Cosmetic dentistry came into being in the ... I mean really big probably the 80s and 90s with all of the veneering and things like that. I did do more veneering probably in the 80s and 90s. I do some veneers now. I don't do as many. We have Invisalign now, which we didn't have then. Personally if it was my teeth and my family and I'm going to treat you like my teeth and my family, I would go, if they're slightly crooked I would go with Invisalign, and most all of our dentists are Invisalign providers, and then I would do a bleaching. If that didn't get you where you wanted to go, then I would do a very conservative maybe even almost like a no-prep veneer. I would do that. Tooth structure is precious and valuable. I just don't jump on the bandwagon of taking off a lot of tooth structure because you can't really put it back. I would say over the years I've become more conservative in the cosmetic dentistry realm than I have the opposite.

Invisalign is the alternative of using clear line retainers instead of the brackets, and bands to straighten teeth. A lot of times the patients that we're treating with Invisalign, some are more complex than others. Usually it's patients that have had braces at one point and neglected to wear their retainers, or their teeth didn't get retainers, and they decided that later in life they want to straighten their teeth again. It's a really good alternative. Especially for adults that don't want to have to have the brackets, and wet rubber bands, and braces that remind them of their childhood. People seem to really like it; are really drawn to it. It provides a great option for straightening teeth to also enable us to do treatment, as well. A lot of times, especially doing prosthetic or restorative work, it's a lot easier if we have the teeth aligned properly, and have a nice bite that winds up well. It helps the work we're doing for restorative aspect, as well.

Crowned lengthening sometimes does have to happen if you have an old filling that is so deep, or for example if you have a lower molar and you've cracked off the lingual of it but you hate to pull the tooth. It's a little bit more uncomfortable when you have to do crowned lengthening but the end product is better, so it saves teeth that you would otherwise have to extract.

First I would usually say to the patient, “Let's take the gingiva up a little bit, see if you can tolerate that, see if you can with that, and if you can, then that's okay.” If you do a little gingivectomy and you have your dermatologist inject a little bit of botox, then your lip doesn't go up as high. Every problem has more than one solution. If it were me before I went and had the front of my jaw surgerized, then I would try a little bit of botox maybe and just a little gingivectomy. You can get a lot of stuff just by doing that.

I had a gentleman a couple weeks ago, and he had a diastema, which somebody had bonded, but the bonding had been coming off. It was several years ago, and it had kind of yellowed. Now if you have a small diastema, which is just the space between your teeth, it's a very tedious process, depends on how far the gum comes down, to get the exact right amount of like maybe a tenth or two of a millimeter on this tooth, and a tenth or two of a millimeter on this tooth, and get that closed, and get that looking one hundred percent natural. It's not ... It is technique sensitive, and it's not uncomplicated so to speak. The easiest thing, if you're going to ... If you don't want to do a veneer right now, and you have a damage or a dark tooth, the easiest thing is just to put a composite veneer over the whole tooth. Diastema closure is a little bit more technique sensitive. Bonding is absolutely wonderful, we use it everyday. When I went to school, we used amalgams, and we don't have amalgam in any of our practices. Amalgam doesn't actually bond to the tooth, our white fillings actually bond to the tooth, and make the tooth a little stronger. We see a lot of older molars that have had amalgams in them, and then as they wear, sometimes the sides of the teeth will break off because there's no bonding involved there. We use bonding, I love bonding, it makes the tooth stronger, you can use it cosmetically, it's the best thing since peanut butter and jelly. We use it every single day. Without bonding I don't think modern dentistry would be as good as it is.