Cosmetic Dentistry in Phoenix, AZ
Smiling with confidence makes you feel great. A beautiful smile is also an important social and professional asset. Yet there are many people who avoid showing their teeth in public or in photographs because they don’t like what they see. If that describes you, then why not start the process of getting the smile you’ve always wanted with a smile makeover?
A smile makeover goes beyond simply responding to dental problems as they arise. It’s a comprehensive smile-rejuvenation plan that’s uniquely suited to your own facial features and aesthetic preferences. The results can be quite dramatic — both in terms of how your will look and how you will feel.
CEREC is the brand name of a German Siemens CAD/CAM system that designs and makes dental crowns at CenterCare. This system offers unmatched precision and speed for Phoenix patients seeking high quality in a busy world.
In years past, all dental crowns were made for patients by a dental laboratory, required 2 weeks to make and used a second appointment to place it on the tooth. Today, using an intraoral scanner, we can transfer an image of a patient’s tooth directly to our computer.
There, CAD software creates a custom shape that is unique to that tooth and relays the data to a robotic milling machine to make the crown using subtractive manufacturing.
In as little as 20 minutes the crown is finished and ready to place on the tooth. The patient leaves the office with a permanent restoration after only a single appointment.
There are many elements that make up an ideal smile; bright, healthy-looking teeth immediately come to mind. But the gum tissue that surrounds and supports those teeth also plays a big role in how appealing your smile will look.
There are various cosmetic issues involving gum (gingival) tissue. For example, your smile may look “gummy” — meaning you seem to display too much gum tissue when you smile, or your teeth appear too short. Sometimes it’s the opposite problem — your teeth appear too long because your gum tissue has receded (pulled back), exposing tooth-root surfaces that were covered at one time. Or, you may have an uneven gum line, meaning gum tissue covers some of your teeth more than others. All of these cosmetic gum problems can be successfully treated with cosmetic procedures performed in the dental office.
Cosmetic gum problems
Excess Tissue. A gummy smile can be caused by excessive gum tissue covering more enamel surface of a tooth’s crown (upper portion) than normal. If that is the case, a procedure known as “crown lengthening” can be performed, in which gum tissue (and sometimes a small amount of bone tissue) is removed to expose more tooth surface.
Receding Gums. Sometimes your gums can shrink down (recede), exposing a portion of your tooth roots. This causes a cosmetic problem because root surfaces, which have no enamel covering, tend to appear more yellow than the crowns of your teeth. Also, exposed roots can be more sensitive to cold or touch, and can be at greater risk of decay. There are various gum-grafting procedures that can cover exposed roots, all of which involve moving gingival (gum) tissue from one site in the mouth to another. For example, roots can be covered with tissue from the roof of your mouth, which is of the same type; or adjacent (nearby) tissue can be moved over to cover an exposed root. Sometimes laboratory-processed tissue from another donor can even be used. All of these options can be discussed with you in more detail.
Uneven Gum Line. If you have an uneven gum line where some teeth are covered by more tissue than others, it is often possible to recontour (reshape) the tissue for a very pleasing effect. This can be done conventionally with a surgical scalpel or with newer dental laser technology. The advantage of a laser is that it seals the tissue as it sculpts it, making the procedure more comfortable and requiring a shorter healing time.
What to expect
All cosmetic gum surgery can be performed at the dental office — and it usually requires only a local anesthetic (numbing shot). In fact, for laser surgery you may need only a topical anesthetic applied in gel form. If you would like a deeper level of relaxation, you can have oral or possibly even an IV sedative; but if this is required, you will need a ride home. Laser surgery leaves no open wounds and causes minimal, if any, discomfort, though the anatomy of the area may preclude laser use. An examination is required to determine whether conventional or laser treatment is in your best interests.
Grafts may take longer to heal, particularly if tissue is taken from the roof of your mouth. If that’s the case, you will have two sites that need to heal: the donor site from which the tissue was taken, and the recipient site where the tissue was attached. Both of these sites will require stitches, usually of the dissolving type. You will need to eat a softer diet and avoid chewing on that side of your mouth for a few days. Though full healing may take a few weeks, you will be able to resume your normal activities the very next day. Whichever kind of cosmetic gum surgery you may need, the procedures are routine and predictable — and they can do wonders for your smile!
Sometimes a smile doesn’t look as appealing as it could because the gums appear too prominent. If this describes your smile and it’s something you want to change, chances are you can be helped by one of several available treatments. But first your dentist will need to determine exactly why your smile looks gummy to begin with. Find out the various causes and treatments… Read Article
Periodontal Plastic Surgery
Millions of Americans have some degree of gum recession — a loss of the tough, pink tissue that surrounds teeth. Receding gums can cause anything from minor tooth sensitivity to tooth loss in very severe cases. Fortunately, the field of periodontal plastic surgery has made enormous strides in devising techniques, including grafting, to deal with the problem of lost or damaged gum tissue… Read Article
Dental implants are small titanium posts that replace the roots of missing teeth (View Example). They are inserted into your jawbone during a minor surgical procedure that takes place in the dental office. After the implant has been placed in your jawbone, a completely lifelike porcelain tooth crown is attached. In some cases, the implant needs to fuse with the bone for several months before it is permanently crowned; in other cases, you can have new (but temporary) teeth the same day your implants are placed.
How many teeth can be replaced with dental implants?
You can replace a single tooth, multiple teeth or all your teeth with implants. You don’t even need one implant for every missing tooth. As few as two Implants can support a removable lower denture, while as few as four implants can provide a full, permanent set of top or bottom teeth.
Is dental implant surgery painful?
Most people find dental implant surgery very easy to tolerate. Any post-operative discomfort can usually be managed with over-the-counter anti-inflammatory medication such as ibuprofen or OTC pain-relievers. Ice can also be helpful.
Are dental implants expensive?
At the outset, implants are more expensive than other tooth-replacement methods such as dentures or bridgework. But they also last many years longer and in fact should never need replacement. So they offer the best, most cost-effective option when viewed as a long-term investment in your health, comfort and well-being.
How do you care for dental implants?
They require exactly the same care as natural teeth: daily brushing and flossing, along with regular dental checkups and professional cleanings. Although implant teeth will never decay, the gum tissues around them can become inflamed or infected in the absence of good oral hygiene. Properly cared-for dental implants should last a lifetime.
Can my body reject a dental implant?
Strictly speaking, implants can’t be rejected because they contain no living cells or genetically coded material. The titanium of which they are made is completely biocompatible, and allergies are extremely rare. But an implant can fail to integrate with the jawbone if an infection develops in the absence of good oral hygiene, or if it is subjected to biting forces too soon. However, this is rare; implants regularly achieve success rates in excess of 95%.
Am I a candidate for dental implants?
There’s a good chance that you are, but this can only be determined after a complete oral examination that includes x-rays of your jaws. Please schedule a consultation to begin the exciting process of restoring your smile and bite.
If gum recession is affecting your health or your appearance, a procedure called gingival (gum) grafting may be recommended. Although it might sound scary, a variety of gum grafting procedures are routinely performed by periodontists (specialists in the area of gingival tissue), and by some general dentists with specialized training in this field.
Gum grafting involves carefully placing a small amount of new tissue in an area where little or no gum tissue currently exists — typically recommended to prevent further gum recession or to cover root surfaces of your teeth that have become exposed. The tissue used in this procedure may come from a variety of sources but usually is taken from the palate (roof of the mouth), after the area has been numbed for your comfort. Then it is delicately sutured (stitched) in place where it’s needed, using suturing material which may be finer than a human hair.
Your body’s natural recovery process takes over after the grafting procedure is complete. During this time, new blood vessels grow into the graft and help it to become integrated with the surrounding tissue. A successful graft can reduce or eliminate problems like tooth sensitivity and further gum recession, as well as improve the aesthetics of your smile.
How do you know if you need a gum graft? Often, you can clearly see or feel the problem. Exposed tooth roots can make your teeth look overly “long,” and they also generally appear somewhat darker than your pearly white crowns. Gum recession is a condition that can increase with age, as we recognize when we hear the phrase “long in the tooth.” But the potential problems of gum recession aren’t just cosmetic — they can also seriously impact your oral health.
A closer look at your gums
Inside your mouth, gum tissue forms a barrier that resists the vigorous mechanical (and microbial) effects of eating, chewing and biting. Gums may begin to recede, or shrink down, for several reasons.
One is ineffective oral hygiene: This includes both inadequate brushing, which fails to remove dental plaque; and excessive brushing, which erodes the tissue. Foreign objects in the mouth that rub against the gums, like poorly fitting removable dentures, tongue bolts, or even fingernails, can also contribute to gum recession.
When the tooth’s roots lose the protection of healthy gum tissue, they can become extremely sensitive to hot or cold temperatures, causing pain when you consume many foods and drinks. Worse, missing gum tissue makes it easier for bacteria to penetrate the roots and cause decay — or for minor trauma to result in rapid gum recession. In either case, the eventual result may be tooth loss. That’s why proper treatment of gum recession is so important.
Treating gum recession with gingival grafting
After a thorough examination and assessment of your teeth, gums and overall health, the gingival grafting procedure may be recommended. The tissue used in this procedure may be obtained from a variety of sources: an area next to the area of recession, from the hard palate, or donated tissue from another person, which has been medically processed to make it safe to use.
There are several different methods of grafting. For example, if you have lost gum tissue in an area of your mouth that’s not highly visible when you talk or smile, additional gum tissue can be placed there to prevent further recession without trying to cover the tooth-root surface completely. This procedure is referred to as a free gingival graft (since the tissue is separated from its blood supply), and it takes about 45 minutes to perform. It is very predictable with a very high success rate. If the objective is to cover root surfaces, the procedure becomes more complicated and will take longer, but is still very successful.
Grafting procedures are typically carried out under local anesthesia, and are generally pain-free. You should experience very little discomfort after the surgery, even if tissue has been removed from your palate, because that donor area is usually covered by a soothing, liquid band-aid-like material. Fortunately, any discomfort that you do have can be alleviated with over-the-counter or prescription anti-inflammatory medication, and it is generally short-lived. A soft diet (and an antibiotic) may also be recommended for a week or so thereafter, enabling the tissues to heal fully; otherwise, your normal activities will not be limited.
Keeping your gums healthy
Following a gum graft, it’s more important than ever to practice good oral hygiene; this will help prevent gum problems from developing in the future. Your regimen should include proper brushing with fluoride toothpaste, daily flossing, a healthy diet, and regular dental and periodontal checkups. Maintaining healthy gums is key to keeping up your overall oral health — and preserving your smile.
Periodontal Surgery — Where Art Meets Science
This article is an overview of how the art of plastic surgical procedures and the science of periodontics can enhance the health and beauty of your teeth. You will learn what periodontal surgery is designed to do, what makes it successful and what to expect during treatment… Read Article
Understanding Gum (Periodontal) Disease
Have your gums ever bled when you brushed or flossed? This most commonly overlooked simple sign may be the start of a silent progressive disease leading to tooth loss. Learn what you can do to prevent this problem and keep your teeth for life… Read Article
Some people feel self-conscious about smiling because they believe their gums are too prominent. Though we each have our own definition of what makes a smile beautiful — including how much gum is too much — a smile will usually be perceived as “gummy” when 4 millimeters (just over an eighth of an inch) of gum tissue shows. If your smile looks gummy to you, it’s important to figure out exactly what’s causing this. Only then can the appropriate cosmetic dental or periodontal (gum) procedures be recommended to give you a more pleasing appearance of the gums and teeth.
Gummy smiles may be caused by one or more factors relating to the gums themselves, the teeth, or even the lip or jaw. Each of these areas will require a different approach to solving the problem. Let’s look at some of the ways a gummy smile can be corrected:
Gums. If your teeth appear too short in relation to your gums, it could be that they are being covered up by too much gum tissue. This problem can be solved with a periodontal plastic surgery technique called “crown lengthening,” which involves removing and reshaping the excess tissue to expose the full length of teeth.
Teeth. There are natural variations in the tooth-eruption process that can result in shorter than normal teeth and gumminess of the smile. If that’s the case, your teeth can be made to appear longer by capping (crowning) them or covering them with thin porcelain veneers. It’s also possible that your teeth have become worn down over time, especially if you have a grinding habit. When this happens, it can cause what is known as compensatory eruption. To compensate for the wear and maintain a functional bite, the teeth actually begin to move (or erupt) very slowly outward from the gum. This makes the smile appear gummier because the gums, which are attached to the teeth, move with them as they erupt. In some cases, orthodontic treatment can be used to move the affected teeth back up into the correct position. Afterward, the worn-down teeth would usually be restored with porcelain crowns or veneers.
Lip. On average, the upper lip moves 6 to 8 millimeters from its normal resting position to a full smile. If the lip is hypermobile, meaning it rises much farther up, more gum tissue will be revealed. Here the action of the muscles that control the lip will need to be modified so they don’t raise it quite so high. Treatment can range from Botox shots that temporarily paralyze the muscles (for about six months), to surgery that permanently restricts how high the lip can move, referred to as a lip stabilization procedure.
Jaw. Sometimes the upper jaw (maxilla) is too long for the face, a condition referred to as Vertical Maxillary Excess. If this is the case, the jaw would need to be repositioned with orthognathic surgery (“ortho” – straighten; “gnathos” – jaw). Of all the treatment listed here, this one is the most complex — but it can achieve dramatic results.
As you can see, there is no one-size-fits-all approach to correcting a gummy smile. However, there are various techniques that can achieve dramatic improvements.
The word “surgery” often brings to mind a stay in the hospital, general anesthesia, and perhaps a lengthy recovery period. However, the experience of having oral surgery is usually very different from that. Oral surgery is often performed in a dental office setting, under local anesthesia, with minimal recovery time. Oral Surgery can range from routine procedures such as tooth extractions and implant placement to more complex jaw realignment surgeries and emergency care for facial trauma.
Oral Surgery Procedures
Oral surgery procedures may be performed to relieve pain, treat an infection or trauma, restore function or improve a person’s appearance. Procedures and conditions treated include:
- Tooth Extractions. There are a variety of reasons why you may need a tooth or teeth removed. You may have a wisdom tooth that is impacted; a diseased tooth that can’t be saved; or overcrowded teeth that need to be removed so more room can be created to facilitate proper alignment during orthodontics.
- Dental Implants. Today’s preferred method of tooth replacement is a titanium dental implant, which is placed beneath the gum line and into the jawbone during a minor surgical procedure. The implant is then attached to a realistic-looking dental crown that is visible above the gum line and indistinguishable from a natural tooth.
- Oral Diagnosis & Biopsies. When a suspicious oral lesion is found, a biopsy is often used to detect or rule out oral cancer — a disease that is treatable if caught early. A biopsy involves removing a very small tissue sample for laboratory analysis.
- Corrective Jaw Surgery. Sometimes a person’s jaws don’t fit together properly. This can affect both jaw function and appearance.
- Snoring & Sleep Apnea. Excess tissue in the back of the throat may need to be removed in certain individuals with sleep apnea.
- TMD. When conservative remedies fail to relieve chronic jaw pain over a long period of time, surgery may be considered.
- Facial Trauma & Reconstructive Surgery. Facial injuries can affect not only a person’s ability to carry on basic life functions such as eating but also his or her appearance. Knocked-out teeth can sometimes be re-implanted or replaced with dental implants.
- Cleft Lip/Palate. These birth defects are among the most common, estimated to affect around one in 700-800 babies born in North America. With proper surgical treatment, the child has an excellent chance of leading a healthy, normal life.
What to expect
Before your oral surgery is performed, x-rays will often be taken to aid in diagnosis and treatment planning. A step-by-step explanation of the procedure along with your anesthesia options will be discussed, and you should feel free to ask any questions you have. Your recovery experience will depend on what procedure you are having as well as your general state of health. It’s always important to let your healthcare providers know what medications you are taking (both prescription and over-the-counter), any chronic health conditions you have, and whether you smoke. This will help ensure your safety and comfort — always the paramount concerns.
Wisdom Teeth – To Be Or Not To Be
Wisdom teeth, which typically make their appearance between the ages of 17 and 25, can cause significant problems when there is not enough room for them to grow in properly. As a person ages, the effects of retained and impacted wisdom teeth can be more consequential. This article reviews the issues associated with wisdom teeth and whether or not they should be removed… Read Article
Seeking Relief From TMD
TMD, or Temporomandibular Disorders, is an umbrella term for various painful conditions that affect the jaw joints. There are different treatment approaches to TMD problems, but not all are based on science. It’s important to be up on the latest information and to be an educated consumer. In this comprehensive article, Dear Doctor magazine provides state-of-the-art information and guidance on what you should know, whom you should see, and what you should ask… Read Article
Dental Implants – Your Best Option For Replacing Teeth
Dental implants have many advantages over older methods of tooth replacement like bridges and dentures — from the way they function and feel to the way they look and last. Vigorous research has documented and confirmed that in the right situations, dental implant success rates are over 95%. It is no exaggeration to say that they have revolutionized dentistry. They may even change your life… Read Article
What makes a smile beautiful? That’s a complex question, but some qualities of a lovely smile are immediately identifiable: good tooth color, shape and alignment are a few of the most important ones. If your teeth could use improvement in any of these categories, porcelain veneers could be just what you’re looking for.
You may already know that a veneer is a thin covering over another surface. In dentistry, a veneer is a wafer-thin layer of super-strong porcelain that convincingly substitutes for natural tooth enamel. When bonded to your teeth, veneers can create a natural-looking, beautiful new surface. That’s because dental porcelain, like natural tooth enamel, is translucent and tough. But it doesn’t stain like tooth enamel does.
Recent years have brought remarkable advances in dental porcelain technology. These days, veneers can be made so thin that they can sometimes be bonded directly onto your existing tooth surface. In other cases, a very thin layer of tooth enamel — as thin as the veneer itself — needs to be removed to fit the new porcelain surface and make it look as lifelike as possible. Either way, the results are sure to make you smile.
Versatility of Porcelain Veneers
Veneers can be used to improve any of the following characteristics of your teeth:
- Color — Teeth can become stained by the foods and drinks we like, from smoking, and even normal aging. Veneers are available in numerous shades, from the most natural to the brightest Hollywood white.
- Size & Shape — Teeth can become worn down from grinding habits, or may not have the shape or size you want to begin with. For example, some people consider rounder teeth more feminine and squarer teeth more masculine. Veneers can be shaped and sized in whichever way is most flattering to your face.
- Alignment & Spacing — Veneers can be used to close small gaps between teeth or make slight corrections in alignment while improving tooth color and shape.
Limitations of Porcelain Veneers
There are some situations in which veneers would be inappropriate. For example, if you have significantly misaligned teeth or a large gap, orthodontics might be a more appropriate solution than veneers. And if you have lost a lot of tooth structure from decay or trauma (or a particularly severe grinding habit), it might be better to restore your teeth with porcelain crowns that cover the entire tooth.
Creating a New Smile with Porcelain Veneers
The first step in creating a new smile with porcelain veneers is to communicate exactly what you don’t like about your smile as it is now. It’s a great idea to bring in pictures of smiles you do like, as a starting point for discussion. It’s possible to see how veneers would look on your teeth in one of several ways. A model of your teeth can be created over which wax “veneers” can be placed; sometimes acrylic (plastic) or tooth-colored filling material can be placed directly onto your teeth to demonstrate the effect veneers would have on them.
Once the plan has been agreed upon, your teeth will be prepared by removing a small amount of enamel, if this step is necessary. Molds of your teeth will be taken and used by a skilled dental laboratory to create your veneers, and you will receive a temporary set of veneers to wear during the few weeks it will take to create your permanent veneers. When the veneers come back from the lab, they will be cemented onto your teeth.
Caring for Your Veneers
Just like the teeth nature gave you, teeth restored with veneers need gentle brushing and flossing every day. This will remove dental plaque and ensure good gum tissue health around the veneers. Regular checkups at the dental office will remain as important as always to your oral and general health. And keep in mind that as tough as veneers are, they may not be able to withstand forces that come from using your teeth as tools (to open packages, for example) or biting into very hard foods like candy apples — which isn’t good for your natural teeth, either! And if you grind or clench your teeth at night, you might be advised to get a custom-made nightguard to protect your veneers — and your investment.
Smile Design Enhanced with Porcelain Veneers
Dear Doctor magazine takes an in-depth look at Porcelain Veneers, a superior yet minimally invasive technique for smile enhancement. Learn not only when veneers are appropriate, but also when they’re not… Read Article
Porcelain Crowns & Veneers
Dear Doctor magazine examines two innovative strategies for improving your smile. In many instances, these two restorative techniques can produce nearly identical aesthetic results, even though they are designed differently for handling different structural problems… Read Article
Porcelain Veneers – Without A Drill
More and more, dentistry, like medicine, is finding ways to be as conservative as possible while providing the best possible results. “No-prep” or “prepless” veneers are one way to improve and enhance smiles without the downside of drilling away healthy tooth enamel… Read Article
A new orthodontic offering at CenterCare is a system known as Six Month Smiles. This system uses white porcelain orthodontic braces with a white wire that is positioned with a highly accurate mouthpiece that is custom made for each patient by an orthodontic laboratory.
Six Month Smiles is especially appropriate for adults in Phoenix because it corrects visible smile discrepancies without changing an otherwise good bite. For this reason, treatment times are shorter and the improvements in appearance can be dramatic. Contact our office to learn more about our orthodontics in Phoenix.