When you think of fine art and priceless paintings, Leonardo da Vinci no doubt comes to mind. It may be a surprise to learn, however, that the same technique Leonardo used to create lifelike works of art is the same technique a master dentist professional uses for reproducing a beautiful “Mona Lisa Smile.” Leonardo’s layering technique used to achieve the Mona Lisa’s alluring, dreamlike quality is identical to the method that a true artistic ceramist will utilize to create lifelike dental restorations.
The cabalistically alluring smile of lady Mona Lisa remains a mystery, but French scientists say they have cracked a few secrets of the famous painting. Researchers at The Louvre have studied seven of the museum’s Leonardo da Vinci paintings, including the Mona Lisa, to analyze the master’s use of successive ultrathin layers of paint and glaze – a technique that gave his works their soft and sensual quality.
Specialists from the Center for Research and Restoration of the Museums of France found that da Vinci painted up to 30 layers of paint and glaze on his works to achieve astonishingly high levels of subtlety. Added up, all the layers are less than 40 micrometers, or about half the thickness of a human hair, researcher Philippe Walter said Friday. The technique is called “sfumato,” and it allowed da Vinci to give outlines and contours a hazy quality (creating an illusion of depth and shadow). The technique’s use is well-known, but scientific study on it has been limited because, until the advent of advanced laser technology, tests required actual samples from the paintings.
Just as Leonardo da Vinci used the sfumato technique to intricately layer paint and glaze (creating beautiful works of art), a master artist uses similar techniques of layering porcelain powder to create realistic dental restorations. Dr. Sun chooses from approximately 30 different shades of porcelain powder, which are layered to create the illusion of a natural tooth. The result is an extremely high quality restoration, indistinguishable from an organically created tooth. It is important to note that the vast majority of porcelain technicians use only a few rudimentary shades of porcelain powder, resulting in a mediocre restoration which may look slightly artificial.
When searching for a cosmetic dentist, look for samples of his or her team’s work! Cosmetic dentists rely on an integrated team of clinical and laboratory experts to assist in creating lifelike porcelain restorations. Realistic shade and color should be present, not one solid shade of white. If possible, see how the restoration illuminates (how the tooth looks in natural sunlight) – is there a shift, like a natural tooth? Find a master artist who can provide you with the smile of your dreams. If you need a resource to find a cosmetic dentist in your area, the American Academy for Cosmetic Dentistry provides a search tool to find accredited AACD cosmetic dentists in your area.
People ask me all the time whether they should have laser bleaching to whiten their smile. “It all depends on whether you are in a hurry to get your teeth whitened, and whether or not you are a candidate for tooth whitening in the first place” – my typical response! The benefits of laser bleaching over an over-the-counter home solution include instant results, a painless experience and a completely guided procedure. If your teeth can benefit from teeth whitening, at-home tray bleaching techniques will work for most people unless their teeth are sensitive, eroding, severely worn or if they have gum recession. If you do have severely discolored teeth, a combination of laser bleaching and home bleaching and whitening toothpaste would be the best approach to obtaining and maintaining a bright and dazzling smile.
Laser bleaching utilizes laser light energy to accelerate the chemical reaction of a bleaching agent, typically a hydrogen peroxide base product. Hydrogen peroxide is very unstable in response to light and heat (which is why over-the-counter 3% hydrogen peroxide solution is stored in opaque dark brown bottles). Because of this, light energy can excite peroxide molecules, breaking the covalent bonds of the bleaching agent. The agent then reacts to and breaks the long, discolored molecule chains into shorter-chained molecules, lightening the tooth color. The bleaching agent used with laser bleaching is a high-strength solution when compared to home bleaching agents or over-the-counter kits. Your mouth will be protected with an isolator to protect the oral tissues , and placement of the bleaching agent is done in a very controlled manner by a highly trained dental professional. Once a 10-to-15 minute bleaching cycle is complete, the teeth will be cleaned and evaluated to discern whether additional applications of bleaching agent will follow. Normal bleaching procedures involve three applications of the bleaching gel, with an “instant average” of six shades of whiteness typically resulting. Laser bleaching is instantly gratifying. In my office, you can watch a movie through virtual i-glasses while the procedure takes place, and before your movie is finished your teeth will have been transformed into a younger, prettier and whiter smile!
Many different types of lasers (or light) are used for eliciting fast chemical reactions in teeth whitening. Some people will experience more sensitivity when infrared energy (heat) is utilized, which appears in most dental offices, but a few alternatives like Argon or KTP lasers (which emit blue and green light) exist. These lasers have the correct level of energy required to excite the bleaching gel, but they leave the teeth cool and comfortable. Most sensitivity is transient, and should subside within a day (Ibuprofen will be helpful if there is any available). After a smile has been bleached with a laser, one must be very careful to maintain his or her newly brightened smile lest the brilliant white color fade and dull over time. Alcohol, soft drinks and smoking are all bad habits which can stain teeth and regress any laser bleaching process. A healthy diet will also be beneficial for your physical and oral health. If you take care of your mouth, your reward will be apparent with a happy and healthy smile.
It’s no surprise that people are hurting financially, given the sheer amount of job losses in America. The stress many of us are under becomes evident even in our oral health! When people become overly stressed, they tend to lapse into bad eating and drinking habits, may start smoking, and often do not take proper care of their oral environment (brushing and flossing twice daily, and after meals). This does not mean, however, that visits to the dentist for serious tooth-related problems should be avoided!
The economy has driven some people to extreme measures regarding dental work, even inducing people to use superglue to fix broken teeth instead of visiting the dentist. Not only is this practice ineffective in properly restoring damaged teeth, the chemical compounds found in adhesives like superglue – which are not designed or manufactured for use or placement within the body – can be dangerous and cause adverse health problems depending on the type of glue. The mouth is a core functioner within the human body, and many problems that originate in the mouth are systemic and eventually affect other aspects of your health. The same is true when it comes to abusing or not properly caring for your mouth.
Applying toxic substances like superglue to the inside of the mouth could have long-lasting systemic side effects far graver than the price of visiting your dental professional and receiving the proper dental care your mouth needs. Of course, prevention is always the best medicine for dental problems, but if they do arise, be sure to at least make a call to your dental professional and speak with someone. The problem could be more serious than you think, and fixing something early on is a healthier, less expensive treatment path than waiting until it is a bigger problem!
Do you have a gummy smile? Do your teeth appear too small, or there is too much gum showing? Aesthetic crown lengthening is a procedure which could improve your smile if you selectively decide to change the proportion of your teeth and gum.
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After Lengthening:
Your teeth are secured to your jaw via root structures that extend from the teeth into jaw bone. This bone is protected by the gums, which extends down over the top of the tooth root structure. Excess gum tissue poses no health risk, but can be unsightly and make your teeth look tiny or not as harmony with your face. Aesthetic crown lengthening remedies this condition by trimming away excess gum (and in some cases bone), reducing the amount of display of gum and lengthening the visible crown of the tooth. Gingival (gum) contouring (like a gingival plasty or soft tissue crown lengthening) refers to trimming of the gum tissue only. Most crown lengthenings refer to the recontouring of both the gum and supporting bone (osseous crown lengthening), when there is more length of the tooth is desired.
Traditionally, crown lengthening is performed with scalpel and mechanical rotary tool which trim and flap open the gum also trim away some bone tissue. This mechanical force results unfavorable inflammatory response of the periodontal tissues and taking up to 8 weeks to heal. The tissue must fully heal before restorations can take place. This procedure is often daunting to many patients!
Thankfully, new technology in the laser dentistry field has made aesthetic crown lengthening much easier and less invasive. By using a small fiber optic tip, laser energy can be manipulated to trim or ablate away tissues , disturbing the surrounding environment much less than traditional mechanical rotary instruments. The less invasive procedure means less pain, quicker healing and less trauma. The body does not react violently to laser treatment as it does blunt mechanical treatment!and often time the restorative work can be initiate quickly or even at the same visit. In some cases, crown lengthening alone can get you desirable bigger smile,but often time , the restorative work like bonding, veneers or crowns are called for the needed improvement or protection on dental structure.
When gingival contouring or crown lengthening is performed – but left with a compromised biological width (2 to 3mm is necessary for safe formation of a protective zone from the gum border to the bone) - gum tissue will stay inflammed and grow back after several months. It is important to have an experienced dental professional for proper diagnosis before getting your gum trimmed. Find a dental professional who been properly trained using lasers for a more comfortable surgical experience (www. Laserdentistry.org). The design of the smile and the shaping of the gum line both need an aesthetic touch (apart from solid surgical technique), so it is equally important for the dental professional have aesthetic background to assure the best aesthetic result (www. aacd.com).
Laser Gum treatment is an exciting treatment modality for treating and managing gum disease. Laser dentistry has been around for two decades, it is very useful in many applications on soft or hard tissues: the focused energy allows for precision treatment while minimizing pain and recovery time. Although only 6 to 7% of dental practices utilize laser technology so far, you may benefit greatly from laser dentistry.
Periodontal disease in particular is a fantastic candidate for laser treatment. The nature of periodontitis (gum disease) involves bacterial growth which affects the supporting structures of the teeth, destroying attachment tissues which create deep periodontal pockets that are not easily cleanable (causing the gum disease to progress). Gum tissue responds very well to laser energy, which removes diseased linings in the periodontal pocket and also kills the bacteria. The laser-tissue interaction is thermal, controlled energy from the selected tip of the laser fiber will evaporate the inflamed unhealthy lining tissue ; its rising temperature will also kill any pathogen present in the tissue. The clean and less traumatic site becomes more efficient and comfortable for your healing. Other benefits of laser treatment include biostimulation (photo-biomodulation) on the cellular level , which energizes damaged cells through light receptors , allowing tissue to heal promptly!
The laser gum treatment is usually administered in conjunction with traditional scaling and root planning (SRP) services, performed with ultrasonic or hand instruments that remove toxic calculus from the root surface. Unlike more traditional methods which use a scaler to scrape away diseased tissue, the laser approach treats the diseased tissues with electromagnetic energy to ablate diseased tissues non-evasively, followed by irrigation with antiseptic solution (chlorhexidine) to flush away and clean the periodontal pockets. For more severe cases, localized placement of certain antibiotic agents (like Arestin minocycline hydrochloride) inside the treated periodontal pocket can assure a complication-free healing process without systemic effects. Low level laser therapy can also be applied to decrease post-operative discomfort and promote healing through photo-biomodulation.
Laser gum treatment has provided tremendous patient benefits as I have witnessed since it has been incorporated into my practice since 1997, but this treatment modality has raised some eyebrows in the periodontal community. It is difficult to establish a parameter with energy and expect to have consistent result on different subjects; there are too many variables from the color, texture, composition and condition of the tissues, whether the origin of the cause has been managed and how the different laser energy is handled by various operators. There are studies which have proven different results, and over-promising commercials also exist which have discouraged development of laser gum treatment.
When properly conducted, laser gum treatment provides a cleaner and more comfortable site for healing. The predictability of tissue regeneration, however, is too complicated for a blog discussion! I do recommend you go to a reliable, non-biased source like The Academy of Laser Dentistry to learn more about the benefits of laser treatment or referrals of certified laser dentists.
“No more drill?” was an exciting news headliner in May of 1997, implying that with Er:YAG dental lasers, drills were no longer necessary for treating cavities! A decade later, we can re-evaluate or validate the pros and cons of cavity treatment with dental lasers.
In recent years, lasers have been utilized for providing precise, less-painful, clean and miraculous medical and dental procedures. In dentistry, various treatments on soft tissues (like aesthetic gum contouring, gum treatment for gingivitis and periodontal disease, apthous ulcers, frenectomies, biopsies and more) are precisely performed and heal faster with less discomfort than traditional treatments. Surgeries can be done in a very clean and fairly bloodless field. Lasers have also been used to aid in faster and more efficient tooth whitening procedures. Later exploration into how lasers can be utilized in the dental field have revealed hard tissue applications, including tooth and bone.
How does laser energy work with our body? The laser-tissue interaction can be looked at by identifying the laser’s characteristics. The laser wavelength (which has a very specific peak absorption curve) is attracted to certain tissues or elements. Our body, as a recipient site receiving the laser energy, is composed of different structures and elements. The best and most efficient results occur when the perfect match is found between the laser’s energy and the target tissue.
Since erbium energy (Er:YAG) is attracted to water and hydroxylapatite (tooth and bone elements), and decayed tooth structures are full of moisture, the laser energy reacts to your decayed tooth structure much quicker than your healthy tooth structure. This means the decayed tooth structure can be ablated away efficiently. The process happens precisely at the target tissue (the cavity), energy does not travel beyond this site – this means the tooth will not react to the process, resulting in less irritation than a traditional dental drill (which carries mechanical vibration and heat, causing irritation to the teeth)!
In comparison, when it comes to restorative dentistry, rotary instruments (like a traditional drill) are still easier, faster and more predictable in creating specific tooth shapes to receive dental restorations, and rotary instruments have been improved, combining elements of both air and electricity, giving better torque energy, less vibration and less noise.
When discussing the removal of decayed tooth structure , the erbium laser is still a wonderful tool to create a sterile, clean site. Obtaining a laser solely for removing tooth decay, however, is not feasible.So there is few dentists offer such service. Erbium lasers are very useful for bone and soft tissue procedures (water component), dental implant recovery surgeries, and aesthetic crown lengthening (eliminating a gummy smile).Hopefully when you need such services can receive the benefits what laser dentistry can offer.
Dentistry is continuously evolving. New technology, new techniques, new prospects – it’s exciting! Get excited about your opportunity to get better dental service, ask your dental professional “what’s new!” Get the whole team excited about what benefits we can all receive from all the new and advanced technology available to us today.
Recently, two guys from completely different backgrounds came into my office asking for the same laser frenectomy, to alleviate their tongue ties, for completely different reasons!
Biker David complained about his tongue-tie condition, noting “it hurts when I kiss.” Yogi Mark wanted to be able to position his tongue to the back part of his palate to reach a certain state of enlightenment. Both men suffered from the restriction of the tongue-tie condition, but it affected their lives in different ways. A happy ending came as both were smart in finding the most comfortable and effective way to rid themselves of their tongue-tie problems.
Tongue ties can affect children and adults of all ages; it is estimated that up to 4.8% of the American population suffers from a tongue tie. What happens is the frenum (the excessive fibrous attachment connecting your tongue to the floor of your mouth) is thicker than it should be, resulting in your tongue’s inability to move about freely. Not only is this physically uncomfortable, but your speech, eating habits and even oral health can be adversely affected! Spacing between the two front teeth can occur due to improper tongue movement, and gum recession can also occur.
Treatment of a tongue tie is a relatively simple procedure, however great advances have been made from the days of scalpel cutting. A laser frenectomy, the most effective treatment for a tongue tie, is the surgical release of tension of the frenum with laser energy. This procedure will enhance the stability of a corrected diastema, gum recession or alleviate a tongue tie. Because the treatment is done with a laser, the laser energy produces a precise, blood-free cut (the energy actually seals the blood vessels and nerve endings), so the procedure is painless, heals quickly and is complication free. Most people will immediately enjoy the benefit of normal free tongue movement; people who suffer from a speech impairment due to the tongue-tie may need training to speak properly.
You can contact the Academy of Laser Dentistry to find a qualified laser dentist to help you if you have a tongue-tie. My two patients were smart in finding a comfortable and effective way to ridthemselves of their tongue-tie problems.
“Does it hurt? How long will it last? How long will it take? How much does it cost?”
These are common questions from patients looking for cosmetic dentistry.
If you’re interested in cosmetic dentistry to get yourself a winning smile, whether the problem is mis-alignment, cracked or chipping teeth, unsightly spacing, uneven or dark colored dentition, uneven or too much (or not enough) smile showing, or even gum erosion, the eternal question always arises: What would be the best solution?
In the past, crowns were the primary choice for masking tooth problems, but since the late 1980s, cosmetic dentistry has offered both bonding and veneers to improve your smile. This leads to the eternal question: “Bonding or veneers?”
Dental bonding involves the application of a durable composite material directly to the surface of the tooth, by your dentist, which is then sculpted and artistically shaped to the exact look the patient desires, to blend naturally and seamlessly with the patient’s existing teeth. A laser (or high intensity light) is then used to cure the composite material, hardening and reinforcing it to the surface of the tooth. This bonding technique has many applications, not only for aesthetic uses but also for prosthodontics and pediatric dentistry. The advantages to dental bonding are a quick treatment time (can be completed in one office visit after a consultation), and a relatively low cost per tooth when compared with porcelain veneers. Durability of bonding will be affected by the oral environment. Since composite bonding is a mixture of quartz particle (70% – 80% filled) and resin, discoloration and breakage is inevitable if your mouth has a high acidic pH value (if you are a soda drinker, lemon lover or candy sucker), if the bonding was not supported by a solid tooth structure, or if you are a night grinder.
Porcelain veneers are fabricated in the laboratory. They are 100% filled with hard mineral particles, and are fired at a high temperature with a vacuum (to procure the best physical properties to sustain the veneer’s strength in the harsh oral environment). Compared to bonding, there is more procedural work involved with porcelain veneers. There are different techniques to fabricate the veneer pieces (which call for different methods of preparation for the tooth); the pressing technique produces a stronger veneer, but requires 0.8mm thickness of the veneer. The porcelain powder build-up technique can produce super thin veneers (0.3mm), which produces a very conservative look on your tooth structure, while at the same time keeping a natural silhouette. The veneer piece lays on top of the tooth structure and is similar to a press-on nail. They chemically adhere to the tooth with bonding composite cement; since porcelain is acid resistant and stronger in physical properties than composite material, this restoration provides long-term service. When getting the veneers, the first visit consists of preparation and imprints f the teeth (which might involve anesthetic). After this, you will leave the office with temporary veneers which look like natural teeth. A wafer-thin veneer is then crafted out of porcelain which is seamlessly cemented to the front side of the tooth on the second visit. In addition to straightening teeth, porcelain veneers can close gaps between teeth, whiten teeth that do not respond well to bleaching, and can also be used to protect damaged tooth surfaces. The advantages to porcelain veneers over bonding is that veneers are much longer lasting (and stronger) than composite bonding material.
Whether you decide to invest in dental bonding or porcelain veneers, make sure you have all work done at a reputable dentist, preferably at a practice which has its own in-house ceramic lab. When ceramic work is done by an in-house lab with an in-house ceramist, any changes that need to be made to the length or color of the veneers can be done without requiring an additional office visit. Remember, the result of the cosmetic procedures are truly varied depending on the ability of the dentist, ceramist, your clinical situation and the communication between all parties involved. Do your research!
Both bonding and veneers are additive procedures, depending on the position, alignment and shape of your teeth, which is the foundation for any new restorations. This foundation will need to be in the right fundamental situation to receive restorations to result in a fabulous smile. In other words, sometimes, you do not need to do much to your own teeth before applying cosmetic restorations. It might be necessary to reduce or modify the tooth structure before anything can be added onto it to make it look perfect.
There is some risk involved with cosmetic bonding or veneers, so be cautious with any cosmetic procedure. A comprehensive evaluation of your present dental condition is absolutely necessary as a first step; blue prints of your teeth and of your prospective dental project are needed to establish clear verbal communication between all parties involved (including you), including possible mock-up or wax-up models to preview possible changes, which could avoid costly mistakes.
Do your homework: finding the right dental professional, discussing every aspect of your dental needs, understanding the pros and cons of each procedure, and making an educated decision will ensure you get the smile you’ve always wanted.
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After Lengthening:
