At Dr Martin Jest Dental Surgery we practice ‘Conservative and Cosmetic, Minimum Intervention Dentistry’. That is – If we can get away with a white filling (or restoration as we call it) for a tooth and it gives a good long term success then that is always the way to go, unless there are further cosmetic requirements that should be considered. We like to save as much tooth tissue as possible!
Amalgam filling material, the black or silver restorative material is slowly becoming used less and less. There is no indication that the material is harmful when used as a filling material. It has the advantage of being used for over a hundred years. There has been much debate in the popular press over the alleged harm that Amalgam can cause. I personally no longer use the material as a routine restorative but don’t feel that it is dangerous to use as a filling material.
Teeth Fillings
There are two main methods of bleaching teeth that are used at the dentist, these are the home bleaching technique, and the in surgery technique. I personally prefer the former because it is the most successful when used by itself and gives the best long term results with the present techniques.
Home bleaching involves taking impressions of your teeth and then casting these impressions up in Plaster of Paris. These models are modified and a clear silicon bleaching stent is vacuum formed over the top of it. It is trimmed up so that it covers the entire surface of the teeth up to the gum line. We get you back to the surgery and make sure these bleach trays fit your mouth comfortably and are well adapted to the gum margin to stop the bleach material leaking out. The correct techniques of applying the gel are then demonstrated to you and a shade of your teeth taken so that we have a record of the starting colour. I also like to take photographs of your teeth so that we have a record of how much the teeth lighten. Generally bleaching then proceeds in your home. I like you to wear the bleach trays at night while you sleep. Studies show that maximum effectiveness of bleaching occours during the first six hours of the bleach being applied to your teeth. This is also more successful at night because the salivary flow rate drops when you are asleep and therefore there is less dilution of the gel by the saliva. Rarely some people find it difficult to sleep with the trays in, so in that case we find that the trays can be used in the evening straight after the evening meal once you have flossed and cleaned your teeth. This usually will give several hours wear time.
I find that we get good results after applying the gel for seven to ten nights. But prefer to wait for 3 weeks before reviewing you again because after you stop there is a little ‘bounce back’ as the teeth darken just a little as the enamel rehydrates. Normally there is a shade change of 7 tones on our shade guide.
Here lies the interesting fact. Most of the lightening that occours during the in surgery whitening of your teeth – when a gel is painted on your teeth and light/heat is applied to activate the bleaching process, is due to dessication of the enamel. When the enamel is dried it goes several shades whiter! Once the process is finished the enamel will slowly rehydrate and go back to the original colour once more! Of course if the patient is given home bleaching trays to “top up” the bleach you will notice that the bleaching is more permanent!
Because it involves so much less surgery time the home bleach technique is normally the cheapest method, and because it works so successfully this is the method that I prefer. Of course you will then have the bleach trays which can be kept for several years. If you want to keep the teeth as white as they can go normally a couple of nights bleaching every six months is all you will require. Extra bleach gel is not expensive and we are happy to provide it if you require.
Teeth Veneers
Veneers are just like false fingernails that are permanently fixed to the front of a tooth to beautify it and to change its shape into one that is more aesthetically appealing. The most natural looking veneers almost always involve modifying the surface of the tooth to obtain the best profile and stop the tooth looking ‘blocky’ and unnatural.
Veneers can be made in many materials.
- Ceramic The most natural looking are made of ceramic in the laboratory by a skilled technician to an exact colour map that the dentist prescribes. They enable the tooth to be lengthened and lightened as required. Well designed veneers are almost as strong as the original tooth. Ceramic veneers are the most expensive but are also the most lifelike, they are the best material for masking darkened or root filled teeth. There are many different types of ceramic, ask your dentist if you are interested in more information.
- Composite Usually composite veneers are fabricated in the mouth by the dentist. The resin is patted onto the prepared tooth and using different shades and translucencies. It is then polished and shaped before the finished product is achieved. Modern composites can achieve a remarkable lifelike effect but it is much harder to mask dark teeth using this method. Because there is no laboratory component they are less expensive to make.
- Acrylic This is usually considered a material of the past due to the increased strength of modern composite resins. Acrylic veneers are made in the laboratory.
Do you have a question?
If you have a question regarding Dental Restorations ask Dr Martin Jest directly. Simply fill in the form at the side and we will get back to you as soon as possible.