Smile Design Makeover by Dr Thomas Bray BDS
before
after
Many people only need minimal dental cosmetic work to improve their smile and appearance. For others, a complete makeover is a priority.
Feeling unhappy with your teeth and smile can affect so many aspects of life such as relationships and confidence.
Improving your smile so that you are happy with the way you look can produce dramatic results.
We offer a FREE Initial Cosmetic Assessment which is an opportunity to discuss your concerns and begin to identify possible remedies.
We will consider all options including dental implants, orthodontics (braces), tooth whitening as well as (or instead of) porcelain veneers or resin/ceramic composites
It may be necessary to combine various different treatments to get the best result.
In some cases we will suggest a complete “Smile Design” service from quality photos and scans of your teeth. The proposed results are presented on screen for review with the dentist so that you can see in advance how the alterations will affect your appearance. We will then produce a tailor made treatment plan to give the desired result.
Porcelain Veneers
Dentists have been making thin Veneers in tooth coloured porcelain for many years to repair worn, damaged or discoloured teeth. Veneers are often made less than 1mm thick and usually require the removal of a thin layer of tooth enamel. The porcelain is bonded to the tooth structure with resin materials resulting in natural looking and remarkably strong teeth. With regular dental care, Veneers can last for 20 years or more.
Cerec or lab-made Veneers?
The traditional way to make porcelain Veneers involves taking impressions of the prepared teeth and sending these to a dental laboratory where they are made on plaster models. These are then returned to the dentist for fitting – typically 2-3 weeks later. With our CEREC digital technology we short-cut this process by manufacturing the Veneers at the dental practice, usually on the same day that the teeth are prepared. Depending on the experience of the dentist, the resulting restorations are of the same quality as those made by a dental technician. There is the added advantage that we work directly with the patient in matching the tooth colour and characteristics and there is no need for plastic temporaries. In some cases, we might advise sending the work to a specialist laboratory in order to get the best result. This may involve additional costs.
We have been making porcelain Veneers using the CEREC technology for a number of years. Over the years, the range of available materials and tooth shades has grown along with our experience in selecting the best of these for each case. As a result, we have been delighted to see increasingly successful results as many happy patients will testify.
What is involved?
Before undertaking treatment with Veneers, we undertake a full dental examination to make sure we know as much as possible about the patient’s teeth and oral tissues. Long-lasting restorations depend on careful and thorough planning including assessment of the patient’s previous tooth wear, diet, oral hygiene, gum health, and occlusion (bite). We also want to plan the ideal end result so with some cases, we undertake a full “Smile Design” process with the help of state-of-the-art computer software.
In many cases, the first stage of treatment is tooth whitening to achieve a desirable tooth colour for the teeth that we are not planning to Veneer. The Veneers are then carefully matched to the same tooth colour. We have found the most effective method for this is guided home whitening which takes about two weeks. In some cases, there may also be a need for periodontal (gum) treatment to eliminate gingivitis or correct irregularities that would otherwise affect the final result.
On the day of the treatment we allow enough time to complete the procedure as quickly as possible and with the minimum discomfort. Up to ten teeth can be completed in a single day.
The teeth and gums are anaesthetised with very small injections which are then topped up painlessly as needed. Preparing the teeth by shaping the enamel, removing previous fillings etc takes about 10 to 15 minutes per tooth. When this has been done the prepared teeth are digitally scanned onto the CEREC computer so that the manufacturing process can begin. At this point, the patient is free to relax outside the surgery leaving the dental team to make the Veneers. Each tooth is separately designed on screen using 3D imaging and then carved from a solid block of porcelain on the CEREC milling machine.
The milled Veneers are then adjusted by hand before being fired in a computerised furnace which hardens and glazes the material to match the patient’s own teeth.
The CEREC process takes about one hour per tooth so we usually allow a whole day to complete up to six teeth. If the Veneers are to be made in a dental laboratory, a silicone impression is taken and temporary plastic Veneers fitted to the teeth.
When ready, the finished Veneers are placed onto the teeth and further adjustments made as necessary before being bonded and finished to ensure everything is just right.
Guarantee
We guarantee all CEREC restorations for a period of two years if regular check-ups and hygienist appointments are kept up to date.
Possible complications
As with all medical procedures, occasional problems can arise during or after treatment and need to be considered at the outset. The initial assessment and diagnosis phase is intended to foresee such eventualities and eliminate them in advance. However, a small number of unexpected complications do occur for example the need for root canal treatment. This may be necessary where there has been significant previous damage to a tooth or where heavy tooth reduction is needed. De-bonding of veneers is rare these days especially where teeth have been minimally reduced. But the unexpected loss or fracture of a Veneer can occur as a result of unforeseen factors such as night time tooth grinding (bruxism) or unusual bite problems. For this reason, we usually recommend the use of a mouthguard at night to protect expensive restorations such as Veneers and to increase their longevity. The good news is that if a Veneer does suffer loss or damage, a new one can usually be made in advance at the practice and fitted at a short appointment.
After care
We will expect to review the finished work at three months and thereafter at regular dental check-ups. We also strongly advise regular hygienist visits for all our Veneer patients. In this way the work can be monitored, and possible problems avoided.
What to do next
For a FREE Initial Consultation to discuss Dental Veneers please contact us.