Bonding is the mechanical/chemical adhesion of a dental restorative material to the natural tooth. After the tooth is specially cleaned and prepared, a bonding liquid is painted on the tooth and set with a special high intensity light. Normally a tooth colored material called a composite is bonded to restore an area of the tooth damaged by decay or trauma. It is also common to bond porcelain to teeth. Large areas of decay or extensive trauma damage to the front teeth are best restored by bonding porcelain veneers, inlays/onlays or crowns.

Treatments 01 of 07

Bleaching - How can you brighten your smile?

Your wedding is coming up and you want your smile to be its brightest. Or maybe you have an important speaking engagement. Or perhaps you just want to whiten. While the expense of porcelain veneers may not be for you, bleaching is an affordable way that you can lighten the color of your front teeth.
Generally, bleaching is successful in at least 90 percent of patients. Consider tooth bleaching if your teeth are darkened from age, coffee, tea, or smoking. Teeth darkened with the color of yellow, brown or orange respond better to lightening. Other types of gray stains caused by fluorosis, or tetracycline are lightened, but results are not as dramatic. If you have very sensitive teeth, periodontal disease, or teeth with worn enamel, your may not be a good candidate. Also note that bleaching will not change the color of existing white fillings or crowns. After bleaching, these may need to be replaced to match the new color of your teeth
Dr.Chetan Bholel offers two bleaching methods, dentist-supervised at home bleaching and in office power bleaching. With at home bleaching, on the first appointment, an easy and totally painless impression is taken of the teeth to be lightened. After you leave the office, a special plaster is poured into the impression creating a plaster model of your front teeth. A thin clear tray is made to exactly fit over the model, with a special space or reservoir where the bleach will go.
Over the counter, non-dentist supervised kits are available at the drug store or on TV, but they lack the ability to make this special custom tray. They use a home made "boil and bite" tray that lack the special reservoir.
On your second visit, you will be shown how to apply the bleach into the reservoir and how to wear the tray. The bleach is a specially buffered gel containing carbamide peroxide (CH4N202) and a special ingredient to reduce sensitivity. The tray is worn nightly while you sleep for approximately a week or until the desired degree of lightening is achieved.
Power Bleaching is performed in the office using a strong hydrogen peroxide gel. The gums are first protected with a special film, the teeth are isolated, and a 40% hydrogen peroxide gel is painted on. The gel is activated using a special strong light and allowed to work for 20 to 30 minutes. Generally, several sessions are required. Extremely dark teeth sometimes respond best to a combination of power bleaching and supervised at home bleaching.
Bleaching can last for about one to five years depending your personal habits such as smoking and drinking coffee and tea. When the teeth start to darken, normally wearing your at home bleaching tray for one night will restore the teeth to their new brilliance. After your initial bleaching, keep your tray in a safe place and store excess bleaching gel in your fridge (don't freeze it).

Treatment 02 of 07

Porcelain Crowns

Crowns, also know as caps, restore the portion of the tooth above the gumline with a man made material, in this case tooth colored porcelain. Crowns may be necessary because of broken down old fillings, fractured, chipped or sensitive teeth. They are generally placed on teeth that have had root canals to protect them from breakage. Crowns are also used to improve the appearance of natural teeth that are malformed, malpositioned or discolored. Crowns can be made of natural looking porcelain and are made to improve your overall smile or to blend in with your own teeth. Sometimes an underlying metal shell is used under the porcelain if additional strength is needed.
Treatments 03 of 07

Porcelain Veneers

Porcelain veneers, also called laminates, are ultra-thin shells of ceramic, which are bonded to the front of teeth. This virtually painless procedure requires little or no anesthesia, and can be the ideal choice for improving the appearance of the front teeth. Becoming increasingly popular in the past 12 years, tens of thousands of porcelain veneers have been placed to mask discolorations, to brighten teeth, and to improve a smile.
Highly resistant to permanent staining from coffee, tea, or even cigarette smoking, the wafer-thin porcelain veneers can achieve a tenacious bond to the tooth, resulting in an esthetically pleasing naturalness that is unsurpassed by other restorative options.
Veneers can work as an alternative to minor orthodontics, but are not recommended in cases of severe crowding or misalignment of teeth or malocclusions. Customarily, veneers are preferable to full crowns when there is adequate remaining tooth structure to support the restoration. Veneers require less reduction of healthy tooth structure than full crowns, without compromising the periodontal or gingival health. It is a blend of art and science that enables a skilled practitioner to achieve a sensational effect.
Using Porcelain Veneers, we can :
• Close Spaces between the teeth (diastemas) • Rebuild broken or chipped teeth • Replace unsightly, stained or washed out fillings
• Reshape crooked teeth • Lighten discolored teeth • Whiten dark yellow or stained teeth
Veneers are very thin and are bonded on the front of your anterior teeth. They have an advantage over bonding alone because the porcelain will not stain or discolor over time. These veneers are about 0.3mm to 0.5mm in thickness but are very strong once bonded to your teeth. They have a "life like" appearance with the strength, beauty, and durability only porcelain restorations can afford. Veneers also have the advantage of not requiring the same degree of grinding of tooth structure that caps or crowns do, yet, they can accomplish a lifelike esthetic result.
Some facts you might want to know about Porcelain Veneers :
• Since they require approximately .5mm of tooth reduction, porcelain veneers are NOT considered a reversible form of treatment.
• Occasionally the preparation of a Porcelain Laminate Veneer does not require the use of a local anesthetic. However, for those patients that are particularly sensitive or anxious, a local anesthetic is advisable.
• The laboratory time required for the fabrication of a Porcelain Laminate Veneer is approximately ten working days.
• Due to the minimal amount of tooth reduction, it is usually not necessary to fabricate any type of temporary restoration. Should a temporary be needed, they can, in most circumstances, be made at the time of treatment.
• Between your preparation visit and the insertion visit, you can expect some sensitivity to hot and cold. This is normal and is due to the removal of a small portion of the enamel covering of the tooth. This sensitivity should disappear after the placement of your Porcelain Laminate Veneer.
Your second visit, the insertion of your laminate, can be accomplished, once again , with or without local anesthetic. This visit is usually longer in length. The laminates are placed with a light sensitive resin which is hardened by using a special light. Once placed your laminates are very strong and will resist most of the forces placed upon them by a normal diet. Porcelain has great crushing strength but poor tensile strength. Therefore, you should avoid anything that will tend to twist the laminate. Opening pistachio nuts with your teeth, chewing on bones or jelly apples is probably not a good idea. As with most things, common sense should prevail.
Treatment 04 of 07

Esthetic Reshaping

Sometimes the selective removal of a small amount of tooth enamel can make the world of difference in the appearance of your smile. A tooth unusually pointed, or longer than the rest can be reshaped, generally without any anesthesia. Often, tiny chips in front teeth can be better smoothed than restored. Some individuals, instead of the entire tooth being dark, have one little spot of darkness, or in some cases, a small spot of extreme whiteness. These discolored spots can be selectively removed and replaced with small white fillings, often avoiding the need for porcelain veneers.
Treatment 05 of 07

Tooth Colored Fillings

White fillings are made from a toothcolored plastic mixture filled with microscopic glass beads (silicon dioxide) called composite resin. Introduced in the 1960s, dental composites were confined to the front teeth because they were not strong enough to withstand the pressure and wear generated by thExisting Silver Fillingeback teeth. Since then, composites have been significantly improved and can be successfully placed in the back teeth as well.
Composites are not only used for restoring decay, but are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth.
Composites have the advantage over gold and porcelain because they can be placed in one visit. Their disadvantage, however, is that they are not as strong as silver fillings, gold or porcelain. They can also, over Replaced with white filling a period of time, discolor. Dr. Chetan Bhole will make recommendations based on his knowlege of these materials and the specifics in your mouth. Often, a choice of treatment plans gives the patient to take part in the decision process.
Following preparation, Dr. Chetan Bhole places the composite in layers, using a light specialized to harden each layer. When the process is finished, he will shape the composite to fit the tooth. The composite is then polishes the composite to prevent staining and early wear. Composites are also use to bond or cement other esthetic restorations, such as veneers and porcelain inlays and onlays (porcelain fillings).
Treatment 06 of 07

Porcelain Inlays & Onlays

A back tooth with a large silver may sometimes show as a dark area in your smile. While tooth colors fillings can sometimes be placed, porcelain inlays or onlays are a better choice when the fillings are too large for composite, but not damaged to the point of needing a crown.
Porcelain inlays and onlays require two appointments and local anesthesia. The existing silver filling is removed and the tooth shaped for proper placement. An impression of the involved teeth and the opposing teeth is taken and a temporary restoration is place. About a week later, after the dental laboratory custom makes the restoration, the temporary filling is removed, the porcelain is fitted and adjusted, and then is bonded or cemented in place.
Treatment 07 of 07