Health

"Whitening is a great place to start," says Dr. Paul DeCarlo of Fort Myers, referring to two non-invasive procedures available from cosmetic dentists: take-home trays and in-office, light-assisted bleaching. The first method involves wearing fitted polymer trays filled with a bleaching gel over your teeth. The gel’s whitening agents are the significantly more potent cousins of the peroxide strips available over the counter. Trays alone can take a few treatments before teeth noticeably lighten. Folks needing white teeth on a deadline can jump-start the process with in-office bleaching. The procedure combines whitening agents with targeted light therapy to speed the reaction. Some lights rely on heat as a catalyst, which can cause temperature sensitivity, but other methods use a blue-green light or lasers that produce little heat.

Not all teeth are created equal. Some are naturally more yellow or gray and no amount of topical bleaching can change that. For such teeth, porcelain veneers can make a real difference. "The teeth are healthy, but you just want to go over them," explains Dr. Jim Massa of Naples. The veneers are contact-lens-thin layers of porcelain or polymer bonded to the surface of the tooth. Unlike bleaching, the color is completely controllable. A small amount of enamel must be removed for most veneers to adhere to the tooth, making the process irreversible. But because the porcelain veneers are stronger and less porous than the original tooth, they don’t stain as easily and they strengthen the tooth they’re attached to.

Veneers don’t just whiten smiles; they can change the shape of teeth to make them appear straighter or longer. "Sometimes the simple shaping of the edges has a dramatic effect," says Dr. Alan Rembos, who offers the procedure to patients at his offices in Sanibel and Fort Myers. Enamel on the front teeth is generally around two millimeters thick, so if a tooth is crooked or sticks out, a little can be shaved off and evened out with a veneer. Porcelain also helps teeth worn down with age and bite patterns. With shortened teeth, the jaw closes higher and creates a frowning appearance. By elongating the teeth, says Massa, "you can almost get a non-surgical facelift, because you elongate the bottom half of the face." But before you commit, both dentists recommend an orthodontic consultation.

The same advances that make porcelain and composite materials so useful on the front of teeth are also working as seamless alternatives to metal fillings inside the teeth. "In my estimation, they are the only fillings that should be placed in anyone’s mouth," says Rembos. Stronger and less temperature-sensitive than silver, composite fillings are both functionally and aesthetically superior to their metallic predecessors.

It’s your mouth, and you only get one, so it’s important to take care in picking the right cosmetic dentist. Check your dentist’s credentials, ask for before-and-after photos, and talk to staff. "Every dentist today is a cosmetic dentist," Rembos says, adding that a good dentist thinks about, "function first, but cosmetics is a close second."