An improved smile can change a person's outlook and how other people react to them, but what is cosmetic dentistry really?
Technically, it refers to any dental care rendered on the externally visible "smile" teeth that a dentist restores. In layman's terms, the public thinks of cosmetic dentistry as "bonding." All our dentistry is actually bonded dentistry, meaning the tooth is etched, a bonding resin (dentin adhesive) is placed and cured. Then the filling material, crown, veneer, or inlay is placed on the bonded surface of the tooth and then cured to the tooth.
No matter what type of cosmetic dentistry one needs, it is quite important to all patients that the restorations are designed to last as long as possible. So that we are better able to achieve this goal, we always do a comprehensive exam first, specifically to identify any occlusal/TMJ disorders. By doing the exam first, we know if the occlusion needs correction prior to doing any specific cosmetic work. It wouldn't do at all to place a smile full of beautifully crafted porcelain veneers, only to have the patient clench and grind due to a problem with their back teeth, and end up shattering the new veneers. This can and does happen with unfortunate frequency if a comprehensive examination of the occlusion and TMJ is not completed prior to any cosmetic treatment.
There are, in reality, two types of bonding:
- Direct bonding: repair tooth structure directly by placing a restorative material (composite) on the area of the tooth to be restored, and shaping and contouring it to achieve the desired outcome.
- Indirect bonding: this includes taking an impression of the teeth that need restoration or reshaping. The impression is sent to a dental lab where they fabricate either a veneer or crown from porcelain. Upon return to our office, we try on the veneer or crown. After assessing the fit and function, and when it looks perfect to the patient, we proceed with the bonding process.