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High beam: Taking an interdisciplinary approach to smile aesthetics

Article-High beam: Taking an interdisciplinary approach to smile aesthetics

Key iconKey Points

  • Achieving optimal cosmetic smile results relies on synergistic efforts and cooperation of dentists, oral surgeons, cosmetic surgeons and dermatologists, says one restorative dentistry expert
  • His views and techniques, as well as those of two other experts, are presented

Dr. Rifkin
Dental aesthetics play an integral role in achieving aesthetic harmony in cosmetic surgery. A beautiful smile is often key in setting a person's facial appearance, and today much can be done to maximize aesthetic smile results in patients. In consulting some cosmetic dental experts about reaching such a goal, several stressed to Cosmetic Surgery Times that interdisciplinary cooperation is crucial.

Dr. Davis
DIAGNOSING THE SMILE "Smile rejuvenation is an important aspect of facial harmony and it really starts with the diagnostics," says Laurence Rifkin, D.D.S., Aesthetic and Restorative Dentistry, Beverly Hills, Calif. "I believe it is the synergistic efforts and cooperation of dentists, oral surgeons, cosmetic surgeons and dermatologists that help achieve the optimal cosmetic result for the patient. Teamwork is essential."

"It's important that cosmetic surgeons know what dentistry and orthognathic treatments can offer the cosmetic patient," says Dr. Rifkin. "The aesthetic correction of a patient's profile should not be done with a chin implant when an underlying bite problem is the root cause of the cosmetic imperfection," he explains. "This is neither appropriate, nor the best solution. I can build on the layers from the dentist standpoint, but the imaging and diagnosis as a team is foundational." Betsy K. Davis, D.M.D., director, Maxillofacial Prosthodontic Clinic, Department of Otolaryngology/Head & Neck Surgery, Medical University of South Carolina, agrees. "Today, we are seeing a lot more patients trying to enhance their appearance through a smile makeover. Many are getting aesthetic-dental procedures done for their own self-esteem. The many different procedures available can each have a dramatic effect — in the right situation."

OPTIONS AND EFFECTS Porcelain veneers or crowns can give the teeth a visual effect of a different color and contour and, according to Dr. Davis, these approaches will produce a more dramatic effect than bleaching alone. Beyond this, periodontal surgery itself can play a major role in achieving aesthetic goals. She notes that, when planning a treatment, not only the contouring of the teeth often needs to be addressed, but that aesthetic re-contouring of gingiva can yield a dramatic improvement in a smile.

In addition, orthodontic procedures can produce a fuller lip and can even correct lip asymmetries. Moving teeth to increase the support of the lip, or adding veneers or crowns with a slightly different thickness on the teeth, will change the support of the lip and ultimately affect the lip fullness.

In Dr. Rifkin's view, porcelain veneers and bleaching procedures are only just the start in terms of procedures one can perform to achieve an aesthetic smile, but he cautions that that sometimes these procedures are nothing more than a cover up. He notes that, while they can be fine and functional when everything else is in order, it is paramount to build the foundation first.

As such, Dr. Rifkin does not advocate "instant orthodontics" during which crowded teeth are covered up with various thickness veneers, as this can easily lead to gum tissue and periodontal problems. Instead, he holds that aesthetic beauty needs to be built up from the inside-out.

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