Our case of the month for October is a tooth whitening case using one of our most popular techniques: take home trays. Teeth whitening is the most popular cosmetic dental treatment. Having whiter, brighter teeth that look clean and healthy is desirable and confidence boosting. The treatment is available to all with their own teeth!
  

THE PROCESS

1. A full clinical examination is required prior to any cosmetic dental procedure.
2. It is highly advised that you visit the hygienist prior to any tooth whitening procedure.
3. Impressions are then taken of your teeth. 
4. The specially made trays are fitted and a demonstration is required to show how to use the whitening gel properly. 
5. The trays and gel are worn for 1 hour a day over 2 weeks. 
6. Whiter teeth! 
7. The trays and gel can be used as a top up over the following months/ years. A typical example is presented below:
 

In general, we adopt a metal free policy wherever possible. This is especially the case at the front of the mouth where aesthetics are highly important. We now routinely use all ceramic crowns for front teeth. The great advantage of these crowns is that with no metal, the aesthetics are excellent and there is no issue with the dreaded 'black' line visible at the gum level. The photograph below shows a super close up view of some front teeth. One of them has an all ceramic crown. Can you tell which one?
 

Our case study is one involving cosmetic bonding of the front teeth. Cosmetic bonding is the NON INVASIVE answer to repair worn, fractured or spaced teeth. The technique requires no drilling, no needles and no pain! Our patient was unhappy about her front teeth due to the severe wear present at the edges. This was due to night time grinding, which is a very common problem. Dr Nissit Patel strongly believes in minimally invasive dentistry and therefore ruled out porcelain veneers or similar techniques which remove healthy tooth enamel. Cosmetic bonding was prescribed and the results can be seen below:
 

We pride ourselves on being progressive and leading the way in modern cosmetic dentistry. In the old days, cosmetic dentistry was more about being invasive and cutting healthy tooth enamel for multiple veneers or crowns. Due to the advances in technology and materials this has all changed. These days, if a tooth does need a veneer or crown, then we will match this tooth with the other teeth as best as possible. This way, the adjacent teeth do not need to be harmed in anyway. Here is a classic example. Our patient required a front tooth crown. After some tooth whitening, a new crown was made in all ceramic. Just look at the result:
 

In the past, back teeth that required crowns or large fillings were given gold restorations. This was a sensible decision given that back teeth are used for chewing food and any crown or filling must therefore be able to withstand the high forces. Gold is an excellent material as it is extremely strong and biocompatible. However, it looks like gold and not like a tooth! Due to advanced in modern dentistry and materials, we are now able to provide back crowns that are completely tooth like and contain NO metal. These are called all ceramic crowns. They are also biocompatible and very strong. One example we like to use at Progressive Dentistry is the E-max crown. 

Below is an example of replacing a gold crown with an E-max all ceramic crown:
 

One of the most popular cosmetic treatments in 2013 is the Social 6 lingual brace. This is a brace that is fitted to the INSIDE of the teeth, making it truly invisible. As it is fixed, there are no compliance issues and the technology of the system means that a wide variety of movements can be achieved. 
 

FEATURES OF THE SOCIAL 6 BRACE

1. As the name suggests, it is placed on the front 6 teeth only. 

2. The aim is to correct the front 4 teeth, the canine teeth act as the anchors. 

3. The usual time frame is very quick, from 6-24 weeks. 

4. It is completely invisible to the eye. 

5. The technology of the wires means that very light but constant forces are applied, which means LESS pain. 

6. The treatment is a complex and skilled procedure and not readily available at most dental practices.
 

CASE STUDY

Below is a recent example of a case treated by Dr Nissit Patel at Progressive Dentistry using the lingual braces:
 

Spaces between teeth can be unsightly and affect self confidence. A space between the very central teeth is often a fashion statement. Famous celebrities such as Madonna and Vanessa Paradis are recognised by their gap. However, spaces behind the lateral incisors are not so attractive and are often associated with the Great British Smile. We have a classic example below:
 

We believe in the least invasive techniques to create beautiful smiles. If you have crooked teeth, overlapping teeth or teeth that are out of alignment then they SHOULD NOT be cut down for veneers or crowns. This is destructive and will cause harm in the longer term. Due to the advances of cosmetic dentistry, teeth can now be straightened discreetly and quickly to enhance your smile and improve oral hygiene. One of the most popular techniques we use is the lingual brace, which is the truly invisible brace as it sits on the inside of the teeth. Our case study highlights a wonderful result achieved with a lingual brace to straighten crooked lower front teeth.
 

Teeth straightening is now a very popular treatment to improve the cosmetic appearance and why not! If teeth are crowded, out of alignment, suffer from spacing issues then they should be treated with orthodontics such as invisible braces. One of our most popular invisible braces is the lingual brace. This is placed on the inside of the teeth making it the truly invisible brace. If the thought of fixed braces on the outside of your teeth fills you with fear, then this is the solution for you. Dr Nissit Patel has a great deal of experience in invisible braces and lingual braces. A case study is presented below: