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The Smile Spectrum, Cosmetic Dentistry
Sure, beauty is in the eye of the beholder, but between staring at yourself on Zoom calls and the return to working from the office (and, frankly, a return to in-person everything), it’s easy to start feeling self-conscious about your teeth.
“A vibrant, healthy-looking smile is one of the first things people notice, and [it] gives professionals—especially those in face-to-face, on-camera, public relations, marketing, or influencer roles—a big advantage in building trust and relationships," says Dr. Steven Lorentzen of Lorentzen Dental.
A multitude of cosmetic treatments can offer patients a boost in confidence—personally and professionally. Long gone are the days of frightening drills, painful injections, and anxiety-inducing implants, which were once necessary for cosmetic dental improvements.
Ahead, local dentists share 10 ways to help you close the gap between your current smile and your pearliest dreams—from affordable, practical solutions to full-scale transformations.
Teeth Whitening
If you’re looking for a simple, economical way to upgrade your grin, most experts agree that teeth whitening is an easy and inexpensive way to go.
It seems like everyone—from Crest to Amazon to Kendall Jenner—has a whitening quick fix in the form of pens, strips, or even light therapy. But local dentists recommend weighing the advantages of in-office versus at-home treatments. A notable difference? Upkeep. “The big advantage of one-visit whitening done in our office is it completes the entire whitening process in one two-hour visit,” Lorentzen says.
Some dental offices offer effective take-home whitening treatments—a step above sto
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Teeth whitening
re-bought strips—that allow for the safety and assurance of expert recommendations at home. “The best [type] is Opalescence Go trays,” says Dr. Walter Palmer of River Bluff Dental.
For patients who prefer inexpensive drugstore alternatives, dentists won’t judge. Dr. Gesica Horn of Serene Oaks Dental recommends that patients who choose to whiten their teeth without dentist supervision use a product with peroxide in the gel and follow the directions of the product. Visible results don’t come quickly—Horn recommends using whitening products for 10 to 14 consecutive days to achieve best results.
“To help with sensitivity, I recommend using a toothpaste made for sensitivity two weeks prior to starting the whitening process,” Horn says. And be sure to avoid beverages and foods that may stain your teeth, such as coffee, red wine, fruit juices, and colas, during the at-home whitening process. (Psst: If you really can’t live without your daily Diet Coke, stock up on straws to help minimize staining.)
If you're using trays, “be consistent about setting aside the time needed to prep your trays, wear them for your prescribed time, then clean the trays thoroughly after wearing,” Lorentzen says.
Bonded Fillings
If you’ve ever gotten a composite resin filling to fix and seal a cavity, then you’ve probably gaped your mouth open in the mirror, struggling to find where exactly that cavity used to be. That’s because the material used to fill cavities is so similar in color to your actual teeth that, like reading an I Spy book, it can be tough to spot the difference between your normal teeth and the filling.
Dental bonding—a dental procedure that repairs chips, reduces gaps, and can change the color and shape of a tooth—uses the same material that is used to fill a cavity. Bonus: Dental bonding procedures are painless and reversible. Recent research into restorative materials seeks to find improvements in bonding performance and create better and longer-lasting bonding materials.
Horn recommends that patients seeking any type of cosmetic care look for a dentist who is an accredited fellow in the American Academy of Cosmetic Dentistry, which conveys that the doctor has significant training and experience in providing exquisite cosmetic dentistry.
“The goal should always be to do the least amount of irreversible dentistry as possible to achieve the patient’s goals,” she says.
Botox and Dermal Fillers
Going to the dentist has been known to be stressful, but modern dental offices are transforming their treatment approaches by prioritizing patient experience, ensuring patients improve their smiles as well as the appearance of their mouths and their jaw structures.
“We are constantly striving to improve our skill sets,” says Hetal Gatecha, clinic director of Reflections Dental Care, which seeks to expand its spa-like dental services (with heated neck wraps, weighted blankets, a massage chair, and eye masks) to include Botox and dermal fillers.
While Botox is often used to minimize signs of aging—forehead wrinkles and crow’s feet, for example—it can also be used for those with TMJ disorders, high lip lines, dentures, and orthodontic treatments that may cause muscle strain, according to the American Academy of Facial Esthetics. Dermal fillers, such as hyaluronic acid and calcium hydroxyapatite fillers, can serve as a substitute for collagen lost due to aging, giving the face a plump, youthful appearance.
Soft Tissue/Tooth Recontouring
Show us those gums! Soft tissue recontouring, also called gum recontouring, allows patients with a gummy smile or an uneven gumline to secure a bigger smile, often after orthodontic treatment. Diode lasers, used in gum-recontouring procedures, help remove gum tissue and perfect a patient's gumline with minimal anesthesia. Some patients may need tooth contouring in addition to gum contouring, Gatecha says, though some experts caution its use.
“Recontouring tooth structure or enameloplasty is not recommended often unless there is plenty of enamel left and removing it will not harm the tooth,” Horn adds. “It’s mainly done to smooth a very small chip.”
Such procedures are often recommended for patients whose teeth slightly overlap; are oddly shaped; appear too large, long, or pointed; are chipped or cracked; are uneven; or have other dips, bumps, and flaws on the tooth surface.
What procedure is simple and has the biggest impact?
Photo courtesy of Nancy Norling
Dr. Nancy Norling
“The use of composite resin to fill a gap or diastema is one of the procedures in dentistry that can have an immediate impact on a patient’s smile.” —Dr. Nancy Norling, Nancy Norling DDS
Photo by Bella Sollé Photography
Dr. Drew Carrell
“I love this question because the answers depend on the characteristics of the smile we are designing. Teeth in a smile may be too small due to excessive gum tissue. Utilizing state-of-the-art lasers to painlessly remove this tissue can dramatically change a patient’s appearance. Other times we may use Invisalign to fix rotated teeth without picking up a drill. My personal favorite is to fabricate no-preparation veneers to instantly transform a smile.” —Dr. Drew Carrell, Lakeview Family Dentistry
Photo by Prenzlow Photography
Dr. Steven Lorentzen
“I’ve built my practice to make all of our cosmetic procedures require as little time as possible from the patient. Even our largest cosmetic cases require minimal visits from the patient to complete. My staff and I work hard behind the scenes in order to make the most use of our patients’ time.” —Dr. Steven Lorentzen, Lorentzen Dental
Photo courtesy of Hughes Dental
Dr. Amy Hughes
“It depends on what you are trying to change. If it’s a black space in between your teeth and you are happy with everything else, this is easy to fix with one appointment of heated injection-molded composite. If there’s a lot you want changed, veneers can generally be done within two to four appointments.” —Dr. Amy Hughes, Hughes Dental
Photo courtesy of Serene Oaks Dental
Dr. Gesica Horn
“Cosmetic bonding is one of the more simple procedures because it can be done in one visit and can be used to change the shade of a tooth, close a gap, or enhance the shape of a tooth.” —Dr. Gesica Horn, Serene Oaks Dental
Photo courtesy of River Bluff Dental
Dr. Walter Palmer
“Tooth whitening.... Patients are [immediately] more confident with their smile and smile more often.” —Dr. Walter Palmer, River Bluff Dental
Photo courtesy of OMS Specialists
Dr. Daniel Sampson, OMS Specialists
“A single dental implant to replace a tooth will cost about the same as a dental bridge, without impacting the adjacent teeth and providing a crown that is more like a natural tooth.” —Dr. Daniel Sampson, OMS Specialists
Photo courtesy of Reflections Dental Care
Hetal Gatecha
“Composite filling, as it's quick turnaround, the results usually last very long, [it's] cost effective, [and it's] one of the easiest procedures with the biggest impact in dentistry.” —Hetal Gatecha, Reflections Dental Care
Crowns
Fun fact: Dental crowns—toothlike caps that replace the top layer of broken, decayed, or worn-down teeth—have been around since 1903. But the technology has evolved (phew!) to create painless replacements that enable your teeth to be beautiful in terms of function and form and—perhaps best of
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Dental crown
all—last longer.
“With good care, crowns last a long time,” says Dr. Amy Hughes of Hughes Dental. “Most of the crowns I’ve done, and what I’ve seen from other dentists, are well over 10 years old—some 20 to 30 years. Wish I could say I get the same longevity out of my car or hot water heater!”
Crowns can also be produced in a single office visit, while crowning visits of yesteryear (AKA 10 to 20 years ago) involved making several visits to the dental office. Dental technology, such as the CEREC Omnicam, uses a 3D LED camera to create a digital model of your mouth, which is transferred to a lab for manufacturing or to a milling machine to create same-day crowns. “This eliminates the need for wearing a temporary crown for two weeks and therefore eliminates the need for a second visit,” Hughes says. “The crowns are made with the same degree of accuracy as from a lab and from the same material. The crowns are milled from a solid block of porcelain, eliminating the weak link of the porcelain-metal interface of the older-style crowns.”
Veneers
Used to cover the faces of chipped, yellowing, or otherwise damaged teeth, veneers have come a long way since their invention in 1928, most recently tapping into digital imaging technology, additive manufacturing, and more durable materials to create more natural-looking and longer-lasting smiles.
A wildly popular staple (and sometimes a punchline when done poorly), veneers contin
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Veneers
ue to be one of the most common cosmetic improvements that local dentists offer. “They can solve so many issues that patients want to fix,” Hughes says, “[such as] length, color, inclination, overall shape, and minor crowding and rotations.”
There are two main kinds of veneers that dentists recommend, each with different color, size, and shape options: porcelain and composite. While porcelain veneers last longer, have better tooth bonding, and are less likely to stain, composite sets are less expensive, easier to repair, and require less prep work.
“Thin, no-preparation veneers are made individually by hand for the most beautiful and lifelike results,” says Dr. Drew Carrell of Lakeview Family Dentistry. “If tooth modifications are needed for a specific patient, my goal is to select the material that will exceed the aesthetic desires of my patient and functionally withstand the test of time.”
Regardless of the material used, veneers can help straighten and whiten a smile without orthodontics or trays. “Our treatment is customized toward each patient’s needs and goals,” Palmer says. “Our goal is to create new and beautiful smiles with a look so natural that their family and friends don’t know they have veneers.”
Orthodontic Treatments
When you think of orthodontics, you might think of gawky metal braces, expanders, and annoyingly miniature rubber bands. Advances in orthodontic treatments mean more and better options. (You’ve met Invisalign, right?). But even if old-style braces are your best bet, dentists and orthodontic specialists have advanced technologies and methodologies at their fingertips to make it a painless process for kids and adults alike.
Take, for example, the use of 3D scans. Say sayonara to disgusting and gag-worthy impression materials, such as alginate, polyether, and vinyl polysiloxane. Intraoral scanners provide more comfortable impressions that ultimately result in more accurate and precise dental treatments.
“Many patients I see in my practice simply want to smile with confidence again,” Carrell says. “Dentistry focused on functionality extends beyond providing a beautiful smile [to] improving the health of the patient.”
Implants
Whether you’ve lost an adult tooth (or never had one to begin with!) or you’re looking to improve the appearance of fundamentally flawed teeth, dental implants are easier than ever before. The result is an implanted tooth that serves as
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Dental implant
a natural tooth would—improving your chompers in both appearance and ability.
Digital imaging technology enables specialists to digitally scan a patient’s mouth and take a 3D image in the office to map out a plan to replace a missing tooth. “Utilizing 3D printing, a guide is fabricated to place the implant in the exact place it needs to be for long-lasting, natural results,” Carrell says.
There are countless benefits. Dental implants keep surrounding teeth more stable and prevent bone loss and gum disease. “Besides cosmetic improvements in the look of the teeth, as well as support of the soft tissues of the face, patients will always get improved function,” says Dr. Daniel Sampson of OMS Specialists. “The support of bridges on implants can make a person look younger by decreasing natural aging lines of the skin.”
Reconstructive Surgery
More than 20 percent of people have an overbite, and up to 10 percent of people have an underbite, meaning about a third of all people experience bite misalignment, which can lead to jaw strain, headaches, earaches, and an increased risk of tooth decay, breakage, cavities, and gingivitis.
For more extreme cases, orthognathic surgery, or reconstructive surgery of the jaw, can correct some of the underlying issues that may have caused problems with chewing, speaking, and smiling.
“The result can be huge changes in facial balance and appearance,” Sampson says.
Custom Cosmetic Dentistry
Much like fingerprints, everyone’s mouth is different, and that means dentists customize their approaches to treating oral health needs. That’s why some dentists offer full-scale dental transformations, which may involve replacing teeth, bridges, crowns, and more. These kinds of top-tier treatments can range from hundreds to tens of thousands of dollars.
“We only work with the top technicians in the country who specialize in cosmetics and full-mouth rehabilitation,” Carrell says. “The ceramists are able to turn our smile design blueprint into reality. This level of planning, teamwork, and execution makes for happy patients with beautiful smiles.”
While some patients require transformative treatments for fundamental flaws, others seek premier treatments to change the appearance of their entire smile, which Lorentzen calls a smile makeover. “These cases typically involve 10 to 20 teeth and use porcelain veneers, porcelain crowns, or a combination of the two to enhance and completely make over a patient’s smile, changing the size, color, and shape of the teeth,” he says.
For these high-caliber appointments, dentists generally set up a consultation appointment first to talk about what the patient wants out of their smile. (And yes, Pinterest boards filled with teeth are welcome.)
At OMS Specialists, experts rely on computer-based imaging and planning to provide the best possible outcomes for implants with minimum discomfort and swelling. “Patients often remark how the pain was less than they anticipated,” Sampson says.
When it comes to any kind of dental care, all dentists use the same approach: Patient needs come first. “Patients are [like] family members for whom we always go the extra mile,” Gatecha says.
Now that’s something to smile about.
This article originally appeared in the September 2023 issue of Mpls.St.Paul Magazine.
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