What to Know About Cosmetic Dentistry
Q: What are the most common cosmetic concerns for your patients? A: I think people are taking better care of their health and their appearance—they realize how important it is to have a great smile. Some come in and they don’t like the color, shape of their teeth or spaces or crowding in their smile. We do Zoom Whitening, whitening with trays, gingival recontouring for short teeth or a gummy smile, veneers and bonding, and bonded fillings that match the teeth. But we do some of these things because we want to preserve teeth and gums.
Q: Is cosmetic dentistry becoming more popular, and if so what services are in demand? A: By some estimates, money spent on cosmetic dentistry has more than doubled in the past five years. Whitening is the most requested procedure, with veneers coming in a close second. Techniques have advanced and these services have become affordable for most people instead of being only for the wealthy.
Q: Many people think of cosmetic dentistry as an aesthetic concern. But you point out many instances where it’s necessary for a patient’s health.A: Your teeth, gum tissue and jaw all must be healthy to provide a solid foundation for cosmetic procedures. We take a lot of time examining the gum tissue and jaw alignment to ensure a successful outcome.
There is a strong connection between overall health and your dental health. Moderate bleeding and inflammation present during your cleaning could be an indication of diabetes. We often refer patients back to their physician for testing and diagnosis. Plaque and oral bacteria entering your bloodstream could be directly related to heart disease.
Q: You specialize in helping people with sleep apnea and TMD—how are these cosmetic concerns?A: [Many come in for help with] tempromandibular joint and muscular disorders (TMD). These are joint dysfunction disorders and it concerns the position of your jawbone and how it fits in your skull. Damage that occurs with TMD includes having chipped enamel, gumline recession, and worn or uneven teeth. You can lose vertical dimension as teeth get shorter. People can be unhappy with the appearance of their teeth, and may have jaw and neck pain, and vertigo.
I take six courses a year on cosmetic dentistry, sleep apnea, TMD and neuromuscular dentistry. Sleep apnea is dangerous so we want to screen people for that. I can look at teeth for signs of wear and many times it’s an indication that the patient has sleep apnea. We look in the airway, check their neck circumference and posture, and send people in for sleep studies all the time. Usually you dive in further and there are reasons why someone’s teeth are a certain way.
Our office is actually part of a multi-site study (in coordination with the Wisconsin Sleep Center and Harvard, Stanford and U-Penn) on the effectiveness of oral appliances with CPAP therapy on patients that have mild to moderate sleep apnea.
Q: What are the newest innovations in your field?A: I’m doing a lot of prepless dentistry for veneers that requires minimal to no removal of the existing tooth structure—so no drilling. This can often be done without anesthetic. Young adults (post-orthodontics) are especially great candidates for this approach. With this new technique, I can be very conservative. You take an impression of the person’s teeth and the lab fabricates the veneer. It’s only for specific cases.
I also do Cerec same-day crowns. The CAD/CAM technology constructs porcelain crowns in the office same day. The crowns are metal-free and bonded to the tooth creating maximum strength.
Q: What are cutting-edge technologies you already use or expect to use in the future?A: iPads and iPhones are offering a wide range of uses from charting, to displaying X-rays and managing dental records.We’re also seeing oral DNA diagnostic testing that measures certain bacteria for treatment of periodontal disease. It also identifies if a patient is predisposed to develop serious gum infections such as inflammatory periodontal disease and/or HPV and related oral cancers.
Dr. Gyurina was recommended for this story by the American Academy of Cosmetic Dentistry.
Shayna Miller is associate and style editor of Madison Magazine.