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Not Smiling About Your Smile?


Options exist for treating unattractive, misaligned and missing teeth

By Judy Latta

One of the first things people notice when they meet you is your smile. A big, bright, picture-perfect smile conveys the appearance of warmth, happiness, youth and health. According to an American Academy of Cosmetic Dentistry (AACD) survey, 99.7 percent of adults believe a smile is an important social asset, and 96 percent believe an attractive smile makes a person more appealing. A study commissioned by the American Association of Orthodontists, however, indicates that more than one-third of American adults are unhappy with their smile. This is unfortunate, because a healthy smile can do wonders for your self-esteem and confidence. The better you feel about your appearance, the better you feel about yourself.

While most people do not naturally have perfect smiles, advancements in modern dentistry have made it possible to have the smile you want. The demand for restorative dental procedures has never been greater, and a plethora of options exist for dealing with unsightly teeth.


Teeth Whitening

One of the fastest, easiest and most economical ways to enhance your smile is to whiten your teeth. As we age, changes in our tooth enamel and dentin cause our teeth to darken. Teeth whitening substances are designed to negate these changes, either by bleaching the teeth to lighten their color or by deep cleaning the teeth to remove the stains that are causing the discoloration.

According to the AACD, professional whitening in a dental office is the best method. Dentists use stronger, more effective agents than at-home whiteners and are knowledgeable about how to protect the gums and mouth from these agents. The effects of dentist-administered whitening treatments can often be visible and your teeth can lighten several shades with only one visit. Many over-the-counter methods of teeth whitening exist, including rinses, strips, gels and various toothpastes. These are typically safe options, but the outcomes will not be as dramatic as those possible in your dentist’s office.



Many people suffer from dental alignment issues, such as misaligned teeth, overcrowded teeth, bite abnormalities and jaw problems. In addition to marring your appearance, these issues, without proper treatment, could put you at higher risk for cavities, gum disease, ear pain, headaches and chewing and speech problems. Thus, orthodontic care can be an important part of maintaining your oral health.

Orthodontic treatments work by applying continuous pressure to your teeth over time to move them slowly into place. As the teeth shift, they loosen from the gum line, moving into alignment, and the bone around the teeth molds to support the new positioning.

In the past, many people avoided orthodontics because they were not interested in having a mouth full of metal. Fortunately, however, options for straightening teeth exist today that are more aesthetic and discreet than traditional stainless steel braces. These include clear braces, which have brackets made of clear or tooth-colored materials; lingual braces, which are placed on the back of the teeth so they are not visible when you speak; and acrylic liners, which are clear removable, custom-made aligners that are nearly invisible to the eye.


Dental Implants

Dental implants are artificial tooth roots that are connected to the jaw bone to replace missing natural tooth roots. Implants provide a strong foundation so a missing tooth can be securely replaced with a synthetic tooth. When you lose a tooth, the bone around where that tooth had been begins to deteriorate, and this leads the surrounding teeth to shift and lose stability. These shifts can cause aesthetic problems, bite issues, and, ultimately, additional tooth loss. Thus, it is important to replace missing teeth as soon as possible. Since it takes time for an implant to fuse to the jaw bone, dental implants, while the most permanent option for tooth replacement, are a multi-visit, often months-long procedure.



A dental crown is a custom-made cap that looks like a tooth that fits over an existing damaged or unsightly tooth or an implant to restore the tooth’s appearance, functionality and strength. According to the American Dental Association (ADA), “A crown can make your tooth stronger and improve its appearance. It can cover and support a tooth with a large filling when there isn’t enough tooth left. It can be used to attach a bridge, protect a weak tooth from breaking or restore one that’s already broken. A crown is a good way to cover teeth that are discolored or badly shaped.”



A dental bridge is a prosthesis that fills a gap of one or more teeth missing due to decay or injury. Using surrounding healthy teeth as a foundation, a bridge consists of crowns fitted to the teeth on either side of the gap to stabilize custom-made artificial teeth in between to fill the gap. According to the ADA, “Bridges help maintain the shape of your face, as well as alleviate the stress in your bite by replacing missing teeth.”


Porcelain Veneers

Veneers are thin pieces of a tooth-colored material attached to the front of discolored, chipped or misshapen teeth to restore the natural look and strength of those teeth. Porcelain veneers are created from several thin layers of ceramic which replace the original tooth enamel. They are produced in a dental laboratory and then fitted to your teeth in your dentist’s office.

To apply a veneer, a small amount of your natural tooth enamel must be removed to make room for the new layers, which are attached with a resin and hardened with a high-intensity light. Since each veneer is custom-sculpted, they are very natural looking, and since the impacted teeth remain mostly intact as compared to those treated with crowns and bridges, veneers are a popular option for smile restoration.


Dental Bonding

Dental bonding is a procedure in which tooth-colored composite resin is applied directly to an unsightly tooth, then it is sculpted, shaped and polished to match the surrounding teeth. Dental bonding can be used to repair decayed, chipped or cracked teeth, to fill gaps between teeth, to restore discolored teeth and to cover a tooth’s root that is exposed due to recession of the gums. Dental bonding is a relatively simple and inexpensive cosmetic dental procedure, and it is not excessively invasive since only a very small amount of tooth enamel is removed. The procedure can usually be completed in one office visit. The downside to dental bonding is that it is not as strong as other restorative procedures, so it is more vulnerable to cracking and chipping.


Factors to Consider Related to Restorative Dentistry

The Columbia University College of Dental Medicine published a primer on factors to keep in mind when considering restorative dentistry. Key points include:

  • It can be expensive; insurance doesn’t cover procedures considered to be cosmetic.
  • Materials aren’t indestructible; they are durable but won’t last forever.
  • It’s important to be realistic. Cosmetic dentists are enhancers, but they can’t change the shape of your mouth or your overall appearance.
  • Long-term durability and appearance will be dependent on your oral hygiene. Your dental work will
    require the same care and attention as natural teeth.

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