Cosmetic dentistry can go beyond the surface

By Duptronics April 27, 2009

Creates confidence and improves chances for success!

Carol Waldman says she is in the business of improving her patients’ lives, one mouth at a time.

The North York-based dentist says she focuses her practice on cosmetic dentistry because “it’s wonderful. When your job is done, people who were afraid to smile are always smiling. You really change people’s lives.”

Improving those smiles involves a variety of treatments ranging from whitening the teeth to restorative work that includes porcelain veneers or crowns and bonding or dental implants, and even additions to gum tissue.

Treatments, says Waldman, are “tailor-made for each person. You do as little as you can to provide as much bang for the buck as possible and not be invasive. Implant dentistry is the most expensive, but over the course of a lifetime, it is not expensive.”

The dollar count can be high for any of the procedures, depending on the problem and the degree of transformation required.

Costs vary with specific dentists and the province of operation, but generally range from a relatively low $100 for an initial consultation and $250 to $500 for a round of teeth whitening (about double this for laser whitening), to $1,000 or more per tooth for veneers, porcelain crowns and other restorative work. As most dental insurance is primarily directed toward covering a portion of treatments defined as medically necessary, individuals usually take the hit for the full cost.

However, patients happy with their enhanced smiles frequently say their new look is priceless or call to thank him, says Ottawa dentist Charles Kamel, pointing out the value of people being comfortable with their appearance.

“Aesthetic dentistry is a very emotional form of dentistry,” he says. “You can change someone’s self-perception in as short a time as one appointment. It creates confidence, gives people a different outlook on themselves and, therefore, a greater possibility of success.”

He paints a verbal picture of “a beautiful woman who has a large space between her front teeth. No matter what the rest of the package is, when she smiles, she has a big hole. And the perception of beauty is driven by society.”

A dental procedure such as bonding can close the gap and transform her appearance immediately, he says. And the dramatic change in her physical appearance can have a profound effect on her self-perception and other people’s reactions to her.

You’re not just treating teeth, says Kamel – “you’re treating the person. Take the degree of tooth exposure, for example. Straight white teeth covered by the upper lip are not going to be noticed. Gums, the clothes that go on the teeth, have a big part in aesthetic dentistry. Just adding some gum tissue can make teeth look better. When we do treatment planning, we are looking at the whole face and we are looking at what the person wants. Some people want to be very subtle. Others want to be seen the minute they walk in.”

Gordon Chee of the Aesthetic Dental Studio in Calgary says this field of dentistry is “most rewarding in terms of improving patients’ self-esteem and self-confidence.” He emphasizes that “the medical and aesthetic go hand in hand. Sometimes, people’s teeth are quite damaged because of bite problems, chipped teeth and so on. So you deal with their dental health first, then the appearance later to ensure the longevity of what you are putting in their mouths. That way, you really make a difference to people’s lives.”

Waldman agrees. “Health comes first. Deal with structural integrity before cosmetics. I am a firm believer that veneers are for teeth that are discoloured, broken down or heavily filled, but not for teeth that are in the wrong place. If a tooth is in the wrong place, I would strongly recommend that the patient has orthodontics first to correct the position of the tooth and then sees whether it needs cosmetic or restorative work after that.”

While Fredericton dentist Deborah Stymiest, the Canadian Dental Association’s first female president, is in accord with the philosophy that “good aesthetics contribute to emotional and social well-being,” the primary focus of her practice is on general dentistry and the mouth as “the window to the body that reflects overall health.”

“When your teeth are healthy and you are without pain, you feel more at ease and smile more readily,” she says. “Teeth whitening and porcelain veneers are very popular today, and public perception certainly favours a bright, white smile, but teeth don’t have to be perfectly white to be healthy and attractive.”


Dental bonding: In dental bonding, a composite plastic resin is applied to the teeth. Bonding can be used to restore decayed or chipped teeth and/or to improve the appearance of teeth – for example, by closing gaps between teeth.

Dental implants: Dental implants are used to replace missing teeth through surgery that fixes the replacement for the tooth into the jawbone. A titanium post (the implant) is used to anchor the false tooth. Some offices do computer-guided implants.

Porcelain crowns: A crown or cap is fitted on top of a reduced natural tooth. Porcelain crowns (unlike metal crowns) are indistinguishable from natural teeth.

Porcelain veneers: To create porcelain veneers, laboratory-processed porcelain is bonded to the surface of the tooth. The seal formed between the border of the tooth and the porcelain veneer prevents bacteria from penetrating the tooth’s surface.

Whitening: Whitening procedures range from the use of toothpastes and strips at home to the application of peroxide gels or laser beams by a dentist. Whitening/bleaching usually requires applications twice a year, depending on such factors as diet.