PERFECT IMPERFECTIONS
In
our minds in the past, we used to actually separate cosmetic dentistry from the
traditional dental treatment, but now in essence, it is all one and the same. We see this routinely in every general
dental practice.
Let’s
take a brief look at the history of cosmetic dentistry based upon the last
paragraph. At one time, cosmetic
dentistry was thought to be just for those “elite” dentists who would only make
a “perfect” smile for patients. There is
even discussion in dentistry whether or not this should become a specialty unto
its own. Associations and organizations
were created solely dedicated to cosmetic dentistry and these were important in
communicating to the dental industry that cosmetic dentistry was here to
stay. There are so many courses that
are still dedicated to the perfect smile and this certainly helps elevate
cosmetic dentistry to the position that it is in today.
But
wait, where were patients in all of this?
In the past, cosmetic dentistry was not only for elite dentists but also
it turns out for elite patients. How
many patients can really afford “the best dentistry” with that “best dentistry”
defined by bright white teeth in a perfectly straight smile. What about cosmetic dentistry for the
general dentist who has everyday patients?
That has certainly been the key to integrating cosmetic dentistry into
mainstream dentistry. Products like Cristal
Veneers by Aurum Ceramics with their no/minimal preparation approach appeals
greatly to dentists and patients alike.
Are the cosmetic results perfect?
The bigger question really should be, do they need to be perfect? Many patients are happy with certain aspects
of their smile and only wanted the teeth made white with minimal change in size
and shape. Many patients are more than
pleased with results when the teeth inclination and the midline may not have
been perfect.
The
question that I want you to think about is this - is perfectly straight and
white teeth really esthetic either by themselves or at all? One of the first lessons we as dentists
learned in the dental school denture lab is when setting the teeth in wax for a
try-in, don’t make the teeth look too straight because perfect looking teeth
look unnatural and fake. Now here we
are doing exactly that in patients mouths in the name of cosmetic
dentistry.
Now
that we entering realm of total facial esthetics with the advent of Botox and
dermal fillers in dentistry, we have now taken a fresh look at facial esthetics
which integrate the teeth with all the soft tissues around it like lips and
cheeks. We have finally stopped
disassociating the teeth from the rest of the face. In other words, we need to stop being so teeth-centered and if we
really are going to go ahead and give our patients great looking smiles, we
need to consider all of the soft tissue around the mouth and indeed the entire
face. What we really know about total
facial esthetics is that people’s faces are not perfect and in fact, some of
the most famous beautiful people in the world have faces that are characterized
by slight imperfections.
Now,
if we go ahead and put perfect teeth into an imperfect face, is that really
esthetic? The answer is obviously no,
perfect teeth many times look very fake because unless the patient has a
perfect face, then these can stand out abnormally and they may look great in
the retracted photographs that dentists adore, but in a full face photograph,
which is the view that really matters to human beings other than dentists,
these perfect teeth may not fit in at all.
Most
esthetic smiles and faces that you see and admire every day is a smile that
falls under the term I like to use called perfect imperfections. In other words, rarely does a perfect smile
fit into a person’s face. It’s the
little characterizations such as a slight rotation, a slight inclination of a
tooth, a little bit of gradual shading and the characterization of the
surrounding soft tissue depending upon the patient’s facial features will look
much more esthetic than trying to force perfect teeth into an imperfect
face. This is what total facial
esthetics has really come to teach us.
You need to look far beyond the teeth if we really want to get patients
a great looking smile. We need to once
again view the full face of the patient in order to give us direction as to
what the teeth should look like and what is truly esthetic for each individual
patient.
Clinician:
Dr. Louis Malcmacher is an
internationally known lecturer and author, known for his comprehensive
and entertaining style. He works closely with dental manufacturers as a
consultant and clinical researcher in developing new products and
techniques. Dr. Malcmacher is a contributing editor for Dentistry Today,
a monthly columnist for Dental Economics, and an evaluator for Clinical
Research Associates. For close to two decades, Dr. Malcmacher has
inspired his audiences to truly enjoy doing dentistry by providing the
knowledge necessary for excellent clinical and practice management. His
group dental practice has maintained a 45% overhead since 1988.
Looking for a speaker for either a lecture or hands on course for your dental society or study group? I would be glad to help.
The 2010 schedule is almost full, so please contact us today at dryowza@mail.com for available dates in 2010!
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