Gallery of Dental Miracles
Dentistry has come a very long way in the last twenty years. The things that have made miracles possible are various, but at the top of my list are:
Bonding materials and techniques, which allow me to remake scary smiles into beautiful or handsome smiles in just a few hours.
Porcelain laminates, artfully crafted by my master ceramist Rich Pavlik. These eggshell thin, custom sculpted porcelain veneers can transform dark, broken, crooked teeth into beautifully aligned, bright, vibrant teeth in just two visits.
Dental rehabilitation, driven by a proper understanding of occlusion, now makes it possible to make old faces look young again. In the past, severely worn teeth meant an old or an ugly appearance, and rehabilitation was often a hit or miss affair—sometimes resulting in painful jaw joints, lisping speech, buck looking teeth or early breakage of expensive dental work. Now, with better understanding of the joints, muscles and teeth, it is possible to give people back a life that they didn’t feel would ever be possible for them again—a life with a comfortable, healthy, attractive smile and teeth that work well together.
Let’s look at some of these miracles more closely…
Bonding is particularly useful for people who have unsightly decay on their front teeth, but who are only interested in repairing the decay, and not interested in making major changes in the shapes or the shades of their teeth. It is a miracle for people, such as the two shown here, who, many years ago came to me with embarrassment and fear. Would it be possible to give them back their self-esteem? Both were fearful of meeting new people and both were young—the smile, above was a
young girl, the smile, below, was a young boy. Both were in their late teens, soon to be looking for employment, and already looking to be attractive to the opposite sex. Had they been born even ten years earlier, this kind of miracle wouldn’t have been possible for either of them. Neither one could believe the results of just a few hours of work. Truly, these are miracles of bonding.
Porcelain laminates are another one of our miracle makers. Here we see a young girl of sixteen, born missing her upper left small incisor that we call a ‘lateral’ incisor. In her case, her canine tooth, large and pointy was located in the space normally occupied by the lateral incisor. In addition, her upper right lateral incisor was much smaller than it should have been, and she had a gap between her two front teeth that she did not appreciate. In two visits, just a few weeks apart from each other, she went from having a very uneven looking smile—with gaps and pointy teeth where none should have been, to having a bright, beautiful smile, with teeth proportionate to their placement.
Here is a close up view of what her teeth looked like before and after we placed the porcelain laminates on her teeth. Notice that we were able to make her right lateral incisor look much bigger, and we were able to make her left canine tooth—the one in the position of her left lateral incisor—look much smaller. Then we made her upper left premolar tooth, that’s the one behind her canine, look as if it were actually her canine tooth. In this way, we were able to successfully fool the eye of any but the most observant dentist, that this beautiful young lady in fact had the correct number of front teeth and that these teeth were all in exactly the correct alignment. These specific details escaped her, though, when I first gave her a mirror. All she could say was, “Oh my God”!
Here we have a different view of this same case, and it illustrates one of the wonderful things about porcelain laminates, and that is, that in order to place them, very little natural tooth structure needs to be disturbed. These two pictures show her before and after the placement of the laminates. Notice how the back surfaces of her teeth have not been affected or changed in any way. The laminates adhere to the front faces and the biting edges of the supporting teeth. In her case, these surfaces only needed to be slightly shaped to accommodate the porcelain. Miracles Indeed!
This gentleman was always troubled by the overlapping of his upper front teeth. In fact, the tooth that overlapped developed a chip at the most prominent corner, a common occurrence when one tooth is so much further out than all of the others. In his case, porcelain laminates were placed not to make his teeth larger, as was the case with the young lady, but to make each of his front teeth just a little bit smaller, so that we could evenly distribute this overcrowded condition over many more teeth. The end result is that each tooth is just ever so slightly more narrow in the ‘after’ photo than in the ‘before’ photo, but not so much that it shows. What does show is that now he has straight and even teeth. We took the lower photo in daylight, and the upper in artificial light, so his laminates appear more yellow than his natural teeth, but, I assure you, in his mouth, his new teeth were just a white as his originals.
Dental Rehabilitation is a miracle for those who suffer with over active jaw muscles. Here is a gentlemen, a kind, sweet middle aged man, who was a salesman. When he came to see me, his smile, if you could call it that, was more like a grimace. He was having trouble in his work and thought that his teeth might have something to do with it. I observed that he had had some previous dental work on his upper jaw, which had all but fallen apart. His upper right lateral incisor for example, had a crown on it where the force of his bite had sheared off the porcelain, leaving a dark metal coping showing when he smiled. His lower teeth showed the extent of his teeth grinding habits; they were each worn down by at least half of their original height. His problems were many—he had missing teeth, he had broken teeth, he had worn down teeth, but most important was the fact that his muscles had grown more and more over active and his teeth wore down more and more. This is a common thing, and it results not only in the kind of wear that you see here, but it also results in the muscles of the face causing deep age-like lines to form, owing to the fact that the distance between the chin and the nose with the teeth together had become less than it should be. Once we re-established the correct height of his teeth, his facial muscles became much more relaxed as you can see by the feeling of his new smile. A miracle!
Here we have a lovely woman in the prime of her life, but having had some dentistry that was less than she would have liked. She came in to see me and her right front tooth had a crown on it that was too long, too white, and too thick. This thickness changed the way that her lower teeth came together, and after a few years, her upper right lateral incisor began to protrude. It had never done that before, so now she had one upper front tooth that looked like it had dropped down and the tooth to its right looked like it had been raised up. What to do? We decided to use modern dental rehabilitation techniques which in her case allowed us to give her back her beautiful, even smile, with proportions like a Greek statue, without the need for orthodontics. What was most important was make sure that the back surfaces of her upper front teeth did not force her lower front teeth to bite down in an unnatural way. That took the stress out of her chewing muscles, the very stress that caused her lower jaw to push her upper teeth out of alignment in the first place. I have learned that in the struggle between teeth and muscles, muscles always win, so I am obliged to rehabilitate in ways that are as kind to the muscles as possible. For this woman, this was a miracle!
This young man, recently married with a baby on the way wanted to make sure that his soon to arrive daughter would only know her daddy with a healthy mouth and smile. He told me that his parents had had very bad teeth, and that he wanted to start something new with his new family. He had had one of his upper lateral incisors extracted when he was quite young, and the other one was severely broken down. In just a few short visits, we rebuilt this fine young man’s smile, and gave him a healthy and strong appearance that he could show his daughter and be proud of. For him, this was a miracle!
This young woman was always embarrassed about her smile. Her teeth were yellow and stained. One front tooth had broken off when she was young and it had been repaired with some bonding material. Over the years, the bonding material began to chip and discolor at its edge, and the rest of her teeth became more yellow, while the white bonding material maintained much of its original color. The result of this was a tooth that was too short, too dark at its edge, too light in its body and, to a much greater extent, all of her teeth exhibited problems with too much space between them and a dark yellow color. For her, we used a combination of porcelain laminates on her lower teeth and porcelain crowns on her upper teeth. In just a few weeks, she became a different person. More outgoing, more assertive and she became, for lack of a better word, ‘classy’. She began to dress better, carry herself with improved posture, and she even improved her speech! Now I can say that it is easier to speak clearly without spaces between the front teeth. In fact, those same spaces can make some people whistle when they speak. This had not been the case with her. What changed was not that it was easier for her to pronounce sounds better, what changed was that now, with her new smile, she chose to speak in a new way. For her, this was a miracle!
This gentleman had some very old dental work on his upper front teeth, a three tooth bridge replacing his upper right central incisor. Originally he didn’t think much of changing it, so we left it alone for a while. Gradually though, he began to realize that it had outlived its useful life. Besides, technology had changed a whole lot since the 1960’s when the original bridge was made! Now he looks as if he never had lost that upper front tooth. Modern porcelain technology in the hands of a master porcelain ceramist yields incredibly lifelike restorations rivaling the look of natural teeth in every way. What a miracle!
Dental rehabilitation is not just for the young! This ‘seasoned citizen’ came to me with a type of dentistry on her front teeth that was wildly popular in the 1940’s. It involved making crowns out of gold and leaving room on the front faces for baking in a ‘brand new’ material….acrylic! These plastic faced gold crowns had their heyday in the middle of the last century, before the technology of baking porcelain onto gold became so well understood. The typical look of these crowns, a dark color owing to the ever thinning of the acrylic facings– allowing the underlying gold to show through– and the wear of the edges just making her smile look much older than necessary. Look now at her new smile—vibrant and beautiful, and perfectly natural—not overly white as is too often done. For her, her new look is a miracle!
Wear and tear affects the young as well as the old. Here is a young lady who suffered greatly during her pregnancy, throwing up so often that the enamel on all of her teeth dissolved away. Many of her teeth were smaller than ‘baby’ teeth. She required dental rehabilitation in order to save the tooth structure that she had left, and to re-establish the correct height of her bite. If you look closely, you can see that the distance between her nose and her chin when her teeth are together is less in the ‘before’ picture than it is in the ‘after’ picture. Also, you can clearly see that the depths of the folds that run between the corners of her nose and the corners of her lips have gotten noticeably shallower in the ‘after’ photo. This is how rehabilitative dentistry accomplishes a ‘face lift’. It is not appropriate for everybody. But for someone who has lost vertical height in their face owing to loss of tooth structure, it is, as it is in this case, a miracle!
Sometimes dental rehabilitation is a dream that a person has been promising themselves for many, many years. ‘As soon as the kids are out of college’, ‘as soon as the house is paid for’, etc. Well, the time came for this wonderful lady and she didn’t want to wait for the two years of orthodontics that it would have taken to straighten out her front teeth. Instead we applied modern dental rehabilitation techniques and in about a month, she had the smile that she had always dreamed about. Now that’s a miracle!
Here’s a woman with a very full life—active in her church and in raising her kids—active even in raising some of the neighborhood kids too! She is filled with the anxieties that only mothers know and over the years it had taken a toll on her teeth. They had worn down and become thin and yellow. When teeth thin out, the color of the darker, dentin layer tends to shine through more and more. This is why worn or older teeth look darker or more yellow. She came needing her mouth to be put back into a state of health. Using modern dental rehabilitation technology, we gave her a ‘dental face lift’, by restoring the proper heights to all of her teeth, and gave her back the lighter, more vibrant look that her smile had before she had come to take on the stresses of the world! For her, this was a miracle!
One of the newest methods that we have to replace old, worn out silver/mercury amalgam fillings is by casting porcelain in the same way that gold is cast. Even ten years ago, only gold could be fabricated by the “lost wax process” that was developed by the ancient Egyptians to make jewelry for the Pharaohs. Now, through the most modern technology, porcelain can be liquefied under tremendous heat and pressure to resemble molten glass and pressed into intricate patterns to the most exacting dimensions. The results, as you see here, are spectacular. Not only do porcelain inlays and onlays fabricated in this way have the precise fit of the gold restorations of old, but owing to the space-age adhesives that we have, restoring a tooth in this way actually strengthens and stiffens it, making it less likely to break in the future. That is something that could not be done even with cast gold without the need to cut away large amounts of natural tooth structure in order to create mechanical bracing. Here, with cast porcelain, we can preserve all healthy natural tooth structure and create restorations that leave the impression that the tooth or teeth never even had cavities! Now that is a miracle!