Many people are unhappy with their smile, but today’s cosmetic dentistry techniques are enabling more and more people to benefit from a more aesthetically pleasing smile. It is important to be aware of all available options when seeking advice. ‘Teeth basically hold the facial bones in place,’ cosmetic dentist Dr Sarkis Nalbandian explains. ‘As we get older or lose teeth the jawbone is less supportive and the face sinks, contributing to an ageing appearance. Maintaining a youthful smile becomes more and more challenging. Using veneers, for example, will give better lip and cheek support, fill out the top lip and enhance facial expression. This is rejuvenating in itself and having a youthful smile is something we all want,’ he says.
The dentist has the power to influence the patient, but the patient is the final decision-maker. So it’s important the patient is presented with all the options and information so that he or she can make the right decision. A plan of treatment can then bedeveloped, which will have a predictable outcome. Minimally invasive treatments, rather than unnecessarily grinding the teeth into ‘bits and pieces’, improve the quality of life as well as addressing the dental and aesthetic needs. According to Dr Nalbandian, this conservative approach maintains and beautifies at the same time.
There are several conservative options available to improve the colour and shape of the teeth and, ultimately, the smile. Discolouration of the teeth can be hereditary and occurs through genetics, or can be a result of such activities as smoking, taking certain medications or drinking red wine or coffee frequently. The best treatment involves the application of a whitening conditioner under a special light, resulting in changes of 3 to 12 shades lighter and brighter.
If the teeth are of sound structure, there are many options available to remodel the shape, to close gaps and to improve the gum line. While a skilled knowledge of aesthetics is necessary, Dr Nalbandian recommends the ‘One Visit Smile Lift’, a procedure which normally requires no local anaesthetic and is painless.‘Composite veneers are applied and the procedure does not require cutting a sound tooth
structure,’ Dr Nalbandian explains. ‘It can be used on people of all ages and the effect is immediate. It is non-invasive and inexpensive because there are no laboratory fees, but the improvement
is dramatic.’
Compromised teeth with minimal tooth structure requiring large restoration will be prone to stress and cracks, and possible fractured teeth resulting from the pressure of biting. ‘Crowns provide more security for tooth structure, but the treatment requires two visits and is more invasive. The individual tooth (or multiple teeth) is prepared and reduced, and a temporary crown is put in place until the second visit when the permanent crown is put in place,’ Dr Nalbandian explains. Porcelain veneers require considerable tooth preparation and are more costly than composite veneers, but may be necessary if minimal enamel and tooth structure are present.
Dental implants may be the long-term solution for patients with single or multiple missing teeth. Implants involve the replacement of dental roots with a titanium fixture, placed in the bone of the jaw and allowed to heal. Implant support provides a stable non-moving foundation for replacing missing teeth. Utilising implants can save adjacent healthy teeth, and help preserve the bone from atrophy. Bone shrinkage after tooth loss can accelerate the ageing appearance of the face.
The aim of cosmetic dentistry is to improve the attractiveness of the smile while addressing the dental needs. Whether non-invasive or more invasive treatments are required, the dentist should assess the patient’s smile as part of the overall facial appearance. This means taking into consideration the symmetry of the individual’s facial features, including the positioning of the eyes, nose, lips and chin, the ears, the hair-line, cheekbones and teeth across the midline. The proportions to each other vertically and horizontally must also be considered with how the smile harmonises within these elements. The aesthetics are unique to every individual, but everyone appreciates an attractive smile.