8218 Wisconsin Avenue, Suite 415
Bethesda, MD 20814
(301) 656-1588

What is Cosmetic Dentistry?

Cosmetic Dentistry is a specialized part of General Dentistry, aimed at creating a positive change to a Patient's teeth and smile. Cosmetic Dentistry much more than teeth whitening or getting porcelain veneers. The ideals of Cosmetic Dentistry addresses both a Patient's functional and aesthetic concerns regarding their teeth and gums and overall oral health.

diastema
bonding

 

Anterior Composite Filling (Bonding)

Bonding teeth is a cosmetic dental procedure where tooth-colored, composite resin is utilized to sculpt the appropriate shape and size of a Patient's teeth. Dr. Malcomson can 'build up' a tooth that may be smaller in size than adjacent teeth.

This dental procedure is fairly simple and can be accomplishes in a single office visit. Dr. Malcomson matches the shade of bonding material to the Patient's natural teeth and prepares the tooth's surface to receive the bonding material. At this point, Dr. Malcomson will gently etch the tooth's surface, apply a conditioning liquid making it easier for the bonding to adhere and the bonding process will begin. A dental curing light is used for polymerization of light cure resin based composites.

Dr. Malcomson may recommend bonding, if you have a diastema, which is a 'gap' between two teeth. This can occur anywhere in the mouth. Generally, a diastema is found between the two front teeth. Although this area can potentially be distressing, it can be cosmetically treated. Dr. Malcomson can bond the teeth, eliminating the 'gap' and effectively camouflaging this undesirable space.but there are a few things to think about before a Patient has this treatment. Personal habits may make bonding a less desirable treatment, eg. the material used for bonding is porous. When a Patient enjoys coffee, tea, red wine or smokes, the composite resin may become stained and 'yellowy" over time. If you are concerned about staining, Dr. Malcomson may recommend closing the 'gap' with porcelain veneers; which do not easily stain or discolor. Natural teeth discolor, so incorporating a whitening regimen will maintain shade consistency with bonding material and / or veneers.

TRUE: Bonding material isn't as strong as your natural tooth. Patients who chew fingernails or pens, may chip the bonding material over time. However, if well taken care of, bonding will last for several years. If you are considering closing the 'gap', ask Dr. Malcomson at your next Hygiene appointment. A custom Treatment Plan will show all associated costs of this simple, yet cosmetically pleasing dental procedure.

  Watch a short Patient education video


Replacing Amalgam Fillings with Composite

Are your silver fillings leaking? It may be the perfect time to replace with tooth-colored composites. Old amalgam fillings do not fully bond to a tooth's structure, often allowing saliva, food, and bacteria to seep down the margin of the filling, leading to further decay. Composite fillings not only adhere to a tooth's structure, but also match the color of your natural tooth. Dr. Malcomson uses tooth-colored composite to restore chip(s), small cracks, and she can rebuild a misaligned tooth's surface (see Bonding). Composite strengthens a tooth by repairing the defect and restoring the affected area. Continual improvements to composite material offers; strength, durability and an increased selection of colors.

Different Strategies When Replacing Amalgam Fillings...
There is no ‘one size fits all’. Malcomson Dentistry offers each Patient a Treatment Plan, outlining procedure options, fees and approximate time frame for completion. Some Patients may elect to begin with 1 - 2 teeth, separating composite restorations into sections: top right the first half of the year, bottom left second half of the year, and so on. Dr. Malcomson can suggest what would be the best option(s) for your needs.

Did You Know Silver Fillings Can Hide Decay?
Silver fillings are opaque to radiographs, therefore it’s difficult to see decay under the filling, until they are quite large. Research shows that while a Dentist examines and takes Bitewing radiographs (once per year), they can only diagnose 50% of what might be going on. A full set of radiographs  (Full Mouth Series) will only show 80 – 85% of what’s going on. This leave 15% – 20% of cavities unseen, due to the metal blocking any decay.

Silver Fillings Expand and Can Crack Your Teeth...
A second factor when considering if you should replace old fillings to amalgam is that a silver / metal filling can crack a tooth (which also doesn't show on a radiograph). For example: Darryl had two metal fillings placed when he was a teen. During his hygiene appointment, it was noted by the Dentist that he had a few hairline cracks on those same two teeth. He has been experiencing sensitivity, which may mean 'the cracks' are getting deeper and closer to the nerve of said tooth. In the near future, Darryl may need to protect those teeth with crowns. Thankfully, in Darryl's case, there is no new decay, it’s just wear and tear that is unavoidable with aging.

If a Patient would like to explore an amalgam restoration (replacing amalgam with composite), Malcomson Dentistry will provide a Treatment Plan. Once the Patient has accepted his/her Treatment Plan, additional appointment(s) will be necessary to complete the composite restoration(s). This natural colored material adheres to the tooth's surface better than amalgam. In some cases, this can mean the difference between getting another filling or having root canal treatment.


Malcomson Dentistry Sealant

Sealants

Dental sealants are thin, plastic coatings painted on the chewing surface of a tooth. Typically posterior teeth (premolars and molars) are sealed to prevent unwanted tooth decay. The sealant bonds to any depression and deeper groove of the tooth, forming a protective shield over the Patient's natural tooth enamel. Thorough brushing and flossing can remove food particles and plaque from smooth surfaces of teeth, unfortunately, it doesn’t always get into the nooks and crannies of the posterior teeth. Sealants protect vulnerable areas from tooth decay. The likelihood of children and teenagers developing decay in the depressions and grooves of their premolars and molars, make them perfect candidates for dental sealant(s). Dr. Malcomson will make a recommendation when this is the case.


Teeth Whitening

Teeth Whitening

Malcomson Dentistry's custom whitening program begins with a short consultation. We sell four 'peroxide' formulas with varied strengths to whiten teeth. Dr. Malcomson will recommend the formula best suited for the Patient's whitening needs, allowing for optimal whitening results. Patients' teeth and lifestyles differ, so might the whitening process - dark or grayish stained teeth may be due to medication and natural tooth structure, whereas yellowy stained teeth may be due to lifestyle (foods, drinking and / or smoking). No matter where you are, Dr. Malcomson can help to brighten and whiten your smile!

During your first appointment with Dr. Malcomson
Your options will be presented and Dr. Malcomson will recommend which formula will allow for optimal whitening. An impression of the Patient's teeth for whitening trays will be taken, 50% payment, then in 4-7 days, the Patient will pick up their whitening kit, given instructions and a shade check will be taken. That same day, you can begin whitening. Provided a Patient follows the whitening protocol, dramatic results are often visible within the first week of treatment. Dr. Malcomson recommends a recent Hygiene appointment followed by the application of a fluoride varnish / desensitizing medicament, that penetrates teeth and enhances your whitening process, as well as preventing sensitivity due to the peroxide. Bitewing radiographs (cavity detecting xrays) are also recommended. You're ready to get started...

Prepare for Whitening...

  • Schedule your 1st 30-minute appointment for whitening tray impressions (50% payment due).
  • Schedule your 2nd appointment in approximately 4-7 days, to pick up your custom whitening trays. Dr. Malcomson will go over whitening instructions and perform a shade check. You’re ready to start whitening TODAY!
  • Schedule your 3rd appointment (15-minutes) in approximately two weeks.

During the teeth whitening process, we suggest:

  • Avoid dark staining beverages like; tea, coffee, red wine, colored soft drinks, and fruit juice.
  • Avoid dark staining foods like; tomato sauce, soy sauce, chocolate - any food or drink that would leave a stain on a white shirt.
  • When a Patient follows 'whitening protocol', dramatic whitening results are often visible within the first week of treatment.

  Watch a short Patient education video on Teeth Whitening


Malcomson Dentistry veneers

 

Veneers

Veneers are bonded to your natural tooth, often changing the color, shape, size, and/or length of the teeth. Dental veneers or dental (resin) laminates are wafer-thin, custom-made shells of tooth-colored material, designed to cover the front surface of ta tooth, improving the aesthetic appearance of your smile. Veneers can be lab fabricated from porcelain or made with a resin composite material. Porcelain veneers resist stains better than resin, mimicking the light reflecting properties of a natural tooth. A resin veneer is thinner and requires less removal of the natural tooth surface before placement.

Are you a Candidate for Dental Veneers?

  • Teeth that are discolored from; root canal treatment; stains from tetracycline or other drugs, excessive fluoride or other causes; or the presence of large resin fillings that have discolored the tooth.
  • Teeth that are worn down, chipped or broken.
  • Teeth that are misaligned, uneven, or irregularly shaped (for example, have craters or bulges in them).
  • Teeth with gaps between them (to close the space).

What are the Steps to Dental Veneers?
Getting dental veneers requires at least two appointments. After the initial consultation and presentation of your Treatment Plan with Dr. Malcomson, two additional appointments are needed: 1. prepare teeth, take impressions and color match. 2. Once the lab fabricates your veneers, Dr. Malcomson will adhere the veneers. Whether you choose to done or multiple teeth, can simultaneously undergo the veneering process described below.

  • Diagnosis and Treatment Planning - This first step involves a Patient's active participation. Share with your Dentist the result(s) that you are looking to achieve. While at the first consultation appointment, Dr. Malcomson will examine your teeth to ensure dental veneer(s) are appropriate and discuss what the procedure entails. If a Patient would like to whiten their teeth, now is the time!
  • Preparation - Dr. Malcomson will remove approximately .05mm of enamel from the tooth surface, which is equal to the thickness of the veneer to be added to the tooth surface. Before trimming the enamel, you may elect to have an anesthetic to numb the area. Next, a model or impression will be taken. The model is delivered to a local dental laboratory, which in turn fabricates your veneer(s). In approximately two weeks, Malcomson Dentistry receives the completed veneer(s) from the lab. *For unsightly teeth, temporary veneers can be placed by the Dentist.
  • Bonding - Prior to cementing the veneer(s), Dr. Malcomson will temporarily adhere to your tooth, examining the fit, size and color. She may remove and trim the veneer (as needed, to achieve the proper fit.) If needed, the veneer(s) color can be adjusted slightly with the shade of cement. Next, Dr. Malcomson will prepare the tooth to receive the veneer, roughening the tooth, to allow for a strong bond. Once properly positioned on the tooth, Dr. Malcomson will use a curing light to activate the dental cement, causing it to harden and cure. The final steps involve; removing excess cement; evaluating your bite; and making any final adjustments in the veneer(s). You will be asked to make a follow-up visit in a few weeks to check how your gums are responding to the presence of your veneer(s), along with examining the veneer's placement.

  Watch a short Patient education video on Preparing for Veneers

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