transparent dental braces

Clear aligners are orthodontic devices that are a transparent, plastic form of dental braces used to adjust teeth.

<span class="mw-page-title-main">Veneer (dentistry)</span> Layer of material placed over a tooth

In dentistry, a veneer is a layer of material placed over a tooth. Veneers can improve the aesthetics and function of a smile and protect the tooth's surface from damage.

Fixed prosthodontics is the branch of prosthodontics that focuses on dental prostheses that are permanently affixed (fixed). Crowns, bridges, inlays, onlays, and veneers are some examples of indirect dental restorations. Prosthodontists are dentists who have completed training in this specialty that has been recognized by academic institutes. Fixed prosthodontics can be used to reconstruct single or many teeth, spanning tooth loss areas. The main advantages of fixed prosthodontics over direct restorations are improved strength in big restorations and the possibility to build an aesthetic-looking tooth. The concepts utilised to select the suitable repair, as with any dental restoration, include consideration of the materials to be used, the level of tooth destruction, the orientation and placement of the tooth, and the condition of neighboring teeth.

The American Academy of Cosmetic Dentistry (AACD), founded in December 1984 by Jack Kammer and Jeff Morley of San Francisco, is the world's largest organization for cosmetic dental professionals. As of 2001, the Academy had membership from 40 different countries. Between 2000 and 2007, membership in the Academy grew by 70% as United States oral health, in particular the incidence of tooth decay, improved markedly while competitively priced cosmetic procedures became more readily available.

<span class="mw-page-title-main">Crown lengthening</span> Dental procedure

Crown lengthening is a surgical procedure performed by a dentist, or more frequently a periodontist, where more tooth is exposed by removing some of the gingival margin (gum) and supporting bone. Crown lengthening can also be achieved orthodontically by extruding the tooth.

Adhesive dentistry is a branch of dentistry which deals with adhesion or bonding to the natural substance of teeth, enamel and dentin. It studies the nature and strength of adhesion to dental hard tissues, properties of adhesive materials, causes and mechanisms of failure of the bonds, clinical techniques for bonding and newer applications for bonding such as bonding to the soft tissue. There is also direct composite bonding which uses tooth-colored direct dental composites to repair various tooth damages such as cracks or gaps.

Dental pertains to the teeth, including dentistry. Topics related to the dentistry, the human mouth and teeth include:

A gum lift is a cosmetic dental procedure that raises and sculpts the gum line. This procedure involves reshaping the tissue and/or underlying bones to create the appearance of longer or symmetrical teeth, thereby making the smile more aesthetically pleasing. This procedure is typically done to reduce excessively gummy smiles or to balance out an asymmetrical gum line. The procedure, also known as crown-lengthening, has historically been used to treat gum disease. It is only within the past three to five years that dentists have commonly used this procedure for aesthetic purposes. The practice of cosmetic gum lifts was first developed in the late 1980s, but there were few oral surgeons and dental practitioners available to perform the procedures. Gum lifts can also include bone shaping to reduce the prominence of the upper jaw and even out the tooth and gum ratio. This method provides permanent results, while simple gum contouring may result in relapse or regrowth of the gingiva.

Irwin Elliot Smigel was an American aesthetic dentist, innovator and philanthropist.

<span class="mw-page-title-main">George A. Freedman</span>

George A. Freedman, DDS is a Canadian dentist, inventor, and dental educator, who is regarded as an international leader in the field of cosmetic and aesthetic dentistry. He is married to Fay B. Goldstep, DDS,, with whom he has shared a private dental practice in Markham, Ontario, Canada, since 1988. Their daughter, Judy Freedman, is a Toronto-based broadcaster.

In dentistry, SMK, short for System kompozytowy most(in Polish), is an adhesive restorative prosthodontic technique, developed in Poland during the 1990s. Using the SMK method, a prosthetic tooth is constructed and fitted without damage to the neighbouring teeth.

References

  1. ↑ Schmidt, Christopher J; Tatum, Sherard A (August 2006). "Cosmetic dentistry". Current Opinion in Otolaryngology & Head and Neck Surgery. 14 (4): 254–259. doi:10.1097/01.moo.0000233596.68928.39. PMID   16832182. S2CID   23958945.
  2. ↑ Maihofer MG (February 2009). "Cosmetic dentistry is not a recognized specialty". J Mich Dent Assoc. 91 (2): 18. PMID   19288658.
  3. ↑ "Specialty Definitions". American Dental Association. Retrieved 24 September 2015.
  4. ↑ "Home - American College of Prosthodontists". prosthodontics.org.
  5. ↑ "What is an Orthodontist And What Do They Do?". Orthodontics Australia. 2019-12-05. Retrieved 2020-10-13.
  6. ↑ "Braces And Changes In Facial Shape and Appearance — Before and After". Orthodontics Australia. 2017-09-27. Retrieved 2020-10-13.
  7. ↑ Sun G (2000). "The role of lasers in cosmetic dentistry". Dental Clinics of North America. 44 (4): 831–850. doi:10.1016/S0011-8532(22)01324-6. PMID   11048275.
  8. ↑ GRAUER D, HEYMANN GC, SWIFT EJ Jr (2012). "Clinical Management of Tooth Size Discrepancies". Journal of Esthetic and Restorative Dentistry. 24 (3): 155–159. doi:10.1111/j.1708-8240.2012.00520.x. PMID   22691075.
  9. ↑ Bugaighis I, Karanth D, Borzabadi-Farahani A (2015). "Tooth size discrepancy in a Libyan population, a cross-sectional study in schoolchildren". J Clin Exp Dent. 7 (1): e100–105. doi:10.4317/jced.51819. PMC   4367995 . PMID   25810819.
  10. ↑ Khan, Sajjad A (17 February 2005). "Your Dental Health". The Day. Retrieved 24 September 2015.
  11. ↑ Sofan, Eshrak; Sofan, Afrah; Palaia, Gaspare; Tenore, Gianluca; Romeo, Umberto; Migliau, Guido (2017). "Classification review of dental adhesive systems: from the IV generation to the universal type". Annali di Stomatologia. 8 (1). Ann Stomatol: 1–17. doi:10.11138/ads/2017.8.1.001. PMC   5507161 . PMID   28736601.
  12. ↑ "Bridges | American College of Prosthodontists". www.gotoapro.org. Retrieved 2017-05-17.
  13. ↑ "Glossary of Dental Clinical and Administrative Terms". www.ada.org. Retrieved 2017-05-17.
  14. ↑ Durey, K.A. (12 August 2011). "Resin bonded bridges: techniques for success". British Dental Journal. 211 (3): 113–118 (2011). doi: 10.1038/sj.bdj.2011.619 . PMID   21836574.
  15. ↑ "CONSENTING TO COMPLEX DENTISTRY" (PDF). Office of the Public Advocate. January 2015. Archived from the original (PDF) on 28 February 2015. Retrieved 24 September 2015.
  16. ↑ Burke FJ, Lucarotti PS (November 2012). "Ten year survival of bridges placed in the General Dental Services in England and Wales". Journal of Dentistry. 40 (11): 886–895. doi:10.1016/j.jdent.2012.07.002. PMID   22864053.
  17. ↑ "Wax-up and mock-up. A guide for anterior periodontal and restorative treatments". ResearchGate.
  18. ↑ Thomas, Manuel S; David, K (2014-01-01). "Importance of anatomic mock-up for predictable esthetic smile design with ceramic veneers". Journal of Interdisciplinary Dentistry. 4 (1): 55. doi: 10.4103/2229-5194.135014 .
  19. ↑ Barker, Olivia (18 January 2008). "Patients smile at getting long in the tooth". USA Today. Retrieved 24 September 2015.
  20. 1 2 "Dental braces - Mayo Clinic". www.mayoclinic.org. Retrieved 2021-04-15.
  21. 1 2 Maihofer MG (February 2009). "Cosmetic dentistry is not a recognized specialty". The Journal of the Michigan Dental Association. 91 (2): 18. PMID   19288658.
  22. ↑ Felton DA (June 2009). "Ethics, dentistry, and the prosthodontist". Journal of Prosthodontics. 18 (4): 291. doi:10.1111/j.1532-849X.2009.00484.x. PMID   19635064.
  23. ↑ "How to Become a Member - American Society for Dental Aesthetics - ASDA". www.asdatoday.com.
  24. ↑ "How to Become a Member - American Society for Dental Aesthetics - ASDA". asdatoday.com.
  25. ↑ Dr. Newell Sill Jenkins, Revue d'histoire de l'art dentaire, p. 20.
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