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Cosmetic Dentistry

Cosmetic Dentistry works to improve the appearance of the teeth.

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SMILE DESIGN

What is Smile Design?

Aesthetic Smile Design
95% of adults will remember an attractive smile.  It projects an image of confidence and fulfillment.  We work with you to develop the smile you desire, whether it is a more youthful, brighter smile or enhancing your natural teeth as they are.  Smile Design is a highly technical process that requires a diverse knowledge background as well as a strong artistic ability that must be perfected by extensive experience.   The process requires precise measurements to create your perfect smile based on your unique mouth shape, gum lines, lips, and the natural shape of your teeth.  The final result is a natural smile that is stronger, more functional, and will make you appear more youthful and energetic.

Principles of Smile Design

If a picture is worth a thousand words, a beautiful smile is priceless.  To design the most aesthetically pleasing and optimally functional smile, we follow the nine main Principles of Smile Design taking into account your unique facial features.  For example, we can use characteristics such as tooth shape to compliment or enhance the shape of your face.

Principles of Smile Design

Midline

Symmetry is a defining feature of an attractive smile.  By ensuring symmetry of the two front teeth as well as neighbouring teeth, the appearance of symmetry can be created in your entire smile.

Horizontal Alignment

Smile lines that are parallel to the horizontal axis of your face are generally considered most attractive. 

Smile Line

One of the most important characteristics of a great smile, a smile line is created by drawing an imaginary line from the biting edges of the back teeth around to the front teeth.  A curved smile line makes you appear significantly younger.   A smile line where the teeth appear straight across ages you because it looks like the product of years of wear.

Gum Line

The most aesthetic smiles have symmetrical gum lines that follow the upper lip.

Smile Width

In the ideal smile, the teeth towards the back of the mouth can be seen in progression.  If the smile is narrow, the back teeth are often in shadow causing the sides of the smile to appear dark.

Embrasures

Embrasures are the natural, slight triangular spaces between the tips of your teeth.  The most natural, youthful looking smile has small embrasure spaces at the front that gradually get larger towards the back teeth.  Teeth with edges that are perfectly flat with one tooth completely touching the adjacent one can make a person look like they have worn their teeth.

Golden Proportions

Smile Design Golden ProportionsThe golden proportion is a mathematic relationship found throughout nature.  It is used as a starting point when designing your smile.  The golden proportion dictates the amount of tooth surface that should be visible when viewed from the front, and will make your smile appear balanced.

Tooth Proportion

When creating the ideal smile, the size of each tooth is governed by an ideal proportion.  Usually, for example, the ideal width to height ratio of the two front teeth is 0.7:1.

Tooth Shade

It is possible to change the shade of your teeth while designing your new smile.  We have a variety of colour and translucency options to choose from in order to give you a smile so natural it looks like one you were born with.

TEETH WHITENING

Teeth WhiteningTooth whitening is a cosmetic dentistry procedure that lightens teeth and helps to remove stains and discoloration. It is the most popular treatment by both men and women alike and the treatments available range from one-hour one-time dental visits to take-home do-it-yourself kits. Tooth whitening is popular because it can significantly improve the appearance of your teeth at much less cost and inconvenience than other techniques.  

Types of Tooth Stains

There are two types of staining as related to teeth: Extrinsic Staining and Intrinsic Staining

Exrinsic Intrinsic Staining

Exrinsic Staining - Extrinsic stains are caused by external factors such as coffee, red wine, tea, other dark-colored foods and drinks, tobacco and routine wear and tear. Essentially they are a natural part of life but they are unsightly and can be removed. Superficial extrinsic stains can be removed with good hygiene techniques such as regular brushing and dental check-ups with cleanings. More stubborn stains can be removed with more involved efforts like teeth bleaching or whitening.

Intrinsic Staining - Intrinsic stains occur much deeper in the tooth than extrinsic stains, forming in the interior of teeth. They can result from trauma, aging, exposure to minerals (like tetracycline), during tooth formation and/or excessive ingestion of fluoride.

Teeth Whitening vs. Teeth Bleaching

According to the FDA, the difference between bleaching and whitening is that the term "bleaching" is permitted to be used only when the teeth can be whitened beyond their natural color and when the products contain bleach. Whitening refers to restoring a tooth's surface color by removing dirt and debris.

Teeth Whitening vs BleachingThe terms are generally mistakenly used interchangeably even though they have different meanings. Whitening sounds less harsh than bleaching and therefore is used even when products contain bleach. It really is a marketing technique more than anything else although there are some distinctions that should be made between over-the-counter (OTC) whitening and dentist bleaching, including:

Strength of Bleaching Agent- Typically OTC products and take-home products usually contain 3% to 7% hydrogen peroxide bleaching agent whereas in-office teeth whitening products contain 15% to 43% hydrogen peroxide.

Mouthpiece Trays- Mouthpiece trays from the dentists as opposed to OTC trays are custom molded to fit the exact impression of your teeth. This allows for maximum contact between the whitening gel, which is applied to the mouthpiece tray, and the teeth. A custom mouth tray also minimizes the gel's contact with gum tissue, which can lead to gum irritation that may be associated with trays that are not custom-made.

Additional Protective Measures- In an office setting, the irritation and concerns associated with the gums from gel contact is protected by your dentist as an extra preventive measure.

Supervised vs. Unsupervised Process- a dentist-supervised at-home or in-office treatment may be safer because it allows the dentist to view your medical history and determine which course of whitening treatment is most appropriate for you. With OTC treatments, you are left on your own.

BONDING

Dental Tooth BondingTooth bonding or dental bonding uses a special tooth-coloured resin that is applied to the tooth then hardened using a special light. This bonds the resin to the tooth either to restore it or to improve the appearance of the tooth.

For what conditions is dental bonding considered?

Dental bonding is an option that can be considered to:

  • Repair decayed teeth (composite resins are used to fill cavities)
  • Repair chipped or cracked teeth
  • Improve the appearance of discoloured teeth
  • Close spaces between teeth
  • Make teeth look longer
  • Change the shape of teeth
  • Use as a cosmetic alternative to amalgam fillings
  • Protect a portion of the tooth's root that has been exposed when gums recede

DENTAL VENEERS

Dental VeneersVeneers are thin shells that cover the front side of teeth. They are used to restore stained teeth, discoloured, deformed or slightly damaged teeth from wearing out. Dental veneers are mainly placed over front teeth, therefore correcting their contour, colour and size to improve the smile’s appearance.

The materials used to create dental veneers are primarily porcelain and composite. A composite veneer can be produced directly, meaning that the dentist builds it directly on the tooth, or indirectly, outside the mouth, usually in a dental laboratory. In contrast, porcelain veneers are produced only in an indirect way. Porcelain is more aesthetic and more resistant to food stains than composite veneers.

INLAYS-ONLAYS

Also known as indirect fillings, inlays and onlays made from porcelain or composite materials are a long-lasting yet cosmetic way to provide a "filling" to teeth with tooth decay or similar structural damage. Whereas dental fillings are molded into place within the mouth during a dental visit, inlays and onlays are created in a dental laboratory before being fitted and adhesively bonded into place by your dentist. 

Inlays and Onlays

Dental inlays and onlays are restorations used to repair rear teeth with mild to moderate decay or cracked and fractured teeth that are not sufficiently damaged to need a crown.

Dental Inlay Onlay Crown

Ideal candidates for inlay or onlay work typically have too much damage or decay in the tooth structure to be successfully treated using a filling, but have sufficient healthy tooth remaining to avoid the need for a crown. This allows the dentist to conserve more of the patient’s original tooth structure. 

There are other benefits to inlays and onlays in comparison to metal fillings:

  • Inlays and onlays are durable — they’re made from tough, hardwearing materials that last up to 30 years.
  • They help to strengthen teeth by up to 75 percent, unlike traditional metal fillings that can actually reduce the strength of the teeth by up to 50 percent.
  • Inlays and onlays prolong tooth life and prevent the need for more dental treatment in the future.

Dental FillingsDental inlays and onlays are used when old fillings need to be removed or replaced. A dental inlay is similar to a filling and fits inside the cusp tips (top edges) of the tooth. A dental onlay is more extensive and extends over the cusps of the treated tooth.

During treatment the dentist removes the old fillings under local anesthesia and takes an impression of the tooth, which is sent to the dental laboratory. The new inlay or onlay is made from this mold in porcelain, gold or composite resin material. The inlay or onlay is then cemented into place at the next appointment. The inlay or onlay blends successfully with the treated tooth and the rest of the teeth to achieve a natural, uniform appearance.

IMPLANT

Dental ImplantA dental implant (also known as an endosseous implant or fixture) is a surgical component that interfaces with the bone of the jaw or skull to support a dental prosthesis such as a crown, bridge, denture, facial prosthesis or to act as an orthodontic anchor. The basis for modern dental implants is a biologic process called osseointegration where materials, such as titanium, form an intimate bond to bone. The implant fixture is first placed, so that it is likely to osseointegrate, then a dental prosthetic is added. A variable amount of healing time is required for osseointegration before either the dental prosthetic (a tooth, bridge or denture) is attached to the implant or an abutment is placed which will hold a dental prosthetic.

Dental ImplantSuccess or failure of implants depends on the health of the person receiving it, drugs which impact the chances of osseointegration and the health of the tissues in the mouth. The amount of stress that will be put on the implant and fixture during normal function is also evaluated. Planning the position and number of implants is key to the long-term health of the prosthetic since biomechanical forces created during chewing can be significant. The position of implants is determined by the position and angle of adjacent teeth, lab simulations or by using computed tomography with CAD/CAM simulations and surgical guides called stents. The prerequisites to long-term success of osseointegrated dental implants are healthy bone and gingiva. Since both can atrophy after tooth extraction pre-prosthetic procedures, such as sinus lifts or gingival grafts are sometimes required to recreate ideal bone and gingiva.

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