The Best Smile Is a Healthy Smile
Area Experts Explore Cosmetic Dentistry Options to Brighten Smiles and Soothe Pain
Cosmetic dentistry may elicit images of perfect celebrity smiles, but local dentists have something else in mind: healthy teeth and gums. When considering cosmetic dentistry procedures, the place to start is with an examination of your oral health by a dentist. Then you can explore myriad new techniques and treatments that can make your smile one of your best features.
“We start by making sure the patient has healthy gums and no cavities,” says Kimet Abdullai, D.D.S., with Dental Care of Oakbrook. “Everything starts with a good exam and a conversation.” She suggests sharing your goals for the appearance of your teeth, so that the dentist can address your main concerns. “I tell people, ‘Beware of the Internet if you’re going to invest in expensive cosmetic dentistry. Do your homework. Not everyone is a candidate for cosmetic dentistry, because you need to address the underlying issues.’” She gives an example: “You may want veneers but just need straightening.” She finds that “most patients are asking for a better smile.”
“Think of cosmetic dentistry as a set of stairs,” says Michael Bond, D.D.S., of Naperville, explaining that each step represents a higher level of complexity, intervention and expense, depending on the need at hand. The first step for an improved appearance would be tooth whitening, which he calls “one of the most effective methods and best for cost.” Next would be cosmetic shaping, bonding or covering with veneers, followed by a full crown, which is made of porcelain and covers the entire tooth, and culminating with surgical implants for missing or weakened teeth.
According to a 2015 survey of dentists by the American Academy of Cosmetic Dentistry (AACD), “Eighty-six percent of patients elect cosmetic treatments to improve physical attractiveness and self-esteem.” The same study reports that the most popular cosmetic procedures are whitening, bonding and veneers, which together totaled 84 percent of the responses. Of course, many cosmetic procedures are used to improve function as well as form, such as replacing teeth that have been damaged or lost due to an accident or decay.
Whitening is the most popular cosmetic procedure, with options ranging from inexpensive over-the-counter kits you can use at home to professional at-home kits customized by the dentist or in-office whitening using laser light that can produce immediate results.
Bond cautions against using the inexpensive products that you can buy in stores, which come with prefabricated trays to hold the bleaching agents. “One size fits all usually fits nobody really well,” he says. The in-home whitening treatment that dentists provide comes with customized whitening materials and made-for-your-mouth trays, which “keep the bleach away from the tissue” and prevent gum sensitivity. He believes that professional home whitening is more effective than quick in-office whitening treatments, although the one-hour office procedure is best for people who have a special occasion coming up, such as a wedding, as well as for those who don’t have the time to devote to days or weeks of whitening treatments.
Although whitening has been “found to be entirely safe to the tooth structure,” says Kevin Moss, D.M.D., a partner with Grove Dental Associates in Downers Grove, he advises against it for patients younger than 16. “Their teeth are still developing.” Whitening also may not be suitable for people with crowns or veneers, which are matched to the color of existing teeth and will not change color with whitening.
Bonding and veneers
Bonding and veneers can be used to fix chipped or mis-shapen teeth and gaps and to improve overall appearance. “Veneers are very conservative,” Moss says. He describes them as thin, porcelain facings for one or more teeth, fabricated in a custom shade to match the other teeth, which do not require extensive alterations to the tooth. A veneer “usually fits in front and covers the tip of the tooth. We can give patients a smile makeover and do it quickly.”
Straightening is an option for young and old. While teenagers may want to rock a brightly colored set of braces, most adults prefer their teeth be straightened in a way that isn’t noticeable. The Invisalign straightening system may be the answer. Straightening is accomplished with a series of custom-made, clear aligners that fit over the teeth and are changed every two weeks. The aligners can be removed to eat or brush, but must be worn at least 22 hours each day, Moss explains.
Bye-Bye Teeth, Hello Dentures or Implants
Like all health issues, prevention is the key to oral health. Yes, you really should floss. The good news from the Centers for Disease Control and Prevention is that fewer people are losing all their teeth. But when tooth decay goes untreated, tooth loss is bound to follow, as teeth loosen and bones deteriorate.
“The first thing that goes is the gums,” says Amarik Singh, D.D.S., with Periodontal Implant Associates in Oakbrook Terrace. “If you treat gum disease early enough, you can help people avoid losing their teeth.” He employs new, less invasive techniques to address gum disease, including pinhole gum rejuvenation. As the name implies, gum recession is treated through a pinhole opening in the gums, without the need for grafting tissue from elsewhere. Another high-tech treatment is laser surgery for infected gums. “It gives the ability to treat people in a much more comfortable way, as it cleans infection and promotes healing at the same time,” he says.
For people with tooth loss, Singh and other dentists offer implants. Although dentures have come a long way in appearance, they tend to be an uncomfortable substitute for teeth. Now, implants are considered the best long-term option, dentists say, although they cost considerably more than dentures.
"The lifespan of a crown is about five to seven years, while an implant lasts 25 to 40 years,” says Rajan Sharma, D.D.S., an endodontist and president of Eon Clinics, with multiple locations including Westmont and Hoffman States. He explains that costs for an individual crown can add up over time, especially if a root canal is required. Unlike crowns, implants do not decay. Implants have a titanium base that is anchored into the bone, which helps to prevent the bone loss that is caused by missing teeth. “The implants are like your natural teeth,” he notes. He advises that patients maintain their implants by having them checked by the dentist every year or so to assess bone and tissue health.
An implant can be done on one or more individual teeth or an entire row of teeth. Sharma, Singh and other dentists offer All-on-4® implants, which can provide a full set of upper and/or lower teeth replacements, using only four implants to anchor the entire arch. In some situations, the implant must heal into the bone for several months before the permanent tooth is affixed. In others, the permanent teeth can be bonded the same day. “Literature supports both options,” Singh explains.
For those with dentures, Vesna Sutter, D.D.S., of Sunrise Dental Care in Geneva, notes that mini-implants may help stabilize dentures. The procedure involves placing three or four small, narrow implants and adding a housing to the denture so that it snaps onto the implants. “You can still remove it,” she says. “It minimizes floating so patients can really chew.”
Ouch, That Bill Really Hurts!
Of course, smile beautification comes at a considerable cost. Professional whitening costs an average of $357, according to the AACD study, while area dentists report that implants can amount to tens of thousands of dollars, depending on the number of teeth replaced.
“There are a lot of different steps you can take to get the smile you love and meet your budget,” Sutter observes. “You can ease into it.” She recommends going in for a consultation with an annual budget in mind. Depending on the situation, cosmetic procedures may be done in phases over a period of several years.
Dental insurance usually doesn’t cover strictly cosmetic procedures, and any coverage is limited. Sutter relates that dental insurance benefits haven’t changed for years, generally topping out at $1,500 a year. Restorative dentistry such as crowns may be covered in part, and dental offices can help you navigate coverage. Check to see if the dental practice you choose covers the initial consultation on cosmetic dentistry free of charge.
Many practices also offer access to lines of credit to pay for expensive procedures such as implants over a period of years.
Cosmetic dentistry “is not just for your health,” Sutter says. “It really changes people’s lives when you’re confident and you can smile.”Edit Module