Cosmetic Dentistry in North York

About the service

Cosmetic procedures aim to improve how your teeth look and, in some cases, how they work. They focus on the colour, position, shape, size and alignment of your teeth.

This page explains whitening, bonding, veneers, crowns and straightening teeth, and what to ask before you decide on treatment.

What happens before cosmetic treatment?

Cosmetic treatment starts with a thorough examination, including any X-rays needed, to check for problems. Existing dental problems need treatment before a cosmetic procedure is considered. The Royal College of Dental Surgeons of Ontario (RCDSO) advises dentists that elective treatment may not be advisable while a patient has active gum (periodontal) disease.

Your dentist can then tell you whether your teeth are healthy enough for cosmetic treatment and what kind of result to expect.

What are the options for whitening teeth?

Teeth darken naturally with age and can be stained by foods and drinks such as coffee, tea and wine, some medications, smoking or damage to a tooth. The Ontario Dental Association (ODA) describes three ways to whiten: store-bought toothpastes, gels or strips; whitening at home under a dentist's care; and whitening in the dental office. Ur Dental offers take-home whitening kits.

An ODA patient-magazine article notes that home whitening supplied by a dentist uses a lower amount of hydrogen peroxide than in-office whitening, so it takes longer to reach the shade you want. In a dental office, only a dentist or a dental hygienist may apply the whitening agent directly to your teeth.

Who should check with a dentist before whitening?

The ODA advises speaking with your dentist before whitening at home, because your teeth need to be healthy and strong enough. The Canadian Dental Association (CDA) says bleaching is not appropriate for teeth with decay and should wait until after pregnancy, and Health Canada advises anyone with gum disease, unfilled cavities or existing tooth sensitivity to consult an oral health professional first. An ODA patient-magazine article advises that if you have had bone loss, you should see your dentist before choosing a method, because thinner gums may be at risk of recession from chemical irritation and exposed roots may be more sensitive.

What results can I expect from whitening?

How much whiter teeth look depends on what caused the discolouration. The CDA says discolouration from some causes, such as a blow to the tooth, may give irregular and unsatisfactory results with bleaching, and other approaches may be needed.

Whitening works only on natural teeth, not on caps, crowns, veneers, fillings or dentures, and existing dental work may look darker beside whitened teeth. An ODA patient-magazine article suggests that if new fillings or crowns are planned, you discuss whitening first so the new material can be matched to your new shade. Results are not permanent, and the CDA does not recommend repeated bleaching beyond the first treatment because its long-term effects are not fully understood.

What should I expect after whitening?

One dentist quoted in an ODA patient-magazine article explains that teeth are slightly more porous, meaning more open to staining, for a short time after whitening, and suggests avoiding anything that would stain a white T-shirt for two to three days. Tooth sensitivity and irritation of the gums are common short-term effects. If either persists or gets worse, stop using the product and contact your dentist; you can reach the clinic by phone during opening hours.

What is dental bonding?

Bonding adds composite resin, a white filling material that comes in many shades, to the tooth. The dentist roughens the surface and applies a bonding agent, then builds up layers of resin that are shaped, hardened with a special light and polished. Bonding is used to repair chipped, cracked, decayed or discoloured teeth, close small gaps and reshape worn or uneven teeth.

The ODA says bonding has a limited lifespan that depends on the individual case, and advises discussing with your dentist whether it is right for you.

What are veneers?

Veneers are thin shells of porcelain or composite resin bonded to the teeth, covering the whole front surface. They can repair chipped or stained teeth, may help close gaps and may correct slightly crowded or overlapping teeth.

Veneers are not reversible. The enamel has to be ground down slightly to make room for them, and the ODA says they are used instead of a crown only when enough tooth structure and enamel remain. A dentist may suggest another treatment if the tooth has decay or gum disease, there is not enough enamel, or you grind or clench your teeth.

What happens when you get porcelain veneers?

Preparing teeth for veneers frequently needs local anaesthetic. The dentist removes a thin layer of enamel, takes a mould of your teeth and fits temporary veneers, then bonds the custom veneers with dental cement at a follow-up visit. Afterwards, brush and floss every day and avoid biting hard objects such as ice or fingernails.

When is a crown used instead?

A crown, or cap, covers a tooth that is broken, misshapen, badly stained or damaged by decay, and can restore a damaged tooth's shape, strength and appearance. If a large part of the tooth is missing, a crown may be needed instead of a veneer. The tooth is frozen and filed down, an impression is taken and a temporary cap is placed. At the next visit the dentist removes the temporary cap and cements the permanent crown, which is commonly made by a dental laboratory technician.

Can teeth be straightened at any age?

Teeth can be moved at any age, and the ODA lists braces and clear aligners among orthodontic treatments. Aligners are removable, but an ODA patient-magazine Q&A notes they are recommended to be worn 22 hours a day and move teeth only while in your mouth.

Your dentist may provide basic orthodontic treatment or refer you to an orthodontist, a dental specialist.

How many visits will I need?

Bonding can usually be done in one visit, and so can composite resin veneers. Porcelain veneers usually need at least two visits, and a crown usually takes more than one. A 2017 ODA patient-magazine comparison describes in-office whitening as usually reaching its result in one session.

What are the risks of cosmetic treatment?

The risks described on this page include that veneers cannot be undone because enamel is removed, bonding has a limited lifespan, and whitening can cause short-term sensitivity and gum irritation, may give irregular results on some kinds of staining, may leave existing dental work looking darker and, if you have had bone loss, may put thinner gums at risk of recession. This is not a complete list: ask your dentist about the risks of the treatment you are considering.

What are the alternatives?

Several treatments can address the same concern. Stains may be whitened or covered with bonding, veneers or, on a badly stained tooth, a crown, and chips and small gaps may be repaired with bonding or veneers. You can also decide not to have treatment.

Who provides cosmetic treatment, and when is a specialist involved?

Cosmetic dentistry is not a recognized dental specialty in Ontario, and the RCDSO does not allow a dentist to call themselves a cosmetic dentist. Dentists are registered either as general dentists or as certified specialists.

General dentists often do bonding, and more complex cases may be referred to a prosthodontist, the specialist in restoring natural teeth and replacing missing ones. You can check a dentist's registration on the RCDSO's public register, Find a Dentist.

How are fees for cosmetic treatment set?

After examining you, the dentist reviews your options and gives you an estimate before going ahead; costs can still change during treatment.

The ODA publishes a yearly Suggested Fee Guide. Dentists set their own fees, which may be above or below it, but the RCDSO says they must tell you if they intend to charge more than the guide. Fees reflect the complexity, time and materials involved, and laboratory-made work such as crowns adds a lab fee passed on at exactly what the lab charged.

The CDA notes that bonding and veneers are often treated as cosmetic and may fall outside what a dental benefits plan covers. Your dentist can submit a pre-treatment form so your plan can tell you what it covers.

What should I ask before I agree to treatment?

The ODA suggests asking why a treatment is recommended, whether there are alternatives, what happens if you refuse or delay it, and how to maintain it. Ask for the cost estimate before you agree.

You can ask for the details in writing, and you can always seek a second opinion, although you will likely pay for that examination.