by Tom Risbrudt, DDS
Exercise is a crucial part of staying heart healthy. Get moving!If you are noticing teeth that are worn, discolored, misshapen, misaligned or missing, you might be a candidate for cosmetic dentistry. People choose cosmetic dentistry for different reasons:
• Some people have generally healthy teeth and choose to change their smile to a more dazzling, more attractive and more youthful appearance.
• Others have dental problems and need to restore their teeth to health and full, comfortable function. During a restoration (makeover) process that addresses their health and functional needs, their dentist can simultaneously create a youthful, beautiful smile.
Regardless of your reasons, doesn’t it make sense to get the best, customized result for you, personally?
Cosmetic versus Esthetic Dentistry
The term cosmetic makes us think of changing or adding something to make it more beautiful. You may associate the word cosmetic with doing something for the sake of appearance. The term esthetic carries with it the connotation of beauty taken to a higher art form. You may associate the word esthetic with the appreciation for the artfulness of the appearance being in good taste. (“Nice caps!” versus “You look terrific—what have you done for yourself?”)
The entertainment industry and the media have greatly influenced the public’s perception of how they want their teeth to look.
Cosmetic/esthetic dentistry has more than one accepted avenue for expression, for instance, “young natural” vs. “young perfect”, “middle-aged natural” vs. “middle-aged perfect,”etc. This influence has resulted in a plethora of products to meet this demand, both in terms of home whitening all the way up to new porcelains to duplicate the extraordinary whiteness achieved with bleaching, for instance.
Every dental restoration (for example a crown, veneer, implant, bridge or filling) can be made in such a way as to achieve an esthetic, natural-looking tooth, or more toward media-driven perfection. But, the restoration also has to be able to stand up to the forces of the bite and oral environment over time. Form follows function, and properly functioning teeth have a specific shape for a reason. A well-trained dentist seeks to balance the esthetic results of a smile with predictable, functional and healthy outcomes that last for many years.
A competent and astute dentist seeks to balance more than shape; he/she seeks to balance the color. Matching the color of your restorations to your natural teeth (if you like the existing color) is important so your restorations blend into your smile. Or, your dentist can bleach your teeth (if you don’t care for the existing color) to a lighter, brighter, more youthful shade before matching the restorations to the selected new color.
So you’re saying to yourself: “Great! Let’s get started! What do I do next?”
The Stages of a Smile Makeover
1. Discussion - Prior to your examination, you should have a real heart-to –heart talk with the esthetically trained dentist, spending time talking about your dental history, medical history, health concerns and oral health objectives.
The best possible outcome of any dental service lies in the doctor and care team understanding your desires for your ideal smile. Everyone has different concepts of beauty, and this applies to teeth as well. Each patient’s treatment plan should be individualized and custom designed to complement the patient’s facial structure, skin, hair and eye color. Make sure your selected dentist has pursued advanced training in dental esthetics to confidently guide you in making good choices.
2. Examination - The comprehensive oral health examination from your highly trained esthetic dentist should be unlike any you have experienced before in terms of thoroughness. The approach should be thorough and comprehensive, in order to avoid surprises later. You should be encouraged to ask questions and voice concerns throughout the process. Keep in mind that disease, nutrition, occlusal function (your bite) accidental injury, your genetic makeup and even more factors affect the appearance of your smile.
3. Photography - Your dentist should use pictures of sample, ideal smiles to start a dialogue. Does the dentist have an extensive library of his/her work? In addition, you may bring favorite smiles from magazines or other sources that you find attractive. Your current smile and teeth conditions should be photographed, and examples used to help visualize the end result. This helps a person to discover how their smile would look in two dimensions. A wax-up model of your mouth provides significant information for both you and the dentist and will help both of you in this process.
4. Laboratory Wax-up - The dental team will make impressions (molds) of your mouth and from the molds create a mock-up of your mouth in wax. On this wax, the dentist can modify the shapes and contour of your teeth and examine the changes in three dimensions. This allows your dentist to do a proper and realistic assessment of your bite.
5. Treatment Plan - Not every course of action is simple, and most mouths cannot be restored without careful study and planning. (If you fail to plan, you plan to fail!) When your dentist has created a well thought out plan, he/she will outline a series of well-planned procedures that are most appropriate for achieving the results you have previously discussed. You will be helped to envision what your ideal smile might look like and to understand the functional enhancement you will experience.
The plan may include treatment by a specialist such as an orthodontist or periodontist. Referral will be made to a specialist your dentist trusts to be as comprehensive and careful as he or she is, and your dentist needs to be in communication with the specialist before you start treatment.
6. Phases of treatment - At each of the phases of the treatment plan that you select, you and your dentist should thoroughly discuss what is involved and address your concerns. The active disease processes should be addressed first, such as cavities and gum disease. If there are TMJ/TMD issues, they should be addressed as well. If finances are a concern, many smile makeovers can be done over a period of years, with the dentistry done in stages. The most urgent health and functional concerns will be addressed first to improve health and comfort, and again, ensure long-term success and predictability.
A makeover process may take anywhere from a few weeks to several months depending upon the scope of your needs. Beware of quick fixes! Before any extensive smile makeover is performed and while it is in process, your dentist should go to great lengths to ensure the final result will meet or exceed your expectations.
7. Temporary or “Provisional” Restorations - Beautiful and durable temporary restorations are made from hard acrylic in the shape of the pre-approved wax-up. These are adhered to your teeth and can be worn while you “test-drive” your new smile for comfort, function and appearance. This time is important as it gives you and your dentist another opportunity to refine the changes in your teeth for optimal results prior to creation of the final restorations.
8. Final Restorations - You will want to have your teeth whitened prior to the fitting or your final restorations so your restorations can be made to match the ideal color you desire. Your dentist will counsel you about appropriate whitening for your circumstances and oversee the process.
9. Follow Up - Your dentist will continue to follow up with you and ensure that your bite is evenly solid and your expectations are met. Any dentist who performs extensive esthetic/cosmetic dentistry can tell you his/her happiest moment is when you say the dentistry you received exceeded your expectations and you are delighted with the results. Your dentist wants to help you maintain your new smile during the years to come and get the most from your dental investment. You and the dental team you trust will continue to partner to ensure your long term health, comfort and appearance.
Now, isn’t this the kind of long-lasting smile makeover you really want? b