The cosmetic touch to brighten your smile

Maria Kegel, Contributor, Jakarta

JAKARTA (JP): What's in a smile? Plenty, if you ask your dentist.

Whiter and straighter teeth can increase your self-esteem, so says Dr. Iwan I. Kustarjo, a dental surgeon at Plaza Senayan in Jakarta.

But the price of a pretty smile does not come cheap, with prices for cosmetic dentistry procedures running into the millions of rupiah.

Bleaching, bonding, laser teeth whitening, veneers and crowns are some of the latest treatments offered by your dentist that can be used alone or with each other to put that perfect smile on your face.

"Cosmetic dentistry lets people smile, and encompasses changing the size, shape and color of their teeth," said Iwan.

Improvements can be made in just one single trip to the dentist. A temporary crown, bridge or filling can mask lost or broken teeth, while bleaching takes as little as half an hour and gives immediate results.

Bleaching is painless for the most part, and Iwan said companies had greatly reduced or eliminated the teeth sensitivity that patients used to report with the product's repeated use.

Although people prefer in-office bleaching for its convenience, Iwan recommended it to be combined with bleaching at home for a subsequent 12 days or nights for a better overall result.

"In-office bleaching uses stronger chemicals than the gel you take home, so it needs the dentist's supervision. It could burn the gums if it's not done carefully, and we use a blocking agent to protect them."

Bleaching, which affects the outer layer of the tooth, can last up to two years, depending on the patient's personal habits.

Consuming grape or blackcurrant juice, coffee, tea, smoking, and even eating Padang food can determine how long the bleaching will last, said Iwan. The kunyit (turmeric) in Padang cuisine is the culprit behind the staining.

"If these items are avoided, then the bleaching lasts longer."

While home-bleaching kits available from the supermarket have a lower percentage of hydrogen peroxide and are safe for everyone, Iwan said the lower content of chemicals means the effects were minimal and a lot of gel was required. The mouth trays also do not fit well as they are not customized to a person's set of teeth.

"That's the difference with using over-the-counter kits. We customize the mouth tray for each patient so that it fits their teeth exactly, and we use a higher percentage of hydrogen peroxide in the gel, so treatment time is reduced," he said, adding that the trays from the dentist prevented the swallowing of large amounts of gel when they were worn at night.

A one-hour laser treatment can speed up the whitening process.

The laser is only an activator and is used along with bleaching as it accelerates the chemical reaction, he said.

"With the rapid advancements being made with the chemicals used in cosmetic dentistry, there may be no need to use lasers soon," he added.

Veneers are placed over the front of the tooth, and they are used to change the color or shape of the tooth.

Teeth that are too small or large, crooked, chipped or oddly shaped are good candidates for veneers.

A tooth is reduced and then covered with the composite resin.

Veneers are not as strong as the original tooth or other materials used in dentistry, and last for about three to four years, Iwan said.

There are other drawbacks. The composite resin changes color after four years and they require maintenance as the bonding materials tend to leak with use, he said.

"If you repair the leaks, the veneers will last longer."

A protruding tooth can be covered with a veneer, but it depends on the degree of its protrusion or misalignment, Iwan said.

"People mostly wear braces to correct their overbite, and then you don't have to cut any enamel."

Bonding, which also combines bleaching, is reserved for teeth that have turned gray or brown due to dead pulp, for example, from a root canal.

Bleaching is carried out first to reduce the color, and then a composite resin is used to restore the chipped or broken teeth or to fill in any gaps.

Crowns are more permanent, but they have limitations, and last for about 10 to 15 years, Iwan said, adding that most patients preferred them because they were stronger and more enduring than the other options.

But problems can arise when gums recede, he warned. The space that opens at the top of the crown means cavities can easily form there.

"As long as your gums don't recede, your crowns will last a long time."