What would the average consumer do when confronted with the news that he or she needs four, or maybe even six, anterior crowns? First thoughts: "Oh no, how much is it gonna set me back? I don't want to destroy good teeth so how many do I really need? How long do I have to walk around with temporaries? Will everyone know I have fake teeth when I smile? Can I trust this doctor to do a good job?"
These days, though, many patients are somewhat dentally educated: they have heard about cosmetic dentistry and know there are specialists who market themselves as more expert than the average GP in providing natural-looking restorations.
A few months ago, when my husband, Andy, was told exactly the above, the first thing I did, in fact, was log into the AACD's website to see who is an accredited fellow of the AACD in our area. But then, after checking out several dentists' websites, looking at photo galleries and other credentials, I took off my "somewhat dentally educated" hat and did what any self-respecting fully educated member of the dental industry would do: I called My Cousin Vinni. [I've been waiting to use that line ever since the movie made its debut!]
Okay, so he's not my cousin and he's not a lawyer but my friend Vinni d'Abate, York Dental/Cerama Laboratory, Branford, CT, is a magnificent dental technician and I knew he'd steer us in the right direction. He sent Andy to Richard Snayd, DDS, a general practitioner at Norwich Family Dental, a good hour and a half from our house. Andy quickly recognized it was worth every mile of the trip to be in his capable hands. Even better, Vinni was determined to make the teeth himself and Andy now has a spectacular smile, vastly improved, in fact, from his original.
After Andy's initial visit with Dr. Snayd, Vinni came to LMT to show us a couple of options via diagnostic waxups. He told Andy he could be conservative and do only four restorations and then showed us a waxup of six restorations and explained his thought process for each option. Ultimately, Andy elected to do all six; this enabled Vinni to select a lighter shade across the smile line.
What really amazed me about these restorations is how thin they are. Particularly because of our 2007 Crown Challenge, I've had the opportunity to see hundreds of crowns--albeit mostly molars--many of which seemed needlessly bulky in comparison to the natural teeth.
Andy's crowns are refreshingly light and beautiful and not too white or long. I worried that, because he is so tall and his natural teeth seemed too short for his stature, Vinni would add too much length. My personal observation--sitting in on countless technical seminars over the last three decades--is that every so often a patient's natural teeth are replaced with needlessly long ones, giving them a horsey look.
Of course, there was no need to worry at all. Vinni was on the same page throughout the process; his work is the real enchilada. On top of the look, the fit was excellent. Only minor adjustments needed to be made occlusally before Andy's new smile was cemented in. After Dr. Snayd placed the last crown, I asked if he is digitally savvy; he replied by gleefully displaying his app-filled iPad and shared it with us so we could enjoy his gorgeous and huge collection of nature photos.
I share these thoughts because I imagine, for you in the laboratory and not on the premises of the dental practice, it's quite a different experience to stand in the shoes of the patient and patient's family when determining the cosmetic aspects of the final restorations.
And I know that as we move into 2012, the average dental patient is becoming a more educated one. At the same time, as dental product manufacturers recognize this trend, some of them are thinking along the lines of pharmaceutical companies; they're considering marketing brand names directly to the consuming public in the hope that the public will push their dentists to offer specific materials or products. Evolution naturally embraces The Educated Patient. You have time to be ready and able to meet these new demands.