Smile Makeover

A smile makeover is the process of improving the appearance of the smile through one or more cosmetic dentistry procedures, such as dental veneers, composite bonding, dental implants and teeth whitening.

Essentially, a smile makeover is something that you choose to have performed, while a full mouth reconstruction is something that you need to have performed.

Smile Makeover Considerations

A smile makeover takes into consideration your facial appearance, skin tone, hair color, teeth (color, width, length, shape and tooth display), gum tissue and lips to develop your ideal smile. Smile makeovers are performed for many reasons and customized according to your unique considerations.

What is it that you like or dislike about your smile or your teeth? Some aspects of your smile that your cosmetic dentist will review with you and that could be improved with a smile makeover include the following:

Tooth Color: Silver or amalgam dental fillings can be replaced with natural, tooth-colored composite restorations, while teeth whitening can improve the color of stained or dulled teeth. Tooth color and shading are important considerations during the evaluation of and preparation for various procedures, including porcelain veneers, crowns, bridges, composite bonding and dental implants.

When considering the color of your teeth, keep in mind that dark or discolored teeth may suggest an aged mouth. A well-shaped smile comprised of bright, white teeth lends to a youthful appearance. The shade your dentist selects for teeth whitening and veneers is carefully evaluated with special consideration given to the tone and color of your face and hair. Cosmetic dentists are skilled at finding the right balance between providing you with a brighter, whiter smile and maintaining a natural tooth color.

Alignment and Spacing: Teeth that are crooked, overlapping or have gaps between them can be straightened and aligned when necessary through orthodontics or Invisalign and improved with veneers.

Missing Teeth: One or more missing teeth can negatively affect the appearance of your smile – as well as affect your bite and increase your risk for tooth decay – making replacement an integral part of oral health and facial esthetics. Missing teeth can be replaced by dental implants, bridges or partial dentures.

Harmony and Balance: Uneven, chipped and cracked teeth can be cosmetically bonded for an improved appearance, and a gummy smile can be re-contoured to help improve the overall look of the smile.

Fuller Lips, Smile and Cheeks: An unshapely or aging face can be improved or rejuvenated with certain procedures in the smile makeover category, including orthodontics and/or oral maxillofacial surgery.

A cosmetic dentist will work closely with you to develop a treatment plan designed to achieve exactly what you want from your makeover. This treatment plan may consist of many cosmetic and functionally restorative procedures, potentially including teeth whitening, composite bonding, veneers, dental crowns, orthodontics (braces), oral maxillofacial surgery and gummy smile reduction.

Esthetic Components of a Smile Makeover

In addition to the color, alignment and balance of your teeth in the esthetic zone of your smile (the section of upper and lower teeth that show when you smile), there are several attributes of your teeth and smile that your cosmetic dentist will evaluate with you when planning your smile makeover. These include:

Tooth Length: Long teeth lend a youthful appearance. Aging produces wear and tear that often results in shorter teeth, and a gummy smile also can make teeth appear shorter. A smile makeover treatment for shorter teeth may include reshaping and lengthening the two front central teeth with composite bonding or porcelain veneers. If you have a gummy smile, your cosmetic dentist may provide treatment to modify the gum line and lengthen the appearance of the teeth using laser dentistry procedures. You may also be referred to a periodontist for crown lengthening if necessary.

Teeth lengthening may also impact your overall facial appearance. For example, shapely, long, square teeth on a round-faced individual can provide a slimming effect.

Smile Line: The smile line is an imaginary line that follows the edges of your upper teeth from side to side, which ideally should be the same as the curve of your lower lip when you smile. This standard point of reference for smile makeovers may be used to help determine how long your new teeth should be.

Tooth Proportions: Your cosmetic dentist will examine your teeth to determine if they are in correct proportion with each other. Most people recognize a pleasing smile as one in which the two central front teeth are dominant and have a width-to-length ratio of 4-to-5. This proportion guides the length and width of other teeth in the esthetic zone so that the smile line appears balanced.

Tooth Texture and Characterization: Cosmetic dentists performing smile makeovers are adept at blending functionality and esthetics. An artistic dentist can characterize your crowns or veneers to create a more feminine or a more masculine appearance, in addition to matching the look and feel of natural teeth or those you've seen in photographs.

The Life of Your Smile Makeover

Cosmetic dentistry procedures require regular oral hygiene care and may require maintenance over time. For example, teeth whitening must be repeated on occasion in order to maintain brightness. Porcelain veneers may chip or break off and need replacement. Permanent composite bonding may stain and require enhancement or replacement. Dental crowns typically require replacement after 10 to 15 years. Gummy smile improvements may also require enhancement over time.

Your ceramist, lab technician and the materials chosen by your dentist also impact the longevity of your smile makeover. To achieve the best results, take special care in selecting your cosmetic dentist and inquiring about your material options.

Full Mouth Reconstruction

Full mouth reconstruction, full mouth rehabilitation and full mouth restoration are terms often used interchangeably to describe the process of rebuilding or simultaneously restoring all of the teeth in both the upper and lower jaws.

Full mouth reconstruction typically involves general or restorative dentists (performing procedures like crowns, bridges and veneers), and can incorporate dental specialists like periodontists (specializing in the gums), oral surgeons, orthodontists (specializing in tooth movements and positions) and endodontists (specializing in the tooth pulp).

The need for full mouth reconstruction may result from:

• Teeth that have been lost due to decay or trauma.
• Teeth that have been injured or fractured.
• Teeth that have become severely worn as a result of long-term acid erosion (foods, beverages, acid reflux) or tooth grinding.
• Ongoing complaints of jaw, muscle and headache pain requiring adjustments to the bite (occlusion).

How the Full Mouth Reconstruction Process Begins

If you think you need full mouth restoration or reconstruction, see your dentist for a comprehensive examination. Your dentist will examine your mouth to determine the extent of the problem and the treatment options that can be used to correct it. In particular, he or she will examine the condition of your:

• Teeth: The condition of your teeth will determine what restorative procedures may be needed, such as porcelain veneers or full-coverage crowns, inlays or onlays, bridges or implants restored with a crown. In particular, your dentist will make note of any cavities and decay, tooth wear, cracks, short/long teeth, root canal issues and any tooth movement.
• Periodontal (gum) tissues: If your gums are not healthy, you will most likely need scaling and root planing to treat periodontal disease. You may require more intensive treatments from a periodontist to ensure that your newly reconstructed teeth will have a solid foundation. Such treatments could involve soft tissue or bone grafts to build up your gums and underlying jaw bone. Your dentist will look for deep pockets, excessive or insufficient gum tissue, periodontal disease and bone density irregularities.
• Temporomandibular joints, jaw muscles and occlusion: A stable bite – one in which you are not in pain when you close your mouth or chew and one that does not cause wear or destruction of your teeth – is important to your overall oral health. Occlusal changes need to be taken into consideration when your dentist plans your restorations. In fact, you may require orthodontics (dental braces) or some other type of treatment (night guard or bite reprogramming orthotic) to correct occlusion before additional restorative procedures can be performed.
• Esthetics: The color, shape, size and proportion of your teeth, and how they appear in relation to your gums, lips, mouth, side profile and face, are also important factors in full mouth reconstruction treatment.

The examination process requires records of your mouth, such as X-rays and photographs, impressions of your upper and lower teeth, models of your teeth that are made from the impressions and a model of your bite. Your dentist may also refer you to specialists (periodontist, orthodontist, oral surgeon) for a consultation in order to develop a treatment plan that is best for you.

Once your dentist has obtained all information relevant to your case, he or she will develop a comprehensive, step-by-step treatment plan to correct all of the problems in your mouth and complete your full mouth reconstruction. If you do not understand the procedure being described to you, ask for a detailed written description of the proposed treatment plan so you can review it. This can be helpful if you want to get a second opinion. Be sure you understand the risks and benefits of the recommended procedures and treatments.

What Procedures Are Needed for Full Mouth Restoration?

Only your dentist and the team of specialists working on your full mouth reconstruction can determine what procedures are needed for your specific case. Other treatments may also be available, so ask your dentist about all possible procedures that might be required for your case and under what circumstances.

Most full mouth reconstructions involve multiple phases and office visits. It is not unreasonable to expect treatment to take 12 months or more, depending on your situation. The following procedures may be involved, depending on your needs:

• Prophylactic teeth cleaning and periodontal care.
• Crown lengthening to expose healthy, sound tooth structure for possible crowns or bridges.
• Orthognathic surgery to reposition the jaw.
• Contouring of the gum tissue to create balance and harmony in your smile.
• Preparation (reduction) of your natural tooth structure so crowns, bridges or veneers can be placed.
• Placement of temporary restorations so you can become accustomed to your new teeth and the feel of your new mouth or bite alignment.
• Placement of permanent restorations, such as crowns, veneers, inlays/onlays or bridges, made from ceramic, ceramic supported by metal or a combination of both.
• Orthodontics (braces) in order to move your teeth into the optimal position for reconstruction.
• Implant placement and restoration to replace missing teeth and/or anchor bridge restorations.
• Bone or soft tissue grafting to enhance the stability of your teeth, proposed implants and/or other restorations.

Full Mouth Reconstruction vs. Smile Makeover

How does full mouth reconstruction differ from smile makeover? A smile makeover is something that you elect to have performed, while a full mouth reconstruction is something that you need.

As the makers of dental materials respond to increasing consumer demands for beautiful, natural-looking dentistry, it is becoming hard to draw a line between purely “cosmetic” (such as elective) dentistry and “restorative” (necessary) dentistry. For example, it is now possible for your dentist to treat tooth decay with a tooth-like filling material that looks natural. If you need full mouth reconstruction, the materials available today make it possible for your dentist to provide you with durable, functional and clinically sound treatments that also look natural.

It is also important to note that a smile makeover – though performed primarily to improve the esthetic appearance of the smile – requires the use of clinically proven dental materials and treatment techniques, as well as exceptional knowledge, training and skill on the part of the dentist. Many of the same techniques and equipment used for full mouth reconstruction are also used to ensure the success and long-term stability of smile makeover treatments.