Cosmetic dentistry has, over the last decade, become increasingly popular. We are asked almost daily by patients how they can whiten their teeth or improve the appearance of their smile. At times solutions can be as simple as bleaching and at other times it can include a more comprehensive approach.
Cosmetic dentistry demands that we begin with the end in mind. It demands the utmost attention to detail. It requires excellent communication between the dentist and the patient…and the dentist with the laboratory that completes the fabrication of the restorations. It also demands that the dentist LISTENS to what the patient desires.
Most aspects of dentistry involve a technical approach which the patient is not likely to be interested in. The patient is only concerned with their ability to chew, the amount of discomfort involved and if the procedure is in the front of the mouth, cosmetics quickly places itself on the top of the concern list.
When the concern is a cosmetic one, it is vital that the dentist take a step back and make sure that he/she is on the same page with the patient. Though the dentist may achieve all the dental goals for the case, if the patient isn’t happy, it is still a failure. Below is an example of case where the patient desired a cosmetic change to his upper teeth.
The patient is a 48 year old male with 4 treatment goals. 1. He doesn’t like the space between his front teeth 2. He would like no space between the crowns and his gum tissue (currently there are dark areas below the crowns on several of his back teeth) 3. He wanted the shape of his teeth to be natural and not too large 4. He would like his teeth white. Figure 1 and 2 contain his before photos.
Before_edited-21-300x125 Figures 1
Before-Bite-300x113Figure 2
Due to the amount of space between his teeth we took an extra step and had the lab complete a wax-up with the planned final shape for the teeth. This reassures both the patient and dentist that the desired tooth proportions are feasible.
WU-Front-300x105Figures 3
WU-Right1-300x92Figure 4
WU-Left-300x81Figure 5
With the wax-up complete, the last decision to be made was the color for the final restorations. In this instance the patient was sincere with his desire for the whitest shade achievable. Before cementing the crowns the dentist confirmed with the patient that he was satisfied with the color. The photos below show the final result after the crowns were cemented.
Mx-Final-300x69Figure 6
Final-Smile_edited-1-300x135Figure 7
As the case was completed we reassess whether our goals were met. (1) All spaces are closed between his teeth. (2) The crowns are continuous with the gum tissues. (3) The teeth have a natural shape and do not appear too large. (4) The teeth are the color the patient desired. The most important goal of treatment achieved was that the patient was happy with the final results.
All Photos and Treatment Completed by Dr. Brandon Helgeson DDS