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Expert Advice from the dental practice of Dr. Deborah Lesem 

At her general dental practice, Dr. Deborah Lesem (100 Rob- ert E. Blvd., 504-286-3880; www.drlesem.com) offers elec-tive procedures, including tooth bleaching, bonding, veneers and tooth replacement via crowns, bridges and dentures. Below, Lesem shares the ins-and-outs of these procedures.

How can cosmetic dentistry improve patients' overall appearance?

Deborah Lesem: There are many ways to change the overall appearance with cosmetic procedures. We can replace enamel that is chipped or worn, which often makes for a healthier, more youthful-looking smile. Bleaching or ceramic or bonded veneers can transform discolored or darkened teeth, making them brighter and more appealing. Of course replacing missing teeth, especially in the front, dramatically improves one's looks.

What is the most popular procedure in cosmetic dentistry?

DL: In my office, bleaching is by far the most popular cosmetic procedure. The cost is reasonable (usually under $300 for custom trays and bleach), and just about anyone can do it, although there are some situations that your dentist can check for before you bleach.

Is there any harm in repeatedly whitening your teeth?

DL: Yes and no. Most bleaches available over the counter or at your dental office are safe if you follow the directions exactly. Some people get into trouble when they try to bleach more often or use more bleach than is recommended. In most cases, overuse or misuse causes sensitivity of the teeth or gums and in more severe cases, can result in permanent damage to the teeth and/or gums. The custom trays made at a dental office work well to keep bleach off the gums. If you choose to do the take-home whitening from your dental office, the doctor or staff can provide you with instructions for proper use, so that you bleach safely and get the best possible results.

How long do results last?

DL: Results are generally permanent, but the teeth can get stained from daily use — eating, drinking, smoking, etc. When this happens, a touch-up treatment (usually only one or two times rather than several days) of bleach may be necessary to bring the color back to its post-bleaching brightness. Some patients choose to touch up their bleach after a professional cleaning to maintain their teeth at the optimum shade. Then they aren't bleaching through plaque, so it will be very effective.

What's the second most popular procedure?

DL: In our office, bonding is very popular, because it often takes only one appointment, usually requires no anesthesia, and patients leave with immediate results. The cost depends on the number of teeth involved, but our fees run about half that of porcelain veneers and the bonded veneers have the advantage of being able to be repaired if one gets chipped or damaged. Porcelain veneers run $1,100 per tooth and must be completely redone if they are damaged. We can change the tooth color, shape or alignment in one visit. Another advantage is that usually the teeth do not need to be ground down for bonded veneers.

Is cosmetic dentistry ever covered by insurance?

DL: Every policy is different, but any procedure that is needed due to decay, etc., is generally covered, so cosmetic procedures that are also taking care of decay or failing restorations will often be covered. Bleaching is rarely covered by insurance. Sometimes bonding or veneers can be covered, depending on the reason — for example, if the tooth has decay or a filling that requires replacement or is fractured — that would usually be covered.

Do your patients notice their quality of life improves after they get cosmetic dentistry?

DL: Yes. It is common for patients to tell us how much better they feel when they are not self-conscious about their teeth. It is a big boost to their confidence.

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