The short version
- Ageing does three distinct things to teeth, and each has its own treatment.
- Enamel thins as well as stains, which is why whitening stops working eventually.
- Short front teeth read as older more reliably than color does.
- Gum health and old restorations are assessed before anything cosmetic.
- A well-made veneer gives the same result at seventy as at thirty.
- Darkening
- Whitening or porcelain
- Worn edges
- Veneers
- Old fillings
- Replacement
- Age limit
- None
You are never too old to improve your smile. The practice’s position on that has not changed in a decade, and the reasoning is specific: what age does to teeth is three distinct things, and each one has a treatment.
What decades actually do
Teeth darken, in two different ways. Enamel takes up stain from everything dark you drink. It also thins, which lets more of the yellower dentine underneath show through. Those two causes compound, and only the first responds to whitening.
That distinction explains a question patients ask constantly: why whitening worked at forty and stops working at sixty. It is no longer treating the cause.
Edges wear. Years of chewing shorten the biting edges and flatten the small irregularities that make a young smile look natural. Short, straight-edged front teeth read as older more reliably than color does.
Teeth chip and drift. Small chips accumulate. Teeth move slightly across decades, opening or closing spacing that used to look even.
Which treatment addresses which
| What changed | What addresses it |
|---|---|
| Surface stain | Whitening |
| Thinned enamel showing dentine | Porcelain veneers |
| Shortened, flattened edges | Veneers, restoring length |
| Chipped edges | Bonding or veneers |
| A tooth that is structurally worn out | A crown |
| Dark or discolored old fillings | Replacement in modern materials |
Darkening responds to whitening where the cause is stain. Where the tooth itself has changed color, porcelain is the answer. See in-office teeth whitening for which stains respond.
Worn and chipped edges are what veneers are for. A veneer resets the length and shape of the front teeth as well as the color. See what dental veneers are.
Structural damage needs a crown rather than a veneer. A tooth filled repeatedly over forty years is a different proposition from one worn at the edge. See dental crowns.
Tooth-colored fillings replacing old dark work are often the least dramatic change with the biggest effect.
Missing teeth are replaced with implants. Dr. Back treats the teeth you have; a case needing implants is referred to a specialist.
What genuinely changes with age
Not whether treatment works. What changes is that more than one thing is usually wrong at once, so the order matters more than it does at thirty.
Gum health is checked first, because recession and bone loss determine what is possible. Old restorative work is assessed, because much of what needs doing is underneath it. Then anything cosmetic goes on top of a foundation that has been confirmed.
A patient in their seventies gets the same result from a well-made veneer as a patient in their thirties. The teeth underneath are no less worth looking after.
Where to start
An examination, which is where those three problems get separated out. The answer is frequently smaller and cheaper than the patient expected: a cleaning, some whitening, and two teeth attended to.
Sarasota Smile Design is on Clark Road in Sarasota, an easy drive from Nokomis, Osprey and Venice, open Monday to Thursday.
Call 941-927-5411, or see cosmetic dentistry.
