ZOOM teeth whitening or bleaching
At Dr Kandhari’s Skin and Dental Clinic we use the zoom whitening system by Philips.
It is by far the best whitening system available. It can lighten or brighten the natural teeth by almost 7 to 8 shades. It can work on all types of stains like those from tea, coffee, aerated drinks, red wine etc.
This is a completely painless and non-invasive procedure which can be completed in just 30 minutes in a single sitting. This works very well to create a beautiful and bright smile with no downtime or discomfort.
Another big advantage of this system is that it causes absolutely no sensitivity to the natural teeth. Unlike the other systems this is a very comfortable procedure, If one takes care than the whitening can last up to 10 months to a year.
Tooth Colored Composite Fillings
Composites are also called “White Fillings” because of their appearance and aesthetics. These are a very good alternative to metal fillings which contain silver. Over the years the metal fillings are being phased out due to various reasons like:
- Presence of mercury in the filling material. This can be a health hazard in the long run especially when there are several old fillings in the mouth.
- Aesthetics - This is a big concern with metal fillings as they do not match the natural tooth colour at all. They appear as dark get silver spots on the teeth and stand out completely.
- They do not bond to the tooth structure at all and is only held by mechanical retention. It also puts stress on the tooth structure due to shrinkage and expansion due to temperature changes.
There are a few steps involved in the placement of a composite filling. It involves
Step1: Tooth preparation and removal of decay.
Step2: Using an etchant and bonding agent to prepare the tooth to chemically bond to the filling material.
Step3: Placing the composite material layer by layer and curing it with a special blue light. This
light results in the polymerisation or curing of the filling material. This hardens the filling and bonds it to the tooth structure.
There are several advantages of this type of filling material
- The finish and appearance of this material is by far the best. It gives a smooth glossy finish which can match perfectly to the natural tooth if done well.
- It chemically bonds to the tooth structure, hence minimal preparation is sufficient. Natural tooth does not need to be sacrificed to retain the filling.
- There is no mercury in the material, hence it is not a health hazard in the long run.
- It does not put additional strain on the tooth by shrinking and expanding due to temperature changes.
- It can be easily repaired and refilled if required without loss of tooth structure.
- There is no downtime with composite fillings, the patient does not need to wait after the filling for the final setting time and can directly have his meals after the filling.
With the advent of newer and better materials, composites can be used in most cases like for deep and complex fillings, tooth buildup and core buildup after root canal treatments. Also, it is the material of choice for direct aesthetic fillings in the front teeth.
Veneers or laminates are like a cover for the teeth, they are designed to cover the front surface of the teeth. They provide an excellent solution for smile designing or smile makeover. Veneers can correct various dental problems like:
- Crowded or spacing between the teeth
- Stained or discoloured teeth
- Chipped or broken teeth
- Uneven teeth of different sized teeth
- Bite correction
Veneers provide a viable solution for anyone looking to fix their front teeth, whether the alignment, colour, size, or teeth position. They can also be used to align teeth to a certain extent in patients who are unwilling to go ahead with Orthodontic treatment. There are several advantages of this treatment like:
- Short duration - the whole treatment can be completed in one or two sittings within a week.
- Very comfortable and painless procedure.
- Highly aesthetic results - Veneers can completely alter or give a complete makeover to one’s smile
- Lasts for a long time - A well fitted veneer can last up to 10 to 15 years.
- Easy maintenance - They are relatively easy to Clean and maintain as compared to other prosthesis.
Types of Veneers
(A) Ceramic Veneers
This is the most durable and long-lasting veneer. It also gives the best aesthetics and retains it colour and polish for a very long time. They do not chip, break or fracture or get dislodged over time.
This typically takes two to at the most three sittings. These are fabricated in the dental laboratory and then cemented onto the prepared teeth.
Step 1: In the first sitting a detailed discussion is initiated with the patient. This is of utmost importance to understand the expectations and what exactly the patient desires in their new smile. After this a thorough oral examination is carried out.
This is followed by intra and extra oral photographs and impressions for a study model and treatment planning. After this at Dr Kandhari’s Skin and Dental Clinic we also do a digital smile designing for the patient. In this we can show the patient how the veneers will look on their face and what will the new smile be like. Once the patient and the cosmetic dentist are agreeable on the course of treatment, we than go ahead with the main clinical procedure.
Step 2: At this stage after adequate anaesthesia and isolation, the teeth are prepared. The labial or outer surface of the teeth need to be reduced to for the veneers to be placed. The enamel surface is trimmed and the final impression is recorded.
After this we immediately fabricate temporary veneers to cover the prepared teeth. These protect the enamel while the final prosthesis is being fabricated.
Step 3: At Dr Kandhari’s Skin and Dental Clinic we try to provide our patients with the final veneers within two to three days. Once they arrive the patient is called for the final appointment. After checking the fit, color, shape and size we fix them with a temporary glue.
Once the patient is satisfied the final cementation process is completed. In about one week’s time the complete smile of the patient is altered. this can easily last up to fifteen years if maintained well and regular brushing and flossing is followed by the patient.
(B) Composite Veneers
This is also known as a chair side veneer. This is completely moulded and prepared by the dentist in a single sitting on the dental chair. No lab is involved in this, and the patient can go back with a new smile on the same day.
There are two main advantages of this type of Veneer:
- It can be completed in a single sitting so patient does not need to wait.
- More economical as compared to ceramic veneers.
After a thorough consultation and oral examination, at Dr Kandhari’s Skin and Dental clinic we go ahead with the intra and extra oral photographs as well as some profile shots. This aids us in the treatment planning and veneer preparation.
Once the patient and the cosmetic dentist are on the same page we begin the procedure. In this the amount of tooth structure to be removed varies on the case. In some cases, minimal or no preparation is needed like in cases where we need to build up the tooth or make them bigger or close the gaps between the teeth.
In other situations, some amount of tooth structure needs to be removed like when we are trying to align the teeth or cover some dark stains and discolouration. After the tooth preparation the veneer is built up layer by layer with composite and moulded to the tooth structure.
Once completed it is finished and polished well and completed.
The main disadvantages of composite Veneers are:
- They get discoloured or stained easily with time as composite tends to absorb colour from our food and drinks.
- Can get chipped or fractured easily as compared to ceramic veneers.
These are also ceramic or porcelain veneers but are much thinner than conventional veneers. They are also known as no prep veneers. They can be considered in areas which do not require any tooth preparation.
The main disadvantage of this system is because of it being much thinner, they tend to chip off or break more easily as compared to conventional ceramic veneers. Although the quality and finish of these veneers are excellent, one needs tone more careful with them.
- Minimal biting forces should be applied to the front teeth once the veneers have been cemented. Like biting into a hard apple or having a hard cookie. Also, certain activities like opening a bottle with your teeth should be completely avoided.
- Regular flossing is very important in between the veneers to avoid any kind of food impaction and to maintain the gingival health. This ensures the gums around the veneers are healthy and adapted well to the gender margins.
Hence, if the veneer procedure is done well by a proficient cosmetic dentist and the treatment planning is done well. It can last for a very long time and give a fabulous aesthetic result. In teeth where laminates and veneers cannot suffice like in cases with very dark dental stains which cannot be covered with a veneer.
(D) Metal Free Aesthetic Crowns
In extensively proclined or retruded teeth where the amount of tooth movement required is more, in excessive spacing or badly damaged teeth veneers are not an option. In such cases a more extensive treatment in the form of full coverage cast crowns are required.
A well-made crown with accurate margins and perfect shade matching can greatly alter and enhance a smile. In adult patients who want to alter their teeth alignment or position without fixed orthodontic treatment or braces, anterior aesthetic crowns are a good option for smile correction.
There are very good quality ceramic and zirconia crowns available, which have high strength and resistance to fracture. These crowns can easily be used in the posterior teeth or molars for chewing.
With the advent of high-quality materials and precise shade matching with natural teeth. It is possible to give very natural looking and highly aesthetic crowns. A highly polished and lustrous surface can be given to the crowns which provide a very good finish.
Also, every root canal treated tooth should be crowned or capped to provide strength and resistance to fracture. As after an RCT the tooth is saved but it becomes brittle in nature so to avoid a fracture it is imperative to cap the tooth.