Regardless of a cosmetic treatment, it’s important to start with a meticulous smile design. In our office we use digital photography and molds of your teeth to see and test what can be done to improve your smile. You get to see how cosmetic dentistry can enhance your teeth before the treatment starts. You can visualize what options might work best; such as whitening, porcelain veneers, composite bonding, orthodontics (braces), bite adjustment etc.  It’s like designing a house.  You want to see what it is going to look like before you start the construction.

Comprehensive cosmetic dentistry in our Annapolis area office involves a meticulous planning and smile design before teeth are restored with veneers or crowns. It is important to understand that balanced bite and proper function are important for longevity of your new smile.

Teeth whitening is relatively inexpensive and may make them look nice.  You can achieve a significant smile improvement, if you are otherwise happy with how your teeth are aligned and shaped.

Enameloplasty, or tooth reshaping is a great option if you otherwise are happy with the color of your teeth.

Porcelain veneers are a beautiful way to correct stained, worn, chipped, or crooked teeth. Veneers are made of glass-like tooth color ceramic. They are placed on front surfaces of teeth after removing a thin layer of enamel. Veneers  don’t change color and are wonderful if you want to significantly change the shape and color of your teeth.

Composite bonding is a less costly alternative to porcelain veneers. A dentist uses a special tooth-color material to shape front teeth without removing the underlying enamel. Though the immediate results are impressive, the longevity of composite material is limited. Composite bonding may need more touch-ups and frequent polishing.

It is essential to diagnose and correct the cause of the problem first, since all factors that damaged the teeth, may continue damaging new porcelain caps, veneers, or bonding. Remember that almost all tooth color materials used in dentistry are brittle by nature. They will last longer if you protect them from bacteria, acids, and tooth grinding.

Tooth grinding could lead to tooth sensitivity, flattened, chipped and broken teeth. You can also develop changes in the bite leading to TMJ damage. Bruxism, or tooth grinding, is very common, occurring in 80% of adults. Talk to your dentist about protecting your teeth if you have any of these signs or symptoms and planning veneers or other cosmetic dentistry.

Because many new materials used in cosmetic dentistry are susceptible to breaking, functional assessment is the key for your dental work to last a long time. Great form follows great function!

A bite evaluation and exam are necessary to determine the cause of the problem. If your teeth are properly aligned and your jaw joints are in harmony with your bite, you might be feeling a difference in pressure on individual teeth. Often the solution is a procedure, called “occlusal equilibration” or reshaping of the teeth to “fine tune” the new bite. Occlusal equilibration is also recommended to stabilize the new teeth position, since even and balanced bite prevents teeth from shifting to their previous position.

When you are grinding your teeth, your chewing muscles work hard to move the lower jaw to make this happen. Those muscles eventually get sore from constant and restless work. When a soft rubber night guard is placed between the teeth, chewing muscles tend to work harder to press on it. This is similar to chewing a gum. I recommend an appliance made of hard acrylic that is custom made for a patient’s TMJ and bite condition. This appliance is called an occlusal splint. It protects the teeth from wear, as well as, correct the alignment of your jaw joints. None of the “one-size-fits-all” appliances do that. In fact, chewing on a soft nightguard may cause significant damage to your TMJ.

Teeth may require root canal therapy or endodontic treatment due to an infected nerve as a result of decay. You can also damage the nerve if the tooth is hitting harder than other teeth during grinding and clenching. You may reverse the effects of chronic trauma and avoid a root canal treatment, if your bite is examined and corrected in a timely manner.

The shooting pain when biting could be a symptom of a cracked tooth. Cracks are thin lines in your teeth that could be asymptomatic for a while. They do indicate hard tooth-to-tooth contact either during grinding or clenching. Most often cracks appear on teeth that are being banged on during grinding.  Jaw/teeth misalignment may cause the grinding to progress. You might be able to save the tooth with a crown or a conservative onlay, depending on a severity of a crack.  It is also important to correct your bite issues to prevent this happening to other teeth.

Receding gums are result of bone loss around your teeth. Loss of gingiva can be unesthetic since it can cause “black triangles” between front teeth that are visible when you smile. Receding gums or gingiva may be due to multiple factors. One factor is the bacterial infection of the gums and supporting bone (gingivitis or periodontitis). Another reason could be a traumatic bite, or occlusion, since during grinding and clenching supporting bone and gums are affected as well.  In addition to treating bacterial infection, your bite should be examined and corrected to prevent further gum/bone loss.

If your problems are significant, your dentist may recommend that you seek care of dental specialists. If this is a case, it’s important to have a team of dentists and dental specialists that understand and agree with your restorative and cosmetic treatment plan. The team may include an orthodontist, a cosmetic restorative dentist, a surgeon, a periodontist, an endodontist etc. This team needs to communicate between themselves about timing and sequence of treatment. Usually such treatment plan is established after your consultations with all treating doctors. The communication is a key to a successful outcome.

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