Your smile can light up a room—or not. Some people are so self-conscious about their teeth or gums, they smile guardedly, if at all. Well, that takes all the fun out of the party. ‘Smile lift’ dentistry can help. Smile lifts typically involve adding length or bulk to teeth to reshape the facial structure, which in turn can smooth wrinkles. Although the term is getting a lot of press lately, dentists have been doing it for years, says Dr. Justin Short, who practices at Des Peres Dentistry and Justin Short Dentistry in Troy, Mo.
“The smile lift is not as new a concept as some like to believe,” says Short. “Cosmetically minded dentists have been using these techniques for years. It’s no secret that whiter, fuller teeth without worn-down edges and chips is one of the most dramatic changes a person can make to take years off their face. By restoring teeth with crowns or veneers, we are able to rebuild worn teeth, which in turn makes the muscles around the mouth and in the lips and cheeks look younger and fuller.”
Short says that once upon a time, a dentist could slap a silver filling in, and the patient was just happy the hole was filled. Today patients are much more concerned about the appearance of what they are having done. He says the most subtle thing he does is adjust contours. A 20-year-old woman has very different contours, corners and edges in her teeth than a 60-year old. Often by adjusting these back to the younger proportions, he can achieve significant improvement in appearance. “We are restoring the teeth, and so the face, to a more youthful state. Lightening the color of the teeth is the first step, then adjusting contours. Veneers or crowns are the Cadillac options that make the most dramatic improvements.”
Dr. Ruth Gomes of VivaSmiles says when patients come in for a smile makeover, she looks at three specific areas to fill out the face: the bone structure and how the lips and cheeks fall on the face; the teeth themselves—how they are positioned, their height, bulk and alignment; and how the gums fit. Because Gomes is an orthodontist as well as a dentist, she can add tooth straightening to the mix. “Sometimes orthodontia can make a major improvement, especially in older people who may have issues with past dentistry or lack of it,” Gomes says. “In the ‘50s and ‘60s, orthodontists frequently extracted a tooth on each side of the upper and lower jaws to make room for straightening. As people age, that creates a ‘witch profile’ because the mouth tends to sink in the middle, making the nose and chin look more prominent.” She says that with a smile makeover, she can increase the bulk of the middle of the upper jaw so the lip protrudes a little and looks fuller. While some people use collagen to make the sides of the mouth curve upward, it can easily be done with dentistry, typically orthodontia and sometimes veneers, to create bulk at the outsides of the mouth.
“We interpret each individual face and pick the shape and size of teeth to go with it,” explains Gomes. It’s important to avoid the fake ‘cookie-cutter’ look, she says. People want to look individual and natural. It’s best to work out a plan with the patient for meeting their goals, like doing the upper teeth, and just whitening the lowers. Sometimes all they need is braces for a year, or to wear an expander to increase the width of the smile to show big, beautiful, white teeth in their proper position.
Dr. Kevin Groth, in private dental practice with associate Dr. Matt Howard, says it’s all about creating a fuller smile and more support for the lips and cheeks. With aging, the smile often looks narrower and flattens out, falling at the ends, he says. “When we do veneers or crowns and bleaching to widen the smile, people see how much better they look,” he notes. “We spend a lot of time taking pictures, making models and then sending the models to the lab to do a wax-up. We let the patients take the models home, discuss them with their spouses, and think about how they would look.”
Groth says getting the right color and contour to duplicate enamel is an art form and requires a very good lab. The texture of the teeth can be too smooth and give an artificial ‘Chiclets’ smile. He has to consider a patient’s skin tone and hair color and how tan they get in the summer. Very white veneers look artificial with a dark tan. “Sometimes, changing the smile is as simple as a little gum sculpting, bleaching and softening the contours of the teeth, especially in women,” Groth explains. “Or it can be as complicated as orthodontia, veneers and crowns to fill in gaps or broaden the toothiness of a smile.”
He says that in the last five years materials have continued to improve. Newer porcelains are more lifelike and translucent and able to better mimic the multilayered look of real teeth. “I’ve done some life-changing cosmetic cases,” Groth says. “People come out more confident and act differently. Cosmetic dentistry is the fastest way to take 10 years off your age.”