Getting an attractive smile is now witnessing the use of advanced aesthetic dental procedures, especially after the recent progress in employing veneers, dental crowns and implants to do so. Statistics reveal that the number of people undergoing plastic surgery is increasing more than ever, with the American Society of Plastic Surgeons (ASPS) reporting that members performed more than 17.7 million surgical and minimally invasive aesthetic procedures in the US in 2018, including on getting the perfect smile. Enjoying their best look is the dream that many men and women are now pursuing, and with advances in plastic surgery and new technologies many people are seeking to enjoy a more glamorous and attractive look. Lecturer in fixed prosthodontics at New Giza University Karim Mahdy explained that fixing a patient's smile could be done through many procedures related to the colour and shape of the teeth. “Choosing the advanced dental technique to work with is relative to each patient's teeth. For instance, if the patient is unhappy with his or her teeth colour, the first option is bleaching. While the patient is undergoing the bleaching sessions, he must follow a white diet, meaning avoiding all foods containing colours, as during the bleaching procedure the pores of the teeth are open and are very sensitive to colours. Specific dental treatments containing fluoride are prescribed to hasten the closing of the pores,” Mahdy said. On the other hand, when a patient is unhappy with the shape of his or her teeth, braces might be applied. Such problems can include spacing, where the front teeth are separated by large gaps, for example, or crowding, which is a lack of space for all the teeth to fit normally within the jaws. “Braces could be the first option to solve these problems. But when the patient is unwilling to wear braces, dental veneers are the second option,” he said. Veneers are very thin white ceramic layers that are placed on the surface of the teeth. Mahdy said that veneers can also be a solution to solve the problem of teeth colour when the patient wants a more permanent solution than bleaching. “However, there are cases where veneers are not the best solution,” he added. For instance, when the teeth are not aligned with the mouth dimensions or have too much crowding, the dentist will need to recontour the enamel layer, which is the outer surface layer of the teeth. This is not a good thing to do as when the enamel layer is gone the veneers will not bond well with the teeth and they may fall off, Mahdy said. For him, the alternative solution is using dental crowns, as crowns will bond perfectly with teeth that have been recontoured. The other case where dental veneers are not the best option is when the patient suffers from tooth decay or has poor dental hygiene. Related to choosing the best colour of veneers that can best suit the patient, this is a process that should be carefully done, as the wrong colour can result in the “too white” ceramic colour sometimes seen in the teeth of actors on television. Mahdy explained that a dental shade guide should be used during the colour-choosing process, when the patient often picks the “whitest” colour on the shade guide. The dentist should clarify to the patient that the colours displayed on the shade guide will look even whiter once applied to the teeth, he said. The whitest colour on the shade guide will look very artificial. But the funny thing is that there is a trend among patients today to pick a “too white” ceramic colour to show that they have had their teeth done. Mahdy said that in the past patients were more prone to choosing shades of tooth colour that would give them a natural look. But today the tastes of many patients are to favour a “too white” look. “I believe that the role of the dentist is to guide the patient and help him or her to enjoy a good-looking, but natural, smile,” he said. He added that in order for the teeth to have a perfect fit after applying veneers or crowns, an initial procedure called a mock-up must be used by the dentist. “A mock-up is a preparation that shows the end result on the unprepared teeth. It serves as a guide in prosthodontic treatment, in order to avoid an undesired final look, like too big teeth, or teeth that don't perfectly fit the mouth,” Mahdy said. The dentist takes the size of the original teeth of the patient and then starts to build the ideal desired look of the patient's smile in the mock-up. At the same time, a smile analysis is done for the patient to identify the ideal look that suits him or her. After completing the mock-up to the dimensions that fit the mouth of the patient, ceramic crowns are made based on the dimensions and using advanced software, 3D printing and other technologies to achieve the results desired in less time. Mahdy's advice for each patient is to be very conscious before taking any steps related to teeth recontouring and veneers. If other options are available, they should be taken, including wearing braces. “Minimally invasive procedures are preferred,” he said. It can also be a good idea to gain the opinion of several doctors specialising in prosthodontics before applying veneers and to be aware of the various steps taken in aesthetics procedures, especially the mock-up.
*A version of this article appears in print in the 18 June, 2020 edition of Al-Ahram Weekly
