If you are not happy with the way your teeth look, it may affect your
self confidence and you may no longer want to smile. Cosmetic dentistry
and materials science has made a great deal of progress in helping
people to gain confidence in their appearance and smile and could
probably help you as well.

When a patient’s teeth have flaws or have become damaged, porcelain
veneers or crowns, also referred to as caps are used to restore the
teeth for a more brilliant smile. Crowns are used to fit over and cover
damaged or flawed teeth. Porcelain veneers are a covering for a tooth
that is custom made to restore the front of the tooth. The covering is
thin and blends with the natural color of the other teeth so it can’t be
easily seen.

Problems that Porcelain Veneers and Crowns Can Address

If you have excessive damage to your teeth because of tooth decay, these
two products can help. Teeth that are stained permanently or are
discolored for a variety of reasons will benefit from cosmetic dentistry
that involves veneers or caps. If your teeth have become brittle after
having root canal or have become fractured for any reason, porcelain
veneers and crowns can address these issues as well.

In the past, crowns were the way that we addressed these problems.
Today, porcelain veneers have become a popular way to make teeth whiter
and brighter and can cover a wide range of conditions. Your dentist will
have to examine your teeth and tell you which of the two methods are
better suited to your needs.

Situations that Influence One or the Other

Your dentist will take a number of factors into account when deciding
whether your teeth would best be served with either porcelain veneers or
traditional crowns. The condition of your gums, what type of bite or
occlusion you have as well as the amount of damage the teeth have
suffered are all taken into our consideration when determining the best
method to restore your teeth. Porcelain veneers rely on intact enamel
for their bond strength and sometimes there won’t be enough quality
enamel for veneers, but with modern crowns made of porcelain, it is
difficult to distinguish whether they are porcelain veneers or caps.

Pros and Cons

When porcelain veneers are applied, very little of the tooth enamel has
to be removed, while when applying crowns, a larger portion of the tooth
is removed for the cap to be able to fit over the damaged tooth.
Porcelain veneers only cover the sides and front, while a crown will
cover the entire tooth and is the preferred method when damage to the
teeth is severe.

Cost is another consideration for the patient. Porcelain veneers, since
they only cover the visible side of the tooth are usually considered to
be cosmetic in nature and may not be covered by insurance, even though
the procedure for veneers and crowns are nearly identical and the costs
usually very close.

You and your dentist can discuss the pros and cons of each of these
products to find the one that will best suit your pocketbook and your
needs. As a dentist, I know that all dental professionals are more than
happy to take the time to discuss the proper procedures that will have
you smiling again, but it is up to you to ask the right questions that
will elicit the information you need to make your decision.

If you have receding gums due to periodontal disease and your teeth look
like they belong to a vampire, there is something you can do to correct
the problem. Using different forms of periodontal plastic surgery, those
of us in the cosmetic field of dentistry will aid you in your quest so
that you can once again show your smile to the world.

Not only is this condition a cosmetic concern but it can also affect the
good health of your teeth and gums. The end results of this condition
can be gum irritation, sensitivity to the surface of the root, bone
loss, root caries or even loss of one or more teeth.

Many advances have been made as to techniques and materials used to
improve not only the appearance of your teeth and smile, but the comfort
level of the surgery involved as well which can be a major concern for
many patients.

Receding Gums: One Cause of the Appearance of Long Teeth

When our gums have receded because of periodontal disease, the teeth
have the appearance of being much longer than the norm. And though it is
not attractive, this is not always the main concern of those of us in
the field of dentistry. Receding gums expose the surface of the root
which can cause sensitivity. Root caries and accumulation of plaque and
calculus (calcified plaque) can result when your condition is not
addressed. When the condition is allowed to worsen it can cause bone
loss and loose teeth. In many cases, your condition can be addressed
surgically by using a small transplant of tissue from the roof of the
mouth or the gums.

Papilla Regeneration

This small section of the gum is often overlooked until black triangles
or holes appear between your teeth. This often indicates that the tissue
between your teeth has been lost. Major advances have been made, but it
is still the toughest surgery we as dentists must perform.

Connective Tissue Skin Graft

For receding gums that have advanced to more than just one or two teeth,
covering root surfaces that are overexposed is not much of a challenge
for today’s cosmetic dentist practitioner. After the underlying
periodontal disease has been controlled and the bone is healthy, tissue
from the palate can be grafted and placed so that the area of recession
is covered. In six months time, a complete recovery can be enjoyed along
with the return of your gum tissue to normal levels. Your teeth look
like they once did before periodontal disease advanced.

If you are unhappy with your smile and have brought your periodontal
condition under control, talk with your dentist about cosmetic surgical
procedures that can be done to improve the look of your smile. Our
profession has come a long way in recent years with different methods to
improve the look of your smile and at the same time address the overall
health of your teeth and gums. Find a good cosmetic dentist in your area
to give you a thorough exam and a treatment plan that will be beneficial
to you and your teeth.

Many dental patients sign on the dotted line when they begin treatment
and later find out that their dental insurance will not cover the full
cost or as much of the treatment as they expected. Most dental plans
allow for a yearly limit of between $1000 and $2000. If the cost of the
treatment you receive exceeds the yearly limit that your plan allows,
you should know beforehand so that you can make other arrangements.

When visiting the dentist, find out exactly how much it will cost. Sit
down with the office manager or the person in charge of insurance and
billing to find out what each procedure will cost. Before you sign for
treatment to begin, check with your dental insurance plan to see what
costs are covered and how much they will pay for your entire treatment
plan. Once you agree to a treatment plan, and allow your dentist to
complete treatment you are liable to pay no matter what your insurance
does not cover.

Payment Options

There are some dentists that will agree to a payment plan that will
allow you to pay off your dental bill in installments. If in your case
your treatment exceeds the yearly limit and treatment is necessary to
keep your teeth in good shape, sit down with the dental team that
handles payments and come up with a plan that will enable you to pay off
your bill at a monthly price that is acceptable both to you and the
dentist. There are also third party credit solutions available that are
specifically geared to help people with dental costs. Your dentist can
often help you find these. You can also go online to find a bank that is
willing to lend you the money. Care Credit is one such company that
extends credit for those in need of medical or dental care whether they
have insurance or not. There are a variety of plans that can be looked
into to find out which plans are best for your needs and your dentist’s
requirements.

If your dental treatment is considered a medical necessity then you have
the right to appeal to the medical part of your insurance plan to pay
for treatment above and beyond what your dental insurance will cover.
This will only work if your dental treatment is truly a medical
necessity.

The Bottom Line

When going to the dentist and offered a treatment plan, be sure that you
have the coverage before you start. If not, discuss the treatment
priorities. Sometimes certain procedures can wait for the next insurance
coverage period. If you are in no pain or if delayed treatment will not
cause further treatment to be needed, you can often wait until your next
year’s limit comes around. Though no dentist will advise you to wait,
you are the only one who knows what your entire situation is and what
you can reasonably afford. The dentist will have your oral health in
mind so don’t be afraid to sit down with him or her and the staff. Your
dentist has your best interests at heart and will work with you in any
way they can in order for you to get the proper treatment you need and
to make sure that your insurance benefits are maximized.

Children with developmental disabilities or challenges face many
obstacles as do the professionals that teach and treat them. It can be
quite difficult for a child with developmental challenges to understand
some of the medical or dental procedures they must endure and
emotionally draining for you as a parent.

Some children act out and can put themselves and the medical or dental
staff at risk, so many doctors and dentists refuse to treat them. We as
dentists can take special classes in order to learn how to treat your
children with developmental disabilities and challenges gently and
effectively.

General Anesthesia

One option that we can utilize is to perform the dental procedures while
your child is under general anesthesia. This ensures that a child that
is prone to violence in an unfamiliar setting is completely safe to
themselves and to others that are around him. A child that has a violent
tantrum in the dental office runs the risk of breaking equipment and
potentially harming himself or a member of the staff.

General anesthesia is recommended for those children that not only are
unable to cooperate but are unable to comprehend the procedure at hand
as well. Children that are in this category should be examined every one
to three years whether there is any indication of dental problems or
not.

Before beginning the exam under anesthesia, you should be made aware of
the risks involved for your children and a consent form needs to be
signed. All medical information pertaining to your child should be made
available to the dental team. Post operative care should also be
explained to you and what you should expect when your child awakens.

Schooling

The medical and dental needs have long been ignored for those children
with developmental disabilities and challenges because of the difficulty
involved in treating them. More dentists along with their staff are
taking classes to learn more about specific conditions and how to
address the special needs of these young patients. We in the dental
profession have the opportunity to become well versed in problems that
may arise and the solutions we can apply will be able to better meet the
needs of children with developmental disabilities. Keeping the child and
the members of our team safe, not letting the child become too
frightened are all being addressed in continuing education for medical
and dental professionals alike in order to further our knowledge and
abilities to work with these very special children.

Everyone deserves the best care that is available and with the new
education programs targeted for medical and dental professionals,
children with special needs can be routinely treated so that more
serious problems do not occur because of lack of early treatment. Not
every dentist or doctor is suited for this delicate but work, but those
that feel they can take on the challenge will find many resources that
will allow them to properly treat and handle children that have
developmental disabilities or challenges. In the end, they will find
that the work with these children is rewarding and worth the extra time
and effort taken in order to give them treatment they need.

If you are a parent of a child with special needs, ask your dentist if
they are equipped to handle those needs or for a referral to someone who
does handle those needs.

The health threat from mercury poisoning has long been an issue in
dentistry due to the inclusion of mercury in silver amalgam fillings.
For many years there was little that could be done about it, because
there were no viable alternative filling materials available. In more
recent years, however, the bonded composite resins have continuously
been improved and strengthened to the point where they are today a very
viable option to the use of dental amalgam fillings, even in the back
chewing teeth.

If you have new cavities or old silver fillings that are in need of
replacement, ask your dentist about tooth colored fillings. These bonded
composite resins can be done in one visit like the old amalgam fillings,
or in the case of more extensive tooth structure damage, in two visits
as an inlay or onlay made in the laboratory.

Amalgams vs Composites

When considering what you want for your teeth, consider the following
points:

* Amalgams cost less generally, but also look cheaper. Amalgams darken
with age and end up as black fillings. Composites are tooth colored and
the newer generations hold their color very well.

* Amalgams contain mercury, which is a very toxic heavy metal. The
degree to which mercury is released from amalgam fillings has long been
in dispute, but there is no question that it is released and absorbed
into the system. It can not easily be removed from the body once
absorbed, so it has a cummulative affect. There is some occurance of
allergy to dental composite resins, but this is quite rare and usually
self limiting as well.

* In order to place an amalgam filling, quite a bit more tooth structure
must be removed, beyond the actual decay in the case of small new
cavities, than with the bonded composites.

* Amalgam tends to expand with age, pushing outward on the tooth from
within the cavity preparation. This leads to many teeth cracking and
breaking off parts of the teeth. When properly handled, composite resins
tend to hold the tooth together because of the bonding.

* Amalgam restorations are weakest at the margin between filling and
tooth where they are thinnest. It is here that they chip and wear and
begin to allow re-decay underneath. Composites are actually strongest at
the bond junction between tooth and filling. There tends to be much less
re-decay at this junction than with traditional amalgam.

* Amalgam conducts heat readily leading to many teeth having post-
operative sensitivity. With properly placed composite resins, we
experience much less post-operative sensitivity than in the past.

It is important that you develop a good raport with your dentist and
discuss with them the materials planned for use in your teeth. Research
your options and ask your dentist about your findings.