Soft but perfect smile

Pretty faced Apoorva landed at our office for Quick fix smile! The demand of the role was a ‘soft but perfect smile ‘in addition to pretty face and acting as well!

The task for us was as under

Imagie 1

·         Remove the overlap of two centrals and align the right central. ( see image 01.)

·         Take the right canine palatally till it almost matches contra lateral canine inclination.

·         After the centrals, it was major concern for the left lateral, as I wanted to incline it mesially at the same time wanted to maintain “face of the tooth “unaltered.

·         The right lateral needed a little body to match the contralateral.

 After taking couple of snaps of smile, full face and intercuspal teeth position, I made impressions for study model. The director of the this serial wanted me to fix Apoorva’s smile in two days ( 48 hours!!)due to delay in shoot!!

I took the challenge and called her the next day to fix the desired effect.

On the day of photography and study model,  me and my associates worked on study models for virtual mock up in composites. My wife sushama made digital mockup for Apoorva's smile.

And we were all set to fix Apoorva’s smile, the next day!!

I started with two centrals by keeping the silicon key (made on study model) in the anterior area from palatal side. It took me two hours to get central in alignment.

Then it was the turn for right canine. To get the best result, always start preparing the labial surface to your desired location as per digital imaging and mock up (does not matter even if it exposes the pulp chambers while doing so!) 

In Apoorva’s case pulp exposure was very much expected beyond doubt. But trust me, as the canine had enough labial width before I could land into pulp, except a pink spot situation, nothing unusual took place..

I primed and bonded the open area of canine and finished the top layers without spending much time. The lateral on left was a challenge as it needed mesial built up, at the same time it was much broader mesiodistally because of the existing space.

There I have added plenty of ochre and brown colour from paint on brush kit.  Fig 03(before) then  fig 04(after)

That mellowed down the distal position of lateral making it virtually invisible!

(I would be happy to get your comments on this)

My take on - Dr. Doug Disraeli Shares Tips on Holiday Foods That Help Maintain a Healthy Smile

I certainly endorse the opinion and advice given by Dr. Disraeli for a cavity free  holiday.

I personally would like to add, few important points, based  on science and experience for the last thirty years of dental practice.

An  ‘Exposure Theory ’ reveals to mankind that 1^st bite of chocolate (especially milk and cocoa based) or any sweets is well tolerated by Human teeth enamel. (Animals DO NOT each chocolates unless pampered as PETS!)

It is an extreme urge to plunge in to the second exposure of sweets, where the whole sad story for holes (cavities) starts with.

Sweets, being sugar based , the moment it comes in contact with smooth or rough surfaced enamel along with saliva in the mouth, it starts becoming ACIDIC with lowering PH.

1^st exposure though, is easily well tolerated by sound and smooth enamels it is the second and the 3^rd  that roughens the enamel of premolar or molars ( mainly because of the anatomy and morphology to chew and then the burrowed wasp in the cusps & grooves of grinders  act as ware house effect,  supplying residual sugar from entrapped sweets to weaken the burrows further and making them deep.

In a holiday tour, one is bound to eat sweets and sugary items because of the apt mood. If one can avoid the 2^nd and 3^rd exposure of sweets , say within 30 to 45 minutes of the 1^st one , it is quite ok to indulge in sugary diet.

It also depends on how vulnerable is the qualitative enamel of one’s teeth.  Some human are blessed  with toughened enamel ,which can resist n number of exposures to sweets.  But if not so strong, (might be genetics plays major role) BEWARE of multiple exposure of sweets in one go.

Take of the thought     Lesser  the Better !!!  :)

"About Dr. Disraeli's Tips for tooth friendly holidays "

Hillcrest San Diego Dentist Doug Disraeli agrees with the saying 'You are what you eat' when it comes to the health of your teeth, and recommends incorporating foods such as dairy (except for those that are lactose intolerant) products and high fiber fruits and vegetables into your holiday meal for a tooth-friendly feast.

"Holiday meals offer starchy and sweet foods that increase plaque buildup on teeth, which can lead to cavities or gingivitis," says Dr. Disraeli. "Combating unhealthy options with tooth-friendly foods such as asparagus or milk promotes a healthy holiday smile."

High fiber fruits and vegetables act as a detergent, helping to remove plaque, and promote saliva flow, which aids in neutralizing acids that attack tooth enamel. Suggestions: Peas, onions, broccoli, kale, apples, pears, raspberries.

Dairy products provide calcium that builds stronger enamel, offering protection from sugars and starches. Suggestions: milk, yogurt, cheese.

Items to consume in moderation during the holidays include:

--  Sugar - the #1 culprit causing cavities.
        --  Alcohol - wears away tooth enamel, discolors teeth and makes teeth
            vulnerable to cavities.
        --  Energy drinks, such as Gatorade and Red Bull - highly acidic and can
            wear away enamel at a faster rate than normal.
        
        

Dr. Disraeli is the owner of the Hillcrest, San Diego dental practice Doug Disraeli, D.D.S. specializing in cosmetic, implant, restorative and general dentistry. Dr. Disraeli is available to offer comments on healthy eating and drinking habits during this holiday season.

Smiles Forever - Case study- Veneers

A patient named Mrs. Nirmala (aged 30 years) visited the clinic with a chief complaint of gaps between her teeth in the anterior region.

On evaluating the case we diagnosed the gap between the two anterior teeth was more than 2mm, so we decided to use the indirect technique of gap closure. We decided to give her indirect laminates in the anterior teeth with the guide lines of smile designing.

Indirect laminates were given to her in the upper arch from premolar to premolar.

Using this technique we achieved satisfactory results.

Smiles Forever - Case study- Discolouration

A young boy named Ankur (24 years) visited our clinic with discoloured upper  left central incisor. Discolouration was mainly due to staining of unfinished composite restorations. Class IV fracture of the tooth was also observed.

T/t plan:

Unfinished composite was completely removed and a veneer preparation was done on same tooth and a composite veneer along with class IV was done. Finishing and polishing was done in the next sitting. The case was completed in a single sitting.