Esthetics

Appearances matter. Our society is very demanding of us to have nice smiles. First impressions are important. 

Studies have shown that people judge others by the cosmetic appearance of their teeth. Note the upper two central teeth figure prominently here. They, especially have to have the same size and shape and colour. Besides being considered to be more attractive, people with nice teeth are subconsciously deemed to be more intelligent, more ethical, and friendlier. Too white though conjures up negative ideas though.

Braces/orthodontics
This is the field of the orthodontist. It often involves a minimum of two years of treatment costing around $7000. Sometimes it involves moving one or both jaws along with the teeth – this means another specialist, the oral surgeon, has to be involved. 

Invisalign has become very popular because there are no esthetically compromising brackets glued to the teeth. Invisalign is only for tipping teeth. But for better, faster, and more complicated tooth movement the brackets and bands are still the best option.

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Real teeth 

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Way too fake for our liking

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Invisalign 

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Clear braces with wire – better, faster but not as esthetic

Bleaching
This involves placing a tight fitting tray around the visible teeth on the top and the bottom. These trays are filled with a whitening agent and allowed to bathe the teeth for a period. Note that these sometimes cause the teeth to be sensitive and can also make the gums sore. A person may have a take home kit which they place over the teeth once or twice a day for two to three weeks. Or they may have a one hour sit down session in the office with a special light that activates a whitening product in the tray that is stronger than the take home whitener. Health Canada sets the limits as to what concentration of whitening agent can be sold to the general public and what can be sold to dentists.

Teeth with a yellow hue lighten the best while those with a grey hue change the least. When a person is going to get bleaching the baseline colour check is done at the start and then this chip can be compared to the teeth later.

Yellowish teeth bleach better - the photos demonstrate a good result. Note all the stuff you see on the internet is not to be trusted. A few pictures are real but most are enhanced.

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Anterior bonding
This involves the use of white filling material to cover the front surfaces of the front teeth. Usually no anesthetic is used for this procedure and the teeth are not damaged at all. It is a reversible process but to date no one we have ever placed it on has ever wanted it removed. This procedure usually takes 30 min to 1 hour and 30 min.  It can change the shape and the colour of teeth and make them look like they are positioned further forward. The main drawback is the addition of material to the fronts. Discretion must be used here as we don not want to create a “Bucky” appearance. The material may stain over time, especially if the person is a smoker or drinks a lot of tea. Red wine and coffee do not stain very much. Occasionally these composite “veneers’ will need to be buffed up, or repaired, or replaced. But the materials keep getting better and better so the results are better and last longer than ever before. Longevity is probably anywhere from 5 or 6 years to 10-12 but these numbers are hard to predict.

Porcelain Veneers
These are ceramic coverings that are made at a dental lab by a dental technician. A certain amount of the front tooth structure has to be removed, impressions/moulds taken, temporaries placed, and then two weeks later these thin little brittle bits of porcelain are cemented onto the fronts of the front teeth. We don’t do these in our office. Our feeling is that they are not good value for the amount of tooth reduction and money that has to be spent and the long term survival rate. The entire tooth has to be made smaller except for a small section on the inside side of the teeth. This is because all porcelain restorations are very brittle so they need to be a certain thickness for strength and to get them thick enough you have to sacrifice tooth structure. Besides being susceptible to breakage they are also vulnerable to leakage meaning they can stain underneath along the edges. Ten years would be a very good length of time for these to last.

Anterior caps/crown
If you are going to go as far as veneers you may as well go all the way and get crowns that have more control over colour, positioning and longevity. You can read about these in our “Crowns” section.