IR Sept VFTB 29/6/07 10:21 Page 1 View from the bench · ‘smile design’. Pick up any dental...

12 September 2007 Irish Dentist View from the bench I’ve never seen Jesus Christ Superstar, so I can’t be sure, but I suspect when the chorus sings ‘What’s the buzz? Tell what’s a-happening’, they aren’t referring to cosmetic dentistry. However, if they were the answer would definitely be ‘smile design’. Pick up any dental magazine or look at any one of the 17,000,000 websites a Google search will kick up and you’ll see there certainly is a buzz about smile design. So, what is smile design? Until recently, with the advent of television makeover shows, it was just what we know as best practice cosmetic treatment planning. Your laboratory should be able to help make this process successful and stress-free for you and your patients. There are umpteen solutions to the misaligned, discoloured and missing teeth that your patients may present before you at your surgery, and it’s your responsibility to talk them through the options so they understand what is and isn’t possible. Your lab should be able to provide you with literature from their suppliers with glossy before and after shots of successful cases using their products, although you may prefer to go to an impartial website such as The British Academy of Cosmetic Dentistry (www .bacd.com ), which has plenty of case examples. Many of my clients find a Masterpiece Study Model a great communication aid. With examples of all the different types of crowns, bridges and veneers we offer, if the patient can actually see the product, the surgeon can quickly and easily explain the difference between an all- ceramic and a bonded crown, or demonstrate a veneer or a Maryland bridge. Once the patient is aware of what is available and how much it will cost, it’s time to get the lab involved in all but the simplest cases. Impressions for study models and, ideally, photographs are dispatched to the lab, while you begin any preparatory treatment such as perio work, gingival adjustment and especially teeth whitening; please remember finished ceramic crowns can be darkened with stain but not lightened. Once the models have been cast and duplicated your lab should contact you to discuss what you are hoping to achieve before going on to make a diagnostic wax-up. This can be trimmed or added to by you to get exactly the effect that you and the patient are looking for. With modern light-cured waxes, veneer wax-ups with minimal preparation can even be tried- in. A soft, clear suck-down splint can be made over the wax-up, giving you a stent guide for the space you are creating during preparation and a mould for temporary/ provisional crowns and bridges. These have the added advantage of giving the patient the chance to get used to the approximate shape and size of the finished restoration. There is one final step before you start prepping the teeth – check that the patient hasn’t got a major holiday, wedding or movie screen test planned for the next fortnight. This might sound bleedin’ obvious, but the number of time I have ended up delivering cases to dentists’ homes at midnight because a patient has forgotten to mention their daughter’s wedding the next week aren’t that rare and normally involve an express fee! So, that’s what I think of as smile design: dentist and technician working together to give the patient the information to choose a treatment and smile they can be happy with for the next 20 years. In the first of a series of six, dental technician Peter Wagon explores the meaning of smile design, and how dentists can work with technicians to provide their patients with the best possible aesthetic and functional results Peter can be contacted at Associated Laboratories Ltd, Day Lewis House, 324 Bensham Lane, Croydon, Surrey CR7 7EQ, England; tel: +44 (0) 20 8689 2905; email: [email protected] ; web: www .theteethpeople.co.uk . View from the bench IR Sept VFTB 29/6/07 10:21 Page 1

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Transcript of IR Sept VFTB 29/6/07 10:21 Page 1 View from the bench · ‘smile design’. Pick up any dental...

12 September 2007Irish Dentist

View from the bench

I’ve never seen Jesus ChristSuperstar, so I can’t be sure,but I suspect when the chorussings ‘What’s the buzz? Tellwhat’s a-happening’, theyaren’t referring to cosmeticdentistry.

However, if they were theanswer would definitely be‘smile design’. Pick up anydental magazine or look atany one of the 17,000,000websites a Google search willkick up and you’ll see therecertainly is a buzz about smiledesign.

So, what is smile design?Until recently, with theadvent of televisionmakeover shows, it was justwhat we know as bestpractice cosmetic treatmentplanning. Your laboratoryshould be able to help makethis process successful andstress-free for you and yourpatients.

There are umpteensolutions to the misaligned,discoloured and missingteeth that your patients maypresent before you at yoursurgery, and it’s yourresponsibility to talk themthrough the options so they

understand what is and isn’tpossible.

Your lab should be able toprovide you with literaturefrom their suppliers withglossy before and after shotsof successful cases using theirproducts, although you mayprefer to go to an impartialwebsite such as The BritishAcademy of CosmeticDentistry (www.bacd.com),which has plenty of caseexamples.

Many of my clients find aMasterpiece Study Model agreat communication aid.With examples of all thedifferent types of crowns,bridges and veneers we offer,if the patient can actually seethe product, the surgeon canquickly and easily explain thedifference between an all-ceramic and a bonded crown,or demonstrate a veneer or aMaryland bridge.

Once the patient is awareof what is available and howmuch it will cost, it’s time toget the lab involved in all butthe simplest cases.

Impressions for studymodels and, ideally,photographs are dispatched to

the lab, while you begin anypreparatory treatment such asperio work, gingivaladjustment and especiallyteeth whitening; pleaseremember finished ceramiccrowns can be darkened withstain but not lightened.

Once the models have beencast and duplicated your labshould contact you to discusswhat you are hoping toachieve before going on tomake a diagnostic wax-up.

This can be trimmed oradded to by you to get exactlythe effect that you and thepatient are looking for. Withmodern light-cured waxes,veneer wax-ups with minimalpreparation can even be tried-in. A soft, clear suck-downsplint can be made over thewax-up, giving you a stentguide for the space you arecreating during preparationand a mould for temporary/provisional crowns andbridges. These have the added

advantage of giving thepatient the chance to get usedto the approximate shape andsize of the finishedrestoration.

There is one final stepbefore you start prepping theteeth – check that the patienthasn’t got a major holiday,wedding or movie screen testplanned for the next fortnight.This might sound bleedin’obvious, but the number oftime I have ended updelivering cases to dentists’homes at midnight because apatient has forgotten tomention their daughter’swedding the next week aren’tthat rare and normally involvean express fee!

So, that’s what I think of assmile design: dentist andtechnician working togetherto give the patient theinformation to choose atreatment and smile theycan be happy with for thenext 20 years.

In the first of a series of six, dental technician Peter Wagon explores the meaning of smile design,and how dentists can work with technicians to provide their patients with the best possible aestheticand functional results

Peter can be contacted at Associated Laboratories Ltd, DayLewis House, 324 Bensham Lane, Croydon, Surrey CR7 7EQ,England; tel: +44 (0) 20 8689 2905; email: [email protected];web: www.theteethpeople.co.uk.

View from the bench

IR Sept VFTB 29/6/07 10:21 Page 1