RAHUL DOSHI HAS EXPLORED THE REACH THAT COSMETICS HAS ON EVERY PART OF DENTISTRY
When the cosmetic dentistry boom first arrived in the UK about 15-20 years ago, it was mostly synonymous with veneer work. The preparations were far more severe and aggressive in nature than the techniques that are around today. The progression then went on to include smile design and makeovers, especially with the arrival of Extreme Makeover UK.
Thereafter, when dentists talk about cosmetic dentistry, it is often in terms of the new smiles that can be created. The term ‘cosmetic dentist’ was also coined. People started to affiliate cosmetic work with crown and veneer work; however, in reality cosmetic dentistry is much more than this.
Cosmetic dentistry is an umbrella term that has now infiltrated every corner of dental modality. In fact, people are more aware of how their mouths should look than ever before. Therefore, every treatment possibility should now take account of various aspects of cosmetic dentistry.
There are certain core principles that we need to adhere to in order to meet the final objectives of any type of dentistry. These include:
- Following the basic principles of smile design
- Establishing natural tooth forms and surfaces that are invisible to see
- Colour and texture to form natural looking restorations
- Correct occlusion patterns for the specific patient to remove interferences
- Harmonious periodontal tissues
- Keeping the oral cavity free of biological deterioration
- Protection of tooth structure via improving tooth structure.
Cosmetic work in Dentistry
•Restorative. Anterior and posterior restorations should follow the natural shape, form and colour that a tooth would have originally. The restoration should appear invisible to the naked eye. There should be no reason why in this modern age we can’t achieve such dentistry.
•Smile design. Minimally invasive smile design work can now be achieved with systems such as ultra-thin veneers, which also take the cosmetic appeal of the entire facial structure into account. Veneers can be placed using pre-alignment techniques or alignment techniques with simple cosmetic bonding. This ultimately achieves beautiful results that are also conservative.
•Teeth whitening systems. These are of course specific to cosmetic dentistry, and patients easily understand the objectives of such treatment.
•Prosthodontics. With dentures, the teeth should be aligned in such a way so the resulting smile looks pleasing and harmonious with the frame of the face. Prosthodontic work should also provide adequate support to lost tissues by correct replacement. Dentures should not look like the way dentures used to look in the past. It should be difficult for any onlooker to establish that the person is wearing them. The teeth and gums should look real and natural.
•Implants. Implants are not just about replacing missing teeth, but also to re-establish occlusion correctly and the appearance of lost teeth. When carrying out surgical procedures such as implants, care should be taken to ensure soft tissues surrounding the implants are harmonious with the resulting crown. This establishes natural tooth form and appearance. The resulting tooth should look like it has
key is to overcome the challenges of not only a lost tooth, but also that of lost bone and tissues surrounding the missing teeth. This means care and consideration needs to be given on how a tooth is extracted to minimise the loss of surrounding bone. This even makes tooth extraction cosmetic in nature.
•Periodontal treatments. Periodontal work can also take the cosmetic end result into account with gum line and gingivae form.
•Orthodontics. This has now become about using techniques that are fast, inconspicuous and cosmetically acceptable to the patient, rather than idealistic long-term treatments to achieve cosmetic enhancements. Idealistic options are perfect for paediatric dentistry, but may not be as realistic for adult dentistry; however, smile design principles can still apply.
To summarise, we have established the fact that almost all dentistry today can be somewhat cosmetic in nature, either via colour, alignment or tooth form. Hence, dentistry can be used to enhance a patient’s appearance and even improve teeth and gums, but still compliment the face.
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Rahul Doshi BDS LDSRCS was the senior clinical director of The Perfect Smile Advanced Training Institute in Hertford, Hertfordshire and offered hands-on training courses in aesthetic dentistry. He lectured both in the UK and abroad and was PPD’s clinical editor. www.theperfectsmile.co.uk