Keep Your Teeth Healthy and Young-Looking with the Help of Today’s Dental Techniques!
Wednesday - January 23, 2008
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By Kevin K.L. Ching, DDS
As you age, certain things are inevitable. You don’t move as quickly as you once did. Your hair gets gray and your skin wrinkles. And it used to be that you lost your teeth and got dentures.
Not so anymore. Advances in cosmetic and preventive dentistry mean that more older adults are keeping their teeth. Only about 30 percent of adults over 65 now wear dentures, and that’s expected to drop to 20 percent within the next decade or two.
“I’ve gone 18 years from learning how to make dentures and thinking it is OK for people to lose teeth, to being appalled if anyone loses teeth. It is a failure,” said Washington D.C. dentist Judith Penski.
Dr. Linda Niessen, vice president of clinical affairs for DENTSPLY International, concurs. “Teeth were designed to last a lifetime. No one has ever lost a tooth because he or she celebrated a 75th birthday.”
Signs of an aging smile
Your smile ages just like the rest of your body. Teeth often darken somewhat, as the dentin layer of your tooth, located just beneath the enamel, undergoes natural changes. Teeth can also become crowded or crooked as years pass, as they naturally migrate forward. Plaque, the sticky, disease-causing layer of bacteria, builds up faster as you age, unfortunately at a time when brushing can be more difficult. This can cause gums to become infected with periodontitis, often resulting in unattractively recessed gums. And finally, the decreased saliva flow in your mouth, either a natural result of aging or a side effect of certain medications, can accelerate decay and gum disease; saliva acts as “nature’s mouth-wash,” washing away food and neutralizing decay-causing acids in your mouth.
The simplest and most common cosmetic procedure, tooth whitening or bleaching is most effective on teeth with yellow, brown or orange stains. Gray-stained teeth, or teeth discolored due to intake of the antibiotic tetracycline, are very difficult to bleach.
Teeth can be whitened in the dentist’s office, or many dentists can supply you with an at-home bleaching kit complete with a mouthguard that is custom-made for your teeth. Both forms use a form of hydrogen peroxide to remove stains and brighten teeth.
While in-office bleaching is considerably more expensive than at-home bleaching kits ($600-1000 per arch, compared to $200-500), the American Dental Association recommends in-office bleaching, because the process can be carefully controlled by your dentist.
In all instances, the ADA recommends against over-the counter bleaching kits. “(Bleaching kits) may cause damage to the tooth pulp, enamel, gums and other areas of your mouth,” said Dr. Kenneth Burrell, director of the ADA Council on Scientific Affairs.
“Your dentist first can tell you if any whitening procedure at all is appropriate for you. He or she can also monitor the procedure and determine if any adverse reactions do occur,” he said. Keep in mind that tooth-colored crowns, bridges and fillings will not bleach; whitening when you have visible tooth-colored restorations could result in a two-toned smile.
Porcelain veneers are custom-crafted, fingernail-thin tooth-colored shells that are bonded to natural teeth They are subtle in color and nearly transparent, so they give a natural-looking enhancement to the shape, size, color or length of the teeth they are affixed to.
Porcelain veneers correct problems such as discolored, worn or misaligned teeth. The down side? Porcelain veneers are relatively expensive, averaging between $450-750 per tooth.
An implant is a stable replacement for a missing natural tooth. It is constructed of a metal cylinder with its base attached to the jawbone and its top attached to a natural-looking porcelain tooth. Over several months, the implant fuses with the jawbone, creating a strong, long-lasting tooth replacement that’s hard to distinguish from your natural teeth.
Bonding is an excellent way to repair chips or cracks in teeth or to change their shape or color, particularly in front teeth.
First, your natural tooth color is carefully matched to the color of the bonding material. Then your teeth are lightly roughened, and a gel is applied to ensure adherence of the bonding material. Once the material is applied, it is sculpted and hardened with a high-intensity light It is then polished to a natural-looking luster.
Bonding works best on small areas, as larger restorations are prone to breakage. In general, bonding lasts from three to five years.
Bonded porcelain or composite restorations (fillings)
Dark metal amalgam fillings can give a gray cast to your smile. They eventually wear out and need to be replaced; they can also cause teeth to fracture and split. Luckily, silver fillings can be removed and replaced with bonded porcelain or composite fillings. These tooth-colored fillings blend perfectly with your natural teeth, so they are nearly invisible. Plus they are usually stronger and more durable than silver fillings.
Tooth-colored fillings cost significantly more than silver amalgam fillings, and insurance plans generally don’t cover the extra cost. However, the difference in appearance, particularly in teeth that are exposed when you smile, is so drastic, many believe it is well worth the extra cost.
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