Cosmetic Dentistry

Silver fillings which are technically referred to as amalgam, have been used since around 1830. When an amalgam filling is planned for a tooth, the material is mixed and then packed into the area where the cavity was. Over about 24 hours, the filling sets and reaches its full hardness. The benefits of silver fillings are that they are less prone to decay at the edge of the filling and that they can tolerate moisture when being placed.

Composites, or tooth colored fillings, have several advantages such as fewer tooth fractures, are more conservative, the filling is bonded to the tooth and of course, cosmetics as they look natural.

White fillings must be glued or bonded to the tooth. This essentially makes the tooth and filling one. Generally this makes the tooth less prone to breaking and cracking. Silver fillings are not usually bonded to the tooth, hence why we see many more broken teeth that have amalgam fillings.

When there is decay in a tooth and a white filling is planned, the only portion of tooth that needs to be removed is the decayed area. With a silver filling, there must be mechanical grooves cut into the tooth to hold the filling in.

Composites are not just white but they come in many shades of white. We have about 15 different shades and translucencies in our office to match your tooth.

Dr. Jordan believes that both composites and amalgam have a place in dentistry. However, most of the restorations he places are composites.

Both veneers and crowns can be used to correct tooth size, shape and color.  Veneers cover 3 sides of a tooth while a crown covers the entire tooth.  When done well, veneers and crowns can look beautiful and dramatically enhance your smile.  Since veneers require less tooth removal than crowns, we prefer veneers whenever possible.  

Common causes of discolored teeth are old fillings, drinking coffee and tea, and aging.

Let’s be honest, whitening toothpastes and mouthwashes don’t really work. Over-the-counter products like Crest Whitestrips do bleach teeth, but they only work on the front teeth, the effect is short lasting, and the strips move around and are annoying.  

The best way to significantly whiten your teeth is to have custom bleaching trays made in our office. Custom-made bleaching trays are very comfortable and last a long time. These trays are the most effective way to deliver prescription strength whitening products that will give you the fastest and the most reliable results. 

Whitening is most effective when done for longer periods of time, such as 6 to 8 hours. What better time to bleach your teeth than when you are sleeping? The research that has been done on whitening shows that most patients can expect good results in about 3 weeks by using carbamide peroxide in custom-made trays worn overnight. Rare conditions such as tetracycline-stained teeth may take 6 to 12 months.  

Like everything, dental fillings age and can discolor over time. If you have stains around old fillings, the fillings may be leaking and need to be replaced or polished. Often times a great improvement can be achieved by whitening and then replacing the old fillings with whiter and more color-stable restorations.  

Many crowns done in the past and today have a black line where the crown meets the tooth.  The black line seen is the metal underlying the white porcelain in the restoration.  While the black line may look bad and be distracting in a smile, it is expected with porcelain fused to metal crowns or PFMs. Occasionally, the metal in the crown may be seen through the gum tissues creating a blue hue.  

Most of the crowns done at our Brookings dental office are metal free.  The materials used for crowns today such as e.max, zirconia and zirconia fused to porcelain are very strong and cosmetic.  In fact, the technology of these materials is so advanced that these crowns look better than PFMs and mimic natural teeth. Since these materials are tooth colored when manufactured, they require less of the tooth to be removed which decrease the chance of sensitivity and root canals.  

Another disadvantage of conventional porcelain fused to metal crowns is that the porcelain can break away from the metal.  When this happens, the gray and black metal will be very visible. If food traps in the broken area, it can lead to decay and gum disease.  Please see examples of the metal free crowns and veneers done by Dr. Jordan in our Smile Gallery section.