Cosmetic Dentist and Cosmetic Dentistry

Dr. Andrew Sih combines art and dental science in cosmetic dentistry.

Where

The Bondi area, including Bondi Junction and Bondi Beach, Sydney and surrounds, and all of Eastern Suburbs.

Why

Through careful observation, examination, discussion and planning, Dr. Sih addresses your cosmetic concerns and will bring you the best results – to your satisfaction.

Cosmetic Dentist Service

In the past twenty years or so, dentistry with its associated advancements in technology, has improved to a point that it can give the results past generations have only dreamt of. It is no longer only possible to keep all our teeth for life, with the availability of modern, advance materials coupled with the better knowledge that comes with more informed dentists, one can provide patients with endless aesthetic possibilities to improve and make ordinary teeth look great.

We can change a patients dental appearance by using:

• Tooth colour materials
• Tooth colour crowns and veneer  
• Tooth whitening procedures
• Orthodontic tooth/teeth movement
• Implant placement

Cosmetic dental related to your teeths overall aesthetic and as such deals with issues such as :

Teeth Whitening
Amalgam Fillings
Gold Fillings
Crooked & Gap(s) Between Teeth
Worn and Broken Teeth
Stained and Discoloured Teeth

Teeth Whitening

The appearance of your smile is one of the first things people notice about you. Cosmetic dentistry can enhance your appearance, make you look younger and feel more confident.

Cosmetic Service : Teeth Whitening

Amalgam Restorations

This is generally known as the ‘silver filling’. The amalgam fillings have served the ‘baby boomers’ well in the past sixty or so years. Many countries overseas are using amalgam as a regular restoration material, and it is still used by some of the Australian dentists today. This is a relatively cheap material and was universally used to restore decayed teeth. It has helped millions of patients to maintain their teeth for many years.

However, one of the main problems associated with this material is its potential to fracture teeth. This has been very costly to the community and kept dentists busy to deal with this problem world over. The amalgam filling has mercury incorporated with an alloy of zinc, tin etc before placed in the prepared cavity. At this point in time, we are not getting into the discussion of whether the mercury, being the heavy metal,  may cause high serum mercury and cause ‘mercury poisoning’.

The real problem with amalgam is its movement within the tooth. It expands and contracts in response to the temperature of the food and drinks we take, at a different rate as the tooth structure that it is placed it.  If any cavity which is not perfectly ‘stress’ protected, hair line crack will develop in the tooth. This crack will propagate with further chewing load and temperature change, and without one noticing, this continues to happen until suddenly one finds ‘I only bite on a piece of toast, and the tooth fractured off’.

Millions of amalgam fillings have cracks in them to a various extent, and it is only time that will extend far enough to cause a major fracture in the tooth.
The other concern to a lot of patients is that amalgam fillings look dirty and unsightly.

Gold Crowns and Inlays

Gold has been the material used by dentists for centuries. It is non corrosive, strong and lasting. Casting is usually used to make crowns to cover and protect a broken- down tooth. A good dental gold work will last for a long time in a very hostile oral environment.

One of the problems with gold is its COST. The fabricating of any gold related dental restorations will cost probably 10 times more then an amalgam counterpart.
Until recently, the COLOR of the gold restoration has become an issue with some of the public.

We have now new and advance materials and resources to address these cosmetic issues in Dentistry.

Crooked & Gap(s) between teeth

Crooked teeth may give rise to a number of health problems. Crooked teeth is mainly caused by the lack of space in the jaw to fit all the teeth in the right places,  or sometimes the eruption of the adult teeth was interrupted by premature loosing of the ‘baby’ teeth during childhood.

Gap(s) between teeth are the opposite. Some people are born with one or more teeth missing.  Some smaller teeth, usually the lateral incisors, can be the reason for the space created by them.

Gaps between teeth may cause minor irritations such as food impaction to major issues such as chewing difficulties and speech impediments. However, some people will also regard this as being unsightly and will affect their smile and overall facial appearance.

Worn and broken teeth

This is a very large subject in dentistry, and will only be considered briefly here.

Thirty percent (30 %) of the adult population in this society will have some form of wear in their dentition. The word BRUXISM is to describe this condition, which is a result of grinding ones teeth while asleep. This phenomenon has been keenly studied and there are many causes:

1. Unstable teeth alignment,
2. Poor restoration contour,
3. Rough porcelain restorations against natural teeth,
4. Early lost of teeth,
5. Unattended broken teeth or fillings,
6. Stressful modern life,

All the above factors contribute to the nocturnal pathological grinding of ones teeth. The body is trying to adjust the bite but with no particular plan while you are asleep. The pattern and the degree of wear can vary greatly. Once the enamel coverage of the teeth is worn, the wearing will escalate. The affected teeth will show wear facet in the molar surfaces and the front teeth will look ‘squarer’ then the regular ones. Often one will find the edges are chipping off and looking thin. In more severe cases, the grinding will reach the pulp and cause pain and if untreated, the tooth will eventually die.

Stained and discoloured teeth

Various ethnic groups possess different shades and hues of their natural teeth. Young children have lighter teeth with a lot more translucency. When we get older, the dentine underneath the enamel matures and will lose its lightness and appear ‘darker’.

Some congenital or early childhood illnesses will deform and give the motley appearance. If the antibiotic, tetracycline, was prescribed for the children when the tooth gems are developing, the classical ‘tetracycline stain’ of the teeth results. The teeth will look dark, lack of translucency and blotchy.

The other causes for staining are genrated from what we expose the mouth to. Tea, coffee, red wine, cigarette smoking will all produce stain on the teeth. Most of these types of staining can be removed by visiting the dental team.

Symptoms that may require a cosmetic dentist

A good cosmetic dental clinician has to deal with many important issues. Your dentist needs to have a sound understanding and knowledge of :

The state of the soft tissue (gum) condition
The state of the hard tissue (teeth)
The state of the occlusion (bite)
The proportion (shape and size) of the teeth
The colour of the teeth
The expectations of each patient

He also needs to have the experience, the artistic flair and the passion to bring the ‘Hollywood Smile’ to you.

The state of the soft tissue (gum) condition

Unhealthy gums appear red, puffy and swollen. They bleed easily and if untreated, the bone underneath will be destroyed. The gum line will recede permanently as the result of the bone lost. This will affect the appearance of the teeth because they will now look longer. Gaps between the teeth will also begin to appear and teeth will sometimes spread apart that will cause further cosmetic concern. If your teeth have spread apart over time, you may have a serious periodontal (gum) problem and you need to consult with your dentist urgently.

The state of the hard tissue (teeth)

The condition of the teeth must be good before any cosmetic dental work to be carried out. There should be cleared and free from any decay. The pulp should be sound and vital. Just as importantly, there should be no crack or fracture line in the tooth itself. If any of these problems are present, they should be dealt with prior to any cosmetic procedures to be taken.

The state of the occlusion bite

A lot of failed dental treatment is due to the failure in recognising and dealing with the occlusion (bite) problems. The ‘bite’ can collapse over a period of time for various reasons:

The early loss of some teeth and without prompt and proper replacement may/will initiate teeth movement and create subsequent bite issues.
Bruxism (night teeth grinding) gives the worn and shortened look of the teeth.    Premature contact, (heavy bite) if not corrected, may cause pain and mobility to the offending tooth/teeth.

It is therefore most important that the faulty occlusion be recognised and corrected, if the patients are to enjoy and regain the comfort of their teeth once more. Correcting the worn front teeth will also enhance the appearance and make folks look years younger.                            

The proportion (shape and size) of the teeth

To a lot of people, a good looking smile should show lots of white and aligned teeth. But if the teeth are not in proportion (wrong shape and size) with the rest of the mouth and face, they will look tedious and outrageous, even if they are white and straight.

Nature provides each tooth shape with a narrow range of defined length/width ratio. It also provides some positioning criteria that the teeth should look certain way when they are lined up against each other, e.g. the lateral incisor should look shorter between the central incisor and the canine. Also the two central incisors (front teeth) should show most while the rest of the teeth curve up gently to the back of the mouth, following the smiling lip line.

If these rules are observed, a ‘Hollywood Smile’ is achievable.  

The colour of the teeth

Every person’s tooth colour is genetically predetermined, just like the colour of your hair and the colour of your skin. However, all human teeth colour will change with the pass of time. There are two factors that alter the teeth colour:

As we grow older, the dentine under the enamel of each tooth matures, and this will cause the darkened appearance of the teeth. This process, however, will affect different individuals to different degrees.
 

The other factor is when the stain comes from normal food and beverage, red wine and coffee, or tobacco smoking. This type of stain that causes the discolouration of the teeth can often be removed by the dentist or the dental hygienist at regular interval.
Darkened teeth tend to give an elderly appearance to a person, and as it is human nature to want to look younger, teeth whitening procedures has become highly popular.

Selecting the appropriate colour for the restoration in the front teeth will definitely give the person a more youthful look, however, careful considerations must also be given to the individual’s age, skin tone, complexion etc, or the desired cosmetic result will not be achieved. Too much lowering of teeth colour will simply make them unrealistically ‘white’ and therefore look ‘false’.

The cosmetic expectation

A very high standard at our surgery has been established to meet the expectation of the most demanding patient in cosmetic dentistry’ should be the Mission Statement for any cosmetic dental practice.

It is most satisfying for a dentist to be given the opportunity to change and restore a person’s teeth, which allows him/her to have new found confidence which comes with a ‘Hollywood Smile’.

Teeth should not only allow you to chew well, but should also look great as well!