Cosmetic dentistry is generally used to refer to any dental work that improves the appearance (though not necessarily the functionality) of teeth, gums and/or bite. It primarily focuses on improvement in dental aesthetics in color, position, shape, size, alignment and overall smile appearance. Many dentists refer to themselves as "cosmetic dentists" regardless of their specific education, specialty, training, and experience in this field. This has been considered unethical with a predominant objective of marketing to patients. The
American Dental Association
The American Dental Association (ADA) is an American professional association established in 1859 which has more than 161,000 members. Based in the American Dental Association Building in the Near North Side of Chicago, the ADA is the world's ...
does not recognize cosmetic dentistry as a formal specialty area of dentistry. However, there are still dentists that promote themselves as cosmetic dentists.
Fields
There are primarily two dental specialties that predominantly focus on dental aesthetics. They are:
#
Prosthodontics
Prosthodontics, also known as dental prosthetics or prosthetic dentistry, is the area of dentistry that focuses on dental prostheses. It is one of 12 dental specialties recognized by the American Dental Association (ADA), Royal College of Surgeo ...
and
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Orthodontics
Orthodontics is a dentistry specialty that addresses the diagnosis, prevention, management, and correction of mal-positioned teeth and jaws, and misaligned bite patterns. It may also address the modification of facial growth, known as dentofacial ...
Common cosmetic dentistry options
Types
Cosmetic dentistry may involve:
# the addition of a dental material to teeth or gums – examples: bonding, porcelain veneers (laminates),
crowns
A crown is a traditional form of head adornment, or hat, worn by monarchs as a symbol of their power and dignity. A crown is often, by extension, a symbol of the monarch's government or items endorsed by it. The word itself is used, partic ...
(caps),
gum grafts
# the removal of tooth structure or gums – examples: enameloplasty,
gingivectomy
Gingivectomy is a dental procedure in which a dentist or oral surgeon cuts away part of the gums in the mouth (the '' gingiva'').
It is the oldest surgical approach in periodontal therapy and is usually done for improvement of aesthetics or p ...
# neither adding nor removing dental materials, tooth structure, or gums – examples:
teeth whitening
Tooth whitening or tooth bleaching is the process of lightening the color of human teeth. Whitening is often desirable when teeth become yellowed over time for a number of reasons, and can be achieved by changing the intrinsic or extrinsic color o ...
(bleaching), laser whitening,
gum depigmentation
Gum depigmentation, also known as gum bleaching, is a procedure used in cosmetic dentistry to lighten or remove black spots or patches on the gums consisting of melanin. Melanin in skin is very common in inhabitants in many parts of the world due ...
# straightening of teeth accompanied by improvement in appearance of face –
orthodontics
Orthodontics is a dentistry specialty that addresses the diagnosis, prevention, management, and correction of mal-positioned teeth and jaws, and misaligned bite patterns. It may also address the modification of facial growth, known as dentofacial ...
# veneers, dental laminates - conservative
# scaling
Whitening
Whitening, or "tooth bleaching", is the most common cosmetic dental procedure. Whitening is a safe process that is effective for most patients. Multiple whitening options are available, including over the counter products such as
Crest Whitestrips Crest Whitestrips is a line of tooth whitening products made by Procter & Gamble.
Description
Crest Whitestrips were introduced in 2001. The product is used by placing a disposable plastic strip directly onto the teeth that contains an enamel-saf ...
, as well as dentist-supervised methods such as in-office treatments or at-home treatments involving trays with a peroxide gel.
Laser whitening is a teeth whitening technique in which gums are covered with a rubber dam and a bleaching chemical is applied on the teeth. A beam of argon laser, which is intended to accelerate the process of bleaching, is then projected upon the teeth. This laser activates the bleaching chemical and lightens the teeth color. Laser whitening is said to be six times more effective in teeth whitening compared to other procedures.
Reshaping
Tooth reshaping removes parts of the
enamel to improve the appearance of the tooth. It may be used to correct a small chip, or to alter the length, shape or position of teeth, as well as when there is
tooth size discrepancy
A tooth (plural, : teeth) is a hard, calcification, calcified structure found in the jaws (or mouths) of many vertebrates and used to Mastication, break down food. Some animals, particularly carnivores and omnivores, also use teeth to help with ...
; it can be used to correct crooked or excessively long teeth. The removed enamel is irreplaceable, and may sometimes expose
dentin
Dentin () (American English) or dentine ( or ) (British English) ( la, substantia eburnea) is a calcified tissue of the body and, along with enamel, cementum, and pulp, is one of the four major components of teeth. It is usually covered by ena ...
. It is also known as enameloplasty, odontoplasty,
contouring
Contouring is a makeup technique that uses cosmetics to define, enhance and sculpt the structure of the face or other body parts, such as breasts.
Contouring is usually produced by placing a warm or cool toned color that is one or two shades da ...
, recontouring, cosmetic contouring, slenderizing, stripping. This procedure offers fast results and can even be a substitute for braces under certain circumstances.
Bonding
Bonding is a process in which an
enamel-like
dental composite
Dental composite resins (better referred to as "resin-based composites" or simply "filled resins") are dental cements made of synthetic resins. Synthetic resins evolved as restorative materials since they were insoluble, of good tooth-like appea ...
material is color matched, applied to a tooth's surface, sculpted into proper tooth contour, hardened and then polished. An examples of a bonded restorations are
inlays and onlays
In dentistry, inlays and onlays are used to fill cavities, and then cemented in place in the tooth. This is an alternative to a direct restoration, made out of composite, amalgam or glass ionomer, that is built up within the mouth.Inlays and onl ...
, which are used to repair decayed & cracked teeth. Teeth damaged by small to moderate decay, erosion, or small fractures can be repaired with direct composite restorations bonded to the teeth. Aesthetics are especially critical in
anterior composite restorations.
Bridging
Dental bridge
A bridge is a fixed dental restoration (a fixed dental prosthesis) used to replace one or more missing teeth by joining an artificial tooth definitively to adjacent teeth or dental implants.
Definitions
Fixed bridge: A dental prosthesis that ...
s are used to replace one or more missing teeth. Teeth on both sides of the space left by the missing teeth are prepared. A bridge is made up of abutments, the teeth that are prepped, and the missing, false teeth, which are called ''pontics''. This procedure is used to replace one or more missing teeth and is cemented in. Bridges can consist of more than three teeth in total and the viability of any bridge is usually determined by applying
Ante's Law and assessing where in the mouth the teeth are. Most bridges are fixed, they can not be removed. Fixed bridges cannot be taken out in the same way that partial dentures can. In areas of the mouth that are under less stress, such as the front teeth, a cantilever bridge may be used. Cantilever bridges or Maryland Bridges are used to replace anterior or front missing teeth, are minimally invasive but do have a reputation for failure. Bridges require commitment to serious oral hygiene and carry risk. The average life of bridges is similar to that of crowns which is nearly ten years.
Veneers
Veneers are ultra-thin, custom-made porcelain laminates that are bonded directly to the teeth. They are an option for closing gaps, enhance the shape, or change the color of teeth that do not respond well to whitening procedures. In the majority of the cases, some level of tooth reduction is necessary for optimal results. To achieve a pleasing smile, dentists fabricate diagnostic mock-ups, which act as a tooth preparation guide before the fabrication of veneers, it allows the dentist to visualize the changes needed to be done on the patient's teeth with respect to size, shape and proportion, its relation with gingival-contour, lip contour and smile line. Mock ups can be a great aid in fabricating preevaluation temporaries, which can give a preliminary evaluation to the esthetics, phonetics and teeth occlusion, in addition, it gives an opportunity to the clinicians to check if they need to do any corrections.
Implants
Dental implant
A dental implant (also known as an endosseous implant or fixture) is a prosthesis that interfaces with the bone of the jaw or skull to support a dental prosthesis such as a crown, bridge, denture, or facial prosthesis or to act as an orthodonti ...
s are prosthetic replacements for missing teeth. According to ICOI (
International Congress of Oral Implantologists
The International Congress of Oral Implantologists (abbreviated as ICOI) is a tax-exempt, non-profit professional association that renders education, holds seminars and meetings, and encourages research work regarding implantology. Founded in 1972 ...
) there are commonly three parts to what it is described as an implant: the implant device which is predominantly made of titanium (which is inserted into the bone), the abutment, and a dental crown or a denture which are connected to the implant through the abutment.
Gum lifts
A
gum lift A gum lift (also known as gingivectomy) is a cosmetic dental procedure that raises and sculpts the gum line. This procedure involves reshaping the tissue and/or underlying bones to create the appearance of longer or symmetrical teeth, thereby maki ...
is a cosmetic dental procedure that raises and sculpts the gum line. The procedure involves reshaping the tissue and/or underlying bones to create the appearance of longer or more symmetrical teeth.
Straightening
Metal braces are used primarily to correct crowded or misaligned teeth. While correcting issues such as jaw alignment are the primary purpose, they can also improve aesthetics.
Clear aligners
Clear aligners are orthodontic devices that are a transparent, plastic form of dental braces used to adjust teeth.
Clear aligners have undergone changes, making assessment of effectiveness difficult. A 2014 systematic review concluded that publi ...
are used as an alternative to traditional metal braces. Clear aligners produce comparable results to metal braces and are preferred by some patients as they are less noticeable to others than traditional braces.
Bite reclamation
Bite reclamation
Biting is a common zoological behavior involving the active, rapid closing of the jaw around an object. This behavior is found in toothed animals such as mammals, reptiles, amphibians and fish, but can also exist in arthropods. Myocytic co ...
is for patients who have had years of excessive wear to their teeth due to grinding or acid reflux can alter their vertical dimension. This gives them a closed or shorter look to their face and smile. By opening up their bite, a qualified professional can reclaim their vertical dimension.
Materials
In the past,
dental fillings
Dental restoration, dental fillings, or simply fillings are treatments used to restore the function, integrity, and morphology of missing tooth structure resulting from caries or external trauma as well as to the replacement of such structure su ...
and other tooth restorations were made of
gold
Gold is a chemical element with the symbol Au (from la, aurum) and atomic number 79. This makes it one of the higher atomic number elements that occur naturally. It is a bright, slightly orange-yellow, dense, soft, malleable, and ductile met ...
,
amalgam
Amalgam most commonly refers to:
* Amalgam (chemistry), mercury alloy
* Amalgam (dentistry), material of silver tooth fillings
** Bonded amalgam, used in dentistry
Amalgam may also refer to:
* Amalgam Comics, a publisher
* Amalgam Digital
...
and other metals—some of which were veneered with
porcelain
Porcelain () is a ceramic material made by heating substances, generally including materials such as kaolinite, in a kiln to temperatures between . The strength and translucence of porcelain, relative to other types of pottery, arises mainl ...
. Now, dental work can be made entirely of porcelain or composite materials that more closely mimic the appearance of natural tooth structure. These tooth-colored materials are bonded to the underlying tooth structure with resin adhesives. Unlike silver fillings (amalgams) they are entirely free of mercury. Cosmetic dentistry has evolved to cover many new procedures and new dental materials are constantly introduced.
Training
The American Dental Association does not recognize cosmetic dentistry as a specialty.
Prosthodontics is the only dental specialty under which the concentration of cosmetic/esthetic dentistry falls. General dentists may perform some simple cosmetic procedures. Consequently, there are questions regarding whether it is ethical for general dentists to treat "smile makeovers" or complex cosmetic and full-mouth reconstruction cases, as they are not qualified to address the complex needs of the patient.
[
]
American College of Prosthodontists
The American College of Prosthodontists is a not-for-profit organization representing prosthodontists within organized dentistry and to the public, with more than 3,700 members worldwide. Prosthodontics is one of the twelve dental specialties defined by the American Dental Association, which recognizes the American College of Prosthodontists as the national organization representing the prosthodontic specialty- the dental specialty of cosmetic / esthetic dentistry, implant dentistry and reconstructive dentistry.
Membership is open to individuals who have graduated from or are currently enrolled in an ADA-accredited advanced prosthodontics program. The ACP is the only prosthodontic specialty association where membership is based solely on education credentials. Certified dental laboratory technician and members of the prosthodontic academic community may become Alliance members of the College.
American Academy of Cosmetic Dentistry
The American Academy of Cosmetic Dentistry (AACD) is the largest international dental organization in the world, composed of general dentists, specialists, and lab technicians focused on the art and science of cosmetic dentistry. Founded in 1984, the AACD has over 7,000 members in the United States and more than 70 countries around the globe. Members of the Academy include dentists, dental laboratory technicians, educators, researchers, students, hygienists, corporations and dental auxiliaries. AACD members seek out continuing education through lectures, workshops, and publications in order to keep up-to-date with all of the advancements in cosmetic dental techniques and technology. In 1984, the AACD was formed and has filled the dire need for credentialing in cosmetic dentistry. The purpose of the American Board of Cosmetic Dentistry (ABCD) is the testing, analyzing, and evaluation of the services of dentists and laboratory technicians for the purpose of awarding AACD Accreditation in cosmetic dentistry. However, this certification is not approved or recognized by the American Dental Association
The American Dental Association (ADA) is an American professional association established in 1859 which has more than 161,000 members. Based in the American Dental Association Building in the Near North Side of Chicago, the ADA is the world's ...
.
American Society For Dental Aesthetics:
Conceived in 1976, the American Society for Dental Aesthetics
The American Society for Dental Aesthetics was founded in 1977 by current President, Dr. Irwin Smigel. It is an international nonprofit organization
A nonprofit organization (NPO) or non-profit organisation, also known as a non-business ...
was developed with a single purpose in mind: continuing dental education to teach dental health professionals the most advanced aesthetic and restorative techniques available. To become a member of the ASDA, a dentist must show a minimum of five years in dental practice, or postgraduate training of two years in an approved program; attendance to at least two ASDA sponsored continuing dental education seminars; nomination by a member accompanied by two letters of recommendation by Society members; presentation of five (5) cases illustrating the concepts of aesthetic dentistry.
History
Newell Sill Jenkins (1840–1919) was an American dentist who practiced most of his life in Dresden
Dresden (, ; Upper Saxon: ''Dräsdn''; wen, label=Upper Sorbian, Drježdźany) is the capital city of the German state of Saxony and its second most populous city, after Leipzig. It is the 12th most populous city of Germany, the fourth larg ...
, Germany.[Dr. Newell Sill Jenkins](_blank)
Revue d'histoire de l'art dentaire, p. 20. He developed the ''Jenkins porcelain enamel'' and improved, thus making a composition of the porcelain paste, porcelain inlays, dental crowns and bridges. Hence, he is regarded as the founder of aesthetic dentistry.
References
External links
{{DEFAULTSORT:Cosmetic Dentistry
Dentistry branches