Cosmetic Dentistry include many different types of cosmetic procedures. In many cases, a cosmetic dentist will implement a combination of several of the following procedures to give you that perfect smile

The ADA recommends to have ones teeth checked by a dentist before undergoing any whitening method. The dentist should examine the patient thoroughly: take a health and dental history (includingallergiesand sensitivities), observe hard and soft tissues, placement and conditions of restorations, and sometimesx-raysto determine the nature and depth of possible irregularities.

There are two main methods of gel bleachingone performed with high-concentration gel, and another with low-concentration agents. High-concentration bleaching can be accomplished in the dental office. Whitening is performed by applying a high concentration of oxidizing agent to the teeth with thin plastic trays for a short period of time, which produces quick results. The application trays ideally should be well-fitted to retain the bleaching gel, ensuring even and full tooth exposure to the gel. Trays will typically stay on the teeth for about 1520 minutes. Trays are then removed and the procedure is repeated up to two more times.

Most in-office bleaching procedures use a light-cured protective layer that is carefully painted on the gums and papilla (the tips of the gums between the teeth) to reduce the risk of chemical burns to thesoft tissues. The bleaching agent is eithercarbamide peroxide, which breaks down in the mouth to formhydrogen peroxide, or hydrogen peroxide itself. The bleaching gel typically contains between 10% and 44% carbamide peroxide, which is roughly equivalent to a 3% to 16% hydrogen peroxide concentration.

Low-concentration whitening is far less effective, and is generally only performed at home. Low-concentration whitening involves purchasing a thin mouthguard or strip that holds a relatively low concentration of oxidizing agent next to the teeth for as long as several hours a day for a period of 5 to 14 days. Results can vary, depending on which application is chosen, with some people achieving whiter teeth in a few days, and others seeing very little results or no results at all.

A typical course of bleaching can produce dramatic improvements in the cosmetic appearance of most stained teeth; however, some stains do not respond to bleaching. Tetracycline staining may require prolonged bleaching, as it takes longer for the bleach to reach the dentine layer. Case studies have been performed on people with tetracycline stained teeth. They used custom bleaching trays every night for 6 months and saw dramatic results and improvement. White-spot decalcifications may also be highlighted and become more noticeable directly following a whiting process, but usually calm back down with the other parts of the teeth becoming more white. The white spots become less noticeable, with the other parts of the teeth becoming more white. Bleaching is not recommended if teeth have decay or infected gums. It is also least effective when the original tooth color is grayish and may require custom bleaching trays. Bleaching is most effective with yellow discolored teeth. However, whitener does not work where bonding has been used and neither is it effective on tooth-color filling. Other options to deal with such cases are theporcelainveneers ordental bonding.

The whitening shade guides are used to measure tooth color with Vitapan Classic Shade Guide being the most widely used with 16 shades. These shades determine the effectiveness of the whitening procedure, which may vary from two to seven shades.

Dr. Biller is a graduate of N.Y.U. School of Dentistry. He is a Master of the Academy of General Dentistry and an attending at Jamaica Hospitals Department of Dentistry. By instructing young dentists, he is helping to shape the future of dentistry as we know it. Dr. Biller has earned Mastership status in the Academy of dentistry mastership fellowship. To earn the Mastership Award he first had to obtain Academy General Dentistry fellowship status by passing an exam and completing 500-course hours within 10 years. To earn a mastership one must complete 600 additional hours, 400 of which must be earned through hands-on courses.

Dr. Biller is the Chairman of the Department of Operative Dentistry and New Concepts and teaches resident dentists at Jamaica Hospital. He is a member of PEARL ( Practitioners Engaged In Applied Research and Learning) an exclusive network of highly qualified dentists engaged in leading-edge research sponsored by the National Institute of Health (NIH). He also works closely with New York University College of dentistry, the NYU Bluestone Center for clinical research, the NIH, and other members of the PEARL Network. Dr. Biller has been practicing dentistry in Queens, NY for over 30 years. He is a resident of Jamaica Estates, where he lives with this wife and three wonderful girls.