Sometimes a patient will show up in a dental office looking for some cosmetic work. It could be for a special event, for example a wedding or graduation, or perhaps the patient finally decided that he could spend the money to improve his smile.
He comes in for an exam and consultation and is ready to get started. Unfortunately, on occasion, the dentist must put the brakes on the cosmetic treatment.
It’s a disappointment for all involved – the patient wants the treatment, and the dentist wants to do the work – but it is necessary in order to provide excellent dental care. It is all about the foundation.
Just as a builder would not construct a house without being sure that the foundation could support the structure, a responsible dentist will look at the whole mouth to ensure that the cosmetic procedure is supported by a good foundation and that the dental work will last.
Although you usually don’t see or pay attention to your back teeth, they are very important. The mouth is structured so that mastication (chewing) is done on the back teeth.
Each tooth in the back has two or three roots, which anchor the teeth to the bone. Each front tooth, however, has one root, and is not strong enough to consistently support the chewing function.
The purpose of the front teeth is incising (biting and tearing). When the dentist examines the patient in anticipation of cosmetic dental work, he is also assessing the health of the gums and the bone.
It is imperative that the bone is strong enough and the gums healthy enough to provide the support for the entire mouth. Options to remediate these “foundation” problems are available. For example, the dentist may suggest periodontal treatment to improve the health of the gums and bone.
To the patient’s chagrin these options take a little time, which defers the cosmetic treatment, but is so worth the time and effort. A dentist who truly has his patient’s best interest at heart will not put cosmetic work on an unstable foundation.
The patient and the dentist want the same thing in this situation. They both want the patient’s smile to be beautiful and long-lasting. Working together, and allowing the necessary time, can make this desire a reality.