The latest developments in dentistry include tooth whitening treatments, micro-abrasion, bonding and veneers. These techniques can whiten and improve the shape and colour of your teeth, even close gaps.
a) Tooth Whitening – Treatments are designed to whiten your own teeth without any artificial additions. There are several ways dentists can whiten your teeth:
1. With very high peroxide gel concentrations, the dentist may very carefully apply the gel and use some heat from a light source (sometimes a laser is used) to whiten the teeth in a short time. This technique is not common and is usually expensive.
2. Plastic trays are custom-made by your dentist using models of your teeth.
a) Sometimes dentists will ‘kick-start’ the whitening in the surgery with high-strength bleach gels in the trays.
b) This is followed by home treatments you do yourself using safe-strength gels. Home treatment alone is the most popular and least expensive method.
Home bleaching works in most cases although the result depends on the initial level of staining of the teeth and the type of staining. It is less predictable on teeth that contain some specific discolourations such as those caused by tetracycline intake in childhood. Home bleaching usually takes about two weeks, wearing trays either during sleep or for a few hours a day, depending on the technique. Home bleaching will not whiten fillings, and it may be necessary to have visible tooth coloured fillings replaced with ones that more closely match the final tooth colour after whitening is completed.
b) Micro-abrasion – can be used to remove discolouration in the surface layer of the enamel. A paste containing acid and an abrasive is used to remove the outer surface of the tooth enamel. If the discolouration is deep in the enamel your dentist may need to remove the affected enamel with a bur and place an adhesive tooth coloured filling. Usually an anaesthetic is not required.
c) Bonding – is a process whereby your dentist cleans and prepares the surface of your teeth and then bonds tooth coloured resin fillings to them. Bonding can be used to repair chipped teeth, close small gaps between teeth, alter the shape of teeth and sometimes cover discolouration in teeth. Bonded resins are simple to re-polish and replace if they eventually discolour.
d) Veneers – are thin (usually about 0.5mm thick) pieces of porcelain, which are bonded to the front surface of the teeth. Veneers can be used to improve the appearance of teeth by changing the shape of the teeth, by changing the colour of the teeth, by masking stains and by replacing small fractured pieces of teeth.
To construct veneers, your dentist will need to remove a small amount (0.4-0.5mm) from the front surface of the tooth.
Your dentist will then take an impression of your teeth. This is sent to a dental technician, who makes the veneers. At the next appointment (usually one to two weeks later), your dentist will carefully clean the repaired surfaces of the teeth and bond the veneers in place. In some cases, because so little tooth is removed, no provisional restorations are needed between the two visits.
Porcelain is a very hard, wear resistant, non-porous material that will keep its appearance far longer than tooth coloured resins. Porcelain, however, is brittle and can chip if hit by hard objects. If you have porcelain veneers, it is advisable to cease habits such as fingernail biting, pen and pencil chewing, biting into stone fruits and barbecue chops and opening packets with the teeth.
Bleaching, micro-abrasion, bonding and veneers can improve many cosmetic problems with teeth. However if the teeth are badly aligned, severely broken down or teeth are missing, it may be necessary to have orthodontic treatment, crowns or bridges constructed or implants placed.