Helaine Smith DMD

A patient came to the office recently. She had spent a considerable sum of money with another dentist for bone grafting and implants and wanted to know why she had “a gray line” showing at the top of her relatively new crowns (two years old).

Her dentist had placed crowns on her top front teeth and the reason for the gray line is that her gums had receded and now the crowns’ metal substructure was showing — as you can see in the photo below that was taken of another patient.

With today’s advanced dental technologies, dentists don’t have to use metal-based crowns and bridge work — something that was virtually unthinkable even five years ago. Using reinforced porcelain, dentists can develop crown and bridge treatments that look 100% natural.

Porcelain also has a natural translucency so that when you smile, the light reflects off your teeth and the porcelain in a natural manner — and making it very hard to tell the difference between your real teeth and your crowns.

As you can see in these before and after photos, non-metal crowns are gorgeous!

These new porcelains are also very strong and last up to 10 years with good care. Although metal-based crowns do last longer — approximately 15 years — non-metal crowns and bridges provide you with a beautiful smile for their entire lifetime.

So instead of having to suffer with ugly crowns for 13 years, you get a beautiful smile for 10 years!

We’ve been “metal free” for over 10 years at our Boston office and have placed many non-metal crowns for patients. The benefits of our cosmetic dentistry services include:

• Custom-made porcelain crowns that exactly match existing tooth color for a perfect smile
• Correcting crooked or mis-spaced teeth and/or closing gaps between teeth
• Smooth and even gum lines with no tell-tale gray line
• Fabricating crowns and contouring your gum line so that when you smile, your top teeth show naturally but not your gum line

If you have unsightly crowns, be sure to ask you dentist about non-metal crowns. You deserve a dazzling and perfect smile!

Missing teeth not only make you feel less than confident, they also make it difficult to chew and can lead to other oral health problems, such as shifting teeth.

Dental implants replace your missing teeth — and unlike a crown and bridge restoration, dental implants don’t shift over time and they’re just as strong as your natural teeth.

If you’ve been considering replace a missing tooth or lost teeth — or you have dentures and want to learn more about implant-supported dentures, please consider calling our office.

We’re offering all patients $200 off their dental implant procedure. Just call the office to schedule your complementary consultation and if you decide to have me and Dr. Favaloro perform your implant procedure, we’ll take $200 off. It’s our way of helping you achieve the smile of your dreams.

I’ve been experimenting with my new Flip camera and asking patients to give me testimonials. It’s been a wonderful experience listing to patients talk and learning why they choose to have cosmetic work done.

In this video, my patient Judy explains why she enjoys visiting my Boston dental spa. Thank you, Judy! (You can also view my other videos at my YouTube channel.)

A recent article on StyleList talks about the new trend for celebrities: adding teeth gaps and imperfections to their smiles.

The article states that movie stars such as Anna Paquin are undergoing cosmetic dentistry in order to replace the gaps and imperfections they originally covered up with dental veneers.

Personally, I think this is a bunch of . . . well, I won’t say the word.

Movie stars already look fabulous . . . they’ve often had plastic surgery, they have frequent Botox injections, and they have armies of people doing their hair, applying makeup, and dressing them.

Adding a “flaw,” such as a gap between the front teeth, can make them seem more “human” — and can in fact help them in their careers. Just look at Harrison Ford and the scar on his chin, which was written into the script of the third Indiana Jones movie. (You can read about other stars and their scars here.)

However, for the rest of you — including the patients who come to see me in distress because they’ve lived with stained, crooked or missing teeth for many years — it’s A-Ok to use dental veneers, dental implants, and other cosmetic dentistry procedures to enhance your smile and regain your confidence.

A recent email from the husband of one of my patients points this out. He writes:

“Thank you for the wonderful job you did with my wife and her veneers. I have not seen her this happy since before her illness.”

This is one reason why I love what I do — I transform people’s lives.

So my advice to you is: Ignore what the movie stars are doing. If you don’t like how your smile looks, or you have gaps between your teeth, call my office to set up your free consultation. I’ll help you achieve the smile of your dreams — as well as make you feel fabulous and confident again.

A Bridgeport, CT woman was awarded $198,000 because a cosmetic dentist promised her a “celebrity” smile but what she got instead was “horse teeth.”

I won’t comment on whether or not the dentist in question was competent.

What really matters is that as a consumer, you must ensure your dentist (and any medical professional) is licensed and has undergone rigorous live-person training in all procedures.

Any dentist can say he or she specializes in veneers, but what does this mean?

Does the dentist have live-patient training in advanced procedures from institutions such as the Las Vegas Institute of Advanced Dental Studies or the Rosenthal Institute?

Has he or she been trained to fully evaluate the patient, including the patient’s facial structure and teeth shape?

Does he or she perform procedures with exacting detail? Sure, any dentist can perform a simple veneer procedure, but is the dentist measuring gums and teeth down to the exact millimeter?

Does he or she work with a trained ceramist in order to ensure natural looking teeth color? (And, when dentists are pressed to make their production number, do they even find it worthwhile to take this extra time?)

As a consumer, you must, must, must research your dental professional and his/her training and experience BEFORE you lay thousands of dollars on the table.

It’s very easy to believe in dentists’ radio and TV ads . . . but the results — a poorly designed smile that looks unnatural and lasts only a few years — speak for themselves.

In a recent NY Times article, A Dental Shift: Implants Instead of Bridges, reporter Jane E. Brody discussed why dental implants are now the new standard of care.

The reasons dental implants are growing in popularity include better materials, advanced technology, and more experienced dental professionals.

And unlike crowns, dental implants don’t decay and can be maintained just like your regular teeth — through daily brushing and flossing.

What I like best about this article, however, is that Brody re-emphasizes the point I made in an earlier post about choosing dental professionals trained in dental implantology:

Just as any physician can legally perform surgery, any dentist can legally do implants. Be sure to choose someone thoroughly trained in the technique. Taking a weekend course in implantology is rarely adequate. There are risks involved in placing implants, including damage to a nerve or sinus cavity, which are magnified when the practitioner lacks adequate training.

Thank you, Ms. Brody, for an informative, fact-filled article that educates consumers!

One of my team members watched the movie Twilight and wondered if heartthrob Robert Pattinson had dental work performed on his teeth — which look pretty good in the movie.

We did a little searching and found that yes, Twilight producers made him wear something close to an Invisalign brace to help straighten out his teeth. According to Pattinson, they wanted his teeth to “be perfect” in keeping with the character Edward — who like his vampire family, has perfect, “razor-sharp” teeth in the books by Stephanie Meyer.

This made us wonder about dental special effects in other movies — and after doing some searching, we found that movie stars do undergo (sometimes painful) dental procedures for the roles they play. Even better, the dentists who perform these procedures can get listed in the IMDb (Internet Movie Database)!

Case in point: Dr. Rick Glassman, who placed Johnny Depp’s gold crowns for Pirates of the Caribbean as well as performing work on Sean Penn in 2004 for the movie The Assassination of Richard Nixon.

And of course, you have Emma Thompson wearing that ugly jutting tooth in Nanny McPhee (we couldn’t find who did that one), and who can forget Richard Kiel, who played the steel-tooth Jaws in the James Bond movie The Spy Who Loved Me.

According to Kiel in a recent interview, the teeth were made by a dentist in Pinewood, CA:

‘The guy [dentist] ended up successfully making one set. He told me he couldn’t make any more – it was just too difficult,’ says Kiel.

During shooting, however, Kiel could only wear them for a few minutes at a time. He said: ‘They were nauseating. They were up in the roof of your mouth and gave you a gagging effect – you felt like you were going to be sick. It did add to the stoic part of my character – to keep from throwing up.’

‘They were kind enough to have a lady with a tupperware container with some cotton at the bottom. As soon as the director called cut, out they came. She would take them and rinse them with mouthwash and leave them to dry off for the next scene.’

Sometimes though, movie stars’ perfect pearly whites actually stand out too much in a movie. For example, while watching Pride and Prejudice, I was struck by the juxtaposition of the characters’ very white, very straight teeth against the very gritty 18th-century background — the dirt, the lack of running water, and closeness of people and their animals. In one scene, for example, you see a pig walking through the house.

And as we all know, people’s teeth rotted and fell out during this time period due to lack of knowledge about dental care and poor hygiene. (Remember, people took baths maybe once a week, if that!)

So the stars’ perfect white teeth were a modern day anachronism in the movie. In fact, in many scenes, Donald Sutherland (who has very bulky veneers!) actually covers up his smile with his hand.

Do you notice movie stars’ teeth? Do you know of other examples of stars who had their smiles enhanced for roles — or had veneers placed that made their teeth look more suited for a “working class” role? Leave your comments below.

My colleague, Dr. Hugh Flax, recently posted a quiz on his blog. Titled, “Is your dentist ‘thoroughly modern’?” the post lists 20 questions you can ask about your dentist — and then score him or her based on the answers. (Dr. Flax based his quiz on a quiz I posted last month.)

I like Dr. Flax’s quiz, but I thought you might find it helpful to understand why he and I agree about asking these very important questions of your dentist. I won’t give details behind all 20 questions, but you might find the following information of interest.

1. Why a clean dental office is important — The obvious reason as to why you want your dentist to have a clean office is due to infection. Simply put, a dirty office spreads germs — such as the H1N1 virus. (The ADA has a wealth of information about infection control. You can also watch the video I did on this topic.)

However, a less than immaculate office also shows you how much your dentist pays attention to details — and a lack of attention to detail in the office setting can translate into how he/she works on your teeth. (Think about that for a minute.)

If you walk into the lobby of your dentist’s office and see a dusty table covered with months old grubby magazines, what does this mean? Or, what if the exam rooms have cobwebs in the corners and old exam chairs covered with cracking vinyl? Such lack of attention can mean the dentist has lackadaisical sterilization procedures.

It also might mean the dentist isn’t offering perfection when it comes to your mouth. (I see this quite a bit when patients come in to have me fix dental work performed by other dentists.)

2. The importance of keeping abreast of new theories / dental advances — As with medical research, dental research is constantly uncovering how our mouths and teeth respond to bacteria and other substances. And, as I’ve posted before, bacteria doesn’t stay put in your mouth — it travels throughout your body and can complicate existing conditions such as heart disease and diabetes.

In addition, dentists today must keep abreast of things such as sleep apnea and new treatments for periodontal disease, tooth decay, and oral cancer, to name a few. And, modern dentists are all about preserving tooth structure — which means they may use non-mental fillings and other minimally invasive procedures.

3. Importance of showing their own work — Question number 17 of Dr. Flax’s quiz asks, “Does he/she have photos of their own work to show?” I thought this an insightful question as most consumers do not know that dentists can purchase pictures for a Website “smile gallery.”

As a consumer, you have no clue whether or not the photos of the smiling teeth on a dentist’s Website belong the dentist. (Yes, I’m serious — which is why it insults me when dental marketing companies tell dentists like me to use “canned content.” Grrrrr!)

This is one reason why I show the full face of my patients on my “Before and After” photos, and it’s the reason I have a photo album in my waiting area full of pictures of my cosmetic dentistry patients standing with me.

I don’t believe in “smile galleries” because I’m helping people transform their lives — and by extension their health — not simply smacking veneers over someone’s yellow teeth.

Dentistry has changed quite a bit in the last 20 years. It’s no longer about simply filling cavities! If your dentist is still using paper charts, x-ray films and light boxes, and has no idea how to place a dental implant, then it really is time you found a thoroughly modern dentist. Your health depends on it.

I recently took a course on how to restore dental implants (or fix a broken or infected dental implant), since restoring an implant is very different from restoring a real tooth. It was a great course (and intense). I learned a great deal — namely that the principles of implants must be respected when attempting to restore an implant!

This Implant Prosthetics program offered by the Misch International Implant Institute was developed for dentists whose primary interest is the restorative phase of implant dentistry. The “Team Approach” is emphasized and many surgeons and periodontists find this program enhances their relationship with their referring doctors.

I attended specific lectures on implant diagnosis, treatment planning and patient evaluation, as well as all prosthetic phases of implant treatment. The course was divided into three sessions consisting of lectures and hands-on laboratory sessions for both removable and fixed prosthodontics.

The Misch International Implant Institute was developed in 1984 to help set and elevate the standard of care in implant dentistry using a hands-on approach. Now world renown, the Institute’s goal is to remain at the forefront of implant dentistry through research, education and its unique clinical applications. Using these tools and a well-trained faculty, the Institute is able to provide its students with the most progressive and documented information.

I’m very happy to have taken the course. As you know if you read my blog regularly, it’s very important to me that I offer my patients the very best in care. Continuing education is just one way for me to accomplish this goal.

Edith came to my Boston office to inquire about cosmetic dentistry. She had wanted cosmetic dentistry for years as her teeth had not aged well but had kept putting it off.

Just looking at Edith and listening to her talk made me realize that fixing her smile would give her what she desired — a more youthful look. An attractive 70-year old woman, Edith had aged well — she has a skin deep beauty — but her teeth, due to age, had worn down and were too short. (Short teeth make us look older.)

In addition, she also had many old fillings that did not keep the natural contour of the teeth shape, plus the shade was a very dark brown. In short, her smile did not match her warm personality or her face.

All of this was easily corrected with porcelain veneers — and in just two visits. Taking into account her warm personality and facial structure, I designed a new smile that enhanced her face and matched her personality. Her new smile will last for years.

If you’re like Edith and feel you have lots of life left to live — but you think you’re too old for cosmetic dentistry, please reconsider. Our bodies age in different ways and while some people’s smile may be gorgeous well into their 70s, other people have teeth that age faster than they themselves do.

Consider cosmetic dentistry as a gift to yourself — and restore your youthful vitality with a beautiful new smile.