Chapter List

• Introduction to Age Erasers for Women
• Stop the Clock
• Age Spots
• Allergies
• Anger
• Arrhythmias
• Arthritis
• Back Pain
• Binge Eating
• Bladder Problems
• Burnout
• Bursitis and Tendinitis
• Cellulite
• Depression
• Dieting
• Double Chin
• Drinking Problems
• Drug Dependency
• Eating Disorders
• Endometriosis
• Fatigue
• Fibroids
• Foot Problems
• Hair Loss
• Heart Attack
• Heart Disease
• Hemochromatosis
• High Blood Pressure
• Hysterectomy
• Infertility
• Midlife Crisis
• The Pill
• Respiratory Diseases
• Sex Problems and Stds
• Smoking
• Snoring and Sleep Apnea
• Stress
• Stroke
• Television
• Thyroid Disorders
• Type A Personality
• Unwanted Hair
• Varicose Veins
• Vision Changes
• Worry
• Wrinkles
• Adventure
• Aerobics
• Affirmations
• Alcoholic Beverages
• Altruism
• Antioxidants
• Aspirin
• Breakfast
• Breast Care
• Calcium
• Career Change
• Change and Adaptability
• Confidence and Self-Esteem
• Cosmetic Dentistry
• Cosmetic Surgery
• Creativity
• Fiber
• Fluids
• Forgiveness
• Friendships
• Goals
• Honesty
• Hormone Replacement Therapy
• Humor
• Immunity
• Learning
• Leisure Time
• Low-Fat Foods
• A Litany of Low-Fat Foods
• Makeup
• Marriage
• Massage
• Medical Checkups
• Optimism
• Relaxation
• Religion and Spirituality
• Resistance Training
• Sex
• Skin Care
• Sleep
• Stretching
• Vegetarianism
• Vitamins and Minerals
• Yoga
• Credits
• Gray Hair Rethinking Your True Colors
• Biological Clock
• Body Image
• Caffeine
• Cancer
• Cholesterol
• Dental Problems
• Diabetes
• Digestive Problems
• Hearing Loss
• Injuries and Accidents
• Memory
• Menopausal Changes
• Metabolism Changes
• Migraines
• Osteoporosis
• Overweight
• Premenstrual Syndrome
• Reaction Time
• Skin Cancer
• Ulcers

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Cosmetic Dentistry

Cosmetic Dentistry

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Something to Smile About

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You've always been ready with a quip and a grin, and people respond to your warmth. But lately, even when you feel like smiling, you catch yourself covering your mouth with your hand. You're just not happy about what the years have done to your teeth.

If your teeth aren't what they once were, don't despair. Cosmetic dentistry can often take years off your smile. A cosmetic dentist can remove the stains that reveal lifetime habits of coffee and cigarettes. If you've lost teeth along the way, the dentist can replace them. She can also fix chips and cracks and build up surfaces to counteract the wear that comes from decades of gnawing steak or chomping ice.

It's all about looking young, fit and healthy instead of down in the mouth. And today's cosmetic dentistry doesn't mean a jaw full of teeth that look like Chiclets. Results can be so natural that no one will ever know your secret.

Getting Back the Gleam

By the time you reach your mid-thirties, that pearly smile has probably lost some of its gleam. Teeth tend to yellow over the years as tiny cracks in the enamel soak up stains from coffee, tea, wine, tobacco and food dyes. Fortunately, these age-related stains bleach away very well, says Stephen Sylvan, D.M.D., associate professor of dentistry at the State University of New York at Stony Brook and a dentist in New York City.

Your dentist can offer two good bleaching alternatives.

At-home bleaching takes commitment, but it's a simple process. Your dentist sends you home with a custom-fitted mold of your teeth and a bottle of buffered peroxide gel. You fill the mold with the gel and wear it for three hours daily (usually after dinner or overnight) for two weeks. The cost of the procedure ranges from $150 to $500 for either your uppers or your lowers. (Many people bleach just the uppers, since they show most when you smile).

If you want faster results, or dislike wearing the mold, you can ask your dentist for an in-office power bleaching. Your dentist can place a rubber dam over your teeth to protect the gums and apply a stronger peroxide solution that is activated by five to ten minutes under a high-intensity light. After two to four sessions a few weeks apart, at a cost of around $200 per visit, your teeth will look years younger, says Dr. Sylvan. The treatment itself is painless, but some people experience slight tooth sensitivity for a few days afterward.

Dr. Sylvan points out that there are also over-the-counter bleaching products available, but he doesn't recommend them. They can be too abrasive on teeth and too harsh on gums, and their effectiveness is questionable, he says.

Take Cover--Quickly

Severe stains--like those you get from taking the antibiotic tetracycline (such as Achromycin) as a kid--may be too tough for bleaching to tackle. That's where veneers come in. Ultra-thin porcelain veneers can cover even the worst of stains as well as fix up chipped and poorly spaced teeth.

Veneers are eggshell-thin pieces of porcelain, but hardly delicate. They are carved, colored and custom-shaped to the tooth they'll cover and then are attached by a process called bonding. The underside of the veneer and surface of the tooth are "etched"--painted with a mild acid that microscopically roughens the surface. Then, the surfaces are fused with a type of resin that hardens under a high-intensity light. The process doesn't hurt and can often be accomplished without the need for anesthetic.

"The bonding of the veneer is so strong that the porcelain becomes an integral part of the tooth," says George Freedman, D.D.S., director of the programs in postgraduate esthetic dentistry at Case Western Reserve University in Cleveland and Baylor College of Dentistry in Dallas.

Making the veneer look natural is an art, says Dr. Freedman. "We can create a whole variety of true-to-life shades and even do a gradient of natural-looking colors on a single tooth. You really can't tell a veneer from a natural tooth, even close up."

Veneers can also be made slightly longer or wider than a tooth to fill in small gaps or improve a lousy smile. Prices for veneers range greatly--from $350 to $2,500--depending on the area of the country you live in or the severity of your dental problem. But they can last more than ten years, depending on how well you take care of them.

Going for the Heavy Guns

A veneer may not be able to correct severely decayed, misshapen or badly positioned teeth, but a crown or a bridge can. Where a veneer is a very thin covering, a crown (or cap) is thicker and heavier and requires grinding down the tooth it will be attached to. A crown is made of porcelain, metal or a combination of the two and then cemented onto a tooth. A bridge is two or more connected crowns.

You and your dentist will need to decide between all porcelain or porcelain over metal. Porcelain usually looks more natural when there's no metal behind it, but you may need the metal base for back teeth, where the pressure from chewing is greater, says Irwin Smigel, D.D.S., president of the American Society for Dental Aesthetics.

And some new porcelains are so good that they look convincing even over metal. "It used to be that the metal backing always made the crown look artificial," says Barry G. Dale, D.M.D., a cosmetic and general dentist in Englewood, New Jersey. "But the new porcelains provide close-to-lifelike quality."

What's the procedure like? Your dentist first gives you a local anesthetic. Then he grinds down about 11/2 millimeters of your tooth (otherwise, you'd have something fatter than the original tooth, which would look out of place and could irritate the gum). During a second visit he cements the custom-shaped crown or crowns into place.

Crowns cost between $450 and $1,000 each. They generally last 10 to 15 years.

How will your mouth feel after a crown is in place? "It's a foreign body, so it's natural that the bite may feel a little strange," Dr. Smigel says. But if after a week you're still experiencing discomfort, check back with your dentist to have the fit adjusted.

Lifelike Dentures That Don't Budge You need a partial or complete denture to fill in your missing teeth, but you gag at the thought. You'd feel like your grandmother. Then how about new, natural-looking teeth that are permanently attached to your jaw? It's possible with dental implants. "Implants, because they're fixed in your mouth, are akin to having your own teeth," says Albert Guckes, D.D.S., deputy clinical director of the National Institute of Dental Research. Here's how they work. A tiny metal cylinder--made of lightweight titanium, the same metal used for replacement hips--is surgically placed into your jawbone. Then a thin metal post is screwed into the cylinder. This part of the procedure, usually done under local anesthesia, will leave your mouth sore and swollen for about a week. The next part of the procedure takes place about six months later. By then, bone has grown tightly around the metal cylinder. It's in rock solid. Your new artificial tooth is mounted onto the metal post. For each implant post you'll pay between $750 and $1,500. Then you ante up for the replacement teeth--usually an additional $1,000 each. That's a lot of loot. But given that implants can last up to 20 years, you may consider them a worthwhile investment, Dr. Guckes says.

Shopping for a Dentist

Needless to say, any cosmetic procedure is only going to be as good as the dentist who does it. You might ask a friend who has undergone cosmetic dental procedures for her recommendations.

Or you could contact the American Society for Dental Aesthetics (ASDA). "Dentists applying for membership present before-and-after cases before the society's board," says Diana Okula, ASDA secretary. "And they're judged not only on how good the results are functionally but also on how the results look."

Write to the ASDA at 635 Madison Avenue, New York, NY 10022. Enclose a self-addressed, stamped envelope, and they'll send you a list of recommended dentists in your area.

Are You Big Enough for Braces? Braces aren't just kid stuff anymore. "They are appropriate for people of almost any age," says Mervin W. Graham, D.D.S., an orthodontist in private practice in Denver whose oldest patient with braces is 65. But at any age, braces work the same way. Here's how, according to Dr. Graham: The braces' tightened wires and rubber band elastics push on your teeth. Bone on one side of a tooth's root breaks down, allowing the tooth to move. And bone builds up on the other side of the tooth, assuring that it will fit snugly into its new home. The process starts with a fitting, after which you'll need to visit your orthodontist for regular adjustments. Your teeth will be somewhat sore for a few days after each visit. Depending on how much your teeth are misaligned, the time you'll need to wear your braces can vary from one to several years. The price of braces will depend on the severity of the correction, but generally ranges from $1,800 to $4,500. If you decide to make the investment, don't worry--nobody will call you Metalmouth. When you were a kid, braces used to mean good-size stainless steel straps and bands around each tooth. But these days, you can be fitted with tiny brackets made of steel or even nearly invisible tooth-colored porcelain, says Dr. Graham.