By Dr. Michel Abbou
A question of hygiene, colour, shape and proportions
“I know how to avoid getting old: welcome the years with a smile… A smile is always young.” (Pierre Dac).
Though a smile makes a person look younger, sometimes even young people dislike their appearance when they grin. It is important that dental surgeons listen to and understand their patient’s concerns. They can then suggest and implement a tailor-made treatment plan to embellish the smile in question.
The clinical case presented here represents a professional requirement for the young 26-year-old patient (a model and budding actress) who dislikes her smile. The request is purely aesthetic; there is no therapeutic reason for treating her teeth. In her very first appointment, we see that her complaint is valid. The plan is to follow a gradual approach to beautify her smile in several stages; each “step” will enable us to define what needs improving next.
A first “prophylaxis” session (60 min) involves the careful cleaning of all surfaces of the teeth (removing tartar, exogenous stains and polishing the teeth). The patient’s oral hygiene methods are also reviewed during this session. It generally takes an hour, without the need for anaesthetic, and involves removing any tartar build-up from the teeth and gums (using manual tools such as scrapers and ultrasounds) as well as any stains (tobacco, coffee, tea, food colouring) that have soaked into the enamel. To do this we use an aero-polisher (using powders with a specific particle size) as well as rotating cupules or brushes (with polishing pastes). There are a great many techniques around to recover the natural appearance of clean teeth.
A second session is dedicated to whitening the teeth, with a technique carried out in the dental chair. This session also requires no anaesthetic, and takes an hour to an hour and a half. It involves applying a hydrogen peroxide or carbamide peroxide substance to the enamel: these products must be handled with precaution (after careful examination of the teeth and the gums) so as not to cause any harmful collateral damage (a protective gum shield is used).
What are the clinical results?
At this stage, it is indisputable that we have “illuminated” the patient’s smile… But she told us she also wanted to:
- Hide the small black triangles created by the gaps in between her incisors
- Change the shape of her incisors (too narrow and too small) to make them look “more glamourous and sexier”, which can be achieved by increasing their volume while keeping them the same colour as the other natural teeth
These two requests can be achieved by applying ceramic veneers to the teeth. Her bright smile “crowns” the protocol with success.
Doctor Michel Abbou
Graduate of the University of Paris VII (France), Faculty of Dentistry. He has been trained and has worked with most of the available main implant systems, including Steri-Oss, NobelBiocare, Camlog and Alphabio, over the past twenty-five years. Dr. Michel ABBOU is a member of the French Association of Implantology and maintains a private practice in Paris.