Aesthetic dentistry, caprice or need?

Three things are important in life: order, work, and teeth. I believe you know the first two in practice, and my practice is the third. It’s my job, it’s my profession, and it’s my favorite subject, except for football, and those other men’s idle talk. But today, more often than ever before, teeth are an attractive topic for most people.
In the modern, highly developed world in which we live, we are exposed daily to the various pressures imposed by our environment and society. One such stress is one of the perfect appearances. Cosmetic surgery has long become a part of everyday life, and undergoing cosmetic surgery is no longer a taboo subject, nor is it an eccentric behavior like twenty years ago. The justification and ethics of such interventions can be discussed in various aspects in the media and professional circles, but the reality cannot be changed. But neither interest.
In dentistry, it may not be subtle to talk about cosmetic dentistry because every prosthetic work in the mouth is always cosmetic. Modern dentistry for many years provides aesthetically very successful, sometimes perfect prosthetic restorations. The technological breakthrough came at the end of the last century with the introduction of new advanced materials and technologies, and the profession responded by raising aesthetic criteria to unexpected heights. Today, aesthetical failures are no longer justified, and the cosmetic outcome of a prosthetic restoration depends solely on the knowledge and experience of the therapist, dental technician, and the equipment of the surgery. When it comes to cosmetic dentistry, it is usually thought of dental procedures that do not have a primary medical indication but are motivated by patients’ desire for a better tooth appearance and a more harmonious smile.

Cosmetic surgery has long become a part of everyday life, and undergoing cosmetic surgery is no longer a taboo subject, nor is it an eccentric behavior like twenty years ago.

The range of procedures used in cosmetic dentistry is very quite wide, from completely non-invasive treatments like dental wellness (de-scaling, sandblasting, protective coating), to whitening, to grinding teeth to make flakes or ceramic crowns. But it is also worth mentioning orthodontics, which deals with correcting the wrong position of teeth and bites and has a grand aesthetic effect. Occasionally, cosmetic dentistry interventions are combined with the wearing of an orthodontic appliance to achieve an even better aesthetic result. It has already been stated that the technological possibilities of well-equipped surgeries and dental laboratories, and the characteristics of modern materials are so great that they allow very high aesthetic results. It is also a potential pitfall for patients and therapists as it leads to unrealistic expectations and promises. It often happens that a patient wants a smile like a famous movie face, and he doesn’t even know that smile is the long-term work of a team of dentists, not to mention the fabulous figures that conclude the job. I don’t know how much the one who paid it was laughing, but surely, the smile worth it. The most important thing for the success of cosmetic surgery on the teeth is to correctly detect the problem and choose the optimal solution, following the rules of the profession, the therapist’s capabilities, and the wishes of the patient.
Planning should take into account the age of the patient, the degree of an aesthetic problem, the condition of the teeth being treated, as well as the condition of other teeth, the bite of the patient, the patient’s habits (smoking, coffee, tea, red wine, hygiene, bruxism). Only the optimum solution chosen will result in the mutual satisfaction of the patient and the dentist.
Professional de-scaling, sandblasting, and dental wellness are nowadays practically a part of personal hygiene and can be practiced from once a month to several times a year. It provides a permanently fresh and radiant smile and prevents cavity and periodontal disease. Bleaching can also achieve several shades of lighter tooth color in a single visit. It is a sophisticated and harmless procedure. Bleaching lamps and hydrogen peroxide-based preparations are used. Usually, all teeth are whitened, after which it is necessary to adjust the filling color with the new shade of the tooth. Individual teeth can be whitened too. Durability depends on the patient’s habits and is directly related to the consumption of food and drink that pigments the tooth enamel, as well as to smoking.

Interventions in the field of cosmetic dentistry most often involve multiple methods and procedures that are combined to produce the best result. Such therapy aims to obtain an improvement in the aesthetic appearance of teeth and smiles, but without adverse effects on the teeth health.

Ceramic flakes have been in vogue for the past few years, replacing the classic crowns in one segment. They are most commonly used on the upper front teeth, the so-called aesthetic zone. They are made of a specific type of ceramics (press ceramics) or zircons. Significantly less tooth grinding is required, but a slightly lower mechanical resistance is associated with this. Radical changes in the patient’s smile, like smile design and smile makeover, are possible with veneers. They are very popular in the younger population, which has a preserved dentition with minor aesthetic defects. Regardless of the gentle preparation of the tooth, it should be emphasized that this is an invasive procedure in which a part of healthy dental tissue is damaged. Ceramic crowns – covers, nowadays, are made almost exclusively of metal-free ceramics, which results in a significantly better, more natural color and transparency. Tooth preparation is somewhat more extensive. Sometimes it is necessary to devitalize the tooth. Crowns are excellent for major prosthetic and implant-prosthetic remedies, which also intervene in the patient’s bite. They have excellent mechanical resistance and durability and are the most common method of prosthetic therapy.
Interventions in the field of cosmetic dentistry most often involve multiple methods and procedures that are combined to produce the best result. Such therapy aims to obtain an improvement in the aesthetic appearance of teeth and smiles, but without adverse effects on the teeth health. The choice of tooth color, shape, and size should be guided by the idea that the result should not be “visible from the plane” but merely a discrete change for the better, which will continue to act naturally and decently.
The selection of therapists and the method of the procedure should respect the criteria of expertise, the experience of dentists, technicians, equipment of the practice, and dental laboratory. That’s why: order and work! Preference should be given to dental prosthetics specialists and specially trained dentists with extensive experience in the field of aesthetics. Everyone has their specialty, mine are teeth, and yours is smile.

TEXT – dr. Marko Krmpotić