Extreme Dental Makeovers
Two Case Studies
By Morey Furman D.D.S

Dental makeovers are a range of dental procedures designed to help transform the look of your teeth. A dental makeover could be as simple as a few cosmetic procedures such as repairing a chipped tooth or replacing a missing tooth, or as complex as a full-mouth reconstruction. The effect is a dramatic change in your appearance, which enhances your confidence and self esteem.

Here are two examples of the way a knowledgeable and artistic cosmetic dentist can change lives.

Patient A - Full-Mouth Reconstruction

Patient A is a 40-year-old man with severe breakdown of his dentition. Years of bruxing (grinding teeth) and neglect have left him with severely worn teeth, many of which have nerve exposure. This condition has left him in chronic dental pain, and he is also extremely self-conscious to the point where he never smiles. He has lived with this condition for many years because of a bad experience he once had in a dental office. He just accepted his situation and didn't realize how it was affecting his self image. After much gentle (and not so gentle) persuasion from his wife, one day he came to my office and decided it was time for a change.

Upon clinical and radiographic examination, models were taken for study. Cases like this are extremely complex. They should only be undertaken by practitioners with many years of experience and education - there is no room for compromise. Understanding the patient's goals and desires, combined with the knowledge and technical experience to treat the complex mechanisms at play, is the only way to get an absolutely fantastic result.

Patient A's treatment plan consisted of full-mouth reconstruction. A full-mouth reconstruction is the process of rebuilding or simultaneously restoring all of the teeth in both the upper and lower arches using any and all necessary dental procedures (such as crowns, bridges, veneers, root canals, periodontics [gums], orthodontics [braces], and oral surgery). Most full-mouth reconstructions involve multiple phases and office visits, and treatment can go on from several months to a year or more.

Patient A's teeth were in such bad shape they needed root canals to prevent infection and relieve pain. One of his biggest problems was he ground his teeth so badly, he was left with very small, very worn, flat teeth. This lead to an over-closure of his jaw, giving him a prematurely aged appearance. Dental problems such as damaged and worn teeth not only detract from your mouth visually, but they also can affect your jaw, leading to TMJ problems. The procedures used to repair worn teeth will depend on the extent of the tooth damage. Generally, a crown can be placed over a damaged tooth to strengthen and reinforce it.

The goals of patient A's treatment were to restore his teeth to their proper size and function, correcting his bite and jaw position, and relieve his discomfort. The treatment would also strengthen his teeth and prevent further wear and breakage in the future. This would give him better, more comfortable chewing ability, a more youthful appearance, and a beautiful smile. Several hours of behind the scene planning and consultation with my cosmetic ceramist allowed this case to be completed in several months instead of years. The procedure took approximately 9 hours of chair time over a three-month period.


Patient B - Operation Smile

Patient B is a beautiful young 25-year-old lady who never smiled. She had badly crowed and rotated teeth. From our initial conversation it was obvious she was extremely self conscious of her smile, and this was a problem her entire life. When she had come to me it was obvious she had several consultations with different dentists with suggestions of porcelain veneers and orthodontic therapy. Patient B knew what she wanted. She wanted her front teeth fixed and she wanted it fast.

Orthodontics (braces) was not a consideration for her. Because of her severe crowding, at least one tooth would have to be extracted to make room for her straightened teeth. Patient B had a deadline. She needed this treatment immediately and something that was going to take six months, a year, or more, just wasn't in her game plan.

Upon clinical and radiographic examination, it was evident to me that this case was also a complex one. In the past 25 years I've treated hundreds of patients with problems similar to this. I knew I could give her exactly what she wanted.

Patient B's treatment plan consisted of a root canal, a crown, porcelain veneers and several fillings and tooth whitening. Cosmetically, I planned a smile makeover, but due to financial considerations we decided to treat only her four front teeth. This was a compromised treatment plan from an esthetic point of view, but it was a treatment plan that patient B could fit into her budget and, would give her what she always wanted. She wanted her crooked front teeth fixed.

The procedure took two and a half hours of chair time divided in two visits, which were ten days apart. Patient B had her new smile in two weeks. She was absolutely thrilled with the results. Her demeanor, self confidence and smile changed in an instant. She now smiles and glows when she walks into a room. This is my reward. IMAGE