Use of Orthodontics to Enhance Esthetics
When cases are being evaluated for esthetic outcomes, a better understanding of the incisal edge position, horizontal plane, and occlusal pathways is essential. Tooth preparation should be our next focus with consideration on how much tooth reduction is necessary to achieve the desired esthetic result for our patients' needs. The amount of restorative space and restoration needed to achieve a desirable outcome seems to be increasing over the years. More patients are opting for restorative treatments with more pleasing and esthetic outcomes. It has always been my understanding that cosmetic dentistry should be as minimally invasive as possible so as not to compromise healthy tooth structure.
As technicians, we make our living fabricating restorations, but nevertheless, let us not forget we must be willing to recognize that more is not necessarily better. It may be easier to control the outcome of our cases when working on more units, but we must at times resist this inclination. Although fabricating two centrals may be easier than matching a natural tooth and perhaps seem more profitable, it may not always prove to be the most prudent.
Further, in today's comprehensive world, rather than relying solely on tooth preparation, orthodontics and the movement of teeth should be fully explored for the preservation of tooth structure and optimal results. Orthodontics can aide in our esthetic outcome. As technicians, we must be willing to prescribe the best treatment options for our patients, recognizing that ultimately this as well will benefit our laboratories and businesses while producing the best results.
With that said, the stigma of orthodontics is clearly not the same as it was 20 years ago, with more patients willing to do what it takes to satisfy their needs and desires. Orthodonture of today is for some viewed as "cool," as evident by the use of this treatment by film stars in the midst of their careers. The accessibility and ease of orthodontic trays and aligners that work at a fairly rapid pace has also aided this transition.
As technicians, our knowledge of tooth/root movement is an imperative part of the diagnostic process. It is, therefore, our responsibility to present and convey this message properly to our patients for a better understanding of the best treatment plan. The words, when presented properly, are critical. Knowledge and a belief in what we do is what gives people the confidence to trust in their dentists. Too often, I hear from a dentist the all-too-familiar response, "the patient does not want that," but does the patient really want to grind down more teeth than necessary to achieve what might be a subpar result? Or, has the treatment plan not been presented properly?
Recognizing that orthodontic treatment is not for everyone, we must continue to re-evaluate our strategies. At the end of the day, our value and ability to work and succeed in this comprehensive dental world remains in our knowledge and ability to execute all of our options.
Peter Pizzi, MDT, CDT