Advances in Cosmetic Dentistry

Just because we’re living in a masked world doesn’t mean your teeth should take a back seat. There’s no better time than now to perfect your smile and enhance the appearance of your teeth and gums through cosmetic dentistry procedures. Advances in technology and modern procedures have made it more accessible and affordable to improve your oral health and gain a beautiful smile. Take a look at some of the latest cosmetic dentistry trends.

Laser Gum Recontouring

For many years, patients looking for treatment of a "gummy smile" required painful surgery and a long recovery."We now can use a laser to trim, contour and shape the gums to frame the teeth for a beautiful aesthetic outcome," said Dr.Adam Zatcoff, periodontist at Total Dental Care in Middle Island. "It’s a good procedure for people who are bothered by showing a lot of gum tissue when they smile, or if their teeth look too short." Laser gum recontouring can increase the size of the appearance of the teeth and decrease the show of the gum tissue, he said. The minimally invasive procedure takes about an hour, and a local anesthetic is applied to help reduce any pain. Often, insurance covers the procedure, Zatcoff said, but out-of-pocket cost for a full mouth would cost about $2,000. "There are also treatments to help with the opposite problem, for people who feel like they show too much of their teeth due to gum recession," he said. "There are procedures that can regrow the receded tissue and cover the exposed roots, also correcting the cosmetic issue."

Ceramic Veneers

Many people are choosing ceramic veneer restoration, which can dramatically improve their smile. "Ceramic veneers are thin shells of tooth-colored, translucent ceramic material, custom designed and created to fit over the front surfaces and edges of teeth to improve their color, shape and overall appearance," said Dr. Bruce G. Valauri, a board certified prosthodontist at ProHEALTH Dental in Lake Success. Ceramic veneers are very durable and can last about 10 to 15 years. "They also resist staining," he said. "Unlike other cosmetic dental bonding materials, ceramic veneers are smooth and dense, therefore will not pick up permanent stain from smoking or from dark or richly colored liquids like coffee, tea, colas or spices." X-rays will be needed to verify the teeth are healthy (without decay), images to document the pre-treatment conditions and impressions to create models of the teeth to communicate the design of the restorations to the dental laboratory, said Valauri. "The process involves minimal, but necessary shaping of the teeth based on the design using local anesthesia," he said. "Temporary restorations will be placed to protect the teeth during the fabrication of the definitive restorations. Placement of the veneer restorations involves cleaning of the teeth and adhesive bonding of the veneers to the natural tooth structure, often without the need for local anesthesia." The treatment is typically not covered by dental insurance and can cost about $1,200 per tooth.

All-on-4 Implant Restorations

This treatment minimizes the number of implants needed to replace a full set of upper teeth, lower teeth or both using only four dental implants per arch. This is a hot trend now, said Zatcoff, and candidates for this procedure are people with no teeth or failing teeth due to decay, fractures or periodontal gum disease, or patients who wear dentures and aren’t happy with them. "Entire mouths can now be replaced with fewer implants using a bridge made of zirconia, which is a beautiful, strong natural-looking ceramic," he said. The concept is that in a single day you end up with a full set of permanent teeth. "There’s a bit of advance preparation, which includes 3D scanning and imaging of the existing teeth or dentures," he said. "With the 3D imaging, you can design a smile in advance and have a good idea of what it can look like before you proceed with the work." The images and scans are forwarded to a laboratory to create the bridge in advance. A local anesthetic is used during the procedure, and a patient may be sore for a few days after."Some insurance companies may cover, but most do not," said Zatcoff. "There may be partial coverage, but it may cost about $20,000 per arch."

Clear Aligners and Teens

From 2013 to 2017, Align Technology, the maker of Invisalign, reported that sales of its products for teenagers more than doubled, increasing from approximately 100,000 to more than 235,000. And in the last two years, the volume of teen and tween patients grew faster than that of adults. "The clear aligner appliance has much more capability than before," said Dr. Brett Kastin, an orthodontist at ProHEALTH Dental in Huntington. "Ten years ago, I could use clear aligners for less than 50% of orthodontic patients because of its limitations. Several generations later, I can consider almost 90% of my comprehensive orthodontic patient candidates for clear aligners with comparable results to traditional braces, sometimes in less time." Kastin does not recommend unsupervised direct-to-consumer orthodontic aligners offered by some companies. "Being supervised by an orthodontist for tooth movement is important for optimal oral health, especially for teens," he said. There may be mild pain or soreness at times as your aligners work to gently straighten your teeth. Insurance coverage for orthodontics varies per patient, he said. "The industry average for reimbursement is approximately $1,500 for orthodontics per child towards treatment. Approximate cost of full orthodontic treatment with aligners is about$5,000 to $6,000 and can take 12 to 24 months depending on the issues."