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Dr. Sarah Jebreil is a member of the American Academy of Cosmetic Dentistry.
Making cosmetic dentistry minimally invasive can mean greater case acceptance and patient comfort.
Cosmetic dentistry can seem complex and intimidating, but it is actually very rewarding when the treatment goals that were outlined are actually achieved and the patient obtains a dream-worthy smile they are excited to share with others.
Using the right tools in the treatment planning phases paves the way for success, and also helps identify patients who may have unrealistic expectations. Cosmetic dentistry is about understanding what the patient wants to achieve and helping them to achieve a realistic goal that is communicated in the treatment-planning phase.
When your patient has interest in improving their smile, the best way to further the conversation is by taking some photos. Placing these photos somewhere large so you and the patient can view the photos is ideal. When the patient sees their image it gives insight to how the patient views themselves and what it is that they most want improved - and if it can actually be done.
Whitening is a great way to get patients interested in cosmetic dentistry. Patients become more accountable for their smile and it alerts them to other areas that are discolored or blemished. I always have any patient who is interested in any cosmetic procedure do whitening first. This is ideal for final shade selection as well as identifying additional teeth to be added to the treatment plan (i.e., they did not get light enough or old fillings or decalcifications became more apparent). Use whitening as a tool to re-evaluate the patient's smile, take more photos, and together observe the changes and nuances that take place.
Whether it is with some quick bonding or with a laboratory-fabricated wax up, a mock-up is a great way for the patient to visualize a more harmonious smile. It is a great way to observe a patient and determine if he or she would be a good fit for the treatment, as well as if it is what he or she is aiming to improve. It almost always "seals the deal" and opens up the opportunity for more questions. You can use it as a medium for you and the patient to discuss desired outcomes.
If your patient has an uneven smile but is not interested in braces or wearing Invisalign for too long, consider Invisalign Express 10 or the Invisalign Lite. These are great ways to slightly broaden the buccal corridors so that the patient develops a broader smile. It is also great for unraveling light crowding in the anterior. These cases can be done in 10-14 weeks, which is amenable to most patients. Moving teeth into a better position allows you to be more conservative in the restorative phase because you do not need to prep as much, or you may not need to do crown lengthening because you have leveled the gingival levels, and so on. Orthodontics is always a conservative option that should never be overlooked.
Composite bonding is my go-to treatment for younger patients who have some uneven edges, decalcifications or too much "negative space" in their smiles. With some nice beveling and microabrasion, I will bond the edges of the centrals and laterals to make them more attractive and give the patient a broader feel to their smile. Bonding is an inexpensive way to have the patient be more excited about his or her smile, and it is often the gateway to other procedures.