About Reshaping Teeth and More

Jamie J. Alexander on October 25, 2018

This is Dr. Jamie Alexander, your Boynton Beach Dentist, and I am back at my desk today, musing about the start of another season. It’s the end of October with Halloween around the corner. I know my kids are becoming excited about the costume they will wear, and today I was thinking about the costume Dracula teeth I might wear for the occasion. And, this brought me to other thoughts…

Costume teeth are strikingly different than the teeth in your mouth, aren’t they? Naturally beautiful teeth are symmetrical on an arch without sharp points or extremely long and short lengths. Ideal aesthetics for a beautiful smile requires everything to be in balance.

Dentists look at smiles all day long — and I want to be honest with you; we hunger to improve aesthetics. If a tooth needs a filling or a crown, we will spend significant time making sure the restored tooth looks as perfect as we can make it, matches the color of adjacent teeth, and fits the patient’s bite optimally. If we are developing a plan for extensive treatment involving multiple teeth, we spend many hours at the lab bench studying models of the mouth and creating wax-up models of changes. When it comes to “solving the functional and aesthetic puzzle” before us, we become totally immersed. I guess you could say, “It’s in our DNA.”

During many years of serving patients the best way I know how, I have had many conversations with patients about what they like and don’t like about their smile. And, what I’ve concluded is everyone hungers for some improvement. There is something about a tooth or an entire arch of teeth, they wish could look better. So, here is an overview of the ways in which dentists modify the appearance of teeth for improved aesthetics, health, and function.
Note: The words “health and function” are important, because dentistry isn’t all about cosmetics. It’s about creating a healthy, pain free environment in which you can masticate your food and smile, speak, and laugh with confidence (ergo, “function”). For example, treating worn and diseased teeth leads to cosmetic changes. Correcting an imbalanced bite often leads to cosmetic changes. Oftentimes, the desire for a cosmetic smile makeover drives restoration and realignment of teeth. And, I have had many whole mouth rehabilitation patients whose health, function, comfort, and appearance were a complex puzzle to be solved.

Some Quick “Cosmetic” Changes Which Involve “Function”

Dental bonding is a very simple procedure in which a tooth-colored resin is applied to the tooth surface and it hardened with a special light that “bonds” the resin to the tooth. It can change the shape of a tooth. It also can change the color of a tooth. It can mask a deep stain. It is a simple, relatively fast and inexpensive procedure. But, it is not quite as durable as some other procedures.

Veneers are another way to change the shape of a tooth and its color. Commonly dental veneers are referred to as “porcelain veneers.” They are wafer-thin, custom-made shells of tooth-colored material that are designed to go on the front surface of a tooth. These shells are bonded to the front of teeth using dental resin. They are very durable once in place. This is a conservative way to close slight gaps in teeth, to make teeth more symmetrical in shape and size, and to strengthen a tooth. When veneers are used, a lot of thought goes into their length, thickness, shape, and color. Thought also goes into how the mouth functions, so placement of the veneers allows for natural eating and speaking. Veneers are a relatively quick procedure compared to some other types of treatment. They can be done in 2 to 3 dental visits, and they are at a lower cost typically than a full case of orthodontics and other restorations. Many patients know about veneers and ask if they can have them, but veneers are not an appropriate treatment for everyone due to oral health circumstances. I will explain why before offering appropriate alternatives.

Recontouring teeth is a procedure where small amounts of tooth enamel are removed to change a tooth’s length or shape. Only very small changes are made to preserve the health of the tooth. Recontouring can be done for cosmetic purposes or functional ones. Often, reshaping is done because there is an occlusal problem. In other words, when the teeth come together in a bite and they are not coming together evenly, the teeth are putting excessive wear and stress on each other. The reshaping of teeth is often done to “equilibrate” them… to make them more evenly seated when they come together.

If a tooth has been significantly damaged, a crown may be recommended for cosmetic and functional reasons. In some cases, the tooth is no longer viable and needs to be removed so health, comfort, function, and beauty can be restored with an implant or bridge. A dental crown is a tooth-shaped cap that is placed over a tooth. When the crown is cemented in place, it fully encases the entire visible portion of the tooth that lies inside that cap above the gum line. And, it is made to fit exactly to the gum line so that it doesn’t show. It can be made from multiple types of materials of varying durability and natural appearance. I will recommend the types of materials I know will predictably provide the best results for the longest time.

Today, porcelain orthodontics can work to realign teeth and replacement of missing teeth with implants, bridges, or removable dentures are topics for other blogs on this website. So, I’ll sign off today by saying if I decide to wear Dracula teeth on Halloween, it won’t be for long, because costume teeth definitely interfere with “function.”