Your Guide to Better Oral Health

Orthodontics vs Cosmetic Dentistry in Malaysia

Orthodontic and cosmetic dentistry often work together in helping patients to achieve the desired smile, function and oral health.

Your smile is one of the unique traits that leaves an impression and sets you apart. A straight, beautiful smile will not only boost your self-esteem but allow better maintenance of oral hygiene, as well as speech and bite functions, which impacts the nutritional uptake of the body, hence eventually improving the overall health and quality of life. With the advent of orthodontic treatment and cosmetic dentistry, achieving a straight beautiful smile is no longer unattainable.  

What is cosmetic dentistry?

Cosmetic dentistry consists of various dental procedures, such as restorative dentistry, internal bleaching, gum treatments, orthodontics come together to achieve desirable smiles on patients to achieve satisfactory aesthetics and proper function of teeth while maintaining the oral health of the patients with the concerns of crooked, stained, missing, fractured, spaced-out teeth, or gummy smiles. Restorative dentistry comprises composite filling, crowns, bridges, veneers, implants that are considered to allow patients to have a natural-looking smile and to perform functions of teeth.

Composite fillings: This tooth-coloured resin material is often used in clinics by the clinician to restore teeth directly. The properties of composite resins allow the filling to be easily manipulated and set, allowing results of an immediate direct restoration of a whiter, natural-looking smile. However, this restoration has lesser strength than porcelain crowns to withstand heavy biting forces, thus being at risk of fractures and eventually reducing the longevity of the filling. Additional decay may occur around the filling if oral hygiene or the seal of the filling is compromised. Composite resin can also take up stains from coffee or tea, hence polishing the filling annually can resolve the stains.

Crowns: Crowns are long-term restorations, often coated with porcelain to achieve the natural colour and translucency of teeth. Crowns cover and protect tooth structures that are weakened, due to root canal treatment, fractured tooth or heavily decayed tooth. As crowns cover the whole tooth, the risks of decay are reduced. Some smile makeovers that use crowns often reduce tooth structures to allow crowns to be fitted on, however minimally invasive techniques such as veneers are advocated now to preserve the integrity of teeth.

Veneers: The less invasive technique of a smile makeover is the use of veneers, with minimal removal of tooth structures. Veneers are as thick as fingernails so they are more fragile compared to crowns and high biting forces should be avoided to prevent fractures. Veneers also leave natural tooth structures exposed to potential decays as veneers only cover the front part of the teeth, leaving the back of the teeth exposed. Nonetheless, veneers can last up to 10 or 15 years, with proper care and oral hygiene. 

Should I Get a Dental Bridge to Replace My Lost Teeth?

Bridges: The fixed and permanent solution in replacing a missing tooth/teeth are bridges. They are more expensive than dentures but they are cemented over supporting tooth structures, allowing patients not to worry about a denture being loose in their mouth. Removal of some healthy tooth structures is required to allow them to act as crowns, holding a ‘tooth’ in place to replace the missing tooth. Good oral hygiene is critical in maintaining the longevity of the bridge and the supporting tooth structures, as food debris can be stuck beneath the bridge, causing a site to harbour bacteria and increasing the risk of decay and gum disease.

Dentures: Types And Costs – Forbes Health

Conventional dentures: Dentures are removable prosthetics to replace missing teeth. Traditional dentures are usually made of acrylics, with or without a metal framework. These types of dentures are the least expensive option to replace missing teeth and can replace 1 tooth or all the teeth. Conventional full dentures rely on suction on mouth structures to hold them in place, while partial dentures rely on clasps over the existing teeth. Since they are removable, patients can maintain better oral cleanliness easily, especially in patients with limited dexterity.

Implants: Implants are getting more popular due to their permanent solution in replacing missing teeth by inserting implants into the bone of the patient. Implants can replace a single tooth, or multiple teeth by having implant-supported bridges, and even implant-supported overdentures. Implant-supported dentures are better than conventional dentures in terms of retention, stability, chewing, speech as well as comfort. However, the suitability of implants is dependent on the amount of bone present in patients to secure the placement of the implants.  Implants require regular professional and home maintenance by having thorough cleaning, this allows the implants to last and  avoids gum diseases. Lifestyle changes such as smoking cessation and reduced alcohol consumption are encouraged to prolong the longevity of dental implants.

The demand for whiter and brighter teeth has increased immensely, driving the innovation and development of various teeth whitening products that can be done at home or in a clinical setting. In the clinic, bleaching gels of higher concentrations of active ingredients are used and can be activated with or without blue light, depending on the type of activation needed. Clinical teeth whitening produces better and instant results, but tooth sensitivity may occur temporarily. Home-whitening kits offer patients the option to whiten their teeth at home with a lower concentration of bleaching agents. Whitening toothpaste contains more abrasives that can polish teeth to achieve a whiter and brighter look by removing the stains formed on the tooth surfaces.

Some stains, such as internal discolouration caused by trauma, or being non-vital, cannot be done with the normal teeth whitening technique, but require internal bleaching to mask the discolouration within a tooth. Internal bleaching is the process where whitening is done within a tooth by placing a chemical through an opening in the tooth. The process can take up to 2 weeks and after the removal of the chemical from the tooth, the hole in the tooth is then filled.

Gum treatments are also part of cosmetic dentistry. Crown lengthening can treat smiles that have a lot of gum showing, also known as gummy smiles, by removing excess gum tissue to extend the length of teeth, using laser therapy or surgical incision. Gum depigmentation, often done using laser therapy, helps reduce the dark complexion of gum caused by natural melanin pigments, metallic fragments embedded in the gum after a dental treatment or medical conditions.

What is orthodontics? Orthodontic treatment and orthodontic braces explained

Why Orthodontic Treatment Is Important | Orthodontist Whitby | Braces  Whitby | Invisalign Whitby

Orthodontics is an area of specialisation in dentistry and is a form of cosmetic dentistry that focuses on correcting crooked, spaced out teeth, or the misalignment of jaws, which impacts chewing of food, speech, oral hygiene maintenance and self-esteem of individuals. In some severe cases of jaw misalignment, surgeries are required to adjust the position of the jaws to establish a more functional bite. Some orthodontic treatments may require the extraction of healthy teeth to create space in the mouth to straighten teeth. To correct the misalignment of teeth, patients would wear appliances for a few months up to a few years. Even after the treatment is completed, retainers are required to be worn to prevent the teeth from moving back to their original positions. Orthodontic interventions such as braces, clear aligners, orthodontic removable appliances, retainers are different treatment options.

Fixed braces are brackets and wires that surround the teeth and are worn for a few years, adjusted by the orthodontist every appointment to correct the alignment. This process causes the bone to be remodeled to accommodate the new changes in the teeth position. There are a few types of fixed braces, such as metal braces, ceramic braces and lingual braces.

Metal braces are the conventional braces that are commonly used.  Each orthodontic bracket is held together with individual elastic ligatures, to hold the arch wire in its place to apply pressure over the teeth. Another type of fixed braces is ceramic braces, that function the same as the concept of the conventional metal braces. Ceramic braces are much less noticeable than metal braces due to the clear ceramic material, hence these are usually for patients who are concerned with aesthetics. The cost of these braces is higher than the metal braces, as well as the maintenance and care required, due to their fragile material type. The elastic ties to hold the archwire in both metal and ceramic brackets are prone to staining, hence rinsing the mouth with water immediately after consumption of food that can stain easily can be a solution to reduce the staining of the elastic ties. 

There are also self-ligating metal braces that come in either metallic and ceramic self-ligating braces and are commonly used in complex cases. They work similarly to conventional braces but without the presence of elastic ligatures, as the brackets have metallic ligatures attached over them, holding the arch wire in place. This type of braces is easier to clean as food particles are not easily trapped between the ligature and the teeth. Shorter orthodontic appointments are needed as the bracket metallic ligatures do not need to be changed as compared to traditional elastic ligatures that need to be replaced during every adjustment visit . This is a slightly more expensive option in comparison to conventional metal braces . 

Lingual fixed braces are hidden braces placed on the back of the teeth and are often opted by patients who are more appearance-conscious. Lingual braces are case-to-case dependent, at the advice of the orthodontist to determine the suitability of lingual braces for patients. However, these braces are more expensive. , Due to this type of braces encroaching the tongue space, it may result in a temporary lisp in patients, causing difficulty in maintaining oral hygiene. 

Fixed braces require very thorough cleaning to ensure no decay or gum inflammation occur as the orthodontic appliance in the mouth can be sites of accumulation of plaque, acids, food debris and bacteria. Compromised hygiene can also cause the surface of the teeth to be discoloured. This occurs when teeth are exposed to acids and tooth minerals are leached out, developing white spots.

Clear aligners, or invisible braces, are one of the latest and popular technologies in orthodontics. The suitability of each case is dependent on the complexity of the patient. Most mild to moderate complexity cases can be corrected by clear aligners, but the more complex cases have to be done with fixed orthodontic interventions or even surgery. Each custom-made plastic aligner consists of very subtle differences in the alignment of the teeth, putting slight pressure on the teeth to reposition the teeth. Aligners are removable appliances, which allow teeth to be cleaned easily as compared to fixed appliances that are difficult to maintain cleanliness. Average treatment time ranges from 12 to 18 months, but can vary due to the compliance of individuals and the complexity of cases.

Some orthodontic interventions involve removable plates that can correct minor teeth misalignment or intervene in the bite of young patients by correcting the jaw relation by restricting or promoting jaw growth. However, these types of removable orthodontic appliances are less common, possibly due to the lack of awareness in treating jaw misalignment since young.

After orthodontic treatments, the use of retainers are critical and are needed to ensure teeth are not moved back to their original positions. There are two types of removable retainers, with one being a clear retainer that is similar to clear aligners; while the other is a retainer plate made of acrylic and metal wires to hold the teeth in place. 

What are the differences between the cosmetic industry and orthodontics?

Cosmetic Dentistry Smile Makeover: What Is It and Should I Get It? -  Lexington Family Smiles

Cosmetic dentistry encompasses a huge range of branches of dentistry, including dental restorations, gum treatments and orthodontic treatments. Cosmetic dentistry that focuses on dental restorations is often viewed as the simpler, quicker way to achieve satisfactory smiles, while orthodontic treatments are seen as a long-term and more complex manner to correct the teeth alignment. 

Cosmetic dentistry is usually not conservative and often requires tooth structures to be removed to allow the bonding of dental materials. Restorative materials can vary in longevity but there may be a need to change or replace them as they do not last forever. However, the position of teeth remains the same, in which severe malpositioning requires orthodontic treatments if restorative dentistry itself cannot change the smile.

Orthodontic treatments can alter the position of teeth, without extensive removal of tooth structures hence the integrity of the tooth is not compromised, although some teeth may need to be extracted during treatment. Orthodontic treatments can correct the bite of patients, improving their speech, bite and eating.

These two branches of dentistry often work together as they are closely related in helping patients to achieve the desired smile, function and oral health to achieve the desired outcome.

Dental technology in Malaysia’s cosmetic industry and orthodontics

The technology in the dental industry is advancing more than ever. The use of computer-aided design/computer-aided manufacturing (CAD/CAM), 3D printing, laser technology and other advancements are integrated into the dental industry, allowing both clinicians and patients to benefit from different options of dental treatments available, the reduced time needed, and improved quality of materials and accuracy in techniques.

Laser dentistry is much used in dentistry, ranging from crown lengthening to orthodontic procedures and teeth whitening activation. Benefits include minimised bleeding and risk of infections.

Various types of dental restorative materials are present to suit each patient’s need for aesthetic, strength, longevity and anti-decay properties. New and improved materials, such as zirconia, ceramics, lithium disilicate, composite resins and glass ionomer cement, are constantly being trialled and tested to provide a range of solutions suited for each purpose for the patient.

For cases with indirect restorations, the use of intraoral scanners is gaining popularity over traditional impression-taking due to the time efficiency, convenience and patient’s comfort. Scans of the mouth can also be used to fabricate dentures, implant abutments, mouthguards and orthodontic aligners. More studies on the accuracy of intraoral scans are needed, as they still have the capacity for improvement.

Digital workflow of dental appliances using CAD/CAM are becoming a staple in the dental industry. It starts with scanned models of the mouth, either by extra or intraoral scanners, then to planning and designing with dental software, and later on to construct dental appliances with machines and finally,  refining by dental technicians. The use of digital smile designing software allows interactive appointments with patients in the treatment planning of a smile makeover, which lets clinicians address concerns of the patients, and have try-ins of designed veneers/crowns before the start of any restorative and orthodontic procedures. By incorporating digital dentistry into practice, the accuracy of fit, reliability in quality as well as time efficiency are the biggest advantages.

The technology of milling machines and 3D printers, as well as material types, is constantly improving. Milling machines in laboratories see an increase in efficiency in production, especially in complex cases such as implant components; while in-clinic milling machines allow the fabrication of same-day crowns in a few hours. 3D printers are the hype in various industries, and it helps the fabrication of many types of dental appliances. The common uses of 3D printers include the manufacture of nightguards, wax crowns and framework for metal casting, dental models and recently, dentures. More research and development are required to establish evidence-based use of many other appliances, but this is a good indicator of the advancement in 3D printing technology in the long run .

Implants are heavily impacted by technology, with complex cases that can be done with the milling and 3D printing of materials, customised into temporary and permanent restorations. Temporary restorations over implants are essential in aiding the healing process and giving a better soft tissue profile . The use of specialised 3D X-ray imaging, known as cone-beam computed tomography systems (CBCT), in guided implant surgery with implant planning software and 3D printed surgical guides, is another advancement in placing implants in suitable positions. CBCT is also helpful in orthodontic analyses, oral and maxillofacial surgeries, forensics and many more.

Fixed orthodontic appliances are usually not custom-made by dental laboratories, but are  bonded directly in clinics using pre-adjusted brackets. However, with the advent of technologies, custom-made prescription brackets of fixed braces can now be made in the dental laboratories, customising each bracket based on the tooth movement the patient needs , which increases patient comfort and efficiency of treatment. Clear aligners are done in laboratories, where plastic sheets are formed over custom 3D printed models that are made according to the changes in teeth position in aligning software. Other orthodontic removable appliances and retainers are customised in the specialised laboratories that work closely with orthodontists.


Cosmetic dentistry and orthodontic interventions have both advantages and disadvantages. 

Cosmetic dentistry: 

  • Faster process in achieving the desired smile
  • May require irreversible removal of sound tooth structures
  • May need replacement over some time
  • More expensive if full mouth makeover is considered 

Orthodontic treatment:

  • Preservation of the integrity of teeth
  • Need not require extensive removal of tooth structures
  • May require extraction of healthy teeth
  • Slower process
  • Lifelong maintenance with retainers
  • Fixed orthodontic treatments are difficult to clean, hence the risk of decay and discolourations are higher

A holistic approach to a smile makeover is needed as cosmetic dentistry and orthodontic treatments come hand-in-hand in achieving the perfect smile.


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