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Beautiful Smiles by Design

By Dr. Stephen R. Snow

This article is endorsed by the
American Academy of Cosmetic Dentistry.

(Continued)

Figure 9.
Figure 9: Before treatment, a photograph of a full smile illustrates how discolored restorations with decay mix with misaligned and worn teeth to form a smile that this patient feels is unattractive.
Figure 10.
Figure 10: A tracing technique is used to design an smile that possesses improved alignment and proportion. The light gray lines represent the original teeth while the dark gray signify the proposed design as it fits within an ideal framework.
Figure 11.
Figure 11: The final result demonstrates how the previous detracting elements have been eliminated or improved in developing a beautiful new smile. (same patient as figure 9 and 10)
Photos provided by
Dr. Stephen R. Snow

The dentist as artist can help a patient visualize the potential results of proposed treatment recommendations using photographic images, tracing analysis, and even computer simulation [Figure 9-11]. While these pictures may differ slightly from the eventual outcome, the dentist can utilize drawings or digitized images to describe particular procedures and to compare how they could affect the final look.

By altering the relative size, edge design, or angulation of the front teeth, the final effect may appear “sexy,” “sporty,” or “sophisticated.” Of course, the enjoyment of all things possible must eventually rub shoulders with the limits of reality. At this point, the cosmetic dentist must take up the consideration of prognosis — the predictability for achieving and maintaining every aspect of the desired outcome. Options may range from limited-scope to all-inclusive, less expensive to more elaborate, invasive to conservative, or durable to shorter term. Inevitably career, financial, and other life activity issues may become part of the discussion. Other realities like age and overall health may play a factor. Some procedures make sense for some patients while they may not be as advantageous for others. Here the dentist draws on both clinical experience and scientific evidence to make recommendations that are ultimately in the patient's best interest.

In crafting the most appropriate smile design, each person must consider what he or she is willing to pursue to achieve the future they have envisioned? Is the commitment to time and money available to complete an extensive design plan? Is there a willingness to accept an enhanced but more limited improvement anticipated with a less extensive design plan? In the end, it boils down to the perspective of value for the each patient. Eventually, the dentist and patient work together to determine the best course of action as they collaborate to achieve a practical and realistic smile enhancement.

Putting The Plan Into Action

To this point, the smile design is still on paper — or perhaps a computer screen. Once the plan is finalized, though, the real work begins: the actual procedures the cosmetic dentist uses to create the patient's brand new smile.

You might be surprised at the wide array of techniques now at a cosmetic dentist's disposal, but most have been in development for decades. Some techniques, like whitening, bonding, veneering or enamel shaping, change the appearance and shape of the patient's natural teeth. Other techniques like crowns, bridgework and implants provide permanent artificial replacements for missing or abnormal teeth that cannot be corrected with the previously mentioned procedures.

Orthodontics may also play a role in many smile design plans to correct malocclusion and faulty tooth alignment. Although the optimum time for orthodontic applications is typically just before or at puberty, cosmetic dentists have realized their benefit for smile design even for adults of all ages. Innovations in braces and other orthodontic devices have reduced discomfort and improved their appearance and even saved time.

Some of these procedures involve just one visit to the dentist; others may take months or even years to complete. Regardless of the techniques involved the outcome should be the same, the smile you once beheld in the mirror has been transformed. A sense of disappointment or embarrassment has now been replaced with confidence as you freely share your new smile with the world. More importantly, dental health has simultaneously been restored. You will be a healthier you and that is definitely something to smile about.


Smile Design Techniques

Here's a brief description of some of the more common techniques used by cosmetic dentists to correct or enhance a person's smile:

Whitening — a chemical application with a peroxide base is applied directly to the teeth to remove minor staining and discoloration.

Bonding — An acrylic material is applied to a tooth that can be shaped and colored to match the natural look of the patient's other teeth. Primarily used for chipped, broken or decayed teeth, as well as to alter tooth shape with minimum tooth removal.

Enamel Shaping — the removal of minute amounts of enamel, the tooth's outer layer, to improve the look of the shape of a tooth.

Veneers — a thin shell of tooth-colored material, usually porcelain, custom-designed to be affixed to the front surface of the teeth.

Crowns and Bridgework — a technique that covers heavily damaged teeth or replaces missing teeth. They usually have an inner core for strength and an outer porcelain shell for the feel and appearance of real teeth.

Dental Implants — as an alternative solution for replacing missing teeth, titanium posts are surgically implanted in the patient's jaw. Artificial tooth replacements are connected to the posts to restore missing tooth above the gum.

Gum Contouring — a minor surgical procedure altering the position of the gum tissue and sometimes the underlining bone, to improve the look and regularity of the gingival line around the teeth.







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