Self Image and Cosmetic Treatment Choices

As I discussed in the previous newsletter, our thoughts can have a profound impact on our physical body at the most basic level.

The research of Dr. Masaru Emoto shows the effect music, words, thoughts, and even photos have on the crystal structure of water. Don’t forget, we are mainly water. Thus, how we feel about ourselves, our self-esteem, can have a lot to do with our physical health.

This is why I believe that procedures that help one feel better about oneself are beneficial.Of course, the expectations cannot be unrealistic. Let us explore some of these options. 


My patients often ask me how I feel about bleaching of the teeth. “Doctor, I’m sure you don’t believe in bleaching… in using a chemical in the mouth. Do you?” In fact, I do believe bleaching provides a very important service.

When dark teeth are made white, causing a person to smile more, it has a positive effect on their well being. Another benefit is the wonderful energy that a smile emits, which has a beneficial impact on the receiving end of the smile.

How does bleaching work?

Hydrogen peroxide is used to bleach teeth. The hydrogen peroxide is used in different concentrations, with the higher concentrations having a more immediate effect. The over-the-counter bleaches, i.e., Crest White Strips, have a concentration of 6-10% of hydrogen peroxide depending on which type you buy. In office bleaches can go up to a concentration of 16%.

I offer two methods of bleaching. One is done in the dental office and the other is done at home. The method performed in the office takes 30-60 minutes and can usually be completed in just one visit. On average, the teeth will lighten 7-8 shades. With the home system, impressions are taken and a custom tray is made for the upper and lower arches. You judiciously place the bleach material inside the tray and leave it in place for 30-60 minutes once to twice per day for approximately two weeks. I prefer this rather than leaving the tray in while sleeping.

Crowns, veneers and fillings will not be made whiter with either procedure. Sometimes the teeth can become sensitive with any method of bleaching. This is temporary.

Remember, your teeth are alive and there is communication from the outside of the tooth to the inside.

Therefore, I do not recommend that sick patients bleach their teeth until they are healthier and less toxic. I also do not think it is a good idea to bleach with mercury in the mouth, as more mercury will come off the filling in the presence of the bleach.

When approaching bleaching from this perspective, I have not seen any adverse effects. What I have seen is that people smile more in order to show off those “pearly whites”.


Sometimes bleaching is not enough. Teeth that are crooked, uneven, too small, spaced, or spaced present a more substantial problem if someone wants a “new smile”. Sometimes orthodontics is the best solution. However, many adults do not like the thought of wearing braces for six months to two years. For all these problems, veneers are often a viable solution.Veneers are also good for anterior teeth with a lot of large fillings.

As many of my patients and readers know, I try to be as conservative as possible. I do not like to “cut” teeth down for crowns unless absolutely necessary.

Traditionally, to veneer front teeth with porcelain, a substantial amount of tooth structure needs to be removed. However, today, with a patented porcelain called “Lumineers”, I can often place veneers with no removal of tooth structure. And in those instances where tooth structure must be removed, the amount removed is usually very minimal. This is a very exciting advancement in dentistry.

Many of you know my receptionist, Jennifer. Jennifer’s front teeth were too small for her face. For years I wanted to do something but I could not justify touching her teeth with the dental drill.Thanks to the “Lumineers” I was able to veneer her teeth without removing any tooth structure. Anesthesia was not even necessary. Now Jen has a “Miss America” smile. How does that make Jen feel? Just ask her.


Little changes often make a huge difference. Just some reshaping of the front teeth or the bonding of material to one or two teeth can completely change a person’s appearance. Do your eye teeth look like fangs? Adding some material to create a softer smile can make a world of difference.

Plastic Surgery

Here the pros and cons definitely need to be weighed. Naturally, plastic surgery is a lot more invasive than bleaching or veneering.

What is the effect of Botox? It seems to be safe, but are there going to be problems that surface over the years upon repeated injections? Then again, if there is a strong positive effect on the way one feels about oneself, this can potentially be more beneficial and negate any detrimental aspects.

When it comes to surgery, (i.e., face lift), there has to be a concern about general anesthesia. The plastic surgeon in our building, Dr. Richard Bensimon, eliminates this risk by doing his procedures without putting the patient out. Dr. Bensimon finds that patients recover much faster and have fewer side effects by just using local anesthetic!

Naturally, doctors have to get to know their patients and be careful of those whose problems will not be solved by a cosmetic procedure. I have seen people that bleach their already white teeth everyday – trying to get them even whiter. I once had a patient obsessing over a microscopic chip on a front tooth. She thought about placing veneers on her front tooth to correct the problem. With magnifiers I could hardly see the “chip”. Veneers will not solve her “problem.”

Everyone has seen the effect of endless plastic surgery on Michael Jackson. Everything is a balancing act.

However, more and more I feel that if a procedure will truly help a patient have a more positive self-esteem, it will in turn have a positive effect on the patient’s overall physical health.

© 2006, Mark A. Breiner, DDS

The information presented is for educational purposes only. You should consult a qualified dentist or health practitioner for diagnosis and treatment. 

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