Smile Makeovers

By: Dr. Marc Lazare, DDS

We are now living in a new age of cosmetic makeovers, where an individual has the ability to enhance his/her appearance or reverse the visible signs of aging just by re-designing their smile. In addition to understanding the value of oral health, both men and women are now focusing their desire on an attractive smile for their confidence, self-esteem and its social advantages.

After all, a smile and a handshake are what create the first impression. A smile and a handshake start every business meeting, every job interview, and leave a lasting impression on a first date. Today, Americans seem obsessed with the notion that beautiful is better, as evidenced by the incredible success of hair, body, skin and weight-loss products that are being sold. With this heightened public awareness, esthetic dentistry is becoming recognized as a necessary treatment for keeping Americans looking beautiful and healthy.

People used to visit the dentist because they had to, not because they wanted to. Now all of that has changed. People want their teeth whiter, straighter and more beautiful, and they want it done quickly. With in-office tooth whitening and porcelain veneers, all of that is not only possible, but often done non-invasively and painlessly. In just a couple of visits a smile can be fully transformed. By reshaping the teeth we create the illusion that the teeth are actually straight and in the proper position.

Veneers can eliminate large gaps between teeth, esthetically correct crowded and rotated teeth, and whiten and redesign one’s smile. Porcelain laminate veneers (a thin, porcelain “shell” permanently bonded the front of one’s teeth) are often selected as restoration of choice for esthetic makeovers because of their long-term dependability. These veneers, which can last 10 to 15 years, are esthetic, durable, conservative in nature and easy to maintain. In fact, porcelain laminates can actually strengthen aging teeth that have begun to fracture. Many times porcelain veneers can be fabricated without having to undergo orthodontics.

In order to maximize esthetics, prevent fracture and maintain the health of the surrounding tissues, tooth preparation is generally necessary in utilizing these restorations. Veneers create the illusion of reality by carefully blending opalescence, fluorescence, and translucency in order to mimic the way a natural tooth interacts with light. This is what separates veneers from simple bonding procedures. Veneers empower one with the ability to change the shape or color of their existing dentition. Today’s generation of dental porcelains combine the properties of esthetics with strength, as the demand for metal-free restorations increase.

Smile design takes into account the entire picture, where the lips and gums act as the frame for the esthetically enhanced teeth. Just as different frames complement different paintings, the design and modifications of one’s smile are considered on an individual basis. Our focus is to improve the entire smile. Fixing just one or two teeth is like renovating one or two houses on a block. It makes everything else look worse. Esthetic dentistry is not patchwork; we concentrate on the entire smile.

Teeth can tell your age….that is, only if you let them. A cosmetic smile-lift can subtract years from your appearance. The cosmetic smile-lift involves non-surgical modifications, where the smile is broadened, teeth are brightened, and the lips are made to appear more full. As people get older, their lips usually lose elasticity and become thin, wrinkles develop, and their face begins to show their age.

Some may turn to their plastic surgeon for a face-lift, but the cosmetic smile-lift may eliminate the need in some cases. We are currently undergoing an esthetic revolution, where new materials, techniques and equipment have enabled the dental practitioner to produce high quality, highly esthetic restorations that are predictable and minimally invasive.

It is essential that restorations such as porcelain veneers and crown and bridgework be performed in a healthy mouth (free of gum disease) as red and inflamed gums can distract from the overall appearance. A mouth that is kept healthy will invariably lend itself to beauty.

In order to create someone’s smile we have to evaluate their total face and listen to their expectations. The shape and design of each patient’s teeth should be tailored to that individual, because each person’s facial contours are different, and these distinct characteristics help to distinguish one’s character.

The starting point of smile design is determining the facial midline. The midpoint between the two front teeth should line up with the midline of the face. The amount of tooth and gums that are revealed differ from patient to patient depending on phonetics (what their smile looks like when sounding certain letters) and smile position. For example, if you were to draw a line between the corners of the mouth when smiling, you will find that a youthful smile will show 75 – 100% of the front teeth below that line.

Different types of smiles can be created just by altering the planes in which the edges of the teeth line up, and by keeping those edges straight or rounding them off. For example, someone who wants a more aggressive look may have the teeth line up straight across without any soft curves, where as some one who wants a more playful appearance may want the two front teeth slightly longer than the teeth directly next to them, and the canine teeth (2 teeth over from the front teeth) would be a little longer and with a more curved point. [see photos].

Just by rounding off the sharp edges of teeth one can create a softer, more feminine appearance. [see photo]. People can correct that sunken in look where the teeth narrow as they go back and they see dark space in the corners of the mouth, by enhancing their smile to fill the vestibule.

The communication and relationship between the patient, dentist and ceramist is of the utmost importance, if one is to have predictable, esthetic dentistry. The dentist must send their laboratory accurate models, bite records and photographs in order to establish the perfect phonetics, esthetics and function.

Final Thoughts

With our minds being educated and our bodies being exercised, what better way is there to communicate how we feel than with a beautiful smile. Patients are paying more attention than ever before to appearance-enhancing dentistry. People simply want to look their best, and once properly educated about their options, will more than likely want to beautify their smile.

Why should one have to go through life hiding their teeth and self-conscious about their smile? A reconstructed smile will add confidence and help to create a more youthful appearance. Is the cost a factor? Maybe, but what greater investment could one make than in themselves