New techniques make beautiful teeth easier to attain and offer an alternative to dentures
Remarkable advances in the field of dentistry have given us new options for improving or replacing defective teeth.
Better braces. Not so long ago, only children wore braces and those who did risk
taunts of “tinsel teeth” and “metal mouth.” But today more than 20 percent of orthodontic patients are over 18 years old, and the braces or other tooth-straightening appliances they wear are hardly noticeable. Metal braces now have fine wires and tiny brackets. Even less obtrusive are tooth-colored wires and brackets. Lingual braces, placed on the inside surface of the teeth, can’t be seen at all. “Brace less” orthodontics, better for minor adjustments, lets patients wear a plastic-and-wire retainer molded to fit the roof of the mouth. Improvements in orthodontics affect more than a patient’s appearance. Treatment time is shorter than in the past because of a superelastic material used to make wires.
Brighter smiles. Cosmetic dentistry has developed several ways to help people troubled by stained or flawed teeth; these include bleaching, bonding, and applying veneers. Bleaching removes stains from teeth with a peroxide solution. Bonding uses a puttylike plastic resin to restore chipped, cracked, or crooked teeth, filling in gaps between teeth and whitening badly stained teeth. These problems can also be solved with porcelain veneers-thin, custom made shells that the dentist affixes to the surfaces of teeth after removing some of the natural tooth enamel.
Truer false teeth. Artificial roots to hold false teeth date back to ancient times; some Egyptian mummies have crude implants set in the jawbone and splinted to adjacent teeth with gold wire. Until fairly recently, however, artificial roots would not anchor firmly enough to last long, and they often caused an infection. What was needed was a substance that would bond with bone tissue finally discovered in the metal titanium. This breakthrough meant that implants were, at last, a viable option for those who could not (or would rather not) wear dentures. Today the most common type of implant is endosteal (see illustration). In this procedure, a dentist inserts a titanium fixture into the jawbone; then, several months later, the dentist attaches a metal post and finally a replacement tooth. This procedure requires sufficient bone for support. Those who have lost too much bone might instead have a subperiosteal implant, in which a metal frame (holding the necessary number of artificial roots) is placed on top of the jawbone, under the gum tissue. Implants can be used to replace any number of missing teeth and generally last at least 10 years. Not everyone is a candidate, however, and there can be complications if the procedure fails. But the vast majority of implants now numbering in the hundreds of thousands-are successful, providing artificial teeth that look natural and feel secure. As one 77-year-old says, “You really forget your teeth aren’t your own.
