Cosmetic dentistry

By Mayo Clinic Staff

Cosmetic dentistry involves procedures to reposition, restore or replace teeth. Primarily it is done to improve a patient's smile or facial profile. Uneven teeth can be gradually guided to their proper location using orthodontics. Malformed teeth may be covered with artificial materials such as porcelain. In some cases, teeth may have to be removed, and replaced by artificial ones.

Orthodontia

Orthodontic treatment moves teeth by installing wire or plastic braces to slowly push or pull them into proper alignment with adjacent teeth. Treatment may take as long as two years, with periodic return visits to inspect, tighten and readjust the braces. Occasionally, it is performed along with jaw repositioning (orthognathic surgery). Tooth restoration or replacement may follow orthodontic procedures, after teeth have been moved into their proper locations.

Orthodontia Risks

Risks associated with orthodontic work include:
  • Problems with dental hygiene that lead to permanent marks on the teeth and tooth decay
  • Gums or cheeks can be injured when the braces rub against the soft tissue
  • After the braces are removed, the corrected teeth may move out of place
  • Teeth roots may shrink

Orthodontia Key Facts

Anesthesia: Typically no anesthesia is needed
Length of procedure: Braces may need to stay on teeth for up to 2 years
Length of stay: No overnight stays
Discomfort: Mild to moderate
Anticipate: Mild to moderate discomfort after each adjustment
Final result: After braces are removed
Duration of results: Long lasting

Restoration

Teeth can be built up and resurfaced through various treatments. Natural or synthetic bone material may be grafted to the jawbone to build up the facial and jawbone contours. Surfaces of individual teeth can be covered with an artificial material such as porcelain. The tooth can be built up using another material onto which the new surface is applied. Teeth may need to be strengthened to serve as anchors for replacement teeth.

Restoration Risks

The risks associated with tooth restoration may include:
  • An allergic reaction to local anesthesia
  • Need for further treatment such as root canal therapy, gum recontouring, or tissue grafting

Restoration Key Facts

Anesthesia: General anesthesia or local anesthesia with IV sedation for some procedures
Length of procedure:
Length of stay: Typically return home the same day
Discomfort: Mild to moderate
Anticipate: Mild to moderate soreness in the jaw and mouth
Final result: Within months for restorations, slightly longer for restorations on dental implants
Duration of results: May need replacement at 10-year intervals on average

Tooth Replacement

Sometimes teeth are missing or must be removed because they are too weak to support artificial teeth. Replacement teeth may be installed either as a removable bridge, which is held by surrounding permanent teeth, or permanently implanted onto a metal post (dental implants). The metal post (an osseointegrated titanium implant) is implanted into the jawbone and allowed to heal for several months before installing the tooth or teeth onto it.

Tooth Replacement Risks

The risks associated with dental implant tooth replacement include:
  • Intolerance of anesthesia
  • Infection at the implant site. If infection occurs after a post implant, the implant may have to be removed.
  • Loss of bone or soft tissue adjacent to implant requiring further corrective surgery
  • Swelling and discoloration for 7 to 10 days

Tooth Replacement Key Facts

Anesthesia: General anesthesia or local anesthesia with IV sedation
Length of procedure: One to two hours
Length of stay: Usually return home the same day
Discomfort: Mild to moderate
Anticipate: Bruising and soft tissue swelling
Final result: 4 to 18 months after tooth has been attached to bridge or post
Duration of results: Long lasting, in comparison to conventional tooth replacement

Treatment is performed by specialists from Dental Specialties and Oral and Maxilliofacial Surgery.