Category Archives: editorial

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Anatomy of a smile makeover

Category : editorial

dental makeoverTransforming less-than-perfect dentition into a stunning, superstar smile is a source of immense gratification for the cosmetic dentist. Cosmetic and restorative dentistry restores and improves the health and integrity of the patient’s dentition and, just as importantly, can improve the patient’s self-image. Today, to be truly cosmetic, dentists must be clinicians, artists, and communicators. To achieve success in all of these areas, the dentist must pay close attention to every detail, from initial patient consultation through treatment planning, treatment, and follow-up care.

In the past, failures of cosmetic cases were frequently due to inadequately meeting the patient’s expectations. By utilizing new technology such as smile selection guides, cosmetic imaging, and temporization techniques — thus creating a “trial smile” — you can reduce this problem and greatly increase patient satisfaction.

In both the esthetic and restorative aspects of dentistry, the dentist is responsible for the patient’s functional and appearance-related needs. However, successful treatment planning first involves listening to the patient’s desires and concerns as you evaluate his or her needs, be it color, shape, or tooth position. To move toward building a successful case, you must identify the patient’s expectations during your diagnosis and treatment planning.

A pleasing, attractive smile can be attributed to the harmony of color, contour, size, occlusal plane, incisal edges, and midline with the patient’s facial features. Often, this harmony can be achieved by treating just the four incisors, the key players in the smile zone. By enhancing their length, width, shape, and alignment, many times you can create a dazzling smile from imperfect teeth. The key to treatment success is creating the smile that the patient wants, not just what you would design. I have found computerized cosmetic imaging to be an essential tool to show patients how they would look with an improved smile — even before any treatment is begun. To maximize this tool, we allow patients to help design their smiles using Smile Shape and Length Selection Guides, and letting them visualize the final result. This generates much enthusiasm and excitement, which increases case acceptance, and facilitates the communication necessary to build a successful case right from the start.

By Lorin Berland, DDS

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Gum Disease and Preterm Birth

Category : editorial

Gum Disease and Preterm Birth


But it is still not clear if more aggressive treatment of periodontal disease affects risk or if treating tooth and gum issues before a woman becomes pregnant can help prevent premature delivery, Steven Offenbacher, DDS, PhD, of the University of North Carolina, Chapel Hill’s Center for Oral and Systemic Diseases, tells WebMD.

Offenbacher was the lead investigator of the newly reported study, which was conducted at UNC, Duke University Medical Center, the University of Alabama at Birmingham, and the University of Texas at San Antonio.

All of the pregnant women recruited for the study had periodontal disease. Half were treated with deep cleaning and plaque removal before reaching their 23rd week of pregnancy and the other half received no treatment while pregnant.

The two groups were followed through delivery. After controlling for well-known risk factors for early delivery, such as smoking and history of giving birth prematurely, the researchers found no significant difference in birth outcomes among the two groups.

About a quarter of women with periodontal problems experience a worsening of tooth and gum issues during pregnancy, but the reasons for this are not clear, Offenbacher says.

“This study shows that this level of periodontal treatment does not affect birth outcomes, but we don’t know if more intensive treatment can make a difference,” he tells WebMD.

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