In the past decade, obtaining a “perfect smile” has become big business. A large number of teeth-whitening products and treatments have been introduced to market, and are sold at pharmacies and grocery stores. A new industry, “cosmetic dentistry”, has sprung up to meet the demand of Americans unhappy with their natural smile. On one hand, any consumer can purchase relatively inexpensive “whitening” strips or toothpaste without ever seeing a dentist. On the other hand, a patient can make an appointment with any one of a large number of dentists who represent themselves as experts in cosmetic dentistry, and pay thousands of dollars for special procedures.
Cosmetic dentistry involves elective treatments to improve the appearance of the teeth. Patients should know that, at present, there is no specialty in “cosmetic dentistry” recognized by the American Dental Association (ADA). There are no standards, criteria or testing required before a dentist can say that he or she is a specialist in cosmetic dentistry. A prospective patient can be fooled into believing that her dentist has, in fact, passed some stringent qualifications set up by the ADA. A patient may mistakenly rely on a dentist’s representation as a specialist as an indicator of competency.
You should know that many dentists calling themselves experts in cosmetic dentistry have only completed a short course. Often, these courses are completed in a single weekend. Some programs last just a few hours, and are frequently sponsored by the manufacturers of equipment and supplies used in cosmetic procedures. The instructors at such courses may have only performed the procedures a few times themselves.
If you are eager to change the appearance of your mouth and smile, you must be aware of the limitations of dental procedures performed by a general dentist, as well as the cost and the risks. Teeth can be whitened using new and powerful bleaches under close supervision. Chipped and cracked teeth may be repaired with inlays, overlays and veneers. Some dentists replace the teeth structure with caps or crowns. Note that straightening teeth requires an ADA specialist known as an orthodontist, a practitioner who uses braces for straightening teeth.
What cannot be done in a dentist’s office is a procedure to change the boney structure of the mouth. There is a specialty in the field of dentistry known as oral maxillary facial surgery (OMFS). This ADA-recognized specialty requires the dentist to complete many years of postgraduate training at an accredited institution, and then pass a written certification exam. Such specialists are trained to perform major procedures involving the cutting, shearing, shaping and repositioning of facial bones. Only major surgery can correct such conditions as overbite and underbite, conditions considered unattractive or imperfect. Such surgeries are not without risks of complications.
Such complications may include serious infection, blood loss, nerve damage, and adverse reaction to anesthestics or painkilling medications. I will detail the consequences of dental procedures gone wrong in an upcoming article.
Another growing field in dentistry involves the insertion of implants. Today, more and more patients consider dental implants, which cannot be removed, to replace lost teeth, rather than traditional, removable dentures. Implants are small screw-like devices made of a metallic alloy. The metal screws replace the natural root structure of a tooth. The screws are placed surgically through the gum and into the bone of the jaw at the location of missing teeth. Artificial teeth are then attached to the top portion of the screw, protruding above the gum. These replacement teeth are known as prostheses or prosthetic teeth.
When placed properly by an experienced expert dentist, prosthetics and dental implants can be a wonderful way to replace missing teeth from the viewpoint of appearance and function. However, many dentists are now performing implant dentistry without the necessary training or experience. The best-trained and educated dentists in this critical area of dentistry are those specializing in oral surgery and periodontal dentistry (the treatment of diseases of the gums and bones of the mouth). There is also an ADA recognized specialty in dentistry known as prosthodontics, involving the actual design, fitting and creation of the new artificial tooth structure. Replacing missing teeth with implants requires planning and precision. In cases involving replacement of many teeth, the dentist performing the implant surgery should work closely with the prosthodontist in planning the best procedure to achieve a cosmetic and functional result.
If you are considering any of these procedures, you should always investigate the dentist you intend to use. A background check involves more than just relying on a dentist’s advertisement in the local newspaper or on a website. There are no “deals” when it comes to having dental procedures. The old saying “you get what you pay for” is as true for dentistry as it is for any other service. Request a written plan outlining the anticipated course of treatment, including the cost of what is proposed. Make sure that if your dentist is proposing a major procedure, he or she is board certified in the area of dentistry involved. Understand what is being offered, and ask questions. Know the time the entire process will take from the beginning to end, the risks involved and the other treatment that is available to achieve the results you are looking for. If you are thinking about major reconstruction, consider getting a second opinion.
