What is cosmetic dentistry and how can it improve my smile?

Cosmetic dentistry encompasses a variety of procedures to improve your smile from subtle changes to major renewals.  There are many techniques and options to treat teeth that are discolored, malpositioned, chipped, misshaped or missing.  Commons reasons to elect cosmetic dentistry are to:  reshape teeth, close spaces, renew worn teeth, or alter the length or position of teeth.  Common procedures include:  teeth whitening, bonding, caps or crowns, onlays and inlays, veneers and reshaping, orthodontics and gingival contouring.

What is tooth whitening?

Tooth whitening is a common and popular chemical process used to lighten teeth.  Some people get their teeth whitened to make stains disappear, while others just want a brighter smile.  Discoloration, which occurs in the enamel, can be caused by medication, coffee, tea, dark colored foods, and cigarettes.  It can also be due to your genetic make up or simply from aging.  Teeth whitening can be performed in the dental office or at home.

What is bonding?

Bonding is the use of tooth-colored materials to fill in gaps or change the color and or shape of teeth.  Bonding lasts several years and often requires only a single office visit.  Bonding is more susceptible to staining or chipping than some other forms of restoration.  When teeth are chipped or decayed, bonded composite resins may be the material of choice.  Bonding also is used to fill cavities, to close spaces between teeth or to cover the entire outside surface of a discolored or misshaped tooth (resin veneer).

What are caps (crowns), onlays and inlays?

Caps, also known as crowns, cover the tooth.  This procedure is meant for the restoration of severely broken down, misshaped or malpositioned teeth and can be used for front or back teeth.  Onlays are partial crowns covering only the part of the tooth that needs to be restored, preserving healthy tooth structure.  Inlays are smaller than onlays and are used when a filling would not be adequate but an onlay is not yet indicated.  Onlays and inlays are for back teeth.  Today caps, onlays and inlays can be made in a variety of tooth matching materials depending on the individual patient’s need for esthetics and strength.  This matching has led to the diminishing use of metals in restorations today. 

What are veneers?

Veneers are thin layers of material, bonded resin or bonded porcelain, applied to an underlying discolored, misshaped and/or malpositioned tooth to achieve a better appearance and/or function.  Porcelain is stronger, often more esthetic and longer lasting than bonded resin, however in some cases, bonded resin can be very esthetic, done more conservatively (preserving tooth structure), involve fewer visits and is usually less costly than porcelain.

What is reshaping?

One or more teeth may have minor irregularities, i.e. a rotation or height difference with its neighbor.   In these situations minor adjustments made within the hard enamel outer portion of the tooth can often be a nice conservative treatment avoiding orthodontics, veneers or caps.

Orthodontics?

We all know about orthodontics, right?  The metal braces that are worn for 2 years.  Not anymore!  Today clear removable trays can be used for many orthodontic procedures.  This is an easier and more acceptable way for adults to do orthodontics almost invisibly.

What is gingival contouring?

Sometimes minor irregularities in gum positions can make for a less pleasing smile.  Gingival contouring is done using a laser, electosurgery or traditional surgery.  Laser is the newest and best alternative since the discomfort, tissue healing and results are most predictable.  Often laser contouring can be done with no anesthesia or just a topical gel anesthetic.

Are there any downsides to cosmetic dentistry?

Some cosmetic dentistry is purely elective but much of cosmetic dentistry today is restoring broken down teeth with the latest tooth matching materials that are strong and look great.  It is important to have an open discussion with your dentist about your preferences and limitations so your dentist can describe the benefits of the available treatment choices and cost differentials.  This will help you make an informed choice which will enhance the health of your mouth and beauty of your smile.

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Dr. Robert A. Gallegos is a Fellow of the American Dental Implant Association and the American Academy of General Dentistry, he is on the faculty of the Scottsdale Center for Dentistry, he is a mentor at the Pankey Institute for Advanced Dental Education and a general member or Fellow of several dental organizations including the American Academy of Cosmetic Dentistry, the American Academy of Dental Sleep Medicine and the American Dental Association.  Dr. Gallegos practices dentistry in Middleburg, VA.  You can learn more about his practice at www.MiddleburgSmiles.com and request a copy of this article at info@middleburgsmiles.com.

 This is a question I’m asked frequently in my dental office.  The saliva glands regularly produce saliva to keep the mouth moist, lubricate the tongue and soft gum tissue and wash the teeth.  If you find that you are constantly thirsty, having difficulty swallowing, experiencing burning mouth or your saliva is thick, foamy or absent you have dry mouth (xerostomia)- and you are not alone.  Approximately, twenty-five percent of the population has this condition.

There are several reasons people experience dry mouth, some of which are normal physiologic changes and others are caused by disease, medications, and lifestyle.  Women may experience dry mouth during normal physiologic hormonal changes in menstruation, pregnancy and menopause.  As we age, our saliva glands produce less saliva.  Examples of disease processes that adversely affect saliva flow include:  Sjogren’s syndrome AIDS/HIV, Alzheimer’s , Parkinson’s , anemia, high blood pressure, diabetes, and stroke.  Nerve damage from trauma can also decrease saliva flow.  Medications and medical treatment including: antihistamines, antidepressants, diuretics, sleep aids, decongestants, chemotherapy and head and neck radiation may also cause dry mouth. Lifestyle choices are also a contributing factor such as: not drinking enough water, smoking, chewing tobacco, and consuming alcohol and caffeine (sodas, coffee and tea).

Saliva is important.  It is the body’s main mechanism for fighting decay, gum disease and for initiating the digestive process.  The lack of good salivary flow leads to poor digestion and a sore or burning mouth all of which may contribute to malnutrition, especially in older adults. 

Here are some things you can do to help manage dry mouth:

• Drink plenty of water
• Ask your doctor about changing medications to those that are not as drying
• Chew sugarless gum or suck on non-citrus flavored sugarless candy
• Brush and floss twice a day
• Brush with a mild-flavored fluoride toothpaste, no whitening, gel or tartar control
• Use over-the-counter saliva substitutes (www.biotene.com)
• Stay away from mouth rinses with alcohol
• Pass up alcohol and caffeine
• Avoid smoking and chewing tobacco
• Avoid overly salty foods
• Steer clear of citrus juices (e.g., orange, grapefruit)
• Avoid dry foods (e.g., toast, crackers)
• Breathe through your nose instead of your mouth
• Use moisturizer regularly on your lips
• Sleep with a humidifier in your room

Understanding the causes of dry mouth and managing them with the assistance of your dentist and physician, along with good oral hygiene and regular visits to your general dentist, will help improve the condition, prevent decay and gum disease and contribute to your overall good health.

Dr. Robert A. Gallegos is a Fellow of the American Dental Implant Association and the American Academy of General Dentistry, he is on the faculty of the Scottsdale Center for Dentistry, he is a mentor at the Pankey Institute for Advanced Dental Education and a general member or Fellow of several dental groups including the American Academy of Cosmetic Dentistry and the American Dental Association.  Dr. Gallegos practices dentistry in Middleburg, VA.  You can learn more about his practice at www.MiddleburgSmiles.com and request a copy of the article at info@middleburgsmiles.com.

Sleep Apnea and Snoring

Snoring and Sleep Apnea may Increase Your Risk of Heart Disease

According to the American Academy of Dental Sleep Medicine, sleep apnea is the most common sleep disorder, affecting nearly 1 out of every 8 individuals. Snoring is the sound of partially obstructed breathing during sleep. While snoring can be harmless, it can also be the sign of a more serious medical condition known as obstructive sleep apnea (OSA). OSA occurs when the tongue and soft tissues fall back into the throat during sleep, completely blocking the airway. Twenty-eight percent of men over the age of 65 suffer from sleep apnea. The good news is that snoring and OSA are improved and often eliminated in patients who seek treatment.

Obstructive Sleep Apnea Has Been Associated With:

• High Blood Pressure
• Increases risk for Heart Attack and Stroke
• Increased risk of Motor Vehicle Accident
• Daytime Sleepiness
• Heartburn
• Morning Headaches
• Depression
• Impotence

Published Article by: Robert A. Gallegos, DDS                                                                       Fellow- American Academy of Dental Sleep Medicine