Improving Your Smile
Bleaching :: Bonding :: Crowns :: Veneers :: Reshaping and Contouring

If you have ever been unhappy about the "look" of your smile, you may want a consult regarding ways to improve your appearance by restoring broken, discolored, or misshapen teeth. The psychological importance of cosmetic dentistry should not be underestimated, as it can greatly improve a person's self-image and quality of life. Some of the procedures which can improve your smile are: placing complete ceramic esthetic crowns or "caps" onto teeth, placing veneers (a very thin porcelain "shell") onto teeth to conceal defects, using bonding technology on a tooth's surface to change its shape or to close gaps, and bleaching discolored teeth to brighten and whiten a smile. Click on the links above for pictures and more information.

What Americans Say About Their Smile...

A healthy-looking smile ranks among the top three aspects of a person's appearance that affect self-esteem. Thanks to Advances in modern dental materials and techniques, Dr. Belote can help you attain the smile you've always wanted. From subtle changes to major repairs, we can reshape your teeth, close spaces, restore worn or short teeth or alter the length of your teeth. These improvements are not always cosmetic. Many of these treatments can improve oral problems, such as your bite. Read more about the procedures, and ask us what is best for you.

Bleaching--Back to Top
Your wedding is coming up and you want your smile to be its brightest. Or maybe you have an important speaking engagement. Whatever the reason, tooth bleaching isn't just for the movie stars, and it isn't just for one day. Bleaching is a common and popular chemical process used to whiten teeth. Discoloration occurs in the enamel and can be caused by medication, coffee, tea and cigarettes. It can also be caused by your genetic make-up or simply getting older. Generally, bleaching is successful in at least 90 percent of patients, though it may not be an option for everyone. Consider tooth bleaching if your teeth are darkened from age, coffee, tea or smoking. Teeth darkened with the color of yellow, brown or orange respond better to lightening. Other types of gray stains caused by fluorosis, smoking or tetracycline are lightened, but results are not as dramatic. (Bleaching can only provide a shift in color from gray to a lighter shade of gray.) If you have very sensitive teeth, periodontal disease, or teeth with worn enamel, your dentist may discourage bleaching. Bleaching does not lighten artificial materials such as resins, silicants, or porcelains.

Bleaching can be performed by your dentist in the office or, under dental supervision, at home. The procedure is a very conservative, cost-effective way to immediately impact your smile. It will improve the color of your teeth, but not change their shape or arrangement. Most teeth will bleach 2 or 3 shades lighter than their original color. Some stains respond to bleaching better than others. We will diagnose if you are a good candidate for bleaching. We can guess what shade your teeth will be after bleaching, but there is no way to accurately predict your outcome.

At home: We create a custom mouthpiece to ensure the correct amount of whitening solution-10 percent to 20 percent carbamide peroxide-is used and that your teeth are properly exposed. Typically, whitening at home takes two or three weeks, depending on the desired shade you wish to achieve.

Laser (in office): The laser bleaching is completed in the office using stronger bleach and a laser light to speed the process. This allows for a better and more immediate result. The laser bleach is very strong. We take many precautions to avoid bleach touching your gums. Often, some bleach will touch your gums during the procedure, causing a slight pinching sensation and a white appearance to the gums for the next hour. Some people experience temperature sensitivity during the procedure. We want you to tell us if you experience discomfort during the procedure.

Combination bleaching: The laser bleaching can be followed with home bleaching consisting of trays that you wear for 2-6 hours/day for 2 weeks. (Home bleaching may be done without the laser treatment.)

How does it work? The active ingredient in most of the whitening agents is 10 percent carbamide peroxide (CH4N2O2), also known as urea peroxide; when water contacts this white crystal, the release of hydrogen peroxide lightens the teeth. Lightness should last from one to five years, depending on your personal habits such as smoking and drinking coffee and tea. At this point you may choose to get a touch up. This procedure may not be as costly because you can probably still use the same mouthguard, and retreatment time is less than the original treatment time.

Is it safe? Several studies, during the past several years, have proven bleaching to be safe and effective. The American Dental Association has granted its seal of approval to some tooth bleaching products. Some patients may experience slight gum irritation or tooth sensitivity, which will resolve when the treatment ends.

Any side effects? Temperature sensitivity is sometimes a complaint after bleaching. The number of patients that report unusual sensitivity to carbamide peroxide tooth-whitening products is very low. Sensitivity can be managed easily by altering the at-home regimen: Daily use of fluoride in the bleaching trays, bleaching fewer hours per day or every other day, and Alternative Treatment Home bleaching can be done alone.

Bonding--Back to Top

Bonding can work wonders for your smile. Using materials that match the shade, translucency and the texture of your teeth, gaps between teeth can be closed, spots and discolorations can be eliminated, and your self-confidence can be enhanced through the improved appearance of your smile. This material can be used on the anterior (front) teeth or posterior (back) teeth. The procedure is sometimes referred to as bonding is because an adhesive agent is used to actually bond the resin to the tooth structure. When teeth are chipped or slightly decayed, bonded composite resins may be the material of choice. Composite bonding is excellent for small defects in the teeth -- spots, chips, or gaps between teeth. For smile alterations involving an entire tooth or multiple teeth, porcelain is the material of choice.

Requiring a single office visit, bonding lasts several years. However, bonding is more susceptible to staining or chipping than other forms of restoration. Bonding also is used as a tooth-colored filling for small cavities and broken or chipped surfaces. Additionally, it can be used to cover the entire outside surface of a tooth to change its color and shape.

Crowns--Back to Top
Crowns, also known as caps, are used in cases where other procedures will not be effective. Crowns have the longest life expectancy of all cosmetic restorations, but are the most time consuming.

Crowns range from full coverage conventional crowns, to conservative onlays or partial crowns. A crown is recommended when there is not enough tooth structure to predictably hold a filling. Crowns are imperative after root canal therapy. Often, crowns are recommended as a better alternative to fillings, or as a preventive measure when there is already a filling in place.

Alternative Treatments:
A filling may be an alternative; often a crown is the only choice to save the tooth. If decay is present, and you choose to do nothing, decay will grow, eventually causing pain, more expensive treatment and or tooth loss. If a preventive crown has been recommended, that tooth is at risk to fracture until treatment is provided.

**Crowns Can Now be Placed in a Single Visit with CEREC2
· The dentist performs the restoration in a single session, usually less than 1 hour.
· No need for a temporary crown that can come off or break requiring additional visits.
· No need for a second visit to deliver the crown.
· The restoration is natural looking, as it is made out of tooth-colored ceramic.

Our office is equipped with an instrument called CEREC 2, allowing us to make and install crowns in one visit. A conventional crown can take 2-10 visits. Here’s how it works. First, Dr. Belote prepares the damaged tooth by painting a thin layer of reflective powder on the tooth surface. Using a special camera, she then takes a picture of the tooth. This eliminates the need to make a messy impression. Dr. Belote works from this photo, which is actually a pin sharp optical impression of the tooth. Using computer technology, she is able to design the crown from the optical impression. Because the design is done chair-side on a color monitor, the patient can watch the design take place. They can also watch as the crown is made. The crown is made out of a block of ceramic material that matches the patients tooth color. It takes about eight minutes. After that, Dr. Belote bonds the newly milled crown to the tooth using an adhesive. In addition to partial and full crowns, veneers and all other single tooth restorations can be made. It’s a win-win situation for the patient and the dentist. Despite the $75,000 price tag, Dr. Belote says her patients won’t see any increase in her fees. The CEREC system was developed in Europe and introduced to the US in the late 1980’s. An updated version is now in place. Over 2 million restorations have been placed worldwide.

How is a crown placed?
A crown is a simple procedure. The decay or existing restoration is removed, and a porcelain or gold crown is made to very accurately fit your tooth. You should be comfortable during the procedure. An impression of teeth and gums is made and sent to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown is made. On the next visit, the dentist removes the temporary crown and cements the permanent crown onto the tooth.

Will it look natural?
Yes. The dentist's main goal is to create crowns that look like natural teeth. That is why dentists take an impression. To achieve a certain look, a number of factors are considered, such as the color, bite, shape, and length of your natural teeth. Any one of these factors alone can affect your appearance. If you have a certain cosmetic look in mind for your crown, discuss it with your dentist at your initial visit. When the procedure is complete, your teeth will not only be stronger, but they may be more attractive.

Why crowns and not veneers?
Crowns require more tooth structure removal, hence, they cover more of the tooth than veneers. Crowns are stationary and are customarily indicated for teeth that have sustained significant loss of structure, or to replace missing teeth. Crowns may be placed on natural teeth or dental implants.

How long do crowns last?
Crowns should last approximately 5-8 years. However, with good oral hygiene and supervision most crowns will last for a much longer period of time. Some damaging habits like grinding your teeth, chewing ice, or fingernail biting may cause this period of time to decrease significantly. Besides visiting your dentist and brushing twice a day, cleaning between your teeth is vital with crowns. Floss or interdental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown area where the gum meets the tooth.

Post-op instructions:

1. You may experience some discomfort and temperature sensitivity. Deep decay will cause stronger symptoms, possibly even the need for root canal therapy.

2. Your gums may be tender, use topical numbing agents.

3. If your bite feels high, you may need a bite adjustment.

4. Be careful not to chew your cheek or tongue while you’re numb.

5. If you have any questions or concerns, contact our office 24 /7.

Additional Fees and Procedures:

1. About 5% of the time, a tooth that needs a crown will need root canal therapy during or after crown treatment. In other words, any tooth that needs a crown is a candidate to need root canal therapy. We try to avoid root canal therapy whenever possible.

2. In some cases we have to perform a surgical procedure on your gums using an electrosurgery unit. The gums will require healing time if this procedure is performed. 

3. Small changes in your bite can trigger pre-existing problems in your joint to lead to joint dysfunction.

4. No medical or dental treatment has a 100% success rate. Treatment can fail, requiring additional procedures to be performed. The tooth can decay around a crown, porcelain can fracture, abrasion can wear a hole in a crown… Most people can expect to replace crowns in their lifetime.

5. Diagnostic techniques are limited and a tooth may require additional, unanticipated treatment.

Tooth reshaping and contouring is a procedure to correct crooked teeth, chipped teeth, cracked teeth or even overlapping teeth in a single session. Tooth reshaping and dental contouring, is commonly used to alter the length, shape or position of your teeth. Contouring teeth may also help correct small problems with bite. It is common for bonding to be combined with tooth reshaping. This procedure is ideal for candidates with normal healthy teeth, but who want subtle changes to their smile. Your dentist will take X-rays to evaluate the size and location of the pulp of each tooth to ensure that there's enough bone between the teeth to support them. Which procedure is right for me? Your dentist can answer many of the questions you may have about techniques used to improve your smile. The condition of your teeth and desired result you want often dictates the best procedure. If you are considering a treatment, there are a few questions you can ask your dentist before deciding if a particular procedure is right for you. What will the changes look like? What should I expect through the course of treatment? What type of maintenance will be required? Your dentist will answer questions you may have about the procedure, maintenance and price to help you choose the treatment that best suits you.

Veneers--Back to Top

Veneers are placed over the front teeth to change color or shape of your teeth. They are used on teeth with uneven surfaces or are chipped, discolored, oddly shaped, unevenly spaced or crooked. Veneers are thin pieces of porcelain or plastic cemented over the front of your teeth. Little or no anesthesia is needed. Veneers are used to treat some of the same problems as bonding. This treatment is an alternative to crowns, which are more expensive.

The procedure requires your dentist to take an impression of your tooth. Before the custom-made veneer is glued directly onto the tooth, your dentist will lightly buff the tooth to compensate for the added thickness of the veneer. Once the cement is between the veneer and your tooth, a light beam is used to harden it. Porcelain veneers require more than one visit because they are fabricated in a laboratory. Veneers have a longer life expectancy and color stability than bonding.

About Porcelain Veneers: The placement of porcelain veneers is a process of removing a small amount of tooth structure from the front of the tooth, so we can place a layer of porcelain to cover discolored or misshapen teeth. Porcelain is the most beautiful of dental materials. It mimics the color and translucency of tooth enamel. Veneers are longer lasting than cosmetic bonding, and can cover more esthetic problems than bleaching or bonding. Because we do remove some tooth structure in this process, you will have to be committed to taking care of your veneers for your lifetime. Porcelain is resistant to fracture and staining, although sometimes a veneer may need to be repaired or replaced.