I recently received an emergency call for a patient visiting Aspen who fell off off her bike and broke her temporary veneers. Practicing in Aspen, such an active sporting vacation destination, we see many such injuries. Luckily, the remainder of her injuries were just a few scratches and bruises. And of course, we put her smile back together in short order.
But an interesting discovery came from this meeting – one that makes me want to educate the world on the best process to insure the perfect smile for each person. In the consult room, the patient mentioned that she liked the temporaries but wanted the permanents shorter. Her dentist assured her the permanents would be made shorter.
My question for her dentist would be how much shorter? How can one expect to get the shape and length of the PERMANENT veneers correct if the temporary ones are not? What blueprint is the lab working with to fabricate the permanent porcelain veneers? Once the permanent restorations are fabricated, the only way to see if they are correct is to bond them permanently to the teeth and HOPE the patient likes them.
It seems to me that if the shape and length aren’t carefully tested and accepted by the patient in the temporary stage, only luck would get the permanents to be exactly right for that patient. In fact, the technique of letting the laboratory design the esthetics of a smile is what I refer to as “Prep and Pray”. In that process, a dentist prepares the teeth, and prays that the lab somehow gets the patient’s smile perfect, while working far away on a model of the patient’s mouth without the benefit of seeing the lips, face, jaw and muscles.
It would truly be a miracle if they got the esthetics, function, and phonetics (speech) correct in the laboratory without first having it tested in the mouth. The shape of front teeth has many effects, such as saying “s” sounds correctly, guiding your jaw properly in chewing, affecting the shape of the lower lip, and giving you a natural beautiful smile.
Since the shape of the front teeth is so important, we should never leave the results to chance. Teeth vary in length and shape, and it is a special art to design the smile for ones face and jaw. It is impossible to be sure of the results being correct without first trying them in the mouth. And trying the shape out in the permanents is much too late. They will already be bonded to your teeth permanently!
The far better process is our Dual Blueprint Method. First, the laboratory changes the teeth on the model to reflect what might be the correct tooth shape for you. (In my practice I do this myself because I have a vision for each patient and don’t trust a far removed technician to have the best vision for you).
Next, on the big day, we reshape your teeth as necessary, and transfer the blueprint on the model into your mouth. This is the second blueprint. We don’t say “don’t worry these are just temps” Instead we say, “please pay close attention to the look, feel and speech of the blueprint that you are wearing and come back in a few days to let us know what you think. We will make any changes neccesary, and only when you are fully satisfied with the shape of the temporaries/blueprint, will we take a quick impression and photographs for the laboratory to duplicate that shape in the permanents.”
No prep and pray! Instead we design your smile on the models, test it in your mouth and in your smile, fine tune it to perfection, and duplicate exactly what you like and tested. This is what I call the Dual Blueprint Method. This process guarantees your satisfaction!
I’m so adamant that this process is followed because it guarantees success, and because we have the ability to do so. I’m sure patients and plastic surgeons would love to try a nose on before finalizing a nose job. But they can’t. Amazingly we can try on a smile, and we must take advantage of the opportunity!
Of course, this process relies on a dentist to fully understand the art and science of tooth shape and position. When looking for a cosmetic dentist to change your smile, ask them if they use a similar blueprint process. Also, ask to see pictures of patients and look to see if the temporary restorations and the permanents match relatively closely. This is the hallmark of using this process correctly and it’s the only process which can virtually guarantee you loving your new smile.