When you begin a smile makeover in our office, you are embarking on an exciting partnership with my laboratory technician and me. You should be full of excitement and anticipation — if you have been dissatisfied with your current smile, and you have great expectations for the results of this project. You will really like what you see in your mirror.

Being completely satisfied with your new look depends upon successful communication — between you and me and also between my dental lab technician and me. As you might expect, your perceptions of how your teeth appear are different from a dentist's perceptions. My education leads me to think of factors that untrained individuals probably won't consider, such as crown (tooth) length, midlines (how the teeth line up with other facial features) and the distance from gum to lip.

It is helpful to be able to describe what you like and don't like about your current smile, and what changes you would like to see. Using visual aids is a good idea. Bring photos and magazine illustrations to show what you have in mind. (Remember that we cannot make you look exactly like a celebrity or anyone else. The pictures are guidelines.)

Things to think about:

• The color, size, shape, alignment and spacing of your teeth.
• How much of your teeth and gum tissues show when your lips are relaxed and when you smile.
• Tooth color: bright “Hollywood” white or more natural looking off-white.

Your makeover is more likely to meet your expectations if you get an advanced view of the results. Computer imaging is one way to do this. Another is for us to make a mock-up of the proposed dental work in tooth-colored wax on models of your mouth.

Finally, a “Provisional Restoration” can be used as a test to make sure that what I envision is also what you, the patient, want to see. A provisional restoration, made from temporary materials, gives you a chance to test out the changes and make sure they work for you — that they not only look good, but they are also functional in terms of biting, chewing, speech, and gum health.

If the provisional restoration works, it is used as a blueprint to make durable and long lasting porcelains in the same design. We will take impressions of the provisional restoration and communicate the relevant information to a dental laboratory technician, who will make the final porcelain tooth replicas for your new smile.

Competent communication and a provisional restoration will put you on track to meet your expectations and obtain the most aesthetic and functional result in your Smile Makeover.

Contact us today to schedule an appointment to discuss your questions about Smile Makeovers. You can also learn more by reading the Dear Doctor magazine article “Great Expectations — Perceptions in Smile Design.”

Parenthood comes with no manual — if it did it would surely include many essential tips to make your job easier while improving your children's lives. One important fact that surprises many people, is the age you should take your children to the dentist for their first dental appointment, age one. The reason that the age one dental visit is so important is that it establishes the foundation of oral healthcare for the rest of their lives. Unfortunately, some parents wrongly assume that because primary teeth “fall out anyway,” they do not need to worry about them. Nothing could be further from the truth!

One problem children may face is Early Childhood Caries (ECC) tooth decay. This is a type of tooth decay that occurs from sucking on a bottle filled with sugary liquids such as formula, juices and fruity drinks for extended periods of time and from a sleep-time bottle. ECC can affect all the primary (baby) teeth in infants soon after they come into the mouth.

Bringing your children into our office for their age one dental visit enables us to establish a friendly, trusting relationship with the whole family while we assess your children's oral health. During this consultation we will identify if the teeth and jaws are developing correctly, whether habits such as sucking on baby bottles are causing tooth decay or if there are other underlying issues that may indicate future problems. And this ounce of prevention often enables us to stop an anticipated problem before it even starts.

Temporomandibular Disorder (TMD), which was formerly known as Temporomandibular Joint Disorder (TMJ), is an interesting condition because it can be hard to diagnose and often mimics many other conditions. It arises when there are problems inside the temporomandibular joint, and the muscles attached to it, causing pain. When treating TMD, we typically start by relieving the symptoms of pain and discomfort with heat, mild pain medications, a diet of soft foods, and some simple jaw exercises. We feel that it is critical to address your pain issues as soon as possible before preceding any further with treatment.

Once we have provided some pain relief and after having completed a thorough history and examination, we can move to the next phase of treatment. This may include the introduction of a bite guard or some form of oral appliance therapy. A bite guard is an unobtrusive yet rigid plastic horseshoe-shaped appliance that fits snuggly over the biting surfaces of the upper teeth. When in place and properly adjusted, this custom-made appliance allows your muscles and therefore jaw joints to relax. And it will prevent you from grinding your teeth, another contributing factor to TMD. We will probably ask you to wear it when sleeping or in times when you are feeling stressed when clenching or grinding habits may be active. We may also suggest that you obtain some relaxation therapy and/or biofeedback from a licensed therapist, as this can prove helpful in treating TMD.

If you have suffered from frequent jaw pain in the past and suspect that you may have TMD, please let us know so that we can address it at your next appointment. Or if you are currently in constant or severe pain, contact us immediately to schedule an appointment. You can learn more about the signs, symptoms, and treatment options for TMD by reading “TMD — Understanding The Great Imposter.”

We have noticed that there are two types of patients when it comes to enhancing a person's smile. One type, which we'll call the “Perfect Minded” patient, expects teeth that are completely regular in their arrangement and of maximum whiteness and brightness, often beyond the range of traditional guides for tooth color. They are looking for a perfect “Hollywood” smile. The other, the “Natural Minded” patient, is looking for a more natural look. This person expects a general sense of regularity and alignment of teeth with definite brightness, but not so much that the teeth are noticeable before and above other facial features. Which type are you?

The “Perfect Minded” Patient
While you expect maximum regularity and alignment of teeth along with maximum whiteness and brightness, the “perfect minded” patient requires a smile completely symmetrical (balanced from one side to the other). If we drew a vertical line down the center of your face (midline), it would fall directly between your front teeth and your smile would look just the same on each side of the line. You also expect your smile to be horizontally symmetric, so that it matches the curvature of your lower lip and the gum lines match from side to side.

The “Natural Minded” Patient
You are looking for a more subtle, natural look produced by including some minor irregularities in your look. Like the “Perfect Minded” individual, you still expect your teeth to be generally regular and well aligned but you also want to have some minor asymmetries (not matching) as you move farther back along your jaw to make your teeth look real. Your preference in tooth color is not a super shade of white, but for a tooth color that looks very natural for your facial skin and hair color.

There is no right or wrong here. What is important is to be sure to communicate your expectations to us before embarking on a program of smile redesign.

Contact us today to schedule an appointment to discuss your questions about Smile Design. You can also learn more by reading the Dear Doctor magazine article “Great Expectations — Perceptions in Smile Design.”

Florence Henderson, star of one of television's most beloved situation comedies, is still actively engaged in a variety of projects at 75-plus years of age. Her bright smile was part of her character as Carol Brady in The Brady Bunch, a popular sitcom that played for five seasons from 1969 to 1974. Though the show was discontinued, syndicated episodes continue to play in the U.S. and 122 other countries.

“I played Carol as the mother I always wished I had,” she told Dear Doctor magazine. Her portrayal of mother and wife in a blended family with six children won her the Smithsonian Institution's TV Land Pop Culture Icon Award, which is on display in the National Museum of American History in Washington, DC.

After her successes on Broadway and in television, she was selected for numerous product endorsements, and The Wall Street Journal ranked her #5 in their top ten television endorsers based on viewer satisfaction. One of the products she endorsed was Polident, a brand of denture cleaners and adhesives. However, Henderson has revealed that she has her own natural teeth and does not wear dentures. Her advice to others who want to keep their natural teeth is to pay attention to prevention. “I think the most important thing one can do as with any health issue is prevention,” she said. “Flossing, brushing, and regular dental checkups are vitally important if you want to keep your natural teeth.”

When she was 22, she says, she had four impacted wisdom teeth removed at the same time. This experience made her aware of the importance of dental care, and since then she has had a checkup every six months. Wherever she travels, she says that she always has mouthwash, dental floss, toothpaste, and a toothbrush on the set.

Contact us today to schedule an appointment to discuss your questions about tooth care. You can learn more about Florence Henderson by reading the Dear Doctor magazine interview “Florence Henderson, America's Favorite TV Mom Has Many Reasons to Smile.”