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Smile by Design, Health Matters, Winter 2011

If the eyes are the window to the soul, then the smile represents the doorway to the house of self-esteem. Unlike the temporary inconvenience of a bad haircut, a displeasing smile fosters low self-esteem that endures for years. Thanks to modern, dentistry, however, not only is it possible to design a beautiful smile but, for some, the transformation delivers a remarkable boost in self-confidence.

"The ideal candidate for cosmetic dentistry is anybody who's unhappy with their smile," says Mark Reber, DDS, MS, a member of the American Academy of Cosmetic Dentistry and general dental expert for the Dental Board of California. Dr. Reber, who has practiced since 1985, is familiar with the emotional impact of an imperfect smile, but hesitates to make judgments for his patients.

"Some people [are comfortable with] a gap between their front teeth," he says. "But for others, [cosmetic dentistry] is a huge confidence boost. So it's more than just the dentistry. It's the psychology behind it."

Also a member of the American Academy of Cosmetic Dentistry, Craig J. Christian, DDS, who practices in Pacific Grove, taught at the Las Vegas Institute for Advanced Dental Studies from 1999 to 2005.

"Just about everything we do has a cosmetic component, from simple fillings to crowns," Dr. Christian says. "Smile design is not just tooth color. It's designing the shape of teeth to compliment a person's face."

Though not an orthodontist, Christian completed a two-year residency in Straight Wire Orthodontics.

"Modern orthodontics involves sophisticated metal technology. It moves the root of the tooth as well as its crown, and that's where you end up with long-term stability."

Christian's dental practice combines art, science and technology.

"Most of what I do could be considered functional aesthetic dentistry," he says. "When we make changes to jaw alignment, it enchances the natural features of the face, broadening the smile, accentuating the cheek bones, reversing the effects of aging. We consider not just how something looks, but how it functions and holds up over time."

Product quality has dramatically improved, says Reber, whose office is in Salinas.

"The bonding material is much better," he says. "And they've come out with porcelain that's much stronger. It's almost like we've arrived at The Promised Land because of its beauty and strength. The biggest key is getting away from metal. Yet you no longer have the risk of breaking that you used to have."

Tooth whitening, or bleaching, is one of the most commonly performed cosmetic dental procedures.

"Whitening is fairly common because of its pricing," says Dr. Reber. "You get a good bang for your buck. That being said, not everyone's teeth whiten predictably," largely because teeth are not really white. They are yellows and oranges, colors that whiten well; but they're also browns and grays, which do not whiten. Crowns and veneers do not white either, Reber adds.


  Whitening of teeth discolored by food and age or darkened as   a result of injury can be achieved by applying a bleaching   agent in a dentist's office. A custom-fitted bleaching tray may   be worn at night.

  Bonding utilizes a composite resin (tooth-colored plastic putty)   that is applied to the tooth's surface to improve the appearance   of chipped, cracked or stained teeth or teeth with spaces   between them. Bonding may be completed in one visit.

  Porcelain Veneers are thin, custom-made, tooth-colored shells   designed to cover a tooth's front surface and camouflage   misaligned, poorly-shaped or discolored teeth.

  Dental Implants are artificial teeth attached into the jaw to   replace missing teeth. While more secure and natural looking   than dentures or bridgework, implants can be expensive, and   the procedure can be lengthy.

  Orthodontics may be the answer for teeth that are crooked,   crowded or don't meet properly. Recent advances include less   visible and more effective brackets and wires.

When searching for a dentist to makeover a smile, consumer caution is advised by both Christian and Reber.

"Buyer beware," says Dr. Christian. "If you don't do your homework, you might be treated by somebody who doesn't have a great deal of training. ... A little knowledge can be a lot of power."

While most cosmetic dental procedures are not covered by routine dental insurance, many are affordable and quick. But for some, the value of a beautiful smile cannot be measured in dollars.

"When we do a smile reveal, patients burst into tears," Reber says. "There is so much emotion tied with that. I love that it's life-changing."