Vital
The Tooth of the Matter
By E.J. Ruskin
A more esthetically appealing smile won’t make you a better person. And you still won’t be able to play the violin. But it may just make you feel better -- and there’s a lot to be said for feeling better. So I went to speak with Jonathan Diamond, a Manhattan dentist with a thriving Midtown practice in cosmetic dentistry. My question: How can we avoid looking a little long in the tooth, even when we are?
Dr. Diamond noted several dental conditions, like discoloration, that make us look older. Some occur with age, others can be exacerbated by our behavior. Still others have been with us since the days of the tooth fairy. Diamond outlined ways to improve the appearance of teeth, and walked me through their pros and cons of each method. We considered issues like expense, pain, time involved, and bang-for-the-buck.
Discolored teeth
As we age, teeth darken toward that extraordinary hue that’s difficult to describe. Coffee, tea, and smoking all contribute to the … uh … distinctive color. Whitening agents mitigate this problem, and, happily, are readily available. They are completely non-invasive, have no downside (except, perhaps, for some short-term sensitivity), and always work, albeit to varying degrees. They are also relatively inexpensive, especially the store-bought products. A whiter smile takes off years. Serious bang for the buck.
For all the similarities between commercial and dentists’ products, there are notable differences. First, the dentists’ products have stronger whitening agents, so they work faster and get your teeth whiter. Second, your dentist makes customized trays, which are precisely molded to your teeth. They whiten more consistently than the trays and strips in commercial products.
What about “laser bleaching”? Dr. Diamond does not recommend it unless you need dramatic whitening by tomorrow.
Before
After
The premium you pay for whitening with a dentist is offset by your access to his/her aesthetic judgment, which is as important as technical skill. Your dentist can keep you grounded – and counsel you to avoid “unreasonable” cosmetic procedures. Teeth can be too white (except, of course, in Los Angeles). And your own dentist can ensure immediate, quality care when you get a wicked toothache on a holiday weekend. Now that’s a good thing.
“Flattened” and chipped teeth
“Flattened” teeth (whose cutting edges have worn away), teeth with ragged edges, pointy corners, or atypical proportions, all look peculiar. Such teeth can be reshaped easily, in a non-invasive, relatively inexpensive polishing procedure that could take only 15 minutes. But it’s most important that you are comfortable with your dentist’s esthetic sense, because reshaping teeth can dramatically alter your appearance ... for better or for worse.
Receded gums
Composite bonding material is used to fill in the spaces left when gums recede. Some receding occurs naturally, as we age. Brushing too enthusiastically will exacerbate the problem. Dr. Diamond favors electric toothbrushes, and notices improvement when his patients switch to them. Their oscillating heads clean well, and patients avoid the excessive pressure than can damage gums.
Oddly-shaped teeth
Not too long ago I checked out a pal’s “fridge photos.” The usual: vacations, celebrations, kids with weird hair. Then I noticed her big, happy, toothy grins in all the photos. Decades of earlier photos all had closed-lip smiles, which just look less joyful, and influence a lifetime of memories. Veneers can do wonders.
Veneers are made of porcelain, and are applied (painlessly) to the front surface of the tooth. They give your dentist a blank canvas, allowing him to create wider, longer, whiter or rounder teeth. As above, become familiar with your dentist’s aesthetic sense. Make sure it is consistent with your own, because it will be reflected in your teeth. While expensive, veneers can make a dramatic difference.
Crowded lower front teeth
This is a classic sign of “older” teeth. Dr. Diamond says crowded teeth can be fixed with braces or with Invisaline, a series of clear, removable trays that gradually straighten teeth. Either way, the process is only minimally uncomfortable. But it does take time and is somewhat expensive. The upside: Straight teeth can markedly improve your smile.
Dr. Diamond strongly suggests asking friends or relatives for referrals, given the trust we impart to dentists. He frequently discourages cosmetic dentistry, because of his own threshold about what is necessary. Naturally, that threshold varies widely among dentists.
Rejuvenating or completely restructuring your smile has become quite common. It usually takes less time (and is substantially less expensive) than redecorating your home. So put at least as much thought into selecting a dentist as you do your interior designer. And don’t forget to smile; we’ll think about laugh lines another day.
E.J. Ruskin is a sculptor and freelance writer.
