Fragrantly Beautiful

Improving your smile line

BY POORNIMA JAYARAMAN, SOUTHERN HEALTH EDITOR

When was the last time you saw a model with a gummy smile or crooked, yellow teeth?

With the mass media constantly bombarding us with images of beautiful, successful people, with brilliant smiles, there is a subliminal pressure of sorts to put your best face forward; since it just might open the magical doors of opportunity, help you leave a positive impression on your colleagues and peers and give you that all-important edge.

There's no doubt about it, beauty is definitely at a premium today.

The role of cosmetic dentistry and orthodontics
Since a smile can convey happiness, warmth, approachability and confidence; general dentists, orthodontists, cosmetic and esthetic dentists are literally in the limelight today as they admittedly have a lot to offer by way of smile design.

No longer are they just someone you go to see for a painful root canal or gum surgery, but they are also skilled, creative artists - the harbingers of hope, who can possibly change your life, by giving you the ultimate smile.

"The smile line refers to the amount of tooth structure that shows during a normal smile and an exaggerated smile," explains Dr. Kyle R. Childers, DMD, MS, orthodontist at Childers' Orthodontics in Benton, Herrin and Harrisburg. "An 'ideal smile' is when the upper lip just touches the point where the tooth meets the gum line. What you don't want to see is half an inch of gum tissue."

Dr. Christopher Hughes, DMD, Hughes Dental Arts Center in Herrin, agrees. "The gum tissue around the teeth is an important aspect of smile presentation. Since the teeth are framed by the lips; the lip position, fullness and color of the lips can also influence aesthetic appeal."

Focusing heavily on cosmetic dentistry and reconstructive dentistry, including implants, Hughes says beautiful smiles have several common ingredients like symmetry and proportion.

But as we age, our teeth get discolored, worn out and chipped, or suffer from further decay.

Sometimes we could have been in an accident and lost a tooth or chipped it. Cosmetic dentistry comes to our rescue here, by addressing all these problems, and helping to rejuvenate and rebuild our smile.

"Even an 80-year-old may come in wanting some cosmetic dentistry!" says Hughes. "And when we are done with it, they are proud as peacocks because they are so happy with the results!"
An orthodontist, like Childers, on the other hand can help redesign your smile by repositioning crooked, crowded, irregular or overlapping teeth, using braces, retainers and other devices.

Orthodontics can also help with other factors that hinder a nice smile, including spaces between your teeth, protruding teeth, misaligned jaws, tooth development and jaw growth problems.

"While children in general tend to have more problems with crooked, crowded teeth, it's simply because they haven't lived long enough to develop stained, worn teeth as yet," says Hughes. "In that case they visit an orthodontist and get help with their smiles."

"However braces won't help a 70-year-old lady with stained, worn teeth," suggests Hughes. "Her teeth are probably straight, but they just don't look good." In that case a cosmetic dentist sets about determining how best to help her out.

Thus while both cosmetic dentistry and orthodontics take an interest in improving smiles, how they go about it is different.

Bleaching
Bleaching procedures have experienced a phenomenal growth in the past few years. Scores of people buy over-the-counter teeth whiteners and visit their dentists regularly to avail of the latest in bleaching technology, to attain the pearly whites they have always dreamt of.

Indeed the most conservative and least expensive option to dramatically improve you smile, it is an extremely common procedure today.

Veneering
Made of porcelain, a veneer recreates the appearance of a new tooth. Also known as laminating, it's like a slip cover that fits over the front surfaces of the teeth and has both functional and aesthetic appeal.

"Cosmetics wise I seem to be doing a lot of whitening and veneering these days," says Dr. Kwonil Park, DDS, cosmetic and general dentist, Dental Group of Carbondale. "If the stain is inside the teeth, bleaching won't get it all. In that case, veneering and capping helps."

A conservative, minimally invasive procedure, Park says all it involves is polishing the tooth surface, where he's putting the porcelain in.

One important aspect of smile design is the relationship between the ends of the tooth to the lip, says Hughes. From our teenage years to our 20's, our teeth usually don't display much wear.

But as we grow older, the teeth start to wear out, just like the bottom of our shoe sole.

While the amount of wear depends on our diet, usage, genetics and personal habits, the teeth are slowly not displayed as much in our smile as we age. "For example, say your tooth was about 10 mm long when you were 18, by the time you reach 45 years of age, it may be down to about 9 mm in length," says Hughes. "With porcelain veneers, we can rebuild how the teeth should look and give a person back their original smile."

"You can also cross over and put veneers on teeth that have minor tooth crowding," says Hughes. "It all really depends on the individual case."

Gummy Smiles
Since the teeth and the gums are part of the portrait framed by the lips, diseased, discolored or too much of gum tissue on display, can take away from the aesthetic appeal of the smile.

A gummy smile, which is also known as the gingival smile line or high smile line commonly provokes strong concern from clinicians. When a person has a gummy smile, the anterior (front) teeth look like baby teeth, since the gum covers up a lot of the tooth, says Park.

"If the problem is caused by excessive gum covering the teeth, a procedure called crown lengthening can be done, where we fully expose the entire crown" says Childers.

The gum area is then reshaped in a procedure called a gingivectomy, using a conventional scalpel, radiosurgery or lasers.

Conventional Scalpel: For more radical removals of gum tissue, the conventional scalpel method works great, even if it can be a bit on the bloody side, which makes visualization challenging for the dentist.

Radiosurgery: Using an electric current, the doctor cauterizes minute pieces of loose, diseased gum tissue and gets rid of pockets between the teeth and gums in order to achieve a sculpted gum.

"I have a radiosurgery unit and I can tell you this: the procedure is very effective with minimal bleeding," says Hughes. "Visualize a sculptor gently and skillfully sculpting a sphere out of a piece of chalk. A gingivectomy is essentially an artistic kind of light application for sculpting gum tissue and I love it because it feels so creative."

Lasers: Used in various ways in general dentistry for the past five to 10 years, "The laser started being widely used in orthodontics only about three years ago," says Childers, who has over 16 years of practice under his belt.

The only one offering a laser gingivectomy in the Southern Illinois region, at present, Childers says the laser is great because it only works on gum tissue and doesn't damage the teeth.

After painting a topical anesthetic on the gum tissue and measuring the amount that needs removal, Childers uses a diode laser to vaporize the unwanted gum tissue in small increments of about half a millimeter at a time.

"It's less invasive, has hardly any bleeding and has no pain associated with it at all," says Childers.

While some people just get a laser gingivectomy done, Childers says he's used it in combination with other treatments with great success amongst his patients. For example, he adjusted the smile line of a young girl over a period of time.

The patient went through two phases of orthodontic treatment at first: slowing down the downward growth of her top jaw using headgear designed to restrict growth for one whole year, waiting two years for her permanent teeth to emerge and then using braces to push up her front teeth for a year.

"The final piece of the puzzle was the laser," says Childers.

Getting the Tom Cruise smile!
Since there are very few of us out there that don't want a good smile or value the way we look, modern dentistry comes to our rescue with several tools and techniques designed to restore teeth to their natural, gleaming beauty.

"Many people come to me and say 'I want to look like Tom Cruise!'" says Park, an ex-New Yorker, who has more than five years of experience in cosmetic dentistry. "What they don't realize is that his teeth are messed up! His center line is off, mid line is off. They just see how white his teeth are and want to emulate him."

With increased life spans and better quality of life, Kwonil says many of his patients have a positive outlook. They say, "I may be 60, but my life starts again. Now give me the whitest teeth you can!"

"People are more savvy today," declares Childers who has many patients coming into his office having already researched procedures they want done on the internet. "They know what they want and will ask for it. Of course it's up to us to determine if it's the treatment they actually need!"

The Big Picture
With the boom in cosmetic surgery, anti-aging products, weight loss procedures and body-beautiful therapies, is it any wonder that improving and redesigning your very smile is taking top priority on many people's lists?

"Everyone is so focused on having pearly whites, that they forget the bigger picture," says Rhonda DeMattei, RDH, Ph.D., assistant professor of dental hygiene, Southern Illinois University, Carbondale. "The focus needs to be on oral health, hygiene and general wellness. What's the point if you have a nice smile, but still have gum disease?"

DeMattei admits that people possibly feel better about themselves, with an increase in self esteem, when they finally have a smile they are proud of. But she fears our society over-emphasizes the importance of a perfect smile and sacrifices the emphasis on dental health.

"It all goes back to our social expectations," says DeMattei. "With big businesses setting the standards, you always see models with the perfect smile, if you open any magazine or switch on the TV." The model then becomes the icon for beauty that everyone wants to emulate on a sub-conscious level.

DeMattei warns that there is a fine line between what's necessary and what the media and dental companies are pushing as perfect. "But on the other hand, thank goodness there are dentists who can give the patient whatever they want, be it veneers, bleaching, straightening teeth or just redesigning the way you smile," says DeMattei.

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posted by Cheryl Levesque @ 6:45 AM