In Health



You don’t have to have a million Internet followers to want to have a dazzling smile. We spoke to four oral experts to find out some modern, innovative ways to make your teeth look their best.

By Betsy Bruce

Panel of Experts
James K. Brimhall, DMD
Adam R Pershing, DMD
James A. Weaver, DDS, Cert. Orth.,
Dr. JAW Orthodontists
Robert Brei, DDS

Picture a more perfect picture of you. This is, after all, the age of selfies, Facebook posts and the “Kiss Cam” at major sporting events. We all want to look our best in just such moments and now its easier than ever to get a smile with a wow factor. Tucson Lifestyle chatted with a panel of some of the top dentists and orthodontists in town to reveal the keys to achieving your best camera-ready smile.

Lighten Up!

The gold standard for whitening, according to our panel, is custom whitening trays available from your dentist’s office. Impressions are taken and sent to the lab to make the fitted trays. Clients wear the trays filled with peroxide gel for about 20 minutes a day for two weeks or until desired results are achieved. You can expect the shade of your teeth to be lifted by one to two shades per week and results can last as long as two to three years. The cost of custom bleaching trays ranges from about $400 to $500 for both upper and lower teeth. Dr. Adam Pershing is a big fan of KoR whitening system, a brand made in California. He says even teeth stained by taking the antibiotic tetracycline in childhood — a notoriously difficult gray discoloration — can be improved by this system.      

Another whitening option available at the dentist’s office is an in-chair UV or blue LED “light activated” treatment. Gums are protected by a dental dam or gel and a strong peroxide solution is painted on teeth; a UV light is then positioned in front of the client’s teeth. You’ll spend from 25 minutes to an hour in the chair and expect to have teeth four to six shades lighter. The most noticeable results will appear following the first treatment. Dr. James Brimhall uses the IVERI system and reports his patients have never had a problem with sensitivity. Cost ranges from $150 (for touch ups) to $500. Not all dentists are sold on this method, which works faster primarily because it uses a much stronger peroxide solution. Dr. Robert Brei reports that in most of these systems, the light or laser dries out the tooth, giving a false brightening affect. Once the teeth reach a state of re-hydration, they will darken a shade or two. 

White opaque or brown stain-like patches on teeth can be caused by several factors, such as fluorosis (too much fluoride), high fevers during tooth development or poor oral hygiene by patients during orthodontic treatment. Dr. Brei has had great results with a new treatment for these patients. The process is known as “infiltration,” and involves a number of chemicals to remove the spotting on the desired teeth without drilling, veneering, crowning or bonding. “Infiltration” works well and can save patients thousands of dollars but most importantly is non-invasive. Cost is $200 per tooth.

The most affordable option for teeth whitening can be found at the drug store. Over-the-counter whitening strips do work, but take a bit of patience. Expect your smile to be a shade or two lighter after a month of use. Spend a bit more for a name-brand product, as the fit and quality will be better. Don’t use strips more than directions indicate because you may have sensitivity problems. Whitening toothpastes contain a gentle abrasive that lightens surface stains such as coffee, tea and red wine, but again, patience is key and they will not whiten teeth more than their natural shade.

Tips on Smiling For the Camera
- Say a word that ends in an “ee” sound, which causes the lips to form a natural smile.
- Run your tongue over your teeth to make them shiny.
- Place your tongue directly behind top front teeth when you smile to lift and relax the mouth.

The Shape of Choppers

Subtle shaping or cosmetic contouring of teeth can make a huge difference in your smile. Maybe your “canine” teeth are a bit too pointy or your incisors (four front teeth) are a bit oversized. Your dentist can gently contour teeth to make them more linear and even, as well as softly rounded. Cost for contouring ranges from $100 to $500 depending on how many teeth are involved.  

Bonding is the process in which tooth-colored resin is used to restore a chipped tooth or minimize the space between teeth. The resin is applied to the tooth, then shaped and contoured for proper aesthetics. A small blue light cures the resin for faster hardening.  Dr. Brimhall says bonding may be used on a few teeth after braces to make them more uniform.

Restoring a badly chipped front tooth with bonding is one of the most challenging things a dentist can do, according to Dr. Brei. Color, shape and durability are all taken into account for a natural-looking result. It’s suggested you don’t use your bonded front tooth to open beer bottles or bite through biscotti!

Veneers are thin porcelain overlays popular with clients who are going for a perfect Hollywood smile. The result is a uniform look with notable whiteness. Clients with stubbornly stained and/or uneven teeth may opt for veneers as well. Dr. Brei says before application, the dentist will check to make sure your bite is properly aligned to reduce the risk of a veneer popping off. Teeth are minimally contoured to accommodate the veneer. You’ll leave the office with a temporary set of veneers, then return for a permanent fitting about two weeks later. Cost per tooth is approximately $1,200. Make sure the dental lab your dentist uses makes veneers with dimension. If they are too opaque, they will not look natural.

The Lowdown on Lipstick
- Wines, berries, reds and rosy pinks accentuate whiteness. Choose colors that have blue, i.e., “cool,” undertones as opposed to “warm” undertones.
- Avoid coral-ish colors; they bring out the yellow tones in enamel.
- Also, steer clear of neons, frosty shimmers, browns and mattes.

Brace Yourself

Braces have come a long way from bands encircling each tooth and a painful process of tightening. Conventional braces are brackets glued to each tooth either in the front or back. Your orthodontist will help you decide which suits you best. Although brackets on the inside of the teeth are more discreet, they require a bit more time in the chair because of the more challenging angle for installation, according to Dr. James Weaver. It also may take your tongue a bit of time to adjust to them as well. Classic metal brackets now come in rectangular and triangular shapes, the triangular requiring a little less time to re-situate teeth. Patients can choose most any bracket design or color imaginable with the University of Arizona’s “Block A” in high demand at Dr. Weaver’s office. Kids think braces are so cool now, that he says they’re actually disappointed if they don’t need them. Cost is approximately $4,000.

Invisible aligners are another option for straighter teeth and are best for patients with minor misalignments. You’ll have impressions made at the dentist’s office and be fitted with a series of plastic aligners that guide teeth into their new placement. It takes a bit of time to adjust to speaking with invisible aligners in place and the first couple of days with each new graduated aligner maybe a bit uncomfortable. Aligners are changed out every two weeks and prices vary from $3,000 for an easy case (10 aligners) to a tougher case, costing $5,500 (30 aligners). Dr. Brimhall is currently wearing Invisalign and says they are great for him.

You may have seen ads for Do-it-Yourself invisible aligners; you purchase a kit to make your own impressions and send them off to a manufacturer for a series of aligners. Dr. Weaver is not a big fan, suggesting it’s best to have a professional involved and that, likely, is not you.  

If you feel your teeth appear too small or you have a gummy smile, a “Gum Lift” is something to investigate. A topical numbing agent is used while the dentist or periodontist uses a laser to contour excess gum tissue. Healing takes 24 hours. Average price: $1,525, and gum tissue may grow back.

If you think your smile could be improved, ask your dentist for suggestions. A good dentist will offer multiple solutions for various problems to accommodate a patient’s budget.

Research finds smiling can make us appear more attractive to others, lifts our mood as well as the moods of those around us, and can even lengthen our lives. So it’s time to stop shirking when the cameras are lurking. This is the day and age of selfie smiles no matter the day … or your age!  TL

Brush Up on the Basics
Brush teeth two to three times daily using gentle up and down strokes for two minutes. Studies find that electric toothbrushes remove about 20 percent more plaque. They also are the best option for people with manual dexterity issues. Replace brushes every three to four months. Regular fluoride toothpaste is fine. Use whitening toothpaste for short periods of time. Floss before bed. Dr. Brimhall is an advocate of woven floss that has a bit of spring to it like Listerine Gentle Gum Care. Consider investing in a night guard to protect teeth from grinding.

The new charcoal toothpastes and tooth powders do a good job of removing some stains, but Dr. Pershing says check the abrasiveness or RDA of the product. The level has to be 250 or less for the ADA stamp of approval. For his patients with a bit of gum recession, Dr. Pershing says use toothpaste with an RDA of 100 or lower. Dr. Brei notes charcoal toothpastes and powders also contain a bit of blue dye that gives the instant illusion of whiter teeth, but the dye comes off after eating or drinking.