The Smile Facelift
Posted: Tuesday 14 September 2010 11:26am
Miranda from Sex and the City famously drew attention to tongue-thrusting in an episode where she had to be fitted with braces to rectify the problem. For something so widespread – up to 50 percent of orthodontic patients suffer from it – tongue-thrusting gets little publicity. I hadn’t given it much thought, either, until one of my front teeth started moving forward. I’ve had good teeth all my life and have always received compliments about my smile but, when your front teeth slip out of alignment (even marginally), it’s easy to develop what dentists call an inhibited or Mona Lisa smile. I am sure I developed more crow’s feet during those months when I opted for crinkly eye contact in place of my usual grin.
The causes of tongue thrusting range from difficulty in swallowing through thumb sucking as a child and heredity. Whatever the reason, I was more than receptive when my dentist suggested porcelain veneers to correct my wandering front teeth.
Fortunately, Dr Miranda Adamou is not only the best dentist I have ever had in my life, she’s also one of Sydney’s most skilled practitioners of “tooth artistry”, as cosmetic dentistry is now known. I’ve never had brilliant white teeth, so Dr Adamou suggested that a smile makeover could also give me full-on dental wattage. “Something more glamorous” she said (her code for bigger, whiter and younger-looking). “Your own smile but better”. Definitely, I agreed.
Porcelain veneers, which are thin pieces of porcelain bonded to the fronts of your teeth to make each one more uniform in shape and colour, can give almost any mouth a near-perfect smile, which is why most of those toothpaste ad-perfect smiles you see on your favourite actors or TV personalities are most likely veneers. But the technology has come a long way since the 1980s when veneers were thicker and not as translucent and gave people so-called “tombstone teeth” which often looked as false as dentures. What hasn’t changed, though, is the fact that once you decide on porcelain veneers, you must keep them for life, since the protective layer of the natural teeth has to be removed. “Dentists don’t remove as much of the natural teeth as they used to” says Dr Adamou. “I try to remove as little as possible – approximately 0.3 millimetres – to create room for the veneer”.
That was a relief because the shaving down aspect of a smile makeover was the main issue that was bothering me. Porcelain veneers don’t last forever, the longevity seems to be about 15 years, so you have to have them replaced later in life. Dr Adamou suggested that I have 10 veneers on the upper teeth to correct the forward-thrusting front tooth, cover any flaws and return the wow factor to my smile. It was good advice, too, because I had recently read in one of the glossies that Kim Cattrall from SATC had been too frugal, installing only eight veneers which barely reached to the end of her smile line. My bottom teeth were fine but they would have to be bleached to match the brighter colour of the new upper ones.
The following week I visited the dental technician so that he could see what size and tooth colour suited my face shape and skin tone. “Your teeth should never be too many shades lighter than the whites of your eyes or they look false” he warned. The thing that I was most relieved about, though, was how thin the porcelain veneers were and they had gradations of colour just like natural teeth. Today’s veneers are seventh generation porcelain ceramides, revealed the technician and, although they become very durable when bonded to the teeth, they are only 0.5 millimetres thick. They also stain less, too, because the smooth surface of the porcelain is almost impervious to dark liquids such as coffee and red wine.
A few days later I went to Dr Adamou’s surgery for the big procedure. It’s a scary thought preparing to have your teeth shaved down, even if only minimally. But the tiny pricks of the anaesthetic injections and having to keep my mouth open for an extended period were the most uncomfortable part of the whole process. Impressions were taken of my teeth to be sent to the dental technician so that he could custom-make each veneer. To look like natural teeth, they must be subtly contoured, ridged and smoothed.
I left the surgery wearing temporaries – composites created by Dr Adamou – because of the increased sensitivity of the teeth. They are thicker and more opaque than actual veneers but give you a good idea of your new look. I loved them and – better still – I didn’t look as toothy as Wayne Newton which was my biggest fear. They also hid my bottom teeth which now looked yellow, so I had to spend the next week religiously using the bleaching tray to make them the same shade of pearly white as the temporaries.
Three weeks later I went back to have the actual veneers fitted. The worst part was pulling off the temporaries because – obviously – they have to be attached well so that you can eat, drink and function normally. But with my gums numbed by the anaesthetic, the tugging was the most uncomfortable part of the whole procedure. Dr Adamou fitted the veneers very quickly following cleaning. Then she handed me a mirror. Even though I couldn’t move my upper lip because the anaesthetic was still doing its job, I was transfixed by a flash of teeth that looked clean, fresh, new and, above all, natural.
Veneers can feel different at first, so most dentists schedule a follow-up appointment to ensure that you are completely satisfied with the “result”. A smile makeover isn’t cheap and can cost $900 or more per tooth. But it’s certainly one of the best appearance-enhancing things I have ever done.
For many people a smile makeover is life-changing says Dr Adamou. “A beautiful smile also makes them feel more self-confident, too”. A renewed smile also makes you smile more – the so-called peacock effect. I told my friends to dredge up all their old jokes because I was ready to laugh at anything. Before my smile makeover, even the funniest gag would only have resulted in a close-lipped smirk.
To reach Dr Adamou, call (02) 9747 4664; 159 Burwood Rd, Burwood, Sydney NSW 2134. Whatever dentist you choose, however, make sure he or she is experienced in cosmetic dentistry.
Gummy grin? Bad bite? The fixes that will make your mouth – and whole face – look younger. Read on to learn about Tooth Reshaping, Jaw Expansion, GlamSmile and more…
GLAMSMILE
Glamsmile is a relatively new-to-Australia procedure that boasts minimal-prep porcelain veneers.
“GlamSmile porcelain veneers, which are thinner than traditional veneers, can be placed after two one-hour dental visits. The first visit is for a consultation, ‘before’ photos and an impression of your teeth,” explains Dr Yvonne King. “At your second visit, which is usually three weeks after your first visit, the veneers are placed.”
In most cases, patients don’t require painful and unnecessary removal of healthy tooth structure, which means no needles, no anaesthesia and no drills. Not only will veneers whiten severely stained and discoloured teeth, they can change the shape, size and alignment of your teeth.
Obviously, every veneer case is different. Your dentist will evaluate your teeth and decide whether orthodontics is necessary before placing veneers. Where the misalignment is moderate, GlamSmile veneers can change the alignment and the shape of the teeth, making them straighter and more symmetrical.
There are three systems – GlamSmile, GlamSmile Plus and GlamSmile Platinum.
“Like anything, veneers are operator dependant,” says Dr. Yvonne King. “If your dentist has a good aesthetic eye, the results you get with even the basic system are very good,” says Dr King. “With the Plus and Platinum range, you get much more aesthetic intricacy. The natural tooth consists of different colours and textures.”
Dr King advises patients to ask their dentist for ‘before’ and ‘after’ shots of their work – and to be sure it really is that dentist’s work.
GlamSmile - Before & After
“A dentist really needs to find out what result the patient is after. It is important to sit down with the patient to find out what really bothers them about their smile, what they’d like to change and the end result they want,” says Dr King. “It is the patient’s choice, but we must inform the patient of all their options, the advantages and disadvantages and possible consequences of their decision. Once the patient is fully informed, they can make an informed decision.”
The basic GlamSmile range will cost you from $5,000 onwards for the upper set, GlamSmile Plus will cost you from $6,500-$7,000 and the GlamSmile Platinum will cost you from between $8,000 and $10,000. “The cost is very patient dependant.” Says Dr King. “It depends how much work is required beforehand.”
Click here to watch the GlamSmile video.
LASER GUM CONTOURING
“Laser gum recontouring is a one-visit procedure that allows us to transform a gummy smile, often considered unsightly, into a very natural looking one,” explains Dr King.
Laser gum recontouring is often performed as an adjunct to veneers. The resulting smile is aesthetically pleasing and often offers extra support for the upper lip, making the whole face appear more youthful.
“In contrast to gingival surgery performed with a ‘scalpel’, which can be quite uncomfortable and requires a period of recovery, the laser gum recontouring is a non-traumatic way to remove the excess gum tissue, without bleeding or swelling that is associated with a scalpel performed surgery, expect to pay up to $1000.” she adds.
JAW EXPANSION
For those wanting a ‘wider’ smile like Julia Roberts, jaw expansion – which also corrects facial contours and bite – could be the answer.
“It is case sensitive,” says Dr Cary Fraser of Bay Dental and Orthodontics, Double Bay. “Not every adult is going to opt for jaw expansion. Jaw expansion will give you a broader smile and by having the bones in a better position, it can be healthier for the body because it [positively] affects the sinuses.”
“The position of the jaw can also affect the head and the neck, so this may help in relieving headaches and migraines. Some people do it purely for cosmetic reasons – for a broader, more ‘toothy’ Julia Roberts type smile. But when I look at it, I’m looking at function as well – what looks good and works well. You’re opening up the airways as well and it can help prevent or reduce sleep apnoea.”
During surgery, a slit is made in the bone to allow the jaws to spread apart.
“We then use either a removable or fixed expander, which you wind, depending on the situation, possibly once a day. Then patients need braces afterwards to align the teeth,” explains Dr. Carey.
The whole procedure can be ‘uncomfortable’ and possibly take between one and a half to three years. There are surgical costs involved so you’re looking at a cost of anywhere between $5000 and $20, 000.
A broader smile can also be achieved with braces.
“We use a new type of braces with lighter wires, which use less friction and are less painful, “explains Dr Fraser. “We have more control and it can take less time.”
Braces placed inside the teeth can work too. “Inside braces are just as effective as outside braces but they take a little bit longer to work,” says Dr. Fraser. ”The advantages of having them on the inside are you can’t see them and they’re very low profile. Some of the disadvantages are that they are more expensive and can affect speech for a little while.”
There is a technique with inside braces that treats only the front six teeth.
“It’s called the ‘social six’,” says Dr. Fraser. “It can take three months and cost around $3000. Full inside braces are cast from gold and are individually made for each tooth, so they can be expensive. Expect to pay around $12,000 and have to wear them for around two years. Normal braces cost anywhere between $5000 and $15,000 and need to be worn for up to one and a half years.”
TOOTH RESHAPING
Tooth alignment can be adjusted with clever use of a file.
“Tooth reshaping is becoming more common and it’s a very conservative, great thing you can do for patients,” says Dr. Sandra Short of Dentartistry in Double Bay, Sydney. “Often it’s just a tiny bit of tweaking needed. Using a file, we slightly reshape the edges and angles of teeth to make them appear more aligned. Shaving off just one-tenth of a millimetre can make all the difference.”
The pain factor is minimal, too.
“It’s not painful because you’re not taking off much tooth and it can be achieved within a one hour consultation,” says Dr. Short. “The patients are always happy with the result.”
If you have a dentist like Dr Short, you might find there is no extra charge on top of normal check-up/consultation charges for minor tooth reshaping.
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