A Guide to Smile Makeover

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A Guide to Smile Makeover

Many people don’t know what a smile makeover is about. Some even think that it is some kind of space science, but it isn’t; a smile makeover is as simple as any dental procedure, with just a more extended downtime. So we’re going to guide you through the steps of making a Smile Makeover

Let’s start with the basics; what is a smile makeover? Well, a smile makeover is a combination of techniques and procedures that work hard to improve your dental appearance, and most importantly, your dental health.

Let’s Start with the Smile Design with Ceramic Veneers

First of all, when our assessment starts, we check that the patient has a good bite and an ideal occlusion so that veneers have no chance of falling.

After looking at that, we take an X-ray; we check there are no bone injuries or infections.

Then we do general cleaning, so the patient’s teeth are immaculate.

The cleaning is done with a pumice stone or with baking soda. An ultrasound is done on the teeth called a Scaler, and any rocks that may be present are removed.

Then, having the X-ray and cleaning done and ensuring that everything is okay and ready to start the treatment. Generally, if the patient has wisdom teeth, they have to be removed earlier.

Why do we do it? We do it because the wisdom teeth always do a domino effect; they push the other teeth and will damage the treatment in the future. Although that also depends on the age of the patient

Next, we do a micro preparation, around zero three millimeters or zero four millimeters to the tooth enamel. It is made that way so the veneer can seal.

The micro preparation is made with retractor threads; they are placed inside the gum so that the preparation I will make is seen in the final impression.

Okay, then preparation is made, zero three or zero four millimeters,  a very minimal preparation. And after the preparation is done, we place the threads; then, we make a separation with a metallic interproximal strip; it is done so that the difference between the two teeth can be seen in the model because sometimes the cast comes out together and sometimes the veneer can leak in the middle between tooth and tooth.

Final polishing is done with a soflex disc, and the impression is taken. I personally take it in a way that is called a double step. After the initial thread is placed, a thread that is a little thicker is set to finish retracting the gum. A mold is then taken, tested in a tray, and we take the impression. I take it with heavy silicone initially, which is the background of printing.

I place it as isolation so that it has room for a new silicone called lightweight silicone; that lightweight silicone is going to copy exactly the preparation that I did. 

When I place that lightweight silicone, the second thread is removed, and with the gum already uncovered, it will copy exactly what I prepared.

Generally, patients get a Mock-up made, which is, as we say, how the design will be when it’s finished. That is sometimes done with some patients or when it is just a micro preparation. It is not done when it does not come with a previous design or when the preparation is minimal. If all this is done beforehand, Then you will have to make an appointment for the Mock-up later.

Let’s say it’s a kind of parenthesis, like a preliminary mold. This mold can be taken with silicone, with the same one we use to take the final one to copy the gums well and copy everything well. And a wax-up diagnosis is made of how the smile design will look.

A record is made of that. The patient can be shown the possible results beforehand, how they can look, with a product called Luxatemp. This acrylic resin can be removed very easily from the tooth, which helps me simulate the results.

If the patient wishes, the mock-up can be made when the final impression is taken, and then that mock-up is left for eight days. 

After the impression is taken, we go to the lab because the veneers are made there, tooth color is taken, and then, patients choose the color; if they want it white or natural, we will guide them through the process. The veneers are sent to the factory, which more or less takes about six days to manufacture.

In the design preparation, we also do hygiene with bicarbonate again, and we do absolute isolation. What is that? That is the most crucial thing in dentistry. 

The first step to do absolute isolation is to place some threads to separate the gum from the tooth. Because that is very important, that makes it so the saliva or that part of the gum that we call clavicular fluid, doesn’t emerge when I am putting the veneer, that will guarantee me that there will be no contamination of saliva.

Then a rubber cloth is placed to isolate the rest of the mouth. When people breathe in, there is a lot of saliva in the whole environment, and even our breath itself could contaminate the work.

A rubber cloth is then placed, and the tooth remains isolated so that we can make a clean segmentation. What is this going to guarantee us? That we will have a long time, the veneers set in the mouth, there will be no leaks in the mouth, and there will be no contamination. 

If we do isolation, a carving is then made on the veneers since the veneers have to be prepared internally. A carving is made on the tooth with a managed protocol, and some adhesives are placed, and then we place the two segments.

We make a withdrawal of excesses. Ensure that there is no segment remaining in the preparation, the gum, or anything like that. We polish, and that’s it; the treatment is finished, the isolation has been removed, and the threads are removed.

If the patient wants, then they can ask for details. The veneers are already prefabricated and ready, but sometimes patients may suddenly want us to fix some details, and they can be fixed at the end, a new bite test is done, and that’s it.

Patients will have to wait about eight days because the gum is significantly damaged, but I prefer to damage it in the same appointment, I would say, but not risk the gum getting hurt the rest of the years that the design will last. The healing is going to need more or less eight days.

Now, let’s explain the steps for smile design with composite veneers.

Like Ceramic Veneers, we have to do preparation, take wisdom teeth out of the picture, and do an X-ray to see that everything is fine.

After that, we can also make a mock-up or a projection of what the design will be when it’s ready because it is always good to make previous appointments to look at the expectation. So let’s say that the beginning is the same as in ceramic. There are already two ways to make a smile design in resin.

In composite, the mock-up’s projection is also made, some records are taken from that mock-up, and those records will give me a base for the resin that I am going to handle; that’s it. The study will then be done the same in the laboratory, the wax-up is done in an articulator like simulating the jaw, and we already have our mold to make the resin design.

If the patient wants it natural, we make a layered design with all the translucent blue effects, salmon color, everything according to the expectation the patient has and the expectation of the color they have. So, according to that, we make the projection.

Some people may say, “Doctor, I want a design, I don’t like it, those are natural,” so we make it monochromatic. We make a design for you, obviously in a single tone, but we also try to give it a natural shape.

So when we have that projection, we put it in the mouth. We also have to do gum isolation; with the absolute isolation ready, we mount the resin; the isolation will guarantee that the resin is not contaminated. Okay, so threads are placed on some occasions, but I put rubber cloth that helps me isolate everything.

The truth is that composite resin work is sluggish, but you still have to do it to guarantee the outcome. We allways use a retractor cord to retract the gum and to mount resin or ceramic.

The color is chosen, the resin is assembled, a carving is made on the tooth, some adhesives are applied, and then the veneer is placed, either directly, that is: to do it in the mouth directly. Or indirectly, which is to do the veneer on a separate model.

So there we have those two. We then shape it, separate, polish it, and after polishing it, we give it a final shine because the veneer has to be polished. Finally, we fix the bite, and we fix the details.

That is Smile Design in Composite Resin. The process is a little easier because that resin can come out in a day or two. Make the upper part first, and then do the lower part. So composite is a little simpler, and of course, we always make sure that you have a good bite, good occlusion, and all that.

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