The Role Of the Laboratory in Cosmetic Dentistry
Cosmetic dentistry is increasing in both popularity and in quality. Not all is “Hollywood”; but, often corrections of smiles, that have embarrassed people for many years, are made more pleasing. Many dentists perform cosmetic dentistry for older patients. So it is no longer the prevue of only the young,rich and famous. All of us want to look as good as we can. Pleasant and attractive smiles are now available to everyone. There are, of course,financial constraints; but, many people have the means to perhaps pass on items that are optional for this form of dental treatment.
The dentist does the intraoral preparation for the placement of crowns, veneers or a combination of both. The dental laboratory takes the impressions and prepares the final cosmetic devices. The impressions are poured in a plaster like material which has strong dimensional stability. The crowns and veneers are formed on the castings and ‘baked’ in high temperature ovens which harden the porcelain This ensures that the final restorations will accurately fit and look great. Good communications between the laboratory and the dentist will results in a good shade, excellent alignment for the “bite”, comfort and a natural appearance.
Shade and colorization is a critical element in a successful cosmetic case. Some patients are not sure what they expect for a final result. This requires close discussion and consultation with the patient, the dentist and the laboratory. On TV and in movies one sees a lot of what I call “Toilet bowl white”. That blanched look which, I feel, lacks in character and reality. I prefer to suggest a light shade with slight gradations from the gum to the biting edge of the tooth. Nothing is more flattering to a patient when they meet friends after receiving their new “look” and people remark about their “hair” or make up. In other words the teeth do not look artificial. Several patients have called following a cosmetic make over to remark on this. They feel they look good yet natural in a flatteringly improved manner.
In some cases a patient may visit the lab to finalize a colour selection. In such cases the lab technician will have received instructions with an option for variance. In cases where teeth are to match teeth that are present such a visit to the laboratory is necessary. A sign of a good colour matching is when a patient asks which tooth is the new one.
The laboratory will work with the dentist to ensure quality in both aesthetics, fit and function. Feedback is required from both parties. A good lab will tell a dentist if a problem exists in the impression and they will be willing to correct any short falls they may make in the processing such as colour.
The winner is of course, the patient. When a patient decides to pursue cosmetic dental treatment a thorough communication between the dentist and patient is required and the final choices should be understood by the laboratory. It is aesthetic team work in action.
The dentist has an opportunity to be many things, a surgeon in preparing the teeth, an artist in designing the final result and a communicator to ensure he and the laboratory understand each others’ need and goals. A natural yet refreshing look is ideal.
Dr Michael Pilon