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OK, I'm slightly exaggerating here... but especially if you live in the US, you may come across websites which offer cosmetic
dentistry to people who, in your or my view, are already blessed with perfect teeth. No need to feel (totally ;)) inadequate
- here's the low-down on what cosmetic dentistry is about!
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| � Mark Parisi - www.offthemark.com |
"Cosmetic dentistry" is the branch of dentistry dealing with the appearance (rather than the health, although the
two are obviously not mutually exclusive) of teeth. For example, "white fillings" can be considered cosmetic because
they look better, but at the same time, they're also "healthier" because they require the removal of less tooth
structure. And in complex cases, cosmetic dentistry can be a godsend, because other solutions which might be acceptable health-wise
are simply not as aesthetically pleasing or functional. Teeth whitening has caught on big time, and doesn't appear to carry
any risks apart from temporary sensitivity in some cases, but beware - teeth whitening or bleaching will not lighten existing
dental work such as white fillings, bonding, crowns, or bridges.
"Veneers" (waver-thin pieces of porcelain which can be glued over the front of the teeth, for example if teeth
are misshapen or severely discoloured not just on the surface) are quite often placed for purely cosmetic reasons, much like
plastic surgery. Because they require the removal of tooth structure, they're "unhealthier" than doing nothing (assuming
it's done purely for appearance's sake, although if you're very unhappy with the shape of your teeth, they're worth considering)
and the procedure carries some risk (and they will be need to replaced 10 or 20 years down the line). In that case, medically
speaking, unnecessary trauma is inflicted on teeth. People need to weigh up the risks and benefits of the procedure. It's
very similar to, say, breast augmentation - you may (or may not, depending on your views) reckon that implants with the sole
purpose of general enlargement are nonsense, but feel that implants are a good idea in the case of breast cancer. In summary,
"cosmetic dentistry" encompasses all dentistry that's not strictly necessary for health reasons, and much of it
is a matter of personal needs, preferences, and opinions.
Regardless of whether or not you are in favour of cosmetic enhancements (and if it's any consolation, there's plenty of
controversy about this within the dental community) - if you suffer from dental phobia, all this talk about cosmetic dentistry
can be a little spooky. After all, you'd be thrilled to bits if you could just get your teeth fixed... but no, seemingly that's
not enough... *sigh*...
Hang on a second! Those websites might lead you to believe that dentists are out en masse trying to make big dollars (or pounds,
or euros) by pushing people into "cosmetic dentistry". And true enough, they do exist - but they are in a minority.
Most dentists who offer cosmetic dentistry do so as an additional service for those who are really unhappy with their appearance.
To find out more, I ventured out and asked a leading cosmetic dentist for his opinion on the matter. Here's the answer:
"Cosmetic dentistry is usually not about health but about changing ones confidence in themselves. Sometimes it is done
to rebuild form and function and is necessary. Other times it is to help patients change things about there appearance they
could otherwise not change. No dentist in my opinion should push cosmetic dentistry, but should make available to patients
what is available and let them choose. Cosmetic dentistry is not for everyone. Only those people who desire change should
consider it (Richard Creasman DMD, Atlanta Center for Cosmetic Dentistry)".
You wouldn't have believed it from looking at their website (www.atlantacenterforcosmeticdentistry.com), but I must admit
- I couldn't have put it better myself!
So what's the story with replacing amalgam fillings?
Replacing existing amalgam fillings with white fillings has its pros and cons. On the pro side, obviously it looks more natural.
Many cosmetic dentists will also argue that it reduces the chance of undetectable decay leading to a silent destruction of
tooth structure until pain indicates the need for treatment, and that amalgam can expand over the years, possibly causing
a tooth to crack.
On the other hand, conservative dentists agree that every time you remove a filling, you remove a bit more tooth substance,
plus you insult the tooth with more trauma. Also, this may cause sensitivity for a while, and having a lot of amalgam fillings
replaced in one go may not be such an appealing idea after all. While x-rays alone aren't enough to detect possible decay
underneath old amalgam fillings, the statistics show that x-rays, careful eye exams and a probe detects most decay. At which
point you should have the filling replaced.
Amalgam fillings can last for a very long time (some sources estimate 14 - 40 years), so the very fact that you have a mouthful
of them and haven't seen a dentist in a while doesn't mean that they all need to be changed. A conservative dentist will not
replace fillings that don't need to be replaced.
For more information on white fillings, which are the method of choice if done properly, visit Dave Hall's website: White Composite Fillings Compared with Amalgam Fillings.
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