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How Your Dentist Can Help You Look Younger

By Dr. Edward Lowe

This article is endorsed by the
American Academy of Cosmetic Dentistry.

How good are you at guessing someone's age? Can you place them in the right year — or even the right decade? According to a recent study, this is harder to do if the person is smiling. That's because we tend to perceive smiling faces as more youthful and attractive.

Yet many of us start to see our teeth deteriorate as we age, which may cause us to smile less. Being self-conscious about smiling can affect one's confidence, which in turn can impact social and professional interactions. But this doesn't have to happen: Skilled cosmetic dentists can successfully reverse many types of age-revealing dental decline. Let's examine the most common cosmetic dental concerns related to aging, and what can be done to resolve them.

Discolored Teeth

If your teeth seem to be darkening over time, it's probably not an illusion. Our teeth do tend to get darker with age. Sometimes it's an accumulation of staining from habits such as smoking and drinking red wine, coffee or tea. But often it has more to do with changes that take place in the structure of the teeth themselves.

Your teeth have a super-hard, somewhat translucent outer layer called enamel. This porous layer often starts out pearly white, but can stain or discolor over the years. They also have a softer inner layer called dentin, which is not white to begin with; it's more yellowish or tan. As we age, our tooth enamel tends to thin out, allowing more of the dentin's color — which itself may darken over time — to show through. This can dull a smile's appearance.

Old dental work can also make a smile look less youthful: White fillings can eventually stain and discolor, and the dark grey color of an amalgam filling sometimes stands out more than we'd like it to. So what can we do about all this?

Teeth Whitening. Professional teeth whitening done at the dental office (or at home with a prescription-strength kit provided by your dentist) is one of the most economical cosmetic dental treatments available. Professional bleaching agents have been proven safe when used as directed, and are very effective on stained enamel. In some cases, they can also be used to lighten a tooth from the inside, after a root-canal procedure is performed. However, if your teeth have more of an overall discoloration due to the dental aging process described above, other procedures for brightening your smile may be more effective than whitening.

Porcelain Veneers. These super-thin, tooth-colored shells are bonded to the front (visible) surfaces of teeth to create a dramatically younger look. Each veneer is made individually, so you can brighten a single dark tooth or a whole row of teeth. Each veneer is customized to blend in perfectly with your smile. Most veneers require a small amount of tooth enamel to be removed so they will fit well and look natural, meaning this procedure actually changes the structure of your tooth (unlike teeth whitening) and is therefore not reversible. Also, because of all the custom work involved, this is not a low-budget solution. However, it is often the best way to turn back the clock — as evidenced by the number of Hollywood celebrities who have had this procedure. And porcelain veneers don't stain!

Dental Bonding. When just one tooth is too dark, it can sometimes be lightened by bonding. This is a simple, in-office procedure in which a sculptable tooth-colored composite material is shaped onto the front surface of a tooth and then hardened. Several layers are applied this way to give the bonded tooth a natural-looking luster. Bonding is a relatively inexpensive procedure, though it does not last as long as a veneer and, unlike a veneer, can absorb stain from smoking, foods and drinks.

Dental Crowns. If one tooth is too damaged or decayed to be restored with bonding or a veneer, a full dental crown might be needed. A crown covers or "caps" the entire visible portion of the tooth; the root below the gum line remains intact. As with most veneers, once a tooth receives a crown, it will always need to have one. Crowns made of porcelain or composites are very realistic looking and can last many years.

Replacement of Old Dental Work. Old fillings, composite bondings or crowns that have become damaged or discolored sometimes create noticeable flaws in an otherwise beautiful smile. If this is the case, consider replacing your old dental work with better-looking (and possibly longer-lasting) materials. For example, a dark-grey amalgam filling can be replaced with a tooth-colored filling. Or, you could opt for a porcelain inlay or onlay — a type of filling usually made in a dental lab and then bonded to your tooth. Porcelain, a tough and translucent ceramic, costs more than composite material, but it also lasts longer and won't stain.

Worn Teeth

Tooth wear is another telltale sign of aging. Young teeth tend to be well-proportioned and curved at the edges, not flat and worn down. The amount of tooth wear people experience over time depends on habits such as teeth grinding, and also on tooth alignment. Those who clench and grind their teeth wear them faster; so do people with orthodontic issues. That's because if your bite does not fit together properly, you can end up wearing down particular teeth. For example, a person whose lower front teeth are crowded together will likely have jaggedly worn upper front teeth because of the way the upper and lower teeth contact each other when biting or moving against each other. What are some ways in which we can change a tooth's size and shape, and protect the teeth from wear?

Enamel Contouring/Reshaping. Sometimes a dental drill can be used to smooth and shape the sharp, flat edges of worn teeth, giving them a more youthful appearance. This is a minor in-office procedure that is relatively inexpensive. Since only the outer tooth surface (enamel) is affected, there is usually no need for even local anesthesia.

However, if your teeth are very worn down, they may need to have length added to them to achieve the youthful look you desire. This can be accomplished with veneers or crowns (both described above) and possibly gum surgery, all of which require a greater investment for a more dramatic result.

If you grind or clench your teeth at night, talk to your dentist about getting a custom-made nightguard to wear while you sleep — particularly if you are contemplating investing in veneers or crowns.

Orthodontics. More and more people are realizing that if your teeth are otherwise healthy, there's no upper age limit for straightening them. Actresses Kathy Bates and Faye Dunaway straightened their teeth with orthodontic appliances in their fifties and sixties, respectively. While Dunaway opted for traditional braces, Bates chose far less noticeable clear aligners. Besides making your smile beautifully straight, orthodontic treatment can help prevent teeth from wearing unevenly.

Receding Gums

Even if your teeth are white and healthy-looking, gum recession can really age your smile by exposing the darker root surfaces of teeth that are usually hidden beneath the gum line. Gum disease causes gum recession, and leads to loss of the bone beneath your gums. If too much bone is lost between your teeth, you might begin to notice little spaces that look like black triangles.

When gum disease begins causing gum and bone tissue to be lost, it's important to get the situation under control as soon as possible with the help of your dentist or periodontist (gum specialist). Extra attention to oral hygiene at home as well as therapeutic treatments in the dental office may be recommended. However, recession can also occur in a healthy mouth subjected to over-aggressive brushing and flossing. Genetics also plays a role, as some people simply are born with thinner gum tissue than others. Fortunately, there are procedures available to restore both gum and bone tissue.

Grafting. Dentists can rebuild lost gum and bone tissue with grafting, a routine in-office procedure generally performed under local anesthesia. Gum grafting can be done by taking tissue from one place in the mouth and moving it to another. Today, laboratory-processed grafting material can be used instead of your own tissue, and is becoming a more common alternative. If your gum recession is not significant enough to warrant grafting, yet it has made your teeth look darker at the gum line, bonding (described earlier) can sometimes be used to restore tooth color.

A More Youthful You

Sometimes, getting the youthful look you want may take a combination of procedures. And there may be different routes to your desired smile — each with its own pros and cons. Some of the things you will need to weigh include the treatment's effectiveness, cost and durability, and its effect on your teeth and gums. When you are making these calculations, don't forget that there are also costs associated with not acting: for example, not being able to smile as freely as you'd like to, or letting the problem get worse and perhaps more expensive to fix later on. These costs may not be as easy to calculate numerically, but they exist nonetheless.

Your own dentist can advise you on any of the procedures discussed in this article. He or she can provide you with the specific information you need and, most importantly, give you a sense of which would work best for you. Together you can move toward projecting the real you inside, which may hardly resemble the date stamped on your birth certificate.

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