Frequently Asked Dental Questions
NYC Cosmetic Dentists Serving Manhattan and New York, NY
Please read the questions below to learn about the treatment options available at NYC Smile Design:
- Do You Perform General Dentistry or Only Cosmetic Dentistry?
- What Can Be Done to Make Me Feel More Comfortable about Seeing the Dentist?
- Are You More Expensive Than Other Dentists?
- How Do I Choose a Cosmetic Dentist?
- Is There a Standard Beautiful Smile for All People?
- How Long Will It Take to Complete My Cosmetic Treatment?
- How Can I Get an Idea of How I Would Look with an Improved Smile?
- What Can I Do about My Uneven Teeth?
- How Long Does Cosmetic Dentistry Last?
- What Can I Do to Change Teeth That Are Too Small?
- How Can I Correct Severely Discolored Teeth from Tetracycline?
- I Have a Gap between My Two Front Teeth. How Can It Be Closed?
- I Have Buck Teeth That Stick Out. Is There Anything That Can Be Done?
- How Do I Know If Cosmetic Dentistry Will Help Me?
- What Are Porcelain Veneers/Laminates?
- Can I Preview What a Smile Makeover Would Look Like?
- Are Porcelain Laminates Different from One Office Than the Next?
- Will You Need to Cut My Teeth to Prepare for Veneers?
- I Don't Want Braces. Can I Still Have a Beautiful Smile?
- How Many Teeth Need to Be Veneered for a Smile Makeover?
- How Will My Teeth Feel after I Have Porcelain Veneers Placed?
- How Do I Take of My Veneers?
- What Is the Difference between Bonding and a Veneer?
- What Can Be Done to Fix Rotated, Misshapen or Chipped Teeth?
- Is It Possible to Change the Shape of My Teeth without Veneers or Crowns?
- My Teeth Look Shorter Than They Were When I Was Younger. What Happened?
- What Really Happens When We Age?
- I Don't Like My Crooked Teeth. What Are My Options?
- What Is Instant Orthodontics? Is There Pain Involved?
- What Are Porcelain Inlays/Onlays? Do They Replace a Crown or Cap?
- Can Anything Be Done to Correct a Gummy Smile Uneven Gumline?
- What If I Have Missing Teeth?
- Which Is Better, a Bridge or an Implant?
- What Is the Difference between Porcelain Fillings and Composite Fillings?
- What Are Caps and Crowns, and Is There a Difference between the Two?
- I Have a Crown That Has a Black Line around It and It Looks Awful. Why Is That?
- How Can I Make My Teeth Whiter?
- How White Should I Make My Teeth?
- How Can I Prevent Discoloration?
- Which Bleaching Method Is the Most Effective?
- Will Bleaching Hurt My Teeth? Is It Safe?
At our practice we focus primarily on cosmetic dental procedures such as:
However, we also perform a full range of general dental procedures such as cleanings, periodontal therapy, white fillings and implants. It is our practice philosophy that looking and feeling great and having healthy strong smile go hand in hand.
Our office is especially cognizant of the fearful patient. Making your experience with us a truly calm and comfortable one is our priority. We understand that each patient’s experiences, both past and present, are truly unique. A patient manner and gentle touch can be expected by all members of our team. In addition, we offer music CDs, DVD movies, noise cancellation headphones, nitrous oxide gas, anti-anxiety medication and sedation dentistry to help our patients get the care they want and need.
Our fees are comparable to similar cosmetic dentists who rank as one of the best. However, our fees are not necessarily higher and in many instances it may be lower. We feel price shopping for cosmetic dentistry can be disastrous. No two cosmetic dental offices are alike. The level of expertise, knowledge and technology can set one apart from the rest.
Before making a decision on cosmetic dentistry, we urge you to come and experience what makes us unique.
Choosing the right cosmetic dentist is a very important question. Ask your dentist about his or her training and credentials and the level of experience they have in smile makeover dentistry.
At this time, cosmetic dentistry is not recognized as a specialty like orthodontics or periodontics. However, it is a branch of dentistry that requires a thorough knowledge of science, technology and an artistic eye, as well as much practice and experience. The terms “cosmetic dentistry” and “smile makeover” have become trendy with all the makeover and reality television shows. Many dentists are promoting themselves as cosmetic dentists. Dentists who are commited and dedicated to the art of cosmetic dentistry have had specific training, credentials, experience and affiliations in this area.
Cosmetic dentists have a vast portfolio of their work and are willing to discuss them with you and show similar before-and-after pictures that resemble the same situation that you are trying to improve. A dentist’s skills and style can be understood by reviewing their portfolio of before and after photographs.
We are all unique, and the beauty of our smile should and does reflect this. This is what makes cosmetic dentistry truly an art and enjoyable creative challenge! Each person is different and their case must be planned carefully. The design of a beautiful and natural smile must consider the sex of the individual as well as be in proportion with the gum line, the lips and the construction of the face of the individual.
Each situation is unique and every client has their own particular issues that have to be addressed. However, on the average, bleaching will take about 1 ½ hours; crown and bridge will take 2 visits to complete and laminates 2 visits to complete. In cases where 2 visits are required, such as laminates, custom temporaries are fabricated that will look better than the teeth you came in with and will be designed to actually look very close to the final porcelain laminates that will be made for you.
By listening to what you want and taking notes we are able to mentally form a picture of what your smile can look like. To show you what we are seeing in our mind, we take a digital photograph of your face. Our Manhattan dentists then use graphic artist software to generate a computerized image showing you with various smile enhancements, such as whitening, shape and length changes.
Another way we can give you an idea of what you would look like with an improved smile is to fabricate a “wax-up” of your new smile. This is when we do the laminates on a duplicate model of your smile in order to see three dimensionally the changes in your smile. You can actually hold your before and after smiles in your hands to compare.
Are the teeth overlapping each other? Are there spaces between the teeth? Is the gumline too low or too high? Have the teeth worn away because of grinding? Depending on the answers to these questions and numerous others, a different approach may be necessary to correct the uneven look. After a smile consultation with our office we can get a general feel of what’s the best approach. Ultimately to accurately plan for the end result we will perform a smile makeover analysis.
This is a very important question, and one that is asked of us many times. There are two things that can have an impact on longevity:
1). Quality of the treatment. Delivering the best outcome requires a high level of meticulous attention to detail. For instance, one of the procedures we do frequently in our office is altering the smile with porcelain veneers. There are literally hundreds of steps along the way, and if one of them is overlooked, it can have an impact on longevity.
2). Condition of the teeth. We recommend custom fitted guards fabricated to help protect teeth from excessive wear. Home care and eating habits are critical in maintaining a beautiful smile. It’s important to avoid rough crunchy foods and biting on objects. Natural teeth can get just as abused in the same way if you are not careful. Meticulous attention to oral hygiene is very important.
To estimate time frames for different procedures we recommend you come in for a consult.
There are a number of ways to correct this problem, including porcelain veneers, crowns and bonding.
Tetracycline is an antibiotic used to treat a number of illnesses in adults and children. It causes severe staining in teeth if used in growing children and sometimes with prolonged use in the young adult. The teeth have a gray or dark brown appearance to them and often times dark bands run across the front of the teeth. Typically these teeth do not respond well to whitening procedures. Porcelain veneers are a truly beautiful answer to this problem. A once dark and unattractive smile can be a brilliant and beautiful white one.
There are a number of ways to correct this problem, which may include one or more of the following:
- Porcelain veneers
Absolutely. And sometimes the solution may be as simple as recontouring and reshaping the teeth which will take one painless visit to complete. Some situations may require braces with Invisalign® to correct. Many instances of buck teeth have been corrected with porcelain laminates. In rare instances we may to do a combination of Invisalign® repositioning of teeth and porcelain veneers if the shapes of the teeth are not harmonious with each other and the facial proportions.
Since each situation is unique, we’ll have a better idea what is necessary after a cosmetic consult.
Are you happy with your smile? Could your teeth be whiter or straighter? Do you have chipped or broken teeth? Do any of your teeth appear too small or too short? Do you see black margins around your existing crowns? Do you refrain from smiling in photos? Does the thought of having to meet new people and smile make you anxious? If you answered "yes" to any of these questions, then cosmetic dentistry may be for you.
Porcelain veneers or laminates are thin shells of porcelain bonded over the front surface of the teeth. They are long lasting, stain-resistant and the most natural looking type restoration. Porcelain is very versatile; it can lengthen, widen and whiten existing teeth. Porcelain looks very similar to a tooth's natural enamel. They are the least invasive type of restoration. We customize the color, saturation and gradation, shape, anatomy and degree of whiteness to whiten and brighten teeth naturally, painlessly and in as little as two-four days.
Porcelain veneers can be placed on misaligned crooked teeth to give the appearance of perfectly straight teeth- instant orthodontics. Porcelain veneers can cover stained, discolored teeth or be applied to whiten and brighten the entire smile. We can bond longer porcelain veneers to worn or chipped teeth to make them look younger and stronger. Or they can be made to match the surrounding existing teeth, too.
Absolutely. Without any vision of what the result will be, the journey is very treacherous.
What we do in our office is listen to your wishes and based on our knowledge of facial forms and tooth size proportions we determine what smile works best for you. Then with cosmetic imaging we get a preview of the end result. Then we create a waxup of the teeth to our specifications. This is the ultimate blueprint which is lifelike.
We truly believe that cosmetic dentistry is a seamless blend of science and art. One is completely dependent on the other. Not having knowledge of science or the education needed for the foundation of every cosmetic case is a situation waiting for disaster. Porcelain can be very different from one office to the next. But more importantly, the expertise and artistry is what can be very different from one office to the next.
Here are a few examples that we believe make porcelain laminates from one office superior over another:
- Not preparing the teeth for the laminate properly
- Overpreparing or underpreparing the teeth
- The level and symmetry of the gum line not addressed
- Using an inexperienced ceramist
- Using an experienced ceramist but not giving them what they need to create the best laminates
- Not determining before starting how the teeth should look in the new smile
- Poorly bonded porcelain
- Not completely removing the excess bonding material between the tooth and laminate interface
- Porcelain laminates were not properly layered and looks like a block of white tooth
These are just a few examples of what is important to not overlook. We encourage you to visit our office for a consult to see what sets us apart. We believe you’ll find us to be the right office for your cosmetic needs. We also encourage you to view our portfolio of before and after cases and to speak to our clients who have already had cosmetic dentistry done in our office.
Porcelain veneering is unlike preparing teeth for crowns. Only a thin layer of enamel, anywhere from .5-.8 mm, is removed to make room for veneers. This small reduction of teeth allows us to create a smile that is natural and not too bulky and sticking out.
You probably have seen people who have had bulky veneers placed and it looks like chicklets. The genius of a beautiful smile design is that no one can tell what was done but they know your faces looks better. Many of our clients have told us their friends have noticed a change but are unable to determine what the change comes from. Their friends ask them “ what did you have done you look great?!”
We get this question asked a lot. More than likely, yes. There are times where we had no choice but to resort to both options. If teeth are so misaligned we must first move them gently into position before veneering them. Only with careful analysis of tooth proportions and jaw dimensions are we able to determine that for certain.
We have been able to help so many people who had absolutely refused braces without compromising the end result. Braces is not for everyone either. For various reasons sometimes braces would not even be the right choice to make a smile beautiful.
A lot depends on how broad the arch is when smiling or how broad we would like the arch to appear to make a dramatic result. In this makeover design, at least 8-10 veneers need to be placed. Often times veneers are placed to correct a problem on one or two teeth and the rest of the teeth in the arch are absolutely perfect and all we need to do is match the new veneers to the existing smile. This is actually one of the most difficult tasks which requires a high level of understanding of science and art to blend the two dissimilar situations seamlessly.
Normally, there is some sensitivity to be expected, hot and cold and biting pressure. This will be a short period of time when the teeth are adjusting to the new environment and it’s absolutely normal to feel that. After your veneers are placed we have you come back in one week to make a few minor adjustments and finalize the polishing.
Porcelain veneers, when properly contoured feel so natural and smooth that most clients say that their teeth feel so much smoother. There is a good reason for that. Porcelain does not scratch very easily and the good part is that plaque does not adhere well to porcelain like it does to natural teeth, so the gums look and feel really great.
As far as diet restriction, there are none. A normal diet poses no problem on veneers. It is important to avoid crushing ice between teeth or chewing hard candy as it should be with natural teeth. The gentler the chewing forces, the longer the veneers can last.
As far as home care, we will recommend individualized products to rinse and brush with. We will suggest non-abrasive and effective products that will poilish the laminates, maintaining their luster and brilliance. We also recommend a night guard after veneers are placed, especially if the bite forces are high or there is grinding of teeth at night.
Bonding is tooth colored plastic material that is placed over missing parts of teeth or when trying to close gaps on front teeth. A porcelain veneer is a strong porcelain lab fabricated restoration. Bonding is also an ideal filling material for back teeth for small cavities or replacing small metal fillings.
One of the problems with bonding is that it can change color and requires more frequent replacement. Because bonding is a plastic material, it is easier to break and chip. The advantage of bonding is that it can be done in one visit and is less costly than placing porcelain veneers.
Veneers, on the other hand, never change color so it can permanently stay the same. They are extremely strong and durable. They become seamlessly integrated with the tooth. Porcelain veneers repel plaque better than natural teeth so the gums look extremely healthy. The whole make-up of the smile can be completely changed to enhance and complement the unique facial characteristics.
The long term restoration of choice is porcelain veneers. A less expensive but less dramatic option in certain cases may be bonding. Done properly, both veneers and bonding can be applied, color matched and shaped to make your teeth appear natural again.
The shape of the face affects the shape of the teeth. For example, if a patient has a round face, we create long square-shaped teeth that give the illusion of a longer face, thus a slimming effect. Porcelain veneers are ideal for changing the shape of teeth, and you can lighten the color at the same time. If you have existing dental work or very misaligned teeth you can still change the shape of your teeth but you may need orthodontics, a reshaping of your gumline or crowns to achieve the desired results.
Reshaping or cosmetic contouring is an ideal treatment for very small fractures or chips or to simply reshape what nature has given you to a more esthetically pleasing smile. Anesthesia is not necessary since we use sandpaper discs and polishing wheels to reshape teeth with a minimal loss of tooth structure. Contouring can change the smile line. If one front tooth is a little longer than the other, contouring can make them the same size. We can round off sharp corners of teeth or pointed canines, to soften their appearance. Smile symmetry can also be achieved with cosmetic contouring.
When teeth look short, it is often the gumline that is the problem. Gum quantity, shape and color greatly influence the cosmetics of your smile. Since your lips frame your smile they too play an important role in your smile's appearance. If they come up too much, it may give you a gummy smile making your teeth appear too short.
We use something called the golden proportion to measure the ideal, more esthetic length your teeth should be. The solution is to reshape the gums to reveal more of your teeth. If the gumline is not the problem, porcelain veneers can add length to short worn teeth, making them look younger and stronger. The golden proportion is used to measure the ideal length your teeth should be made.
Most people don't realize that teeth are so important to maintain a youthful look. The intricate and complex relationship (interplay) between teeth, bone and muscle tone is rarely discussed. Healthy long teeth have strong bone surrounding them and strong muscle tone and always maintain a youthful look at any age. Many people have had facelifts and other corrective facial surgery to help them look younger. But if the smile with a rejuvenated face reveals discolored, crooked, chipped or fractured teeth, the youthfulness created by the plastic surgeon will be lost. A well-maintained smile is a necessary part of a better, younger look.
As we age:
- Teeth get short.
- Teeth get crooked, especially on the bottom.
- Teeth get very dark and stained.
- Gums recede and, we start seeing spaces forming in between teeth.
- The amount of bone around teeth thins out.
With these changes to teeth, we see important changes in muscle tone:
- The muscles around lips begin to sag, giving a sunken-in appearance.
- The skin around the lips begins to wrinkle since the support mechanism is lost.
- The lip tissue flattens out and may curl over shortened teeth.
What can be done:
- Wrinkles can be reduced if lips are plumped out with collagen, a procedure that must be repeated throughout your lifetime every few months if you wish to maintain a certain look.
- Wrinkles around the lips can also be reduced when the upper portion of a normally paper thin veneer is thickened. We build out the veneer and, as a result the facial area above the veneer is pushed out, thereby smoothing upper lip wrinkles while causing lips to appear more full and pouty and give a Kim Basinger pouty look.
- Longer veneers can be placed to lengthen teeth and give that youthful Halle Berry look and actually push out the lower lip, reducing the appearance of wrinkles.
- Teeth can be instantaneously straightened with paper thin veneers that will create symmetry to crowded and crooked teeth.
- Teeth can be permanently whitened to any shade you desire with shaded veneers that will never stain or darken with age.
- If you smile and all you see are your six front teeth, none of the back teeth, then your upper jaw is so narrow that back teeth are hidden. This of course can be corrected with invasive jaw expanding surgery or you can place veneers that widen the width of back teeth giving the appearance of an expanded jaw instantaneously and conservatively. This will improve the support and muscle tone of your cheeks and give you that Julia Roberts' smile.
All of this can be accomplished in 2 painless visits.
Orthodontics for adults is very common today. Approximately 30% of our adult patients are currently receiving orthodontic treatment. You can move teeth to align them with traditional metal braces, or ceramic braces or with the invisible Invisalign® system. Removable orthodontics is also available for certain cases.
Another option for giving the appearance of straight aligned teeth is to use porcelain veneers or laminates. The veneers will fill in spaces, giving an impression of perfectly aligned teeth. We refer to this as instant orthodontics. Whereas traditional orthodontics may take 1-2 years to complete, instant orthodontics can take as little as 1-2 visits.
With modern dental technology, uneven teeth can be reshaped and laminated with high tech ceramics. We call this instant orthodontics, using veneers or laminates instead of braces to make teeth look straight. It can close large gaps and correct overcrowding in as little as 1-2 days. It is typically a pain free procedure requiring only the use of local anesthetics.
You are a candidate for this if you would like your teeth to look straighter and cannot commit to the time for conventional orthodontics. The extent to which this approach can be used depends on how crowded and crooked the teeth are to begin with. Sometimes a combination of limited traditional orthodontics and ceramic enhancement may be the best choice.
Porcelain inlays and onlays are custom lab fabricated restorations that are placed in teeth that are too broken down for a filling to be placed. They are extremely esthetic and natural looking and help hold a badly broken down tooth together, actually strengthening it. In some cases they can be used instead of a crown or cap as a more conservative approach to restore a broken down tooth.
Gum quantity, shape, symmetry and color greatly influence the cosmetics of your smile. Since our lips frame the smile they too play an important role in your smile's appearance. The lips and gums should be in harmony. If your lip comes up too much it may give you a gummy smile. The solution is to reshape the gums to reveal more of your teeth.
Artistic sculpting of gum tissue can make a dramatic improvement in one's smile. The healing time is very rapid and predictable.
There is no reason to live with missing teeth. A full set of teeth improves self-esteem, speech, digestion, and sense of taste. It makes all the other teeth last longer by reducing the stress on the remaining natural teeth.
Those patients who suffer from temperomandibular disorders (TMD) often are unable to become pain-free without a full set of teeth to balance musculoskeltal and dental forces.
They each have advantages and disadvantages. We are not advocates of one treatment over another. Since any cosmetic situation that involves a missing tooth presents its own challenges and circumstances, careful and well thought out plans will give the best outcome.
The advantage of an implant is that it will permanently replace a tooth since it’s anchored in the bone with a crown placed on top of it. A disadvantage of implants is that it can take at least 6-8 months to complete.
Bridges are not anchored into the bone like implants are, but they are anchored to adjacent teeth. This will require preparation of teeth for crowns. If you have teeth that do not have any fillings in them or they are minimally restored you might not want to put crowns on them for a bridge. In this case it would be better to do an implant. But, the advantage of having a bridge as opposed to an implant is that it is fairly quick and can be completed in a few short weeks. Bridges can be done with an all porcelain system so that they can look beautiful. If the adjacent teeth are getting weak from poor bone support or excessively large fillings, having a bridge in place will give the teeth more support.
With the all porcelain systems, teeth can be prepared for bridges more conservatively than before. Another disadvantage of having a bridge is that the teeth that are anchoring the bridge can no longer be flossed. An implant supported crown is a separate unit and is flossed like your own teeth.
Porcelain fillings, also known as inlays and onlays, are laboratory processed and therefore require two visits to complete. They are extremely strong and durable and they seamlessly blend with the tooth.
Composite fillings on the other hand are placed directly over a tooth and won’t require a secon visit. They are the perfect filling material in a replacement of a small metal filling or small cavities. They are also less costly than porcelain inlays and onlays. However, since they are plastic mixture filled with small glass particles they cannot withstand heavy biting forces or in replacement of large metal fillings. They can chip or fracture in these situations.
If this is the case, the best filling material would be porcelain inlays and onlays since they have improved fracture toughness and are more capable of withstanding daily chewing forces.
A cap or crown are they same thing. They refer to complete coverage of the tooth. They are generally necessary when teeth have gotten weak from previous large fillings to protect them from fracturing or teeth that have fractured and now they need support. Crowns are also placed on top of implants or on teeth that have had root canal treatment. Crowns are placed to make a bridge.
This is caused by the underlying metal lining of the crown which makes the tooth look artificial and fake. Contemporary cosmetic dentistry affords us to completely avoid this unsightly problem. When it is absolutely unavoidable to use crowns, we prefer to use all porcelain crowns. The strength of this crown is similar to the metal lined porcelain crowns and some even suppress that.
All porcelain crowns allow light to pass through just like the enamel on teeth does. When the porcelain is artistically layered to fabricate a crown it will look natural and no one can tell a cap was placed over the tooth. When the tooth is prepared properly and the correct ceramic is used for the all porcelain crown, teeth will not only look real, they can actually look better than the original shape and color.
We find that many of our patients are displeased with the color of their teeth. While enamel is the strongest substance in our body, it is porous and can stain. Culprits include:
- Cranberry juice
- Red wine
- Soy sauce
Trauma to the teeth, tetracycline, nerve degeneration or simple aging can also change the color of teeth.
Whitening toothpastes are effective surface stain removers but they won't brighten your teeth. Some contain titanium dioxide, a white pigment in paint, giving a temporary appearance of lightening. They also consist of abrasives and may wear down enamel and expose yellow dentin, the vital tooth structure that lies beneath the enamel. With long-term usage, this may actually then give the appearance of yellowing teeth.
Bleaching whitens teeth by placing a bleaching solution on the enamel to remove deep stains. If you have natural teeth and are pleased with their shape and position, bleaching may be your best option. The results are not permanent and depending on your diet and lifestyle habits may need touchups anywhere from 2-5 years. If you want to make a permanent change to the shape, position or color of your teeth, porcelain veneers can be ideal. If you have existing crowns that need to be whiter, you can upgrade to whiter, all-porcelain crowns. If you have bonding or tooth color fillings you may need to change them once you have completed bleaching.
As we get older, our teeth pick up stain and become discolored. Many people are choosing shades that are whiter than in the past. Extremely white, opaque teeth on older individuals are a true sign they have undergone some type of cosmetic dentistry. In our office we strive to give you the look you want without looking “done”. You will attain a beautiful white esthetic outcome, but it will look real and complementary to your face.
- Have professional cleanings at the recommended time interval
- Drink beverages with high stain potential through a straw
- Avoid abrasive toothpastes, which can wear down enamel and expose yellow dentin below it
- Brush immediately after eating or drinking foods with a high stain potential
- If you aren't able to brush right away, rinse with lots of water or eat something crunchy like fruits or vegetables that will clean teeth naturally.
Our experience has proven that a combination of an in-office supercharged laser bleaching session along with take home bleaching trays to be most effective. We start with in-office power bleach for a quick change to the appearance and luster of the teeth, generally 6-9 -shades lighter. The longer the exposure of the teeth to the bleaching, the more dramatic the results.
A true sign that someone has undergone some form of cosmetic dentistry is when you see very opaque white teeth. In our office we feel it is important to gain a sense of realism with every improvement and not artificiality.
Studies have shown that bleaching gels cause no harm to teeth when used under direct dental supervision. Some people experience temporary minor sensitivity during the bleaching process but typically people do not experience any side effects. As with any cosmetic procedure, patients need to exercise judgement in how they go about whitening their teeth.
Patients should avoid over the counter alternatives since these use trays that are ill-fitting and cannot be individually fitted, increasing the risk of burning gum tissue. They may also cause bite problems.
For answers to specific questions you might have about our dental services and which treatment options might be right for you, please contact NYC Smile Design today. Our office can be reached online or by phone at 212-452-3344, and we serve patients in Manhattan, New York City, and the surrounding areas.