Smilemakeover involve a comprehensive assessment of your smile esthetics in order to improve its overall look. Typically one or more cosmetic dentistry procedures, such as dental veneers, dental implants, gingival contouring and teeth whitening, will be required for several teeth in both the upper and lower arches in order to achieve the look you want.
Are you curious about how your dentist might use cosmetic dentistry techniques such as porcelain veneers, teeth whitening treatments, and dental crowns to make changes with the appearance of your smile? If so, take a look at our before-and-after makeover simulation picture sets. These are actual photographs people have sent in that we've edited so to illustrate the types of changes a dentist using modern cosmetic dental procedures can make with a person's smile.Cosmetic dentistry focuses on improving the appearance of a person's teeth, mouth and smile. In ot her words restorative, general and/or family dental practices address dental problems that require necessary treatment, whereas cosmetic dentistry provides elective — or desired — treatments or services.
Dental implant is an artificial tooth root replacement and is used in prosthetic dentistry to support restorations that resemble a tooth or group of teeth. The most widely accepted and successful implant today is the osseointegrated implant, based on the discovery by Swedish Professor Per-Ingvar Brånemark that titanium can be successfully fused into bone when osteoblasts grow on and into the rough surface of the implanted titanium.
dental care is the taking care of teeth. It includes, and may refer to:

• Oral hygiene, the practice of keeping the mouth and teeth clean in order to prevent cavities (dental caries), gum disease, and other dental disorders.
• Dentistry, the professional care of teeth, including professional oral hygiene and dental surgery. Sinus lifting is a common surgical intervention. The trained periodontist, oral surgeon, or in the more simple surgical cases the general dentist, thickens the inadequate part of atrophic maxilla towards the sinus with the help of bone transplantation or bone expletive substance and as a result creates a better quality bone site for the implantation.
Bone grafting will be necessary in cases where there is a lack of adequate maxillary or mandibular bone in terms of front to back (lip to tongue) depth or thickness; top to bottom height; and left to right width. Sufficient bone is needed in three dimensions to securely integrate with the root-like implant. Improved bone height -- which is very difficult to achieve -- is particularly important to assure ample anchorage of the implant's root-like shape because it has to support the mechanical stress of chewing, just like a natural tooth. If an implant is too shallow, chewing may cause a dangerous jawbone crack or full fracture. Typically, implantologists try to place implants at least as deeply into bone as the crown or tooth will be above the bone. This is called a 1:1 crown to root ratio. This ratio establishes the target for bone grafting in most cases. If 1:1 or better cannot be achieved, the patient is usually advised that only a short implant can be placed and to not expect a long period of usability. implant dentistry an interdisciplinary forum for general practitioners, specialists, educators, and researchers, publishes relevant clinical, educational, and research articles that document current concepts of oral implantology in sections on biomaterials, clinical reports, oral and maxillofacial surgery, oral pathology, periodontics, prosthodontics, and research.
Oral implants Oral or Dental Implants have opened the door to the 21st century in dentistry and oral rehabilitation. They have increased the treatment possibilities for patients and improved the functional results of their treatment. Patients who had to compromise their esthetic appearance, chewing functionality and nutritional intake due to complete or partial tooth loss can now be restored back to various degrees of normal esthetics and function. Since the commercial distribution of Dental Implants, the field of Oral Implantology has undergone a rapid and progressive development. Many professionals have branched off and specialized in this particular field. Their continuing research efforts reward this field with new concepts and developments almost on a daily basis. Research efforts from many different disciplines such as material science, physics, medicine, biochemistry and others form the foundation for continued improvements in the field of Oral Implantology as well as the hard-ware being used. What was several years ago considered to be alternative or experimental treatment in dentistry is often considered Standard of Care now. Porcelain laminates porcelain veneers, sometimes also termed dental veneers or dental porcelain laminates, are one of cosmetic dentistry's more recent developments. These wafer-thin shells of porcelain which are bonded onto the front side of teeth can be an excellent cosmetic solution for teeth that are stained, chipped, or slightly misaligned.
* Porcelain veneers create a very life-like tooth appearance.
Veneers dental veneers are custom-designed shells of tooth-like ceramic material that, when applied over the surface of a tooth, can cover worn tooth enamel, uneven tooth alignment or spacing and chips or cracks. Dental veneers fall into the category of cosmetic dentistry because they create a bright, white smile with beautifully aligned, shapely teeth. Even better, the translucent ceramic quality of today's veneers provides a more natural look than what’s been available in the past. Regardless of what causes unattractive teeth, dental veneers may solve most or even all of your cosmetic dental issues, including: Porcelain veneers The two most common materials used in the manufacture of dental veneers are composite resin and porcelain veneers. Both porcelain veneers and composite veneers can be fabricated by a dental technician in a dental laboratory; composite veneers can also be directly fabricated inside your mouth at the dental office.
Dental veneers that are indirectly fabricated — fabricated in a dental laboratory — are bonded to the teeth with various types of resin cement. Of the two options, porcelain veneers are longer lasting and more expensive.
Ceramic veneers are extremely thin shells made of a strong and durable dental ceramic. A participating dentist removes a small amount of enamel from the front and sides of the tooth. This makes room for the veneer and prevents the restored tooth from feeling or looking bulky or unnatural.
Lumineers are porcelain veneers that offer the painless way to a permanently whiter and perfectly aligned smile. Your LUMINEERS dentist can apply these contact lens-thin "smile shapers" to teeth without any grinding or shaving, transforming teeth into a naturally beautiful smile that looks perfect for every individual. LUMINEERS can even be placed over existing crown or bridgework without having to replace them.
LUMINEERS are contact lens-thin and are placed over existing teeth without having to remove painful tooth structure (unlike traditional veneers.) LUMINEERS is the painless, permanent cosmetic solution for stained, chipped, discolored or misaligned teeth.
luminares by cerinate can only be made from patented Cerinate porcelain unavailable anywhere other than the Cerinate Smile Design Studio. In just 2-3 visits to your LUMINEERS dentist, you can have a custom-made smile that is clinically proven to last over 20 years - and it is completely reversible since your natural tooth structure is still intact! Get your perfect smile today!
Hollywood smile
our mission is to provide all of our patients with the highest quality of care, comfort and the best experience that one could have. Our belief is that going to the dentist should be an experience and not a test of endurance. Therefore, our friendly staff is committed to provide each patient the best service along with comfort and care. They are highly trained and provided the best
continuing education constantly, to keep our dental office a technologically state of the art, and also elevate the expectations of our patients about dentistry. Your beautiful, healthy, functional and comfortable smile is our Goal and to achieve that we all strive.
Bruxism is the grinding of the teeth, and is typically accompanied by the clenching of the jaw. It is an oral parafunctional activity that occurs in most humans at some time in their lives. In most people, bruxism is mild enough not to be a health problem; however, 25% of people suffer from significant bruxism that will become symptomatic. While bruxism may be a diurnal or nocturnal activity, it is nocturnal bruxism which causes the majority of health issues, and can even occur during short naps.
Teeth whitening • In-Office Teeth Whitening
• At-Home Teeth Whitening
The term "whitening," on the other hand, refers to restoring a tooth’s surface color by removing dirt and debris. So any product that cleans (like a toothpaste) is considered a whitener. Of course, the term whitening sounds better than bleaching, so it is more frequently used — even when describing products that contain bleach. Bleaching the term "bleaching" is permitted to be used only when the teeth can be whitened beyond their natural color. This applies strictly to products that contain bleach — typically hydrogen peroxide or carbamide peroxide.
Britsmile
BriteSmile has a single purpose: brightening lives by brightening smiles. BriteSmile pioneered today's teeth whitening practices by spearheading a breakthrough patented blue-light technology called The BriteSmile Whitening System. Our state-of-the-art BriteSmile Whitening System is quick, effective and gently delivers a naturally brilliant smile. Consider this, in as little as 1 hour, a professional BriteSmile Teeth Whitening experience can yield a brilliant & healthy smile that will last for years. Now that is breakthrough. Moreover, BriteSmile is clinically proven to improve oral health while whitening up to 14 shades brighter.
Zoom whitening Take a first step in feeling good and looking great with brighter, whiter teeth in less than an hour. Zoom! teeth whitening is safe, effective and very fast, and performed only by a dental professional. The procedure is simple. It begins with a short to cover your lips and gums, leaving only your teeth exposed. Than Dentist applies the whitening gel. Invisalign
The Invisible Way to Straighten Teethbr
It is easier than ever have the smile you have dreamed of! Invisalign is a simple way to straighten your teeth without braces, bands, brackets, or wires. This proven technology allows you to invisibly achieve the perfect smile through the use of a series of removable, aligning trays.
Cerinate veneers much like any other veneer laminate, is designed to improve the appearance of chipped, worn, or discolored teeth. What makes Cerinate veneers better than other types of veneers in that Cerinate porcelain is stronger and more durable than those made of plastic. It is a durable material that can endure chipping, cracking, and staining. Cerinate Porcelain is different from other porcelain veneers is that it can be made very thin and translucent while maintaining its strength. Also it does not irritate the gums and it has the appearance of a tooth’s natural structure. Cerinate Porcelain also has low coefficient thermal expansion, which means that it prevents the material from fracturing or de-bonding. This is a material that can help you achieve a long-lasting aesthetically pleasing smile.
If you’re considering Cerinate veneers to enhance your smile, the following information will provide you with a good introduction to the procedure. This is just designed to give you a basic understanding of the procedure. But for more detailed information about how this procedure will help you, we recommend that you consult a cosmetic dentist with experience in applying Cerinate veneers.
Smile Consultation
This visit allows you to meet Your Doctor and clinic’s staff in a relaxed environment. During consultation, we listen closely to patients feelings, concerns and dreams about smile and long term dental health. We will discuss what options of treatment we can offer to you and answer any questions you may have. We are also excited to show you photos of before and after photos of patient's teeth.
With today's cosmetic dentistry procedures, it has never been easier to attain a beautiful, healthy smile...a smile that's dazzling, white, straight and even. Many people are simply amazed to discover the difference cosmetic dentistry can make in their appearance and confidence. They're even more surprised by how quickly the smile makeover can be completed.
The CEREC 3 acquisition unit incorporates a mobile PC that has been specially designed and approved for medical applications. The PC is equipped with a flat panel monitor, a high-precision 3-D measuring camera, and a microprocessor-controlled image capture card. The card processes the images from the 3-D measuring camera in real time.
Duzzling white smile
A smile. What is a smile?
• A smile opens doors.
• A smile opens hearts.
• A smile lights up a room.
• A smile consoles sadness.
• A smile brings joy.
• A smile speaks of loving and caring.
• A smile soothes the soul.
How can a simple facial expression do all that?
Ahhh…But it can - it’s wonderful, isn’t it?
That’s a lot of responsibility for just one expression, don’t you think? It is!
And that’s why a warm smile is so important.
• Smiles leave a lasting impression on others.
• They’re the first thing people see when they look at you.
Are you conscientious of smiling because your teeth are less-than-dazzling due to stained and/or yellowed teeth?
Would you like to take years off the age of your smile and add a fresh, new healthy looking glow to your teeth?
Is it time to change the way you face the world and greet each day with an energy and vibrancy that can only come from self-confidence, a confidence that is a direct result of your brilliant, dazzling white smile?
Dental hygiene is the practice of keeping the mouth and teeth clean in order to prevent dental problems and bad breath. Teeth cleaning is the removal of dental plaque and tartar from teeth in order to prevent cavities, gingivitis, and gum disease. Severe gum disease causes at least one-third of adult tooth loss. Generally, dentists recommend that teeth be cleaned professionally at least twice per year. Professional cleaning includes tooth scaling, tooth polishing, and, if too much tartar has built up, debridement. This is usually followed by a fluoride treatment for children and adults.
Between cleanings by a dental hygienist, good oral hygiene is essential for preventing tartar build-up which causes the problems mentioned above. This is done by carefully and frequently brushing with a toothbrush and the use of dental floss to prevent accumulation of plaque on the teeth.
Contouring
Using a polishing instrument, the dentist removes small amounts of surface enamel of one or more teeth to compensate for the imperfections. Followed up with a smoothing and polishing of all the surrounding teeth, this quick, painless, and inexpensive procedure can make a big difference in your smile. Because it is relatively inexpensive and noninvasive, it is a good place to start changing your smile to the one that you have always wanted, but Mother Nature failed to give you.
Gummy smile most people with gummy smiles feel embarrassed in social situations as they stress over who’s focusing on their large gum line. Cosmetic dentists have made things easier. You can achieve your desired smile in a couple simple visits. Treating a gummy smile does not mean extensive surgery and lots of pain. In fact, it’s one of the easiest dental flaws to treat. When you’re ready to make-over your smile, schedule a consultation with your cosmetic dentist to discuss your dream smile and your concerns. Most cosmetic dentists state that when you smile, your upper lip should fall where your gum and two front teeth join.
To get a healthy, attractive smile, techniques such as lip repositioning and crown lengthening are used.
lingual orthodontic

With Lingual Orthodontics you can straighten your teeth with braces that are not visible. The reason for this is because they are placed on the inner surface of your teeth, inside the mouth where they cannot be seen (unlike conventional braces that are placed on the outer surface of your teeth).
TRANSFORM THE SMILE YOU HAVE
INTO THE SMILE YOU WANT..... It is never too late to look and feel at your best! Problems like crooked teeth, spaces between the teeth or teeth that stick out can be corrected.
Most adults seek orthodontic treatment for cosmetic reasons; however, many may seek treatment because of jaw dysfunction, excessive wear of individual teeth or problems with dental hygiene.
Whatever your reasons, we will concentrate on straightening your teeth and achieving harmony of your teeth, jaws and face.
A SMILE CAN SAY A THOUSAND WORDS
A SMILE IS UNIVERSAL
IT SPEAKS IT'S OWN LANGUAGE.....
A beautiful smile radiates confidence and projects a positive image. It is an important part of looking and feeling great. It may even make you look younger!
Increase your self esteem with an attractive smile.

The braces are placed on the inside where they cannot be seen.
incognito braces Custom-made of gold, and fixed to the back of your teeth so they are invisible braces. Also less likely to lead to damage to teeth from decalcification and decay. Easily tolerated and very effective.
What is Invisalign®?
• Invisalign® is the invisible way to straighten your teeth without braces.
• Invisalign® uses a series of clear removable aligners (pictured to the left) to straighten your teeth without metal wires or brackets.
• Invisalign® has been proven effective in clinical research and in orthodontic practices throughout America.

How Does Invisalign® Work?
• You wear each set of aligners for about 2 weeks, removing them only to eat, drink, brush, and floss.
• As you replace each aligner with the next in the series, your teeth will move - little by little, week by week - until they have straightened to the final position your orthodontist or dentist has prescribed.
• You'll visit your orthodontist about once every 6 weeks to ensure that your treatment is progressing as planned.
• Total Invisalign treatment time averages 9-15 months and the average number of aligners worn during treatment is between 18 and 30, but both will vary from case to case.
How Are Aligners Made? You'd Be Amazed...
• The aligners are made through a combination of your orthodontist's expertise and 3-D computer imaging technology
Crown lengthenning this common procedure involves the removal of gum tissue (gingiva), bone or both to expose more of a tooth's structure. Before crown lengthening is done, you will visit a periodontist. At this visit, the periodontist will review your medical history and your X-rays. He or she will set a date for the surgery. Before the surgery, you may get a professional tooth cleaning. If the tooth needs a crown, your periodontist may put on a temporary crown. This protects the tooth. It also makes surgery easier, because the surgeon will be able to see how much soft tissue or bone to remove. The area will heal in about three months. Then, your dentist will prepare the tooth again. He or she will make a new temporary crown to fit the lengthened tooth. Then, he or she will make the final crown.
Bonding The dental bonding procedure utilizes a composite resin and is used for a variety of structural as well as cosmetic purposes. One can draw a parallel between dental bonding materials and a sculptor's clay. By using dental composite resin bonding your dentist can restore chipped or broken teeth, fill in gaps and reshape or recolor your smile.
Extreme makeover as a cosmetic dentist specializing in creating beautiful smiles, I understand you are looking for a dentist who will listen to precisely what you would like to accomplish with your cosmetic dental procedure. Most of my patients are educated men and women who come into our office with fairly specific goals for their smile.
Age perfecting Tooth loss is becoming increasingly common these days. This is very much evident from the record of dental implant in New York and several other places. People these days are quite conscious of their looks and take all measures possible on their part to correct any defect that is visible to the eye. So something as trivial as tooth loss can be easily fixed by dentists through dental implants.
Overdenture Improved stability is sometimes obtained with overdentures, appliances that use remaining teeth and roots for support. An added advantage of overdentures is that the remaining roots help preserve the alveolar bone—the part of the jawbone that holds the teeth—in turn preserving important bone, nerve, and tissue that tend to degenerate in the presence of complete, full-mouth...
Implant Overdenture If you are missing all your teeth, you need a full denture. There are several ways of doing this. You can have an implant overdenture, as we explain here. You can have a series of implants placed and teeth placed over these implants. This is the most comfortable and functional option.
With an implant overdenture, two implants may be placed in the front of your jaw, and they may or may not be joined by a bar. The bar increases the retention and stability of the teeth. A common complaint of people who wear complete dentures is that they are hard to keep in place, resulting in problems eating and speaking, and also causing soreness as the teeth shift and rub on the gums.
Periodontal (Gum Disease) Treatment: Early gum disease treatment may include tooth scaling and cleaning at three-month intervals along with use of medicated mouthwash and proper flossing. Later-stage gum disease treatment may include deep-plane scaling, periodontal surgery and laser surgery. General dentists, family dentists, periodontists and cosmetic dentists may perform gum disease treatment. However, availability of the latest material, technology and the level of expertise varies among dentists.
Dental Implants Dental implants are artificial tooth replacements that are used to counter tooth loss. The procedure is categorized as a form of prosthetic (artificial replacement) dentistry, though it also falls into the category of cosmetic dentistry as well.
Although you have a number of restorative options for the treatment of missing teeth, none have proven to be as functionally effective and durable as implants. In many cases, dental implants may be the only logical choice for the restoration of all necessary functionality of the teeth and supporting structures.
Strong, durable and natural in appearance, implants are among the most successful dental procedures performed.
Tooth Loss
Teeth are lost because of:
• Tooth decay
• Root canal failure
• Periodontitis (gum disease)
• Trauma to the mouth
• Excessive wear and tear
• Congenital defects
People who have lost teeth might feel too self-conscious to smile or talk. Additionally, biting irregularities caused by tooth loss can have a negative effect on eating habits and this can lead to secondary health problems like malnutrition. Regardless of the nature of problems related to tooth loss, dental implants may provide a simple remedy with proven results.
Advantages of Implant Dentistry
Dental implants are stronger and more durable than their restorative counterparts (bridges and dentures). Implants offer a permanent solution to tooth loss. Additionally, implants may be used in conjunction with other restorative procedures for maximum effectiveness. For example, a single implant can serve to support a crown replacing a single missing tooth. Implants can also be used to support a dental bridge for the replacement of multiple missing teeth, and can be used with dentures to increase stability and reduce gum tissue irritation.
Procedural advancements, including the development of narrower “mini” implants, mean that more people than ever before are finding themselves candidates for implantation. However, candidacy for implantation still varies, meaning that your dentist may determine that you should opt for an alternative restoration. Keep in mind, too, that dentists do not need a specific license by law in order to perform implant dentistry. A general or restorative dentist may perform the crown and bridge placement that is associated with implant restoration. However, prosthodontists are the specialists who often complete this crucial procedure. Periodontists and oral surgeons perform the implant surgical procedure itself.
The Dental Implant Procedure
Today's dental implants are virtually indistinguishable from other teeth. This appearance is aided in part by the structural and functional connection between the dental implant and the living bone. Implants are typically placed in a single sitting but require a period of osseointegration.
Osseointegration is the process by which direct anchorage of a dental implant root and the bone of the jaw occurs. Osseointegrated implants are the most commonly used and successful type of dental implant. An osseointegrated implant takes anywhere from three to six months to anchor and heal, at which point your dentist can complete the procedure with the placement of a crown. Once the implant has anchored with the jawbone, artificial prosthesis may be attached and the process is done. If osseointegration does not occur, the implant will fail.
Detailed procedural steps are as follows:
Preparing the Jaw for Implantation: A dental implant is commonly composed of a titanium material screw and a crown. A small-diameter hole (pilot hole) is drilled at edentulous (where there is no tooth) jaw sites in order to guide the titanium screw that holds a dental implant in place. To avoid damaging vital jaw and face structures like the inferior alveolar nerve in the mandible (lower jaw), a dentist must use great skill and expertise when boring the pilot hole and sizing the jaw bone.
Placement of the Implant: After the initial pilot hole has been drilled into the appropriate jaw site, it is slowly widened to allow for placement of the implant screw. Following this placement, a protective cover screw is placed on top to allow the implant site to heal and the dental implant to anchor (osseointegration). After several months, the protective cover is removed and a temporary crown is placed on top of the dental implant. The temporary crown serves as a template around which the gum grows and shapes itself in a natural way. The process is completed when the temporary crown is replaced with a permanent crown.
Success Rates of Dental Implants
Dental implants are among the most successful procedures in dentistry. There is no guarantee that an implant procedure will be successful, but studies have shown a five-year success rate of 95% for lower jaw implants and 90% for upper jaw implants. The success rate for upper jaw implants is slightly lower because the upper jaw (especially the posterior section) is less dense than the lower jaw, making successful implantation and osseointegration potentially more difficult to achieve. Lower posterior implantation has the highest success rate for all dental implants.
Dental implants may fail for a number of reasons. The cause is often related to a failure in the osseointegration process. For example, if the implant is placed in a poor position, osseointegration may not take place. Dental implants may break or become infected (like natural teeth) and crowns may become loose.
If you are a smoker who is considering a dental implant, your dentist will likely advise you to give up smoking before undergoing the process because smokers face a higher risk of implant failure. Since the procedure can be extremely expensive, you risk wasting your money on dental implants if you do not give up the habit. On the plus side, dental implants are not susceptible to the formation of cavities; still, poor oral hygiene can lead to the development of peri-implantitis around dental implants. This disease is tantamount to the development of periodontitis (severe gum disease) around a natural tooth.
Implant Dentistry: New Procedural Strategies Dentists trained to perform implants, crowns and/or surgery have begun to use a new strategy for the replacement of missing teeth. Dental implants are placed into locations where teeth have recently been extracted. When successful, this new strategy can shed months off of the treatment time associated with dental implants because osseointegration is sped up. Candidacy for this type of early intervention is dependant upon anatomical factors of the extracted tooth site. For example, in many cases the extracted tooth site is wider than the implant, making it impossible to place the implant into the site immediately after extraction. Dental work would have to be performed first in order to create a perfect fit for the implant.
Another strategy for implant placement within narrow spaces is the incorporation of the mini-implant. Mini-implants may be used for small teeth and incisors. Get more information about alternatives to traditional implants by checking out our mini implant section.
Full mouth reconstruction: While consulting with you about a smile makeover to primarily improve the esthetic appearance of your smile, your dentist may discover that there is a need to provide necessary treatment to correct functional problems with your bite, muscles, teeth and bone structure. If you need full mouth reconstruction, the materials available today make it possible for your dentist to provide you with durable, functional and clinically sound treatments that also look natural.
Sedation dentistry, as the name implies, is a technique used by a trained dentist to provide a relaxing and anxiety-free experience for people receiving dental treatment. A major benefit to the sedation technique is that people often feel the procedure lasts only a few minutes when in fact, it might have taken hours to perform. Most people rarely feel any discomfort after the procedure.
Partial denture A partial denture is a removable dental appliance that replaces multiple missing teeth. It can be attached to the teeth with clasps (clasp or conventional partial) or it can be attached to the teeth with crowns with precision attachments (hidden clasps). Both types have a metal framework and plastic teeth and gum areas.
Full denture are prosthetic devices constructed to replace missing teeth, and which are supported by surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable, however there are many different denture designs, some which rely on bonding or clipping onto teeth or dental implants. There are two main categories of dentures, depending on whether they are used to replace missing teeth on the mandibular arch or the maxillary arch. There are many informal names for dentures such as dental plate, false teeth and falsies.

Advanced gum treatment Periodontitis is the inflammation of the tissues that hold the tooth in its socket. If left untreated it can result in the destruction of the tooth attachment as well as the destruction of the bone itself. Sometimes basic treatment is not successful at getting the gum disease under control. This is because the pockets in severe periodontitis are so deep that it is not possible to fully clean the roots without actually looking at them. The dentist may then suggest gum (periodontal) surgery. This treatment involves pushing the gums away from the teeth so that the roots can be seen. It is only by doing this that the dentist can be sure that the roots are clean. Two types of gum surgery are available:
1. Surgery to clean the roots of the teeth - root planing.
2. Surgery to replace the lost bone and soft tissues as well as clean the roots of the teeth
Those who need surgery include:
• Patients who have deep periodontal pockets and gum disease
• Patients who have short teeth which need crowns. The teeth can be made longer so that crowns can be fitted
• Patients who have a high lip line, show a lot of gum and need their smile improved.
The dentist will usually refer to a periodontist who is a specialist in gum diseases and its treatment.
Prevention of this condition can be done by visiting a dentist or hygienist for advice on brushing and flossing techniques and the use of special brushes, together with regular cleaning and dental appointments. Maintaining good oral hygiene will help to prevent gum conditions from worsening.
Zirconium crowns Zirconium oxide forms the core of each crown and provides the cross-link that bridges the gap of missing teeth. The precision fit of the Zirconium core is derived from computer guided Swiss lathes that cut the form out of a solid Zirconium oxide block. The cutting instructions are obtained from a laser beam that reads 120 points per millimeter from the anatomy of a model of the prepared teeth. Once formed, new synthetic porcelain (99.9% pure) is baked on to the Zirconium core and then shaped like a tooth. Because of the extreme accuracy of the crown fit, the crowns can be cemented with biocompatible dental luting material. This avoids the use of an invasive procedure of etching the tooth with acid and injuring the pulp or nerve of the tooth. This latter procedure often times results in the pulp dying and necessitating root canal therapy.
zirconiumoxide implants Most of the dental implants are made of titanium, a metal that has special qualities that make it useful for this purpose. Titanium develops a thin film on its surface that protects it from corrosion. It is resistant to acids, salt solutions and oxygen, among other things. Titanium also is almost completely non-magnetic and is extremely strong for its weight.
Perhaps most important, the body does not reject titanium implants as foreign objects. When implants are placed in bone, it grows around the implant in a process called osseointegration.
Titanium implants come with many types of surfaces, including acid etched, plasma sprayed, acid etched and grit blasted, and hydroxyapatite coated. Hydroxyapatite is a part of what bone is made from. It bonds with bone in a process called biointegration
Dental implants made from zirconium have not yet had much attention, but due to new and modern manufacturing processes they now match the specifications and prices of classic titanium dental implants.
Some people do not want to put metal [titanium] into their bones and therefore welcome the zirconium implants. And I have read that titanium dental implants are more prone to inflammation than zirconium implants, and that inflammation is now being linked to heart disease and cancer so maybe zirconium dental implants might be safer from an "immune perspective." All thoughts on this topic will be greatly appreciated.
Porcelain laminates, are wafer-thin shells of porcelain that are bonded onto the front side of teeth so to create a cosmetic improvement for a tooth. Porcelain veneers are routinely used by dentists As a way to make cosmetic changes for teeth that are discolored, worn, chipped, or misaligned.
DaVinci Porcelain Veneers
What are porcelain veneers?
Porcelain veneers are ultra-thin shells of ceramic material, which are bonded to the front of teeth. This procedure requires little or no anesthesia, and can be the ideal choice for improving the appearance of the front teeth. Porcelain veneers are placed to mask discolorations, to brighten teeth, and to improve a smile. Highly resistant to permanent staining from coffee, tea, or even cigarette smoking, the wafer-thin porcelain veneers can achieve a tenacious bond to the tooth, resulting in an esthetically pleasing naturalness that is unsurpassed by other restorative options.
Why would you recommend a porcelain veneer?
Replacement for Crowns: Porcelain veneers are an excellent alternative to crowns in many situations. They provide a much more conservative approach to changing a tooth's color, size, or shape.
Treating Severe Discolorations:
Porcelain veneers can mask undesirable defects, such as teeth stained by tetracycline, by an injury, or as the result of a root-canal procedure, and are ideal for masking discolored fillings in front teeth.
Alternative for Orthodontics:
Situations in which the anterior (front) teeth are mildly misaligned, crooked, or rotated can be corrected with porcelain veneers through a procedure called Instant Orthodontics.
Repair old crowns and bridgework:
In certain circumstances, old crowns or bridges can be resurfaced with a porcelain veneer to repair or add new life to an old restoration.
Popular Diastema Treatment (gaps between teeth):
Patients with gaps or diastemas between their front teeth or teeth that are chipped or worn may consider porcelain veneers.
In our photos here, the patient is a young male who complained of multiple diastemas (spaces) of the upper teeth, a gummy smile and congenitally short teeth.
Treatment consisted of placing six custom Da Vinci porcelain veneers and laser gum lifting and recontouring to produce a fuller symmetrical smile.
Generally, veneers will last for many years, and the technique has shown remarkable longevity when properly performed.

Cosmetic and Implant Dentistry
Premium Porcelain Makeover Dentistry Components
Many of the more successful patient-centered cosmetic dental practices strive to develop a choice of more than one treatment plan for each patient, incorporating a range of best choice products and procedures.
The degree of access to premium products and the amount of creative experience acquired in using advanced technologies determines a doctor's ability to provide more choices and treatment possibilities for a particular patient need.
Many of Dr. Briglia's patients seek having the best that restorative and reconstructive dentistry can provide. The desire for having "nothing but the best" typically stems from:
• Wanting things done right the first time
• Achieving a cosmetic or functional outcome that best mirrors or mimics Mother Nature herself
• Having restorative components that have the best endurance record
• The ability to have new restorations match existing teeth perfectly
luminares
Lumineers are marketed as a no-prep veneer. No-prep meaning that no preparation or grinding (maybe minimal) of the tooth is required. Prep veneers require that a certain amount of tooth structure be removed in order to accommodate the porcelain to replace it.
No-prep veneers (Lumineers) are usually additive situations where there is missing tooth structure, such as worn/fractured edges or spaces between teeth (diastemas). Situations like these allow the ceramist to build in some esthetic qualities to the veneers, such as an incisal halo and opalescense.
Prep veneers (DaVinci veneers) are used in situations of high esthetic demand. We prepare teeth for veneers when we want to correct rotations, change the color or brightness of a tooth, or there is a concern about the final thickness of the tooth.
Not sure if you are a candidate for veneers? ... Unsure of which technology is best for you? Contact Dr. Pohl to arrange a consultation for learning more about DaVinci and Rembrandt technologies and the advantages of each that can help you obtain the most dramatic cosmetic result imaginable.

Diestema is a gap or space between two teeth. The term is most commonly applied to be an open space between the upper incisors (front teeth). It happens when there is an unequal relationship between the size of the teeth and the jaw. Many species of mammals have diastema as a normal feature, for example the gap between molars and incisors in rodents.
Diastema is sometimes caused or exacerbated by tongue thrusting or the pulling action of a labial frenulum (the tissue around the lip), which can push the teeth apart.
Diestema treatment
Diastema Treatment Choices
Frequently Mother Nature creates a few spaces between our top front teeth. These spaces are called disatemas. Some people are just fine with them while others think they look sexy. Even others find them unappealing and wish to have them changed or closed.
There are four basic choices in dealing with diastemas:
• Do nothing and enjoy the characterization of your personality while smiling
• See an orthodontist who can close these spaces down through braces and essentially move all your teeth around over the course of treatment. Treatment may take one to four years depending on the case. This is a very good choice and provides the least intervention to the individual tooth.
• Choice three involves the use of porcelain veneers. These are micro thin pieces of porcelain that are bonded to the outside of the tooth. They are an excellent choice in many situations. However, frequently they require the shaving or carving down of the outside and in-between surfaces of your teeth. Also known as Instant Orthodontics.
• The fourth choice is using what is called a conventional crown and bridge. There is, in certain circumstances, a very specific need to adopt this technology.
Shaving or precision carving down of your tooth is done here as well, to an even larger extent than porcelain veneers. There are nonetheless significant advantages for this technology. There is a far greater control in the manipulation of the "apparent’ location of the teeth. This translates to a greater ability to "move" the tooth from a perception perspective and therefore create a better esthetic result. Even more important than this, again, where indicated, there is less flexure of a tooth with a porcelain crown than a porcelain veneer.
Important Considerations for Choosing Treatments
If there is not a sturdy, largely un-compromised tooth under a veneer, the tooth will flex during chewing and porcelain will fracture. This occurs often. Patients who grind their teeth can also be at risk for damaging certain types of veneer applications.
When you have a porcelain crown there is more substructure over the tooth that resists this flexing and therefore less likely to fracture.
Mini-Dental Implants
Narrower implants may be used for small teeth and incisors. Also, a narrower implant may best serve patients who require stabilization of lower jaw dentures, pre-molar teeth, or a missing tooth that was located in a narrow area. A small number of narrower implants are FDA-approved for the purpose of prosthesis stabilization, including the mini-dental implant. Only certain dentists may perform this procedure.
There are some core differences between traditional implants and mini implants:
• Mini implants are approximately half the width of their traditional counterparts.
• The implant is not fully submerged during a narrow implant procedure.
• Should implant failure occur, the small size (that of a toothpick) means grafting is not necessary.
• Mini implants are less costly.
• Mini implants are solid though they do not contain a screw.
Gum contouring - "gummy smile"
Patients are often concerned that too much gum is showing when they smile or that their teeth look too short. This problem commonly referred to as a “gummy smile” can be easily remedied by gum reshaping or contouring.
Excess gum tissue is marked out by the dentist and then trimmed away using a special laser which also cauterises (seals) blood vessels and so minimises bleeding. After the procedure the gum is left to heal and the results are immediate. In some cases where a large amount of gum tissue is removed the healing process may take longer and it may be necessary to trim bone on the front of the tooth root to prevent re-growth of the gum tissue. The results are usually permanent and relatively inexpensive.
One Dental Implant-Immediate Implant
Immediate implant/ one day implant offer patients to leave the office with esthetic and functioning teeth in place directly after implant insertion. ...
Today the implant procedure may be performed with a tooth crown in place directly after implant placement or within a few days, meaning that you can eat and smile directly after the treatment.
This makes implant treatment very similar to general crown & bridge restorations.
NobelDirect™ is the ultimate form of simplicity and tissue friendliness, taking implants even closer to traditional crown and bridge therapy. The implant is machined from a single piece of titanium, incorporating both implant body and an integral fixed abutment.
The procedure is easy and very efficient: in one appointment is not only surgery performed but a provisional crown is also in place. Patient discomfort is much reduced due to the less invasive procedure.
Advantages
Less Discomfort: Patients expierence minimal discomfort, especially during a flapless procedure.
Reduced Chairtime: The one-stage surgical procedure reduces chairtime, saving the patient time, expense and discomfort.
Immediate Function : An esthetic restoration can be achieved immediately, providing patients with immediate gratification.
Stable and Esthetic Soft Tissue: Marginal gingival tissues and the interproximal papillae remain stable for two reasons. First, the implant/crown margins can be prepared to accommodate the correct facial, lingual and interproximal anatomy. Then, the TiUnite surface beneath that preparation allows for a shallow sulcus and a normal junctional epithelium that is attached to the TiUnite surface.
Reduced Bone Loss: The osseoconductive implant surface and the immediate function protocal reduces potential bone loss at the alveolar crest. Why Immediate Function?
Historically implants have been associated with a time consuming surgical procedure. This is no longer the case with Nobel Biocare implants. In most situations they can be inserted and used immediately, based on a refined treatment protocol and a unique implant surface.
Immediate function makes it easy for both patients and dentists: Implants become a natural adjunct to teeth and the patients get immediately restored teeth – and immediate quality of life.
Osseointegration is the direct structural and functional connection between living bone and the surface of a load-bearing artificial implant, typically made of titanium. It is a property virtually unique to titanium and hydroxylapatite, and has enhanced the science of medical bone, and joint replacement techniques. Branemark’s theory of osseointegration
Branemark proposed that implants integrate such that the bone is laid very close to the implant without any intervening connective tissue. The titanium oxide permanently fuses with the bone, as Branemark showed in 1950s. Osseointegration can be defined as,
1. Osseous integration, the apparent direct attachment or connection of osseous tissue to an inert alloplastic material without intervening connective tissue.
2. The process and resultant apparent direct connection of the endogenous material surface and the host bone tissues without intervening connective tissue.
3. The interface between alloplastic material and bone.
Branemark also stated that the implant should not be loaded and left out of function during the healing period for osseous integration to occur.
Biointegration
Components of the implant
An implant normally consists of two parts:
1) The part of the implant that will be inserted into the bone during surgery is called the fixture. The fixture is shaped like a hollow screw. The bone will grow onto surface of the fixture.
2) The part of the implant that breaks through the mucosa (the gum) is called the abutment. The abutment is anchored in the fixture by means of a screw. Above the gum the abutment carries the tooth replacement. The abutment can be shaped in many ways, depending on which function and tooth replacement are needed.
Biotechnology
Implants are made of the metal titanium in an almost pure form. Titanium's ability to be integrated in the bone has been known for more than 25 years. Years of experience and research form the basis of the knowledge and use of implant technology today.
Oseointegration of an implant is a direct structural and functionally stable connection between the living bone and the surface of an implant that is exposed to mechanical load.
Biointegrationen in the bone usually lasts 3-4 months in the lower jaw and 5-7 months in the upper jaw. If the implant is placed in an area where a bone augmentation has been performed, it may be necessary to postpone the loading of the implant.
The survival rate of an implant under optimal conditions is at least 96% after 5 years (i.e. 96 out of 100 implants are in function for at least 5 years). The few implants which do not integrate are normally lost during the first year. After the first year, the risk of losing an implant is very small when the implants are properly cleaned (good oral hygiene).
Many implant clinics will offer the patients some kind of guarantee for the implant treatment.
A successful implant treatment depends on:
1. The height and width of the jawbone in the area receiving an implant. The bone must have a certain size to achieve a good result.
2. The bone quality may vary due to medicinal or hormonal conditions, but is also different in the same person depending on the anatomical location. These conditions are evaluated when the treatment is being planned by the dental surgeon.
3. The shape and structure of the implant affect the implant's ability to integrate into the bone and keep the bone level around the implant when it is functionally loaded.
The greater the diameter of the implant , the greater the contact area that is obtained to the surrounding bone. Different techniques are used to produce a rough surface on the different types of implants. The area of the rough surface on the picture is increased 3 times compared to the smooth untreated titanium surface.
4. Immediate loading of the implant after the placement into the jawbone is normally avoided for at least 3 months. Microscopic movements of the implant in the bone can cause delay or destroy the ability of bone to create a stable connection to the titanium surface. However, a limited loading of the implant after the placement is acceptable, but only in cases where a primary stability of the implant is obtained after the placement procedure.
When the implant is integrated in the jawbone, the amount of functional loading is a critical factor for the survival of the implant. For example, a treatment with a large bridge construction on an insufficient number of too short implants may result in a loosening of the implants or the abutments.
5. Infection in the wound in relation to the implant placement is very rare and is not considered critical for the survival of the implant. Infection of the gum and the bone after the implants have been functioning in the mouth (periimplantitis) can on the other hand be the reason for the loss of implants. Periimplantitis is normally the result of inferior oral hygiene of the implants that support the crowns, bridges or dentures. This is the reason why it is very important to keep the implant supported constructions thoroughly clean.
Orthodontics, Orthodontists
This directory provides listings for General Dentists who practice orthodontics and Certified Orthodontists. The Orthodontics Dentistry Directory strives to provide resources of orthodontic dental care for virtually every city, large or small... but especially for areas where Orthodontists are not available.
Braces...nothing but braces and the orthdodontic practitioners who work with them to produce results that people want.
Braces for children...braces for teenagers.....braces for the "twenty, thirty, forty and fifty-somethings" and braces for seniors too.
Have a preference for Braces? Look at the variations that are available with today's new technologies:

o Braces for the practical minded person
(standard metallic braces)
o Braces for those people who enjoy "making a statement"
(gold braces!)
o Braces for people who prefer the invisible look
(clear braces)
The Orthodontics Directory will always be in development. We depend on our viewers to tell us what cities need to be included. If you can't find an orthodontic resource or Orthodontist in your area we will help you find one that is close by, usually within 3-24 hrs.
Bruxism: What's Behind the Grind?
Our upper and lower teeth are supposed to glide together smoothly, touching only when we are chewing food. Unnatural grinding or clenching can cause wearing and cracking of the teeth, as well as serious jaw impairment.
The reality is that all of us grind our teeth on occasion — when we are angry or anxious, for instance, or when our sleep is disturbed. But when we grind our teeth on a regular basis, we have a condition called bruxism (from the Greek bryx, meaning a “gnashing of the teeth”).
If bruxing persists, as it does in an estimated 20 percent of the population during waking hours and 8 percent during sleep, it can have a negative effect on tooth enamel, bone, gums and the jaw.
In the past, grinding (sideways movements of the jaws, with the teeth just touching) and clenching (clamping the uppers and lowers together) were believed to be caused by malocclusion (a bad bite). However, the latest research sees lifestyle reflexes — our ways of dealing with anxiety and stress — as the primary cause, with sleep disturbances and malocclusion serving as secondary and tertiary causes.
How Serious is Bruxism?
Bruxism starts early in life while the teeth are still in the process of developing. An estimated 15 percent of children reportedly grind or clench their teeth. Although the condition eventually wanes, with only three percent of the elderly continuing to brux, it takes a toll during the intervening years.
While enamel subject to normal stresses wears down at the rate of .3 millimeters every ten years, it is not uncommon for bruxers to experience two millimeters of enamel erosion by their mid-twenties. What’s more, nighttime bruxing can occur as often as 40 minutes for every hour of sleep, producing up to 250 pounds of force per square inch. That's enough pressure to crack a walnut.
Teeth Grinding
Of the two reflexes, teeth grinding is more common during sleep and occurs equally among men and women. Sleep is the time when the brain goes into a semi-resting state but stays alert enough to notice potential alarms, like a dog barking or the blare of a siren. This “disturbance reflex” appears to be exaggerated among those who have airway resistance, causing breathing difficulties during sleep.
In response to sleep disturbances, the brain makes a quick decision as to whether these noises are simply routine, permitting the body to stay asleep, or serious enough to serve as a wake-up call. It is at the moment of arousal from the sleep state that bruxing takes place.
Grinding may also result as a medication side effect among those being treated for depression, developmental disorders and schizophrenia, and among those taking recreational drugs such as ecstasy and cocaine. Certain medications and drugs act on the brain, stimulating it. The resulting brain stimulation is believed to contribute to grinding.
Clenching
Clenching is more likely to occur during the daytime, with women likelier to clench than men. One theory is that women are more predisposed to be vigilant. For example, they are more alert to the sound of a baby crying. This type of conscious attentiveness translates into more frequent closings of the jaw rather than sideways grinding motions.
The Consequences of Bruxism
Over the years, the accumulated toll of bruxing can produce a wide range of damage that includes:
• Front teeth worn down so they are flat and even in length.
• Micro-cracks and broken fillings, eventually leading to nerve damage.
• Teeth ground down to the dentin, causing sensitivity to heat and cold.
• Gum recession, due to pressure on the gum line.
• Loose teeth, caused by the rocking effect of bruxing, and gum pockets, also produced by the back-and-forth rocking effect.
• Headache and aching jaws due to overuse of muscles.
Bruxism Treatments
While there is no cure for bruxism, the condition can be managed through treatment. If you suspect that you clench or grind your teeth, consult your dentist to undergo a bruxism evaluation. Your dentist is in the best position to evaluate the extent of wear and tear on your teeth, gums and jaw, and to provide a practical remedy to offset further damage.
The Custom-Fitted Bite Plate Remedy
One such practical remedy is the use of a bite plate that has been custom-fitted by your dentist. Wearable day or night, it acts as a bumper guard, absorbing the force of the clenching or grinding. While horseshoe-shaped over-the-counter night guards are also available, they tend to be uncomfortable and are so soft that they may get chewed away. In addition, over-the-counter night guards do not account for occlusal discrepancies that may be the source of your bruxing problems; a night guard custom fabricated by your dentist's laboratory technician does.
Unfortunately, many of the soft night guards actually stimulate a wearer to grind in their sleep. Although the teeth may be protected by a soft night guard, the muscles and jaw joints will not be protected; thus, many muscle symptoms (such as headaches), will increase with the use of soft appliances. Custom-fitted plates, made of hard acrylic, can help bruxers avoid such problems.
Additional Bruxism Treatments
• A custom-fitted oral appliance that treats airway obstruction, to be used as an alternative to the bite plate. This therapy should be supervised by a physician who does regular sleep studies to make sure the oral appliance is effective.
• Orthodontics, when misaligned teeth are part of the problem.
• Stress reduction via psychotherapy, biofeedback, yoga, meditation, vacations, et al.
• For extreme cases, muscle relaxants or botulism toxin (Botox) to minimize spasm in overworked jaw muscles.
• An adjustment to your medications, arranged by your physician in consultation with your dentist.
Dental Flossing
Daily flossing can help prevent serious oral health problems.
Flossing in between your teeth is an essential oral hygiene practice for avoiding gum disease and preventing tooth decay. Also known as periodontal disease or periodontitis, gum disease affects 75 percent of Americans and is one of the main causes of tooth loss in adults. Pervasive as the oral disease may be, it can be easily prevented by brushing and flossing your teeth.
Recent studies have determined a link between gum disease and increased risk of heart disease and stroke. Maintaining a good oral hygiene regimen may help to eliminate the inflammation factor associated with gum disease, potentially reducing the risk of heart disease and stroke. In general, maintaining good oral hygiene habits may help prevent more serious health complications
Why We Floss: The Frontline of Oral Health
Many people don’t realize the importance of flossing and often forego the hygienic practice, believing that tooth brushing is adequate for the removal of plaque, the sticky substance that forms on the surface of and in between the teeth.
Tooth decay is a serious oral health concern that is caused by a buildup of plaque. If dental plaque is allowed to accumulate, it can combine with the sugars and/or starches of the foods that we eat to produce an acid that attacks tooth enamel. Tooth brushing removes plaque from the surfaces of the teeth, but only flossing can remove plaque that accumulates in between the teeth.
Dental plaque can also irritate the gums to the extent that they bleed easily and become red and tender. If plaque is not removed from in between the teeth with dental floss, the gums can eventually start to pull away (recede) from the teeth. When this happens, bacteria and pus-filled pockets can develop and the bone that supports the teeth can be destroyed. Once the bone is destroyed, the teeth will loosen and/or require removal.
Optimal Flossing Techniques and Types of Dental Floss
Flossing your teeth is not hard, does not take much time and should be performed at least once daily. The following steps detail optimal flossing techniques for maximum effectiveness:
• Select the type dental floss that you prefer.
• Tear off a piece of floss about 18 inches long.
• Wrap one end of the floss around either your middle or index finger
• Wrap the other end of the floss around the finger on your opposite hand.
• Grip the floss tightly between your thumb and finger.
• Gently insert the dental floss between your teeth. Be careful not to snap the floss or you could damage your gums.
• Gently move the floss back and forth against the tooth on both sides and underneath the gum line.
• Repeat this process in between all of the upper and lower teeth.
• It is important to floss against the backside of a tooth even if there is no tooth behind it.
There are different types of dental floss from which to choose. Among the different kinds of floss are dental tape, waxed floss, woven floss and unwaxed floss. Your hygienist or dentist can recommend which is most appropriate for you.
Flossing Products: What Are Your Options?
The American Dental Association recommends that flossing should be done daily. There are numerous products available that are designed to make flossing easier.
For those who suffer from arthritis, a device known as a dental flosser would be ideal because they are easier to hold. The vibrating dental flossers feel pretty good as they massage your gums, but they are more expensive than traditional dental floss. They can be recommended by your hygienist or your dentist. Many kids prefer the fun-shaped dental flossers that are now available because they seem to be easier to manage with small hands.
The best dental flossing product is the one that you will use everyday. The bottom line is that flossing is an essential component of your daily oral hygiene practices and should not be overlooked.
Oral Health and Pregnancy
Expectant mothers and women contemplating pregnancy have unique considerations when it comes to dental care. Failure to adequately care for your oral health during this sensitive time could have serious consequences for you and your child.
During pregnancy, your teeth and gums are more susceptible to bacterial accumulation due to an associated increase in hormone levels. It is important to properly care for your teeth before, during and after pregnancy to safeguard your oral health and that of your unborn child. By maintaining your oral health, you will reduce your risk of pregnancy complications that can result if dental conditions are left untreated.
Oral Health Conditions Associated with Pregnancy
There are a number of oral health conditions associated with pregnancy; some common, some not so common. More often than not, these conditions can be prevented through proper oral hygiene practices and consultation with your dentist and medical professional.
Pregnancy-related oral health conditions include some of the following:
Pregnancy Gingivitis: Pregnancy gingivitis is a common condition affecting women during pregnancy. It is caused as a result of bacteria becoming trapped in between your teeth. It can be managed if diagnosed early enough.
Pregnancy gingivitis can yield a variety of symptoms, including:
• Red, swollen or tender gums
• The sensation of loose teeth
• Spaces between teeth
• Receding gums
• Bad breath
• Pus along the gums
• Change in bite
It is important to seek the advice of your dentist about gingivitis so that the condition does not progress into periodontal disease. The development of periodontal disease can be additionally problematic for pregnant women and their children.
Periodontal Disease: Periodontal disease can develop as a result of untreated gingivitis. Also called periodontitis, it leads to the deterioration of bone and surrounding gum tissue.
Periodontal disease may produce a variety of symptoms, including:
• Bleeding gums
• Inflamed gums
• Tender gums
• Chronic bad breath (halitosis)
• Tooth loss
• Infection
Periodontal disease can also be asymptomatic (producing no symptoms at all) even while silently causing erosion of your gums and supporting bone structure. While periodontal disease is a concern for everyone, it is especially problematic for pregnant women. The development of periodontal disease during pregnancy poses an increased risk for pre-term labor and low birth weight babies. Pregnant women suffering from periodontal disease should consult with their dentist and medical doctor immediately.
Pregnancy Tumors (Pyogenic Granulomas): Pregnant women with gingivitis or periodontal disease are more susceptible to the development of pregnancy tumors, also called pyogenic granulomas. These tumors make it difficult for you to eat or speak and can cause discomfort. Pregnancy tumors can be removed by your dentist during pregnancy. Dental Visits and Pregnancy
During your second trimester, it is important that you visit your dentist for an oral hygiene check up and professional dental cleaning. Dental care performed during pregnancy should be limited to that of a routine nature. Invasive restorative and cosmetic procedures should be avoided.
If you have a toothache, bleeding of the gums or pus around your tooth, schedule a visit with your dentist for a checkup. These symptoms may be signs of an oral infection which, if untreated, could spread throughout your body during pregnancy. Infections of the mouth or teeth during pregnancy increase the risk for complication. Gum infections are the most common form of infection during pregnancy. Less common infections include abscesses inside or at the end of the root of a tooth. Such abscesses may require a root canal.
Dental Treatments to Avoid During Pregnancy
As stated above, there are a number of dental procedures that should be avoided during pregnancy.
X-rays: Although X-rays only produce a small amount of radiation, they are not recommended during pregnancy.
Extensive Dental Work: Restorative and cosmetic dental procedures including those that require you to sit in a dental chair for an extended period of time are not recommended during pregnancy. If you sit for long periods in the dental chair, you put increased pressure on the major blood vessel that supplies blood to your lower extremities which can make you feel faint.
Consult with your dentist and medical doctor to determine procedures that are deemed safe for you and your unborn child.
Self Help Dental Care Tips for Pregnant Women
Brush and Floss: Brush and floss three times a day to prevent the accumulation of bacteria on and around the teeth.
Morning Sickness and Vomiting Aids: Morning sickness and vomiting may be improved with a warm water or antibacterial mouthwash rinse. Baking soda used as toothpaste has been known to relieve an upset stomach; however, check with your doctor before using baking soda during pregnancy, especially if you have high blood pressure.
A Healthy Diet: A diet for healthy gums during pregnancy includes calcium, B12 and vitamin C.
Pregnant women who practice good oral hygiene and consult with their dentist and medical doctor are considerably less likely to experience problems throughout the term of their pregnancy. Oral health and general health are interrelated, as are the health of mother and child.
Tooth Brushing
Brushing your teeth with fluoride toothpaste is arguably the most essential component to the maintenance of good oral health. Tooth brushing cleans and whitens your teeth, while helping prevent the onset of tooth decay and gum disease, one of the leading causes of tooth loss in adults. Removing tooth stains and avoiding bad breath are added benefits of tooth brushing.

Why We Brush: The Frontline of Oral Hygiene
The foods that we eat contain sugars and starches. When plaque — the sticky substance that forms on the teeth — combines with these sugars and starches, an acid is produced that attacks tooth enamel and causes tooth decay.
Dental plaque can also irritate the gums to the point that they become red, swollen, tender and can bleed easily. Gum irritation can lead to gingivitis, an oral condition that precedes gum disease (periodontitis). Gingivitis can be treated and reversed if it is diagnosed in its early stages. If plaque is not removed, the gums can eventually start to pull away (recede) from the teeth. When this happens, bacteria and pus-filled pockets can develop and the bone that supports the teeth can be destroyed. Once the bone is destroyed, the teeth will loosen and/or require removal.
Brushing your teeth removes plaque from the tooth surfaces while flossing removes plaque from in between the teeth. The American Dental Association recommends that you brush your teeth at least twice a day for about two minutes, preferably after eating.
Optimal Tooth Brushing Techniques
Brushing at least twice a day is an essential practice in maintaining good oral health; however, it is imperative that you brush your teeth properly. The following steps detail optimal brushing habits:
• Use a small amount of ADA-approved toothpaste.
• Hold the brush at a 45 degree angle.
• Use gentle and short strokes, moving your toothbrush back and forth while brushing the outside areas of your upper and lower molars (back teeth).
• Use the same motions and brush the outside areas of your upper and lower incisors (front teeth).
• Using back and forth motions, brush the biting surfaces of your upper and lower molars.
• Brush the insides of your upper and lower molars with the same back and forth brushing motion.
• With the tip of your brush, brush the inside areas of your upper and lower incisors using gentle up and down strokes.
• Lastly, brush your tongue to remove bacteria and keep your breath fresh. Tongue cleaners/scrapers can be even more effective at removing bacteria and stains from the surface of the tongue (especially at the back of the tongue).
In order to maintain good oral hygiene, it is important to brush your teeth at least twice a day, floss daily, use an oral rinse, eat a well balanced diet and visit your dentist for regular check ups.
Toothbrushes: Electric or Manual?
Deciding whether to buy an electric or manual toothbrush basically comes down to what you desire as far as comfort and convenience. Oral health experts believe that brushing with an electric toothbrush can be more effective than using a manual toothbrush. Electric toothbrushes are designed to replicate the functionality of the professional brushes used by dentists for in-office cleanings.

Many dentists recommend electric toothbrushes for optimal oral health. When used correctly, an electric toothbrush can be more effective than a manual toothbrush in removing plaque from the teeth and gum line. This is because they tend to increase brushing time while helping users reach difficult areas of the mouth. Most electric toothbrushes have a setting that notifies the user when to stop brushing. This notification helps prevent over-brushing that can damage tooth enamel and foster gum recession.
The best toothbrush to buy is an extra soft bristled brush with a small head that fits easily in your mouth and has a handle that feels comfortable in your hand. Another advantage of electric toothbrushes is that they usually have larger handles, which are great for kids, older adults and people who suffer from arthritis. Although prices of electric toothbrushes have dropped in recent years, the obvious advantage of manual toothbrushes is their inexpensiveness. Manual toothbrushes also provide more flexibility than electric toothbrushes, helping to reach difficult areas of the mouth. Some manual toothbrushes also offer convenient accessories that aid oral hygiene, such as built-in tongue scrapers that can be more effective in cleaning the tongue than brushing.
Whichever toothbrush you decide to buy, remember that using it is what counts. Be sure to replace your toothbrush (or toothbrush head) every three months or sooner if the bristles start to fray or wear out.
Bad Breath (Halitosis)
Bad breath, otherwise known as halitosis, is a very common oral health issue. People of most any age may suffer from halitosis, including:
• Individuals with poor dental hygiene.
• The elderly, young children and disabled who have difficulty maintaining dental hygiene.
• People who use mouth appliances, including dental braces and dentures.
• Smokers are more prone to halitosis and periodontal disease (another contributor to bad breath).
• People with certain medical conditions including, but not limited to, tooth decay, impacted teeth, abscessed teeth, periodontal disease, alcoholism, uncontrolled diabetes, sinusitis, post-nasal drip, allergies, throat and lung infections (such as bronchitis) and dry mouth. Dry mouth may be the result of a high protein diet, non-fibrous diet or medical condition.
• Individuals on certain medications, including, but not limited to, certain vitamin supplements, antihistamines, calcium blockers, cardiac medications, blood pressure pharmaceuticals and psychiatric drugs have been known to inhibit saliva flow or produce dry mouth, which may lead to halitosis. Dry mouth may also lead to excessive thirst and tooth decay — a good foundation for halitosis once again.
• Poor dieters who are dehydrated because of certain foods they eat may have bad breath. Foods that contribute to halitosis include diet soda, onions, spices, garlic, curry, cabbage and coffee. High protein food debris lodged between the teeth can produce halitosis as well.
Bacterial Origins of Bad Breath
Researchers have determined that bad breath typically originates during open-air interaction with bacteria in the mouth, the nose or the stomach. There are numerous nasal triggers for bad breath. Nasal dysfunction, including a genetic abnormality in the nasal passage, may inhibit proper mucous flow. The bacteria found in sinusitis, post-nasal drip and allergies may pass from the nose to the back of the tongue where, if neglected, it can lie dormant due to improper saliva flow or poor dental hygiene.
Bad Breath Bacterial Scents
Biologists have determined that numerous types of bacteria contribute to halitosis. Interestingly, all of these bacteria are found in other types of unpleasant odors, including corpse scent (a combination of oxygen and sulfur compounds and/or nitrogen-containing gases such as cadaverine), decayed meat (putrescine), rotten egg stench (hydrogen sulfide), smelly feet (isovaleric acid), as well as feces aroma (methyl mercaptan and skatole). When bacterial plaque is not removed from the teeth, gums, or in between the teeth, it continues to grow and ultimately may lead to halitosis, tooth decay and gum disease.
To think that such scents could be emanating from your mouth is unpleasant indeed, illustrating the importance of exercising proper dental hygiene and maintaining regular dental check-ups.
Burning Mouth Syndrome
Burning mouth syndrome (BMS) is a chronic, painful condition characterized by burning sensations in the tongue, lips, palate (roof of the mouth), gums, inside of the cheeks and the back of the mouth or throat. The discomfort cannot be easily attributed to any physical abnormalities in the mouth or any underlying medical disorders. A complicated and poorly understood condition, burning mouth syndrome affects seven times more women than men. Most people suffering from burning mouth syndrome are middle aged, but younger individuals also have been affected by the condition.
Burning mouth syndrome may also be called burning tongue syndrome, burning lips syndrome, glossodynia, stomatodynia and scalded mouth syndrome.
Symptoms of Burning Mouth Syndrome
There are a number of symptoms associated with burning mouth syndrome, most notably the sensation of pain or burning. The pain or burning sensation is typically mild in the mornings, becoming progressively more intense throughout the day, peaking in the evening and subsiding at night. Some burning mouth sufferers feel continuous pain while others experience intermittent burning sensations. The pain associated with burning mouth syndrome can last for several months or years.
Other symptoms of burning mouth syndrome include a sore or dry mouth, tingling or numbness on the tip of the tongue or in the mouth and bitter or metallic changes in taste.
Causes of Burning Mouth Syndrome
Multiple systemic, oral and psychological factors have been associated with burning mouth syndrome. The exact cause of the condition is still not clearly understood. Psychological factors (such as anxiety or depression) may be a cause and effect of the frustrating burning sensations, with each aggravating the other. Sodium lauryl sulfate, a surfactant used in many types of toothpaste, has also been implicated as a possible cause of burning mouth syndrome.
It is important to note that a diagnosis of burning mouth syndrome is made in the absence of other oral or systemic conditions that could cause the burning sensations. Because a burning sensation in the mouth can result from, or be a symptom of, a number of medical conditions, several oral and systemic diseases must be ruled out before a diagnosis of “burning mouth syndrome” can be made.
If you are experiencing burning sensations in your mouth, it is important that you visit your dentist as soon as possible to discuss your symptoms and undergo an examination. Your dentist will likely review your complete medical history and perform a thorough oral examination in order to help identify the cause of the burning sensations in your mouth. If oral thrush (oral candidiasis), Sjogren’s syndrome and/or other dental issues are ruled out as the cause, you may be referred to a physician or specialist (oral pathologist) to treat the condition. Blood work and other diagnostic tests could include those that look for infection, nutritional deficiencies, diabetes or thyroid problems and allergy testing.
Factors Affecting Burning Mouth Syndrome
There are various factors that can cause burning mouth syndrome, some of which include:
Nutrition: Deficiencies of iron, folate and vitamin B complex have been associated with a burning sensation in the mouth. As a result, some treatment approaches have included supplements of B vitamins and minerals like zinc and iron.
Dry Mouth (xerostomia): Medications, Sjogren’s syndrome, and any number of other causes can lead to dry mouth and its related burning sensation. Drinking more liquids, using artificial saliva and/or eliminating the cause of the dry mouth may eliminate the burning sensation.
Oral Candidiasis (Oral Thrush): A symptom of this oral fungal infection is a burning sensation in the mouth, particularly when consuming acidic or spicy foods, or when the cottage-cheese like lesions are scraped from the inside of the mouth. The plan that your dentist recommends to treat oral thrush can help end the burning sensations associated with this oral yeast infection.
Anxiety/Depression: Psychological causes for burning mouth syndrome are considered when no other reason or explanation for the burning sensation can be found. Stress from depression and anxiety can alter the flow and composition of saliva, as well as initiate oral habits that compound problems that trigger burning mouth syndrome. These include tongue thrusting and teeth grinding (bruxing), both of which can irritate the mouth and lips.
Diabetes: Diabetics are more susceptible to oral infections (including oral thrush) that produce burning mouth sensations. Additionally, diabetics are prone to vascular changes that affect the small blood vessels in the mouth, creating a lower threshold for pain. Therefore, it is important for diabetics to maintain control of their blood sugar levels in order to help resolve the burning mouth symptoms.
Menopause: Hormonal changes have been associated with a burning sensation in the mouth in middle-aged women. Burning mouth is among the most common oral manifestations of menopause. However, hormone replacement therapy has only been effective in relieving burning mouth symptoms in certain patients.
Other: Nerve damage (neuropathy) affecting taste and pain in the tongue and dysfunction of the nerves in this area has been thought to be responsible for burning mouth. Additional causes of burning mouth syndrome could be irritating dentures (denture stomatisis), allergies, gastroesophageal reflux disease, thyroid problems, tongue thrusting and cancer therapy.
Treatment for Burning Mouth Syndrome
The treatment for burning mouth syndrome aims to alleviate symptoms. Burning mouth syndrome treatments include different medications traditionally used to relieve the underlying causes of other conditions, such as depression and chronic pain. Tricyclic antidepressants (amitriptyline/Elavil), antipsychotics (chlordiazepoxide/Librium), anticonvulsants (gabapentin/Neurontin), analgesics, benzodiazepines (clonazepam/Klonopin) and mucosal protectors have provided effective relief for some patients. In addition, topical capsaicin (the natural chemical in cayenne pepper) has been used to desensitize patients suffering from burning mouth syndrome.
However, despite the success of these approaches in certain situations, there is no universal treatment for burning mouth syndrome that is effective in all cases. Treatment is planned to meet the specific needs of each patient. The cost of treatment varies depending upon the medications prescribed (if any), how long they will be needed and whether or not medical and/or dental insurance will cover all or some of the costs.
Additional relief from the symptoms of burning mouth syndrome may be achieved by making some simple changes:
• Stop using mouthwash that contains alcohol.
• Stop using toothpaste that contains sodium lauryl sulfate.
• Chew sugarless gum, preferably sweetened with xylitol.
• Avoid alcoholic beverages.
• Use baking soda and water when brushing your teeth.
• Refrain from drinking beverages with high acidity (fruit juices, coffee, soft drinks).
• Abstain from tobacco use.
• Sip water or suck on ice chips.
Smile Makeover
Authored By: Allison DiMatteo
Reviewed By: Larry Addleson, DDS, FAACD
• Preview & Treatment
A smile makeover is the process of improving the appearance of the smile through one or more cosmetic dentistry procedures, such as dental veneers, composite bonding, dental implants and teeth whitening.
Essentially, a smile makeover is something that you choose to have performed, while a full mouth reconstruction is something that you need to have performed.
Smile Makeover Considerations
A smile makeover takes into consideration your facial appearance, skin tone, hair color, teeth (color, width, length, shape and tooth display), gum tissue and lips to develop your ideal smile. Smile makeovers are performed for many reasons and customized according to your unique considerations.
What is it that you like or dislike about your smile or your teeth? Some aspects of your smile that your cosmetic dentist will review with you and that could be improved with a smile makeover include the following:
Tooth Color: Silver or amalgam dental fillings can be replaced with natural, tooth-colored composite restorations, while teeth whitening can improve the color of stained or dulled teeth. Tooth color and shading are important considerations during the evaluation of and preparation for various procedures, including porcelain veneers, crowns, bridges, composite bonding and dental implants.
Oral health issues must be dealt with prior to cosmetic treatment. Image courtesy of Larry Addleson, DDS, FAACD
When considering the color of your teeth, keep in mind that dark or discolored teeth may suggest an aged mouth. A well-shaped smile comprised of bright, white teeth lends to a youthful appearance. The shade your dentist selects for teeth whitening and veneers is carefully evaluated with special consideration given to the tone and color of your face and hair. Cosmetic dentists are skilled at finding the right balance between providing you with a brighter, whiter smile and maintaining a natural tooth color.
Alignment and Spacing: Teeth that are crooked, overlapping or have gaps between them can be straightened and aligned when necessary through orthodontics or Invisalign and improved with veneers.
Missing Teeth: One or more missing teeth can negatively affect the appearance of your smile — as well as affect your bite and increase your risk for tooth decay — making replacement an integral part of oral health and facial esthetics. Missing teeth can be replaced by dental implants, bridges or partial dentures.
Harmony and Balance: Uneven, chipped and cracked teeth can be cosmetically bonded for an improved appearance, and a gummy smile can be re-contoured to help improve the overall look of the smile.
Fuller Lips, Smile and Cheeks: An unshapely or aging face can be improved or rejuvenated with certain procedures in the smile makeover category, including orthodontics and/or oral maxillofacial surgery.
A cosmetic dentist will work closely with you to develop a treatment plan designed to achieve exactly what you want from your makeover. This treatment plan may consist of many cosmetic and functionally restorative procedures, potentially including teeth whitening, composite bonding, veneers, dental crowns, orthodontics (braces), oral maxillofacial surgery and gummy smile reduction.
Esthetic Components of a Smile Makeover
In addition to the color, alignment and balance of your teeth in the esthetic zone of your smile (the section of upper and lower teeth that show when you smile), there are several attributes of your teeth and smile that your cosmetic dentist will evaluate with you when planning your smile makeover. These include:
Tooth Length: Long teeth lend a youthful appearance. Aging produces wear and tear that often results in shorter teeth, and a gummy smile also can make teeth appear shorter. A smile makeover treatment for shorter teeth may include reshaping and lengthening the two front central teeth with composite bonding or porcelain veneers. If you have a gummy smile, your cosmetic dentist may provide treatment to modify the gum line and lengthen the appearance of the teeth using laser dentistry procedures. You may also be referred to a periodontist for crown lengthening if necessary.
Teeth lengthening may also impact your overall facial appearance. For example, shapely, long, square teeth on a round-faced individual can provide a slimming effect.
Smile Line: The smile line is an imaginary line that follows the edges of your upper teeth from side to side, which ideally should be the same as the curve of your lower lip when you smile. This standard point of reference for smile makeovers may be used to help determine how long your new teeth should be.
Tooth Proportions: Your cosmetic dentist will examine your teeth to determine if they are in correct proportion with each other. Most people recognize a pleasing smile as one in which the two central front teeth are dominant and have a width-to-length ratio of 4-to-5. This proportion guides the length and width of other teeth in the esthetic zone so that the smile line appears balanced.
Tooth Texture and Characterization: Cosmetic dentists performing smile makeovers are adept at blending functionality and esthetics. An artistic dentist can characterize your crowns or veneers to create a more feminine or a more masculine appearance, in addition to matching the look and feel of natural teeth or those you’ve seen in photographs.
The Life of Your Smile Makeover
Cosmetic dentistry procedures require regular oral hygiene care and may require maintenance over time. For example, teeth whitening must be repeated on occasion in order to maintain brightness. Porcelain veneers may chip or break off and need replacement. Permanent composite bonding may stain and require enhancement or replacement. Dental crowns typically require replacement after 10 to 15 years. Gummy smile improvements may also require enhancement over time.
Your ceramist, lab technician and the materials chosen by your dentist also impact the longevity of your smile makeover. To achieve the best results, take special care in selecting your cosmetic dentist and inquiring about your material options.