If the idea of taking 10 or 20 years off your appearance sounds appealing, but cosmetic surgery seems too drastic or dangerous, there is another option. Cosmetic dentistry is catching on among those who want a big change in their looks without a big ordeal. It's painless, non-invasive, and the dentist's tools have come a long way since braces and chalky-looking bonding.
"The smile is one of the most positive emotions," explains Manhattan dentist Larry Rosenthal. "Cosmetic dentistry is the ability to change the appearance of a tooth or a row of teeth, and more importantly, it's the ability to change the way someone smiles. Today, using smile design principles, we can make teeth look very real and very natural, and make people look 10, 20 years younger," he adds. "I love watching a patient look in the mirror and say, 'Oh God, that's me? I've waited for years to look like this.' It's a very rewarding profession."
Something of a celebrity in the once dowdy field of dentistry, Rosenthal has developed a treatment he calls a "smile lift." Through word of remade-mouths, he has won a devoted following among the famous and rich, some of whom jet into New York from other continents to change their lives by having him change their teeth.
Cosmetic Dentistry: Designing A New You
Rosenthal achieves these transformations through the combination of a state-of-the-art technology called porcelain veneering — a process whereby little ceramic covers are custom-made for and attached to individual teeth — and a cosmetic surgeon's eye. In fact, many cosmetic surgeons and dermatologists refer patients to Rosenthal to achieve alterations for which collagen injections or surgery used to be the only alternatives.
"We call it a 'smile lift,'" he explains, "because the corners of the mouth, as you get older, turn down. That has a connotation of a frown, of aging, of skin starting to sag a little bit. Some young people have it too, by the way. What we do is, by building the tips of the sides of the teeth out, we're able to support the lips. And the pink part of the lip, it's called the 'vermillion border,' will roll up, and all of a sudden your lip will be fuller permanently. It's all because the teeth were set in the right place and were designed properly. That is the essence of true smile design."
Needless to say, Rosenthal feels the perfect smile should also feature near perfect, but always natural looking teeth. Whether a patient's teeth are discolored, chipped, crooked, or gapped, Rosenthal can design a renovation plan that might include some combination of bleaching, laser gum contouring, and porcelain veneers. With each new patient, he first sits down to discuss the problems that need to be fixed, and the overall effect the patient wants to achieve. "We'll design and shape teeth according to the personality, the look and size of a person, even their hair and eye color will come into play. It has evolved truly into an art form," says Rosenthal, who uses computer images during the planning process to show the patient what he or she would look like when the work is done.
Creating Custom Teeth
To manufacture the required veneers, ceramicists in Rosenthal's in-house lab mix liquid porcelain to the desired shade, and hand-paint it onto platinum foil to form each tooth-shaped veneer. To avoid an unnatural whiteness, the color is built in layers along the surface of the veneer in tones varying from something approximating two-percent milk near the gum line end of the "tooth," to more of a skim-milk shade at the tip. The porcelain is then baked in an oven for two minutes at 1,800 degrees Fahrenheit. When they're done, and the foil is peeled off, the resulting half-millimeter-thick wafers are translucent, with a surface texture virtually indistinguishable from natural tooth enamel.
In some ways, they're an improvement on real enamel. "Saliva can't penetrate, stains can't penetrate, the color will stay the same and the shine will stay the same, for 10 to 15 years. It's one of the hardest substances known to mankind," explains Rosenthal. As an added plus, he says, "It's almost like a skating rink to bacteria. You put your tongue around your teeth and you don't feel that morning plaque because the bacteria can't stick to it."
The porcelain veneers are attached to the patient's teeth with a bonding agent derived from the substance that NASA developed to attach ceramic heat shield tiles to the space shuttle. Because the veneers are created in Rosenthal's own lab, simple smile-lifts can be completed in a single day, and even complex jobs can be done in under a week. And since the entire process is non-invasive, there is no recovery time. This new lease on beauty, however, doesn't come cheap.
Cosmetic Dentistry: How and How Much?
To get a star-quality ceramic smile, the cost can reach astronomical levels, depending on how much work your mouth needs. Individual veneers range between $700 and $1500 per tooth, so a whole mouth restoration can run into the five-figure range. However, Rosenthal says there are cosmetic dentistry options for every price range and sometimes all a patient really needs is one or two veneers, combined with bleaching and other techniques. Simple in-office chemical bleaching, for example, only costs a few hundred dollars, and laser bleaching runs about $1,000.
If you're interested in finding a cosmetic dentist in your area, Rosenthal has this advice:
- Find a dentist who has taken some hands-on courses, either at universities or accredited institutions.
- Make sure the dentist has information to give you about all the procedures (pros and cons), so you have a realistic understanding of what you're going to go through and the results you can expect.
- Make sure the dentist has performed the procedure before, even written papers about the procedure.
- The dentist should be able to show you before and after photos of other patients, and should be able to put you in touch with previous patients so you can ask about their satisfaction with that dentist's work.
- There is no licenser for the specialty of cosmetic dentistry, but you can contact the field's largest membership organization, the American Academy of Cosmetic Dentistry, to find a cosmetic dentist in your area.