Marielaina Perrone DDS Cosmetic, Family, and Implant Dentist
Many of us choose haircuts or clothes based on our facial or body shape so why not our teeth? We are all born with a set of teeth that may or may not be perfect to us. There may be minor flaws or major ones to our eyes. With modern cosmetic dentistry, teeth changes can be made to improve your overall appearance and look very natural.
Facial Analysis and Cosmetic Dentistry To Transform Your Smile
It is essential for your dentist to do a facial analysis in treatment planning for cosmetic dentistry. The face drives the shape and position of the teeth. If someone smiles at you and it’s a high and wide smile, the teeth might be out of balance or out of proportion to the face. If this is the case, the smile needs to be altered to bring about balance and proportion.
Simply put, the face, mouth, and lips direct the size of the teeth. The facial aesthetic drives the tooth size and position. Your dentist will need to look at the face from both the front and the side, the relationship between the lips and the teeth and the teeth’s shape, color, size and position.
“There is an important harmony that exists between teeth and facial features for a successful cosmetic dentistry result.”
The shape of the head, size and position of the eyes, nose, lips, cheekbones all play a role in determining the size, position, shape and contour of the teeth. Your cosmetic dentist should do a complete analysis with models of your mouth and records may include extra oral photographs of the full face, profile, smile and intra oral photos of the teeth, bite, gums, and arch form, and measurements. The architecture of the mouth, including the patient’s lip line (e.g., a high lip line give a “gummy smile” appearance), and gum line contours are an integral part of facial analysis.
Cosmetic dentistry utilizes many procedures to make the changes necessary to make your smile complement your face. The goal in cosmetic dentistry is to create a natural looking smile, so that only the dentist and patient know what was done. This becomes especially important as we age. Listed below are some of the cosmetic dentistry procedures that can be used to make complementary changes:
-Dental Bonding. Dental bonding is the process in which tooth colored dental materials are bonded to a tooth. This might be one of the easiest cosmetic dentistry procedures to change our look. Using dental bonding we can change shape, size, color, length, and close any spaces that might be present. Dental bonding is generally completed in the dentist office in as little as an hour. The main drawbacks of dental bonding are chipping, wearing, and staining. The final product is not as strong as a porcelain restoration and may need to be updated over time, but can be done in less time for less money. While dental bonding is also used to restore teeth damaged by tooth decay it can also be used as a cosmetic veneer. This procedure can easily alter your smile in as little as an hour, and is minimally invasive. Dental bonding is a very easy way to make your smile youthful looking again.
-Porcelain Veneers and Porcelain Crowns. Often referred to as “instant orthodontics”, porcelain veneers can change the alignment of teeth, if the alignment issues are not too extreme. Porcelain veneers and porcelain crowns can be a great way to replace lost tooth structure and alter imperfect teeth creating a more youthful appearance. These cosmetic dentistry procedures tend to require more than one visit, but the results will give you a beautiful, youthful smile that lasts. Porcelain Veneers are custom made, ultra thin, tooth colored shells that are adhesively bonded to the teeth, and do not change color over time. This allows the cosmetic dentist to not only alter color of your teeth, but shape and lengthen as well. Porcelain crowns can be used on teeth that either already have crowns or need more extensive work (having large restorations or tooth decay). Both porcelain veneers and porcelain crowns can as used in cosmetic dentistry to give the patient a flawless, more youthful and attractive smile.
Tooth Shapes To Complement Your Face Type
A good cosmetic dentist will note all factors during treatment planning. Individual facial type is one of those important factors in cosmetic dentistry. The following is a guide to different facial shapes and their complementary teeth shapes:
-Small Face: A small face requires smaller porcelain veneers or porcelain crowns. Long, square shaped tooth shapes should be avoided. If the teeth are too long it will not be in line with overall proportions of your face.
-Angular or Square Shaped Face: For this type of face softer edges are required. This will help soften the overall smile and merge it better with the rest of your face. Sharp angled teeth may be too harsh of a look.
-Fuller Face: Just like vertical stripes make a person look slimmer, slightly longer teeth can create a slimming effect.
-Thin Face: The key here is to avoid thin, long teeth. They will only make your face appear longer. Wider, fuller teeth will broaden your smile and add fullness to your smile.
Other factors to consider:
-Tooth color - Lighter teeth are what most of us desire when altering cosmetics. Keep in mind, that skin color, lip color, and hair color effect how whit your teeth appear. You, and your dentist should go through several options to see what will work best for you.
-Tooth size - As we age our teeth tend to shift, chip, and wear. Tooth size and shape consequently change. Restoring back to proper proportions make your teeth appear healthier and more youthful.
Cosmetic Dentistry Conclusion
Many dentists call themselves cosmetic dentists, but not all have the proper training, experience, and skill to take an ordinary smile and make it extraordinary. The key to it all, is overall improvement, while keeping it looking natural. The best cosmetic dentistry procedures is make your smile appear natural with the proper color, shape, and light reflecting properties. Your friends and loved ones will love your new smile, without realizing what you have had done!
Cosmetic dentistry has become such a common term that almost every dentist calls themselves a “cosmetic dentist”. The American Dental Association does not recognize
cosmetic dentistry as a specialty in dentistry. The fact is, that even though cosmetic dentistry is not officially recognized, it does take extra skill, experience, and training. A good cosmetic dentist is concerned with both the esthetic outcome as well as the functional outcome working together in harmony.
Common procedures used in cosmetic dentistry include teeth whitening, porcelain crowns, dental implants, limited tooth movement, gum sculpting, dental bonding, and porcelain veneers. With the exception of teeth whitening, all of the other procedures require extra skill on the part of the cosmetic dentist. The goal in any cosmetic dentistry procedure is to have the final product look and feel as natural as possible. This includes proper treatment planning before and skilled preparation during the procedure. Choosing the ideal procedures, utilizing the highest quality materials, and pairing with the best dental laboratories are what makes for ideal cosmetic dentistry results. Being able to correct or fix any issues that might arise are just as important.
Cosmetic Dentistry Case Example
Patient came to the dentist with a list of things she did not like about her teeth. She did not like spaces between teeth, wanted whiter teeth, and also had a badly decayed tooth in the upper molar area.
Step 1 – Fully explain your wants and needs. You and your cosmetic dentist need open lines of communication. An agreement should be reached about what can and cannot be done based on time, budget, and function.
Step 2 -Full treatment planning records need to be taken. Pre operative x-rays, study models, and digital photographs. These are essential for a good cosmetic dentistry outcome.
Step 3 – Options for treatment should be presented. Discuss options and develop an agreed upon treatment plan. In the pictured case, the mouth was healthy (except for decayed molar) and free of periodontal disease. Patient was shown what the final treatment could look like. Such visual cues can be very helpful in decision making. In this case the treatment plan decided upon included:
-Removal of an extremely decayed molar, and replacement with a dental implant.
-Porcelain Veneers to correct shape, size, color, and spacing of the front six upper teeth.
-Teeth Whitening – This will allow the patient to whiten the teeth to a more desirable color, so that the new porcelain veneers, and implant crown can be matched to a more visually appearing, cosmetic color.
Step 4 – Patient has badly decayed molar removed and is referred to periodontist for implant consultation and placement. Following placement of dental implant patient will wait 4-6 months for healing and bone strengthening to occur before final porcelain crown can be placed.
Step 5 – Begin Teeth Whitening. This procedure can either be done in office (in one hour), or the patient can complete teeth whitening at home over the course of 2-4 weeks. This step is important as the final porcelain veneers and porcelain crown will be fabricated to match the new, lighter, final shade following teeth whitening.
Step 6 – Following teeth whitening, porcelain veneers procedure can begin. Porcelain veneers (also referred to as porcelain laminates) are super thin, custom fabricated
shells of tooth colored porcelain designed to cover the front surface of teeth to improve your smile’s overall aesthetic appearance. These shells are adhesively bonded to the front of the teeth changing their color, shape, width, and/or length. At end of this appointment patient will be sent home in temporary veneers while the laboratory can fabricate the custom porcelain veneers.
Step 7 – Placement and bonding of final veneers. This is a critical step in this case as the porcelain veneers must not only line up properly to close gaps but also be the right color and shape.
Step 8 – Placement of porcelain crown following healing of the dental implant.
Step 9 – Happy Smile!
Cosmetic Dentistry Conclusion
There you have the steps involved in a typical cosmetic dentistry case. Sometimes there are extra visits if any issues arise but if planned for properly the patient should know exactly what to expect in terms of the cosmetic dentistry treatment schedule as well as finances. Cosmetic dentistry can transform an ordinary smile into one that makes the patient smile bright for a long time to come.