BLEACHING AND COSMETIC DENTISTRY
There is not a single body language action that is more universal, from culture to culture, than the smile. A nice smile can give a person self-confidence and conversely a smile that harbors crooked, discoloured and misshapen teeth can contribute to shyness and withdrawal. This is not to say that a more cosmetic smile makes a better person. However, many of us strive to create an image to others that will, we hope, reflect positively. It is true, maybe sadly, that a first impression goes a long way in forming the overall view that others have of us.
Cosmetic dentistry has become the main focus of many dental practices. Dentists can change the colour, shape and alignment of our teeth with the end result looking whiter and straighter than before. Changing the alignment of teeth can be done orthodontically (by moving teeth with wires and braces) or by putting facings and coverings over teeth to give the illusion that they are straight. The facings are called veneers and the full coverings are called caps or crowns.
Veneers are made of porcelain. The procedure involves very slightly polishing the front surface of usually the front six teeth (removing approximately 0.5-1 millimeter) and then taking a mold of these polished surfaces. At a second appointment, custom-made veneers are bonded onto these prepared surfaces. The colour and shape are chosen to maximally enhance the esthetics of that person's smile.
If the teeth have large fillings in them already, are broken, or if extra stabilization is needed, crowns are excellent restorations to not only strengthen teeth, but to also maximize esthetics.
If one is happy with the shape and position of one's teeth, one way to improve the esthetics of a smile is to whiten the teeth. There are a variety of methods to achieve this. Whitening agents can be easily purchased. These agents work either as abrasives or by chemical bleaching. If you are using abrasives to remove stains on your teeth, you must be very careful. Using these products every once in a while is fine, but daily use over a prolonged period may actually make teeth more yellow by removing enamel and uncovering the yellow layer underneath the enamel. The chemical agent used to bleach teeth in both store-bought and professional formulations is called hydrogen peroxide. Both store-bought and professional formulations will whiten teeth. The question is how well?
Agents purchased in a store contain varying amounts of hydrogen peroxide and therefore are variable in their effectiveness. Professional formulations contain standard amounts of hydrogen peroxide and their results are therefore more predictable. However, the
effectiveness of all of these products is patient-specific. The same product may have drastically different results on two different people. This is because the pores in our teeth vary in size. The better the bleach is able to diffuse into the enamel, the more profound the whitening will be. There is no way to predict the end result except that with the professional formulations, some degree of whitening should always occur.
Bleaching done by a dentist can be carried out during a dental visit; can be done by the patient over successive nights; or can be done by the patient during four, 15 minute sessions, daily for one week. It is safe and with professional guidance, no damage should occur to the oral structures. The only side effect may be slightly sensitive teeth for a few days.
How long the bleaching lasts will depend on the habits of the patient. While a home bleaching session is occurring and for a few days afterwards, one should refrain from smoking, drinking tea, coffee, colas or red wine. Following this, our teeth will stay whiter if we abstain from the above activities and if we take care of them. It is much like bleaching a white T-shirt. If we exercise in this shirt frequently, wash it weekly and spill sauce on it, it will not stay white for very long and we will need to re-bleach it sooner rather than later.
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