Dr. Pia Lieb, DMD, DDS Cosmetic & Reconstructive Dentist
Dr. Lieb, DMD, DDS is a leading authority in cosmetic, reconstructive and general dentistry renowned for creating some of the most celebrated smiles worldwide. She lives and practices in New York City.
A mouth makeover might make you look younger.
Posted on April 26, 2011
Chips and cracks and yellowing, oh my! These are some of the inconvenient tooths we have to look forward to post-menopause.
But, there’s good news. Unlike expensive and invasive nipping and tucking procedures to age-proof our skin, it’s quite easy to turn back the clock on our aging smiles.
“It’s not only easy,” says Dr. Pia Lieb, a leading authority in cosmetic and reconstructive dentistry. “It really makes a huge difference. Chipped, cracked and yellow-brownish teeth are such a giveaway to how old you are.”
Here, Dr. Lieb (grins) and bares it all about your aging teeth.
How do teeth show our age?
Teeth can discolor, turning yellow or brown. Gums begin to recede with age. And just as your nails get more brittle, so do teeth. Because of this, you have a higher chance of fracturing a tooth after menopause.
Also, women over 50 may experience cracks in their teeth due to the breakdown of metal fillings they have had for 25-30 years. The way they fill cavities now is different than the way they used to fill them (with composite instead of silver or mercury). Women over fifty may have metal fillings which are much stronger than the tooth. Their tooth flexes and the restoration (filling) stays rigid. This causes micro-fractures and stress breaks.
Do you see a lot of shifting teeth in women over 50?
There really isn’t much shifting after 50 unless you have periodontal disease (gingivitis). Gingivitis causes bone loss and then the teeth shift because there’s not that much holding them up.
What are some effects of menopause-related hormone changes on teeth?
Dry mouth. When you start menopause, you get dry everywhere. The way women have to use KY jelly...well, they get dry in their mouths too. A dry mouth can increase the instance of cavities. When you don’t have the saliva to clean your mouth, the plaque sticks more. If you have gum recession, you get even more gum recession. You should always try to keep your mouth as moist as possible.
Gum recession, discoloration, cracks and fractures....Sounds scary! Can we talk about the options for correcting these problems (or covering them up)?
Okay. Let’s start with gum recession.
The main thing is to stop it from getting any worse. There are two options. If you have 1-2 millimeters of gum recession you’d just fill it in by placing a restorative filling on the root. The patient would be in an out of the office in 45 minutes. If there’s 3-4 millimeters of recession, you’d need to take tissue from other areas of the mouth to cover it up. It’s called a flap. This procedure is slightly more involved and depends on the severity of the case, but most likely the patient would still be in and out within an afternoon.
How much does this treatment cost?
It’s a wide range depending on the case.
What are the options for treating discoloration?
Laser whitening, at-home whitening or veneers. Laser whitening or in-office whitening are instant fixes. You can see changes in one visit and you are less likely to get teeth sensitivity. However, it’s more expensive than at-home whitening. Whitening may not work for you if you have high tetracycline staining or if your teeth are extremely discolored and you’ve tried numerous times to whiten without results. In that case, veneers are an option. Like faux nails, porcelain veneers cover the outer visible surface of the tooth only.
What's the best at-home whitening method?
Dentist-made, custom trays are far better than at-home whitening methods due to the strength of the peroxide and because they reach the individual gum line. Each tooth has it's own shape, so whitening strips may either go on the gum or not reach the gum because they are not custom. I created a product called SexySmile. It combines a state-of-the-art tooth whitener, breath freshener and long-lasting lip gloss in one stick. Unlike white strips, you can apply it to the entire surface of the tooth.
Are there specific behaviors from your past that lead to very discolored teeth?
If you or your mother used Tetracycline (an antibiotic that leads to teeth staining), excessive drinking of tea, coffee or soda and smoking. Some people just have genetically yellow teeth.
How much does this all cost?
Veneers can cost anywhere between $2500 - $3500 per tooth. Whitening can cost anywhere from $500 (for at-home whitening) to $1300 (for laser whitening).
If I just got a whitening toothpaste and used that for a few months, would it make a difference?
No. Toothpaste just removes the stains. It does not whiten teeth.
What are the options for treating fractures?
You have to cover fractures. If they are in the front and vertical then you might be able to get away with veneers. If the fractures are in the back, you’d most likely need a full-coverage crown.
How much are crowns?
Crowns are in the same range as veneers $2,500-$3,500 per tooth.
How would you fix crooked teeth in someone over fifty?
If the person is a candidate for Invisalign, it’s a good option because they are clear. If not, I’d refer them to an orthodontist for full brackets. It depends on the case.
Can you ever be too old for Invisalign?
No. And you can’t be too young either. They start them in their teens now.
What’s the cost of Invisalign?
So, it’s never too late to have your teeth straightened?
It’s never too late. And 99% of people who need their teeth straightened are candidates for Invisalign.
Is there any temporary, quick fix for bad teeth?
Snap on Smile are like temporary crowns that snap on to your teeth. We take a mold of your teeth so it’s individualized They’re not supposed to be worn more than a year. If you have a missing tooth and you get an implant, while it heals, you can use Snap on Smile. You can get a cosmetic effect without putting any pressure on the site where you’ve had the implant. It’s also great for events. If you’re daughter or son was getting married and you weren’t feeling comfortable with your smile... this would be phenomenal.
How much does Snap on Smile run?
It can range from $1,500 to $3,000 per arch.
What routine should someone absolutely follow for beautiful teeth?
Brushing and flossing every day. A routine checkup at a dentist every six months and x-rays when needed. There are also little things, like don’t drink too much citrusy liquid or soda because it melts away your enamel. Prevention is key. If your going to be a problem-child and drink a lot of soda and citrus than go in for cleanings more.
Why do people focus so much on anti-aging for skin and not for teeth?
I don’t know. The first place your eye goes to on someone’s face is her smile. That’s a fact. You can Google it.