By Dr Lawrence Spindel, Friday July 3, 2009

Cosmetic Dentist New York                    


As a Cosmetic Dentist practicing in Manhattan for over twenty years I have placed a large number of cosmetic dental restorations. Most of these were made of either bonded dental composite, porcelain, or a combination of these two materials. Although they can be durable restorations they sometimes can chip, break or stain.  With that in mind you can help keep these restorations in their best condition by doing a few  simple things.


Plaque Control is extremely important to maintaining esthetic restorations. Dental plaque can cause bonding to become porous and to stain internally. Patients with poor oral hygiene often have to replace their bonded fillings,and porcelain veneers more often than patients who brush and floss well.


Also patients with good oral hygiene often exhibit less gingival recession due to the  long term effects of periodontal inflammation Patients with chronically poor oral hygiene seem to experience more gingival recession. A common reason that patients choose to replace their porcelain veneers is their gingival margins have receeded 1-2 mm and the exposed tooth structure is a different color than their porcelain restorations.


Another common reason that esthetic dentistry needs to be replaced is breakage. There are a few simple things to keep in mind if one wants to minimize breakage of cosmetic dental restorations. First off avoid chewing hard  things that need to be ‘cracked. Breaking shells, chewing on ice cube, or cracking bones or jaw breakers can wreak havoc not only on your cosmetic dental restorations, but can harm your teeth as well.


Undue occlusal forces on porcelain or dental bonded restorations can be destructive and lead to there replacement. If you have porcelain anterior restorations, do not use your front teeth to chew your finger nails, bite on pencils, hold pins, or tear open packages. You should be able to bite into apples, fruit, and fresh bagels. Some very delicious but stiff baguettes may be challenging to some bonded restorations placed on the edges of teeth


Similarly Bruxing or grinding your teeth can lead to a fracture of a cosmetic restoration. If you have either of these habits, most cosmetic dentists recommend patients wear a well constructed night guard , that will protect the teeth and any restorations during sleep. Both Bruxism and Tooth Grinding can and do occur in sleep and the patient can be unaware of it.


Another cause of replacement of cosmetic restorations is the shifting of teeth. Most people are unaware that there teeth can slowly shift over time. This can occur whether their teeth are restored with cosmetic dental restorations or not.  If a patient has a number of dental restorations anteriorly and the teeth shift noticeably this can cause the smile to be less esthetic. Often when teeth shift, spaces (diastemas) between the teeth can become noticeable, teeth can appear longer or more prominent.


After I place porcelain veneers, or multiple porcelain anterior restorations, I usually recommend patients wear a night appliance as a retainer. This appliance can either be a occlusal night guard or an orthodontic retainer. Wearing either of these appliance will prevent teeth from any unwanted movements and also may prevent breakage.