DxD Session held on July 31, 2018.
Dr Jerry Lim is a firm believer in taking a holistic approach to aesthetic dentistry, focusing on not only restoring the functional capabilities of the patient, but going one step further to enhance and balance the appearance of the patient’s smile and face. He is currently adjunct lecturer at his alma mater National University of Singapore, and was past President of the College of General Dental Practitioners Singapore.
Dr Jerry answered questions from readers on:
- Smile makeovers
- Veneers and bonding
- Teeth whitening
- Gummy smiles
The average cost of dental bonding in Singapore ranges from $300 - $500 per tooth.
Most of my patients who have a gap in between their teeth would go for dental bonding. The procedure involves adhesively bonding a tooth-coloured composite to the side of the tooth and extended to partially cover the gap. The other half will come from the other side of the adjacent tooth.
As you are only in your 20s (I wish I was still in my 20s), my reccomendation would be to go for a more conservative approach. The colour of your teeth at this age is usually brighter than when you are in your 40s.
I would suggest for you to do an aesthetic dental bonding, or partial resin veneer.
Yes, crooked teeth can be indeed be ‘straightened’ with porcelain veneers or crowns. However, there might be a risk of nerve injury.
Let's examine the details. When you say crooked teeth, this means that your teeth are not aligned and we'd need to bring them into a well aligner arch. Teeth that are protruding will have to be trimmed sufficiently to make them go in line into the arch. Our teeth have a range of 1.5 - 3.5 mm of enamel and dentine thickness.
Imagine you have to bring the tooth in line by 2.5mm (which is normal when moving crooked teeth), you would have to trim away almost 3-3.5mm of tooth structure. Sometimes, this will encroach into the nerve of the tooth making root canal treatment necessary!
Yes, you can get veneers if your teeth are not straight. However, it depends on the severity of your misaligment.
If your misalignment is mild and the veneers will be resting mainly on the first layer of your teeth (the enamel) then they will be strong with sufficient strength to withstand the stress of chewing function.
Beyond a certain level of misalignment, it would be prudent to actually align the teeth first then place veneers on them later. It may be costly now but certainly less than the biological cost you will be paying should you decide to trim a lot of the teeth structure away for veneers.
A few of my patients have nightmares of their teeth falling out! It's actually quite distressing when your veneers crack and drop off.
First of all, make sure the veneers are well bonded onto the teeth. This is a very technical aspect of the treatment. It needs to be done well.
After the veneers are well bonded onto teeth, their strength to withstand chewing forces are actually quite high. The day to day function of your teeth should not post any problems but night grinding and clenching can break the veneers. Thus, if you grind your teeth at night, you should wear your night guard.
This is a difficult question to answer because there are so many aspects to an aesthetic smile makeover other than just colour. Your dentist will have to correct the shape and the inclination of the teeth, and ensure that the natural spaces between each tooth is either preserved or enhanced, not encroached.
Our eyes can pick up imbalances and appearance that do not harmonise like nature do. In this picture, the teeth looked too bulky and the angle of the inclination is wrong. The white is too stark and opaque. It's too monotone and not three-dimensional enough. The shape of the teeth are also too rounded at all corners.
No, porcelain veneers cannot be easily removed.
Reason being, the procedure of getting veneers require the trimming some of your teeth. Trimming is an irreversible procedure. Furthermore, veneers are carefully bonded onto each specific teeth. Even if they were removed, your teeth and smile will look different. They do not go back to original form.
Good news, dental veneers are not known to be painful procedure because we're not working on the nerves of your teeth, unlike in a root canal procedure where absolute numbness is required. It's typically a pain-free procedure.
After your dentist numbs your teeth and gums, you will not be able to feel much of the procedure. The mild trimming of the enamel layer is usually painless. In some cases, when I employ minimally preparation techniques, I'm able to do it without any local anesthesia. However, this has to be assesed on a case by case basis.
Hi there, judging from the picture, it seems to me that you have short looking teeth because the width and the height of the teeth appear to look the same. Normal looking teeth have a width that is less than the height. Usually this ratio is anywhere from 70% to 80%.
A tooth can look short due to: a) excessive gums or b) the wear and shortening of the edge of the tooth. We need to establish the cause of the short or small teeth before proceeding.
Generally, smile makeovers can range from $1,500 to $5,000 depending on multiple factors.
Here's a summary of the range of costs:
- Teeth whitening - Approximately $1,200
- Veneers - from $1,500 to $2,500 each
There are a variety of procedures available now to improve one’s smile. Your doctor would have to find out the issues affecting your smile before he/she can reccomend a treatment(s) to improve your smile.
Hi Miomao, from your question, I assume that you're referring to getting Porcelain Veneers in a Smile Makeover procedure.
Filing your teeth down is an irreversible procedure and should not be taken lightly. I am glad you did your homework to understand the issues and steps involved.
I understand how your front teeth are affecting you. If done properly, removing the surface layer of the teeth by 0.5-1mm should not result in permanent sensitivity. It should be transitional, lasting up to a 3 months in rare cases. These are very technical procedures that requires a very experienced dental team.
Porcelain veneers do not have definite life span. If your veneers are still functional and aesthetically pleasing, it is not necessary to replace them.
However, fluorosis staining is one of the most common staining due to excessive fluoride intake. It is also a common reason for people to seek porcelain or resin veneers treatment due to severe forms of fluorosis.
More often, porcelain veneers fail through fractures or debonding.
Dental bonding is an universal term to describe something that is adhesively attached to the tooth. Usually it is referred to treating cavities or to close spacings between teeth.
If you are referring to using resin for smile makeover, then it is referred to as resin veneers as opposed to using ceramics which is referred to as porcelain veneers.
The straight up answer is no. Let me explain.
1. From your pictures, the upper and lower teeth close to meet each other in a tight interlocking position.
2. When arranging the lower teeth, the arch would become slightly bigger as the width of teeth is now aligned in a straight line. This occupies a larger circumference.
3. Your bite will become compromised if we don't align the upper and lower arch in a correct manner. The function and feel will be uncomfortable, and your teeth will be edge to edge.
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