MALLIGAI DENTAL HOSPITAL - Blogs , Uncategorized

An Extensive Guide to Understanding Lefort Fracture Types and Their Implications

Wed, 29 Nov 2023 10:36:34 +0530

Lefort fractures, named after the French surgeon René Lefort, encompass a spectrum of severe facial injuries resulting from high-impact trauma. These fractures, classified into three primary types, necessitate a thorough understanding due to their complex anatomical involvement and varied clinical presentations.

An Elaborate Insight into Lefort Fractures and Midface Anatomy

The midface region encompasses a complex network of intricately interconnected bones and delicate structures essential for facial aesthetics, sensory functions, and structural support. Comprising the maxilla, nasal bones, zygomatic bones, and the orbital floor, this intricate assembly plays a pivotal role in facial form, function, and overall harmony.

Understanding Lefort Fractures and Their Anatomical Implications

René Lefort's classification system introduced a fundamental framework for understanding midface fractures by categorizing them into three primary types, each intricately intertwined with specific anatomical patterns and distinctive clinical presentations.

Exploration of Midface Components:

Maxilla: Forming the bulk of the upper jaw, the maxilla is a central component of facial structure, housing the teeth and providing foundational support to adjacent structures. Fractures involving the maxilla can significantly impact dental occlusion and facial aesthetics	Zygomatic Bones: Often referred to as cheekbones, the zygomatic bones contribute to facial contours and the integrity of the orbital region. Fractures here can cause cosmetic deformities and compromise the stability of the orbit.
Nasal Bones: The paired nasal bones contribute to the nasal bridge's form and structure. Fractures in this area can lead to visible deformities, functional impairments, and nasal obstruction.	Orbital Floor: The orbital floor forms the base of the eye socket. Fractures affecting this delicate structure can result in orbital blowout injuries, causing double vision, enophthalmos (sunken eye), or restricted eye movement.

A Comprehensive Examination of Lefort Fracture Types

Lefort I Fracture:

Lefort II Fracture:

Lefort III Fracture:

Diagnostic Approaches and Imaging Modalities:

Clinical Evaluation: Initial assessments involve a thorough medical history, physical examination, and evaluation for associated injuries, focusing on signs such as facial asymmetry, bruising, and malocclusion.

Imaging Techniques: Computed tomography (CT) scans remain the gold standard for diagnosing Lefort fractures. These scans offer detailed views of fracture lines, bony displacement, and their impact on adjacent structures.

Treatment Strategies for Lefort Fractures:

Initial Management: Immediate stabilization and airway management are crucial in severely injured patients, often involving securing the airway and addressing any associated life-threatening injuries.

Surgical Intervention: Definitive treatment frequently involves open reduction and internal fixation (ORIF) techniques, aiming to restore facial anatomy and function. Surgical options include the use of titanium plates, screws, or wires for stabilization and reconstruction.

Complications, Long-term Implications, and Prognosis:

Initial Management: Immediate stabilization and airway management are crucial in severely injured patients, often involving securing the airway and addressing any associated life-threatening injuries.

Surgical Intervention: Definitive treatment frequently involves open reduction and internal fixation (ORIF) techniques, aiming to restore facial anatomy and function. Surgical options include the use of titanium plates, screws, or wires for stabilization and reconstruction.

Conclusion:

Lefort fractures represent intricate injuries that require a multidisciplinary approach for optimal management. The detailed understanding of each fracture type, their clinical presentations, diagnostic methodologies, and treatment modalities is imperative for healthcare professionals involved in trauma care and facial reconstruction.

In conclusion, the complexity and severity of Lefort fractures underscore the necessity for specialized expertise and collaborative efforts among trauma surgeons, maxillofacial specialists, radiologists, rehabilitation teams, and institutions like Malligai Dental to provide comprehensive care and achieve favorable outcomes for affected individuals. The integration of resources and expertise from facilities such as Malligai Dental is crucial in the holistic treatment and recovery journey of patients with Lefort fractures.

Essentials of Sinus and Teeth Pain

Sun, 08 Apr 2018 00:18:00 +0530

How important is sinus in dentistry?

A toothache is one of the worst pain one can experience. This toothache can be confined to that particular region, or it can be a throbbing pain that can radiate to the head and jaw regions. This tooth pain as such is caused by main reasons, and some may be not even due to the tooth itself!! One of these can be due to a blocked sinus. If you suffer from chronic nasal congestion as well as toothaches, the two might be related, and this is a two-way relationship.

In a study conducted over a 5-year period, 198 patients with 244 affected sinuses fulfilled the proposed criteria. The incidence of chronic maxillary sinusitis in the population was 0.02%. A dental pain manifestation was found in 40.6% of the sinusitis cases. [1]

Like how a blocked sinus can cause tooth pain, so can an infected tooth cause sinusitis.10-12% of maxillary sinusitis are of odontogenic origin. [2]

How does it affect tooth pain?

A sinus is an air-filled cavity, which is located in the skull. It plays a very important role in conditioning the air that we breathe in before it reaches the lungs. The sinus is lined by a membrane, which acts as a hub of both healthy and harmful microorganisms.

There are 4 sinuses seen in the skull namely the frontal, ethmoidal, sphenoidal and maxillary air sinuses. When dentistry is concerned, the important relationship is seen with the maxillary air sinus. This is to the discrete placement of the sinus in the upper jaw and the roots of the upper molar teeth being related to this sinus.

The sinus is lined by a membrane. This membrane can become inflamed and infected. If this happens, it can block the nasal passage, and the passage can become packed with mucous. The bacteria which is now trapped in the sinus will multiply and cause an infection. Pain and bad taste in the mouth is the sequel to this.

If you have an infection in your maxillary sinus, pressure starts to build and then it presses down on your jaw bones.

Since the upper back teeth are the ones close to the sinus, they are the ones usually affected and cause a sinus toothache.

The cause of the pain? It is the roots of the upper first molar teeth and since they lie to close the sinus floor, or sometimes even extending inside them. The nerves of the roots will be affected by the swelling and pressure. Even though our teeth might be in good health, we will experience sensitive teeth. This is a sinus toothache, and it can be very painful. The longer the sinus block is left untreated, greater the pain.

Symptoms and Management of sinusitis :

One of the classical symptoms to recognize sinus infection causing toothache is pain that is experienced in the tooth when you bend down. This occurs due to shifting of pressure in the sinus. The sinus, jaw and nasal area tend to feel sore and painful too. A headache too can be usually associated with sinusitis and tooth pain. Typically a sinus caused a toothache disappears once the sinusitis is treated and a tooth disease-causing sinusitis disappears once the offending tooth is treated.

There are certain home remedies that one can attempt to do, to manage the symptoms. Flush your nasal passages, take multiple steam inhalation sessions in a day to reduce the soreness and heaviness in the face. Keeping the body hydrated is also of uttermost importance and stick to a hot meal plan through the period of sickness.

If the home care management fails to subsidize your symptoms, visits the Dentist and the ENT to rule out potential complications. Management would include starting on a first line management of antibiotics such as Amoxicillin or Augmentin. Once the underlying pathology has been treated, the other manifestations tend to subside.

OROANTRAL FISTULA

As the name suggests [ORO-Oral cavity, ANTRUM-Sinus, FISTULA-]

An epithelium-lined pathologic tract] an oroantral fistula is an abnormal communication between the sinus and the oral cavity.

It can be due to various reasons. One of the main reasons for such fistula formation is an infection near the end region of the root, especially the upper first and second molars. The infection proceeds onto form a communication between the teeth and sinus.

The oro-antral fistula can be detected using various methods. A thorough examination intraorally using the mouth mirror is usually carried out to detect the fistula. Treatment would be that when the doctors would prescribe a mouth rinse and a course of antibiotics. Surgery will be indicated in the later stages to remove the fistula.

IMPORTANCE OF MAXILLARY SINUS IN DENTAL IMPLANTOLOGY:

The success of fixed prosthetics like dental implants mainly relies on the quality and quantity of bone at the implant site. So when implants are planned in the upper back tooth, especially the upper molar region, the maxillary sinus plays a pivotal role.

This is mainly due to the position of the maxillary sinus near the roots of the upper molar teeth. When the level of the sinus comes down due to various reasons such as prolonged nonreplacement of teeth, aging etc, the height of the available bone for implant placement becomes less viz., less than 10 mm. Hence comes the need for a procedure called

‘SINUS LIFT SURGERY’

TYPES OF SINUS LIFT SURGERY- Performing a sinus life surgery is as important as placing a dental implant. Following a thorough diagnostic examination and various confirmatory tests, a conclusion will be drawn as to which method of sinus lift is to be performed. Each of the techniques has its indications and contraindications and must be performed strictly in accordance with them.

There are mainly two types of sinus lift surgeries

· -Direct

·- Indirect

I) Direct sinus lift- Direct sinus lift is mainly indicated when the bone height is very less. It involves making a small window in the wall of the sinus and packing the sinus with a bone graft material. This usually has a longer healing period and immediate placement of implant would be difficult. Since the height of the bone is minimal, it requires from 4 to 6 months for healing and bone regeneration after the sinus lift procedure

II) Indirect sinus lift- This procedure can be indicated in cases where there is a moderate level of bone present (7-8mm). The sinus is approached from the crest of the alveolar ridge and an osteotome is used. This is a less invasive procedure and has a shorter healing time and waiting period. This is usually a ‘one step procedure’ were implant can be placed on the same day as the sinus lift.

If implants are placed simultaneously with the sinus lift procedure and the process of loading should be increased gradually. It will allow the bone to recover and regenerate after grafting. The patient should be under regular medical supervision in the postoperative period.

Sinus lift surgery proves to be a very important aid for successful implant placement. A study was done to evaluate the success rate of sinus lift assisted implant surgery. A success rate for dental implants in the sinus lifts reached 95.2% after a period of 24 months of evaluation. [3]

COMPLICATIONS OF SINUS LIFT SURGERY:

Success and failure are two sides of the same coin. Complications are possible, regardless of the technique. A study was conducted were a group of 45 patients in whom a sinus lift procedure had been performed was evaluated for sinus pathology 12 to 60 months after bone transplantation and implant insertion, using a questionnaire, conventional radiographic examination, and nasoendoscopy and postoperative maxillary sinusitis was detected in two of five patients with a predisposition for sinusitis, but in none of the other 40 patients. The occurrence of iatrogenic sinus membrane perforations during surgery was not related to the development of postoperative sinusitis in patients with healthy sinuses. [4]

But these complications can only arise as a result of poor dental implant hygiene or non-observance of certain restrictions given by the doctor after the sinus lift procedure.

REFERENCES

1. Melén I, Lindahl L, Andréasson L, Rundcrantz H. Chronic maxillary sinusitis: definition, diagnosis, and relation to dental infections and nasal polyposis. Acta oto-laryngologica. 1986 Jan 1;101(3-4):320-7.

2. Brook I. Sinusitis of odontogenic origin. Otolaryngology—Head and Neck Surgery. 2006 Sep;135(3):349-55.

3. Bortoluzzi, M. C., Manfro, R., Fabris, V., Cecconello, R., & Derech, E. D. (2014). Comparative study of immediately inserted dental implants in sinus lift: 24 months of follow-up. Annals of Maxillofacial Surgery, 4(1), 30–33. http://doi.org/10.4103/2231-0746.133071

4. Timmenga NM, Raghoebar GM, Boering G, van Weissenbruch R. Maxillary sinus function after sinus lifts for the insertion of dental implants. Journal of Oral and Maxillofacial Surgery. 1997 Sep 1; 55(9):936-9

How Bad Breath could affect your job opporutunity?

Mon, 12 Mar 2018 20:49:20 +0530

Ramya ( name changed), 25 years old Female ( Receptionist at front desk) reported to our Malligai dental hospital for the chief complaint of having bad breath from her mouth during the morning and also during the daytime.

When our chief doctor was interacting with her, Ramya explained that she was having low confidence in the job while communicating with the customers because she feels that her customers are finding difficult to come close to her when she talks. Her doubt is whether her customers and colleagues were not happy because of her bad breath.

Then Our chief doctor did a thorough check-up for Ms. Ramya and found that she is having a severe gum disease medically called as aggressive periodontitis. Bad breath, has drastically affected her job, and because of this, she was not able to have proper communication with the customers.Her situation demands her close explanation about her product and services to customers in a close contact where bad breath caused a lot of issues.

So we loved to help her in this situation. After proper treatment for periodontitis for Ms.Ramya using the latest therapy protocols by our resident Periodontist, Ramya got her problem solved and had the joyful environment at her workplace and she gained confidence in communicating with the customers.

The human brain is connected to the external world through five senses which are vision, hearing, sense of smell, taste, and touch.

When we go to any wedding, and other functions the pleasant odor or sweet smell of the perfumes used by the human beings around us gives us a lot of mood elevation. Vice versa we feel very unpleasant and very disturbed when we come across any persons with foul smelling odor around in our moods due to this.

What is Bad breath ?

Bad breath also called as halitosis ( in dental terms) is a persistent, unpleasant odor in exhaled breath, usually not severe sometimes it may be a symptom of the underlying health situation. Bad breath is often is due to result of poor dental hygiene, particular food that the patient eats and also due to other life style habits.

How to identify bad breath?

1. lick the wrist with saliva and allow it to dry.

2. After 3 min just smell it and see

3. This is how others feel when you go near them

How People react to bad breath?

1. They might turn their face away when you are talking to them to avoid the bad smell from your mouth.

2. People might move back a little bit so that they don't get the back breath on their face.

3. They might offer you mouth fresheners and mint other chewing gums very frequently when you go close to them.

4. The worst problem with bad breath is it becomes very personal even though the problem is with the tooth and the gums it could affect the person very badly.

Why bad breath affects a person's personality ?

Self-concept of a patient is made up of self-image, self-idealization, and self-esteem.

What are they?

Self-esteem: How much you like yourself?

Self-image: What do you think others think of you?

Self-idealization: What do you/Whom do you want to become like?

When you have severe bad breath, it will affect your self-image very badly, and it will certainly affect your confidence also.

There was a patient who once shared the story, which this patient had chronic bad breath during a meeting when one of his office colleagues has told that his bad breath is disgusting.This caused a deep depression for this patient, and it affected him very severely.

What are the causes of bad breath?

Food and beverages :

Certain foods like garlic, onion, spices, cheese, meat may causes bad breath until they are eliminated from oral cavity. High consumption of alcohol, caffeinated drinks and low carbohydrate diet can cause bad breath.

Improper brushing of tooth and tongue causes food entrapment in between the tooth leading to rooting of the food resulting in bad breath.

Chewing tobacco or smoking :

Chewing tobacco or smoking causes bad breath because of the nicotinic product present in it.

Health issues and bad breath

Chronic lung infection :

Long standing infection in lungs like chronic obstructive pulmonary diseases, pneumonia results in bad breath.

Diabetes :

Patient suffering from diabetes may have gum inflammation, frequent pus discharge in the oral cavity which may cause bad breath.

Bacterial infections :

Certain food accumulation on the back of the tongue causes the favourable environment for bacterial infection leading to bad breath.

Respiratory infection :

Respiratory failure and infection in the upper respiratory tract cause bad breath. Nasal discharge at the time of cold causes bad breath.

Liver or kidney failure :

Liver or kidney failure at times causes mousy rat, fishy odor in the breath.

Gum bleeding :

Bleeding gums, food and plaque accumulation in the gums causes bacterial accumulation leading to bad breath.

Sjögren's syndrome :

Sjogren's syndrome is associated with dry mouth, rheumatic arthritis, and kertoconjuctivitis . The dry mouth may lead to an acidic environment in the oral cavity which may lead to bad breath.

Periodontal disease :

When the gingival diseases are not treated at the initial stages, it affects the periodontium, leading to periodontal diseases. These periodontal diseases result in bad breath.

Do you know that periodontal disease can cause heart attacks?

Periodontal diseases cause release of toxins which can transfer from oral cavity to the bloodstream and helps in the formation of fatty plaques in the arteries which may cause blood clot thus leading to blockade of blood circulation resulting to sudden heart attack. So when you have gum diseases consult the dentist at the earliest before it causes heart diseases.

Patient suffering from rheumatic arthritis should be given antibiotics before giving any dental treatment as the bacteria from the oral cavity can directly hit the heart which may at times leads to death.

Mouth ulcers :

Mouth ulcers are the painful condition which occurs in the oral cavity when there is oral ulcer it may be single large or multiple small ulcers which leads to bad breath.

Medications :

Consumption of certain medication like antihypertensive drugs ( ACE inhibitors) , antisialagogues causes decrease in salivation leading to dry mouth and bad breath.

Salivary gland disorders :

When there is the destruction of salivary flow due to certain salivary gland disorders like pleomorphic adenoma or sialolith may cause the decrease in pH of saliva creating acidic nature in the oral cavity leading to bad breath.

Symptoms of bad breath :

If you have the following symptoms, you may have bad breath, and you need to consult your dentist immediately.

1. Foul smell in the oral cavity :

Certain systemic diseases like gastric oesophageal disease, liver or kidney failure may result in foul odor indicating the systemic diseases because of which you may feel the bad breath.

2. Anxiety :

Bad breath may affect your inner peace of mind and makes you to be the very anxious person.

3. Stress :

Mouth ulcers in the oral cavity may occur due to stress. Stress ulcers at times cause severe lousy breath when left untreated at the earliest.

4. Dry mouth :

Decreased salivary flow leads to lowered pH of the oral cavity which leads to dry mouth. The dry mouth can be an indicator of bad breath at times.

Diagnosis of bad breath :

The following diagnostic method can be used to detect bad breath. Bad breath can be categorized into various level according to the odor.

Halimeter:

The bad breath is caused due to volatile sulfur compounds. Thus the decreased level of sulfur can be detected using Halimeter.

Gas chromatography :

Gas chromatography is the standard method of detection of bad breath caused by volatile sulfur compound.

BANA test :

BANA test uses various enzymes which helps in the detection of the bacteria causing the bad breath.

Prevention of bad breath

"Prevention is always better than cure"

Brushing teeth and tongue :

Brushing teeth twice daily and use of tongue scrapper is essential to remove the food accumulated in the teeth and tongue after eating, this helps in prevention of bad breath.

Flossing :

The proper method of flossing once a day keeps you away from bad breath.

Replace the toothbrush :

It's advised to replace the toothbrush two months once or as soon as the bristles of the tooth brush worn out replacing the toothbrush regularly may improve bad breath.

Avoiding certain foods:

Avoiding onion, garlic may helps you to stay away from bad breath.

Care of denture:

If you wear denture, remove them at night and clean to get rid of bacterial build up from the foods and beverages.

Hydration:

Drink plenty of water and swish cold water around in your mouth. This is especially helpful to freshen " morning breath."

Regular dental checkup :

Regular dental checkups and cleanings are required to stay away from bad breath.

Holistic methods of prevention of bad breath

Cloves, fennel seeds, and aniseeds

Chewing a handful of cloves, fennel seeds or aniseeds helps to fight against bacteria causing bad breath due to its antiseptic qualities.

Parsley

Parsley is rich in chlorophyll, a breath deodorizer with germ-fighting qualities helps in prevention of bad breath.

Citric acid fruits

Citric acid stimulates the salivary gland and encourages the flow of breath freshening saliva.

So we found that Ms.Ramya had bad breath due to periodontitis and improper brushing. After treatment ( scaling and periodontal treatments) and giving the motivation and knowledge about the bad breath, Ms. Ramya followed the instructions strictly, and bad breath subsided in a year. She started gaining confidence in communicating with the customers, and her colleagues began having a comfort zone with him.

So if you or you family members, colleagues or friends are having this problem, you can approach Malligai Dental Hospital in Chennai for your bad breath or your nearest dental hospital at any time and have confident smile with your family and at your working environment.

What is All on Four Implant treatment?

Sat, 25 Nov 2017 17:49:55 +0530

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Basics of Mouth Rinsing

Tue, 27 Jun 2017 15:33:53 +0530

You've got lots of choices if you're looking for a way to freshen your breath. But if you want to do something healthy for your teeth and gums too, make mouth rinsing part of your daily routine.

"Today mouthwashes are not just perfumes for the breath," says Mark Wolff, DDS, PhD, chair of cariology and comprehensive care at New York University College of Dentistry. "They can also reduce gingivitis [gum disease], tooth decay, tartar and plaque, and they can whiten."

Do I Need to Rinse?

Mouthwash is not a substitute for brushing and flossing. But if you have trouble doing those correctly, rinsing can help protect you from cavities or gum disease. Fluoride rinses help prevent tooth decay.

"Mouthwashes, when added to a good home care regimen of brushing and flossing, can target a condition that you are facing," Wolff says. "You don't swish for 2 minutes with a whitening mouthwash and suddenly have white teeth. But if you brush well and keep the plaque off of them and use that mouthwash as part of the package, you do get whiter teeth."

A mouth rinse won't cure serious problems, though. If you have regular bleeding of your gums or consistently bad breath, for example, see your dentist. He might prescribe a mouthwash that's stronger than the kind you buy over the counter.

Mouthwash Ingredients

Read the labels carefully on over-the-counter types. Ingredients -- and the benefits they provide -- vary by brand.

They usually include one or more of these:

Fluoride. It helps reduce tooth decay and prevent cavities.

Antimicrobials. They kill the bacteria that cause bad breath, plaque, and gingivitis, an inflammation of the gums at the early stages of gum disease.

Astringent salt. It's a type of deodorizer that can temporarily cover up bad breath.

Odor neutralizers. They can attack the cause of bad breath.

Whiteners, such as peroxide. They can help against stains on your teeth.

source: WebMD

What is Smile Designing?

Thu, 22 Jun 2017 00:40:49 +0530

A smile makeover is the process of improving the appearance of the smile through one or more cosmetic dentistry procedures, such as:

Dental veneers
Composite bonding
Tooth implants
Teeth whitening

Some of the components taken into consideration include your facial appearance, skin tone, hair color, teeth (color, width, length, shape and tooth display), gum tissue and lips. Smile makeovers are performed for many reasons and customized according to your unique considerations.

What is it that you like or dislike about your smile or your teeth?

Some aspects of your smile that your cosmetic dentist will review with you and that could be improved include the following:

Tooth Color: Silver or amalgam dental fillings can be replaced with natural, tooth-colored composite restorations, while teeth whitening can improve the color of stained or dulled teeth. Tooth color and shading are important considerations during the evaluation of and preparation for various procedures, including porcelain veneers, crowns, bridges, composite bonding and dental implants.

When considering the color of your teeth, keep in mind that dark or discolored teeth may suggest an aged mouth. A well-shaped smile comprised of bright, white teeth lends to a youthful appearance. The shade your dentist selects for teeth whitening and veneers is carefully evaluated with special consideration given to the tone and color of your face and hair. Cosmetic dentists are skilled at finding the right balance between providing you with a brighter, whiter smile and maintaining a natural tooth color.

Alignment and Spacing: Teeth that are crooked, overlapping or have gaps between them can be straightened and aligned when necessary through orthodontics or Invisalign and improved with veneers.

Missing Teeth: One or more missing teeth can negatively affect the appearance of your smile – as well as affect your bite and increase your risk for tooth decay – making replacement an integral part of oral health and facial esthetics. Missing teeth can be replaced by dental implants, bridges or partial dentures.

Harmony and Balance: Uneven, chipped and cracked teeth can be cosmetically bonded for an improved appearance, and a gummy smile can be re-contoured to help improve the overall look of the smile.

Fuller Lips, Smile and Cheeks: An unshapely or aging face can be improved or rejuvenated with certain procedures in the smile makeover category, including orthodontics and/or oral maxillofacial surgery.

A cosmetic dentist will work closely with you to develop a treatment plan designed to achieve exactly what you want from your makeover. This treatment plan may consist of many cosmetic and functionally restorative procedures, potentially including teeth whitening, composite bonding, veneers, dental crowns, orthodontics (braces), oral maxillofacial surgery and gummy smile reduction.

Aesthetic Components of a smile makeover

In addition to the color, alignment and balance of your teeth in the aesthetic zone of your smile (the section of upper and lower teeth that show when you smile), there are several attributes of your teeth and smile that your cosmetic dentist will evaluate with you when planning your makeover. These include:

Tooth Length: Long teeth lend a youthful appearance. Aging produces wear and tear that often results in shorter teeth, and a gummy smile also can make teeth appear shorter. A treatment for shorter teeth may include reshaping and lengthening the two front central teeth with composite bonding or porcelain veneers. If you have a gummy smile, your cosmetic dentist may provide treatment to modify the gum line and lengthen the appearance of the teeth using laser dentistry procedures. You may also be referred to a periodontist for crown lengthening if necessary.

Teeth lengthening may also impact your overall facial appearance. For example, shapely, long, square teeth on a round-faced individual can provide a slimming effect.

Smile Line: The smile line is an imaginary line that follows the edges of your upper teeth from side to side, which ideally should be the same as the curve of your lower lip when you smile. This standard point of reference may be used to help determine how long your new teeth should be.

Tooth Proportions: Your cosmetic dentist will examine your teeth to determine if they are in correct proportion with each other. Most people recognize a pleasing smile as one in which the two central front teeth are dominant and have a width-to-length ratio of 4-to-5. This proportion guides the length and width of other teeth in the aesthetic zone so that the smile line appears balanced.

Tooth Texture and Characterization: An artistic dentist can characterize your crowns or veneers to create a more feminine or a more masculine appearance, in addition to matching the look and feel of natural teeth or those you've seen in photographs.

Maintaining your Results:

Cosmetic dentistry procedures require regular oral hygiene care and may require maintenance over time. For example, teeth whitening must be repeated on occasion in order to maintain brightness. Porcelain veneers may chip or break off and need replacement. Permanent composite bonding may stain and require enhancement or replacement. Dental crowns typically require replacement after 10 to 15 years. Gummy smile improvements may also require enhancement over time.

Your ceramist, lab technician and the materials chosen by your dentist also impact the longevity of your smile makeover. To achieve the best results, take special care in selecting your cosmetic dentist and inquiring about your material options.

Your oral health must be evaluated before a cosmetic dentist develops a plan for your smile makeover. Your dentist will conduct a comprehensive evaluation of your teeth, gums, underlying support structure and bite (occlusion) to determine candidacy for a smile makeover. If your evaluation reveals that you have an oral health problem – such as a misaligned bite (malocclusion) or gum disease – you will need to have that taken care of first.

Preview

Cosmetic dentists incorporate a variety of dental technologies to show you the changes that you can expect to see in your smile. For example, during your oral health evaluation for veneers and crowns, your cosmetic dentist may create a wax model mockup of temporary teeth to accurately communicate the requirements of your procedure to the dental lab technician. Temporaries and wax mockups also offer you a preview of the expected outcome to ensure that you are comfortable with the proposed treatment plan.

Other methods available for you to preview your smile makeover include the following:

Dental Imaging Software: Imaging technologies offer a preview of your results. Your dentist may use imaging technology to communicate the specifications for your procedure to the dental lab technician or any other dental professionals involved in your treatment plan. However, a digital image only gives you an idea of what you might look like when the treatment is complete; it may not fully match your final results.

Before and After Photos: Before and after photos of other patients who have had smile makeovers offer examples of the results you may expect to see. The photos may also give you an idea of the quality of work performed by your cosmetic dentist.

Dental Study Models: Your dentist will take an impression of your teeth and fill it with plaster to form an exact model of your teeth. The plaster can then be reshaped by trimming away excess areas or enlarging areas that require more volume. Dentists use study models to show you every aspect of the changes you can expect to see with your makeover. Dental lab technicians also use study models as guides for fabricating materials like crowns or veneers.

Your dentist may work with a laboratory that incorporates digital technologies. In such instances your dentist may be able to use digital scans of your teeth, rather than traditional impressions, for use in making the models of your teeth and smile.

Dental Composite Bonding Mockup: Dental composite bonding may serve as a mockup of your smile makeover. The dentist can temporarily bond composite resin material to your teeth so you can fully visualize the impact of the procedure before treatment begins. In the case of veneers, dental composite bonding allows you to identify how comfortable you are with their look, feel and fit. Adjustments may be made until you are comfortable with the function and appearance of your new smile. Temporary mockups have no lasting impact on your teeth once they are removed.

cost of a smile makeover

The duration of treatment and cost of your smile makeover will vary depending on your dentist, your location, your level of dental insurance, the state of your oral health and the extent of your customized makeover plan.

Your treatment may be more expensive and take longer if your dentist identifies any underlying oral health issues before beginning treatment. Although these restorative procedures may be covered in part by your dental insurance carrier, you will still pay more for treatment than someone with immaculate oral health.

With proper care and regular dental visits, your smile will look good and your crowns, veneers and other restorations will last for many years. In fact, resin-based restorations (such as tooth-colored fillings) can last anywhere from three to nine years or longer with proper care. Porcelain restorations can last 10 years or more before they need to be replaced.

Maintaining Your Results

Knowing how to modify your oral hygiene habits to best care for your restorations will help you maintain your new smile for years to come.

Highly abrasive toothpastes and tooth brushing habits can scratch the surface of restorations, dulling their polish and luster. As such, non-abrasive fluoride toothpastes are recommended. An example of non-abrasive toothpastes is Rembrandt, which was originally developed for use by people with cosmetic restorations. Brush two-to-three times each day for maximum effectiveness.

Flossing is a key factor in removing debris and plaque from the teeth, and actually increases the lifespan of restorations and helps prevent tooth decay. Flossing is important for everyone, but is especially important for people with veneers, since impeccable gum tissue health is important.

Mouthwashes containing alcohol have been shown to have a negative effect on composite fillings. What's more, the alcohol content in mouth rinses, over time, can degrade the bond between your restorations (crowns and veneers) and your teeth. Use alcohol-free mouthwashes instead.

Food and Drinks to Limit or Avoid

Avoid foods high in sugar and limit between-meal snacks to prevent cavities. Limit consumption of coffee, soda, tea, etc. to keep your smile stain free.

Do not drink alcoholic beverages excessively. Too much alcohol can ruin your dental work.

Other Precautions

Refrain from biting and/or chewing hard objects such as pens, staples, metal, bottle caps, etc.

If you grind your teeth (bruxism) and were fitted with a night guard to prevent damage to your teeth and restorations, wear it.

Considering that the cost of porcelain veneers ranges from $900 to $2,500 per tooth, and the cost of composite bonding is approximately $250 to $1500 per tooth, you'll want to follow your dentist's and hygienist's maintenance recommendations in order to maximize longevity.

Although cosmetic dental restorations are not indestructible and will eventually need to be replaced (five to seven years for composite; 10 to 15 years for porcelain), the life of your new smile depends as much on how well you take care of it as on the skill and talent of your cosmetic dentist.

Replacing a broken or fractured veneer or crown involves impressions, shade matching, a temporary and waiting for a permanent restoration. And, depending on your dentist's policy, you may be responsible for the full cost of replacing the damaged dental crown or veneer.

Follow your dentist's instructions to ensure the long-term beauty of your new smile, and be sure to keep all follow-up and regular cleaning appointments with your dentist and hygienist.

source: orginal article can be found on consumer guide to dentistry