Cosmetic Dentistry Orange County | Huefner Sensational Smiles Blog

Labels: laguna beach, lake forest, orange county cosmetic dentist, porcelain veneers, smile design

Breaking and losing a front tooth can be devastating and very embarrasing. Everyone sees it.

Rita broke off just such a tooth at the gum line and it needed replacement. We discussed several options with her (placing a porcelain bridge, a removable partial denture or dental implant). In her case she didn't want to do anything to the adjacent teeth, so a porcelain bridge wasn't chosen. Also, she didn't want a tooth replacement that came in and out like a removable partial denture, so that wasn't chosen either. She wanted something permanent and very strong and accordingly, chose to do a dental implant.

Here is the process that we used to restore her tooth and smile with the dental implant.

First, the remaining part of the tooth (the root) was removed (extracted). A dental implant was placed into the area were the root was.

Then a zirconia abutment was made.

It was placed into the metal dental implant.

A porcelain crown was made that fits onto the zirconia dental implant abutment.

The porcelain crown was cemented onto the zirconia dental implant abutment.

This was a successful case, but could have looked better had veneers been done on the two adjacent teeth to cover over the yellow root areas. Notice how beautifully matched the dental implant was to the two adjacent teeth!

Dr. Norman Huefner, General and Cosmetic Dentistry, Laguna Niguel, CA

Labels: dental implant, irvine, laguna niguel, mission viejo, porcelain crowns, porcelain veneers

When considering cosmetic dentistry and a smile makeover what is the perfect “smile style” for your new porcelain veneers or porcelain crowns? In previous articles I discussed that there are over 30,000 different ways that a cosmetic dentist can create a new smile and that there are over 60 different documented “smile styles” available for cosmetic dentists to use as guide and to better communicate with to the cosmetic dental patient and the dental ceramist.
In this article we’ll discuss one of the most popular “smile guides”, Dr. William Dickerson’s “LVI Smile Library”. I am particularly fond of this library, as I started my advanced cosmetic training at Dr. Dickerson’s prestigious Las Vegas Institute for Advanced Dental Studies over a decade ago. And since then, following many of the concepts I learned at LVI, I’ve done several thousand porcelain veneers and cosmetic crowns, created sensational smiles for hundreds of my patients.
Each smile style is a combination of the teeth shapes for the front six teeth. For example, the four front teeth (incisors) could be either square at the corners, square at one corner and rounded at the other, or rounded at both corners. Similarly, the cuspids or eye teeth (third tooth back) could be pointed, rounded or flat. Combining these different shapes each produces a uniquely different smile style. Please note, this smile library below is only to choose the basic shape of the front six teeth, and in no way reflect the color, length, surface texture or translucency that the porcelain veneers or crowns will have. Those other things are addressed in other aspects of smile design and choosing the best combination for your “sensational new smile”.

For most females, the “Enhanced” smile style is one of our most popular designs. Note that the second teeth from the center are a little shorter than the front teeth. This is a youthful effect we call “the gull wing” that really looks nice on females. The “Hollywood” style above is a little more “toothy” and works well for males and especially those wanting to show off a little more teeth. The “Oval” style might look best on someone with a very round face. Notice how very round the edges of the four front teeth are? The “Aggressive” style has tooth edges that are flat almost straight across. We use it mostly for men and it simulates someone who might be a bit older and have a habit of grinding his teeth. The “Youthful” style simulates the shape of unworn teeth that might be seen in a 14 year old. Although many adults like this name because they think it might give them the illusion of being significantly younger, we almost always utilize this design in much younger individuals. The “Mature” style has squarish edges on the four front teeth and is another design that we frequently use for men. The “Softened” style is a very popular design that we use for those wanting their smile to help make them appear a little younger than their years. It is my preference to use smile designs that have the cuspids (also called canines, the third teeth back on each side) that are slightly round, not flat (too old looking) or pointed (too aggressive looking). It is important that both the patient and cosmetic dentist actively discuss the different smile styles at the beginning of the smile makeover process. Using our technique called “the trial smile” we’re able to make provisional veneers or crowns so that our patient can “test drive” their new smile prior to making any final decision regarding the smile design for their final porcelain veneers or porcelain crowns.

Dr. Norman Huefner, General and Cosmetic Dentistry, Laguna Niguel, CA

Labels: LVI smile library, orange county porcelain veneers, porcelain veneer style, smile catalog

Hating the two old "caps" that had been placed on her two front teeth a number of years ago, Tracy wanted teeth that looked natural and would give her a nicer looking smile.

BEFORE

When we looked closely at Tracy's smile we noticed that there were several other problems besides just having bad looking caps. There was a disproportion of her teeth size (the front two teeth were too wide and thick and the rest of her teeth were too small). She showed too much of her gums when she smiles. The gums and root areas around the front two teeth were dark. Her side teeth leaned in and because of that, didn't pick up much light and made her teeth look darker. Also, she really wanted a whiter, brighter smile.

After much discussion Tracy decided on having her two front caps redone with new all-porcelain crowns and have porcelain veneers on her other teeth. Also, to have some minor gum reshaping with the dental laser so that there would be less of her gums showing and that the gums that did show would be more even. Here is the results we achieved with Tracy's new smile with porcelain veneers and two new porcelain crowns.

AFTER

Dr. Norman Huefner, General and Cosmetic Dentistry, Laguna Niguel, CA

Labels: irvine, laguna beach, mission viejo, orange county cosmetic dentist, porcelain crowns, porcelain veneers

Tracy Kemble was recently featured in the MAC 2008 calendar for the month of April. Dr. Huefner did Tracy's smile makeover with MAC porcelain veneers. Tracy's photo also appeared on the cover of the Journal of the American Academy of Cosmetic Dentistry.

Beautiful Tracy with her beautiful new smile....a picture is worth a thousand words, especially if the picture is of someone as gorgeous as Tracy! Of course all of Tracy's veneers were fabricated by one of MAC's (Microdental Advanced Ceramics) award winning ceramists!

Dr. Norman Huefner, General and Cosmetic Dentistry, Laguna Niguel, CA

Labels: aliso viejo, anaheim, huntington beach, orange county cosmetic dentist, porcelain veneers

Most people would agree that your smile is very important to you. Many might say that it even sends a message to the whole world about you…about your health, about how you take care of yourself, about how good you look, etc. Your smile is about a third of what you see of your face, so to many that is very important.

Labels: cosmetic dentist, laguna beach, porcelain veneers, san clemente, santa margarita

Not happy with her teeth and smile, Uliana wanted to know what options cosmetic dentistry might have for her. Her teeth were very discolored and wearing down on the edges. She also had a crossbite on one side and didn't like the way her porcelain-to-metal crowns and bridge looked.
BEFORE
We recommended porcelain veneers on her front teeth and replacement of her old crowns and bridges with all-ceramic porcelain crowns (non-metal based) and porcelain bridge. She wanted to be involved in the design of the shape and length of her "new teeth" and was particularly concerned about achieving a full smile. The results we achieved for her were sensational!
AFTER

Then a few weeks later we took her post treatment portraits right in our "sensational smiles studio". As you can clearly see, she was very happy with her cosmetic dentistry and porcelain veneers. One of these portraits that we took will be entered in the American Academy of Cosmetic Dentistry annual Smile Gallery competition. Wish us luck!




Dr. Norman Huefner, General and Cosmetic Dentistry, Laguna Niguel, CA

Labels: aliso viejo, cosmetic dentist, ladera ranch, newport beach, porcelain bridge, porcelain veneers

1. The first appointment for new porcelain veneers or porcelain crowns is a diagnosis and treatment planning visit, about 1 hr. 15 minutes. This consists of a full examination with x-rays, models of your teeth, photographs of your face and teeth, gum length and facial analysis, and smile design analysis. No local anesthetic is needed or given at this appointment.

BEFORE

2. Tooth preparation and “trial smile” (temporary veneers) appointment, about 2-3 ½ hrs. A gentle local anesthetic is given to numb the teeth. Sometimes a tranquilizing medicine in the form of a pill is given to make the patient more relaxed and comfortable. The patient leaves that visit with their “trial smile”, the “test drive” of the new smile with temporary veneers. During the next few days the patient evaluates the shape, length, contour and color of the trial smile for esthetics, comfort and phonetics (who the teeth might effect speech).

3. “Trial Smile” approval for the final shade, length, contour and color. This visit is done 2-4 days after the tooth preparation visit and lasts about 45 minutes. No local anesthetic or tooth drilling is done at this appointment. Patient and doctor finalize all aspects of the smile design, especially the color and length of the porcelain veneers or porcelain crowns. Approved smile design is photographed, teeth measured for length and models are taken for the master ceramist to use in fabrication of the final porcelain veneers or porcelain crowns. Patient signs written approval of smile design and their final choice in porcelain veneer or porcelain ccrown shade.

"TRIAL SMILE"

4. Porcelain veneer or porcelain crown placement appointment, about 2-3 hrs. Local anesthetic is given, the temporary veneers or crowns (“trial smile”) are removed, permanent porcelain veneers or porcelain crowns are placed for the patient to preview and approve. Patient sees veneers or crowns on their teeth in three lighting conditions (fluorescent, incandescent and natural sunlight) as part of the approval process. Patient signs written approval accepting final porcelain veneers or porcelain crowns prior to final placement (bonding the porcelain veneers or porcelain crowns onto the teeth with laser).

5. Porcelain veneer or porcelain crown check appointment, about ½ hr, 2-5 days after placement. No local anesthetic needed or given at this appointment. The bite (occlusion) of the porcelain veneers or crowns are checked and any adjustments indicated are done.

AFTER

6. Portrait appointment (optional, no fee for this appointment), 1-4 weeks after placement. Dr. Huefner, gold medal winning portrait photographer, takes your portraits of his porcelain veneer or porcelain crown patients as part of “the celebration of your new smile”. A DVD or CD is given to the patient that included all photographs taken.

JILL FRICK AND HER BEAUTIFUL NEW SMILE WITH PORCELAIN VENEERS

Dr. Norman Huefner, General and Cosmetic Dentistry, Laguna Niguel, CA

Labels: cosmetic dentist, irvine, laguna beach, mission viejo, san clemente

The length of the teeth, especially your front two teeth, is an extremely important part of how the world sees your smile. If your teeth are too short, it may make you look older than your years and take a lot away from the power of your smile. If the teeth are too long, because the gums have possibly receded over the years, then the smile can be unattractive or even distracting. The length of the front teeth needs to be “just right” for a great smile. So, when cosmetic dentists create a new smile for their patients, with porcelain veneers, bonding or all-ceramic crowns, what are the criteria that they use?The first test I use is to check my patient when they relax their mouth and face muscles, with the mouth slightly open and separating the back teeth so they aren’t touching together. The upper lip has to be totally relaxed. In general I would like to see 1-2mm (about 1/8”) of the front teeth showing. If I don’t see any teeth showing, the front teeth may be too short. If I see more than that, there may be a short upper lip or a large overbite and long teeth that I have to take into consideration.

The left photo shows teeth that are probably too short and the one on the right is of unworn teeth, which is more youthful and attractive. The next test is having the patient give a full smile. How much of the upper front teeth do I see then? If all of the front teeth show, then the next thing I want to see that the tooth is longer than it is wide (rectangular). If the front tooth is as wide as it is long (square), it may be considered too short and/or aged. If it is wider than it is long, the teeth would definitely be considered too short and very aged! The most common reason for short teeth is from wearing away from a grinding habit, which is more pronounced with older individuals.

The left photo shows teeth that are too long for the smile. The next photo shows worn teeth that are now square. The third photo demonstrates severely shortened and worn teeth. The last photo shows teeth that are normal in shape and length for this patient’s smile.There was a study done once where the public was shown various people smiling and could observe the full length of the front teeth. Almost universally they thought that the most beautiful smiles had front teeth that were 1.29 times longer than they were wide (in dental terms a 78% width-length ratio). Thus, a great starting point for a dentist is to measure the width of the tooth, do the math, and then establish the ideal visual length for the front two teeth. (By the way, one test you can use on that might give you an idea as to how well trained your dentist is with cosmetic dentistry would be to ask “What is the ideal proportion of the length of the upper front two teeth?” Answers of 78% (ideal), 75-80% (acceptable range) or 1.29 times longer than wide are answers that probably indicate that the dentist has studied the finer points of cosmetic dentistry.)This length can be tested to see how the patient likes the length before any treatment is even started. Without needing any numbing medicine or doing any drilling, filling material can be added temporarily onto the short front teeth. Then the patient and dentist can evaluate the length for optimum esthetics when the patient has a relaxed mouth or a big smile. There is another criteria that cosmetic dentists like and that is for the edges of the eight upper front teeth to follow the contour of the lower lip when smiling. Cosmetic dentists call this “following the smile line” .

This photo demonstrates a nice smile that follows the “smile line” and teeth are attractive and normal in length for this patients smile. It should be obvious that this is a post-treatment photo of a lady with 8 porcelain veneers. The last test that we use is to verify the esthetically determined teeth length with phonetics or “speech function”. If the teeth are too long then they will hit the lower lip to much and affect the ability to produce the “f” and "v" sounds. If the patient says the word “fifty-five” or "victory" cosmetic dentists like to see the upper teeth to gently touch the lower lip. If the front teeth hit too hard and the teeth are too long, making a proper the “f” and "v" sounds will be difficult.

But more important than all of these cosmetic dentistry criteria is that the patient likes his or her new smile with porcelain veneers and can comfortably and appropriately speak. Establishing the length of the new veneers should be a joint decision between the cosmetic dentist and the patient.

Dr. Norman Huefner, General and Cosmetic Dentistry, Laguna Niguel, CA

Labels: c, cosmetic dentist, irvine, mission viejo, orange county cosmetic dentist, porcelain veneers, san juan capistrano

Nobody likes having crooked teeth and those who do almost always say that the thought of having straight, beautiful teeth is very appealing to them. But the idea of many months or even several years of orthodontics (braces) keeps many adults from doing anything about it.

Kandes was just such a person. She had crooked teeth and definitely didn’t want braces. She was at the point in her life that she didn’t have the time and want a great smile in the quickest way possible, and for her braces were just out of the question.

However, Kandes also had something special going on in her life and now was the time to do something about her smile. She was “Mrs. Southwest 2005? and competed in the Mrs. U.S. Globe beauty pageant.

So, how could she get a beautiful smile without doing the old braces route? The answer of course is that cosmetic dentistry with porcelain veneers is usually a great alternative to orthodontics, especially for adults. Although not technically orthodontics, the results are straight teeth in just a couple visits, which in comparison to the traditional 1-3 years of orthodontics seems to be almost “instant” in comparison.

BEFORE

The photo above shows what she didn’t like about her teeth and smile. Her teeth were crooked, chipped and discolored. She especially didn’t like her upper left eye tooth (canine), which she called her “fang tooth”. The photo below is the beautiful result we achieved with porcelain veneers in three visits.

AFTER

Although there are many circumstances when orthodontics is absolutely the best course of treatment (younger patients, teeth with good color or “bleachable”, teeth not worn, chipped or having multiple fillings or crowns), there are also many times when cosmetic dentistry is a preferably way of getting a sensational new smile (adult, discolored teeth, crowded or spaced teeth, multiple fillings or chipped teeth). Clearly the advantage of a couple visits and the ability to create the color, shape, position and length of the teeth to compliment the patients face gives cosmetic dentistry many advantages to the busy adult.

Dr. Norman Huefner, General and Cosmetic Dentistry, Laguna Niguel, CA

Labels: cosmetic dentist, instant orthodontics, irvine, ladera ranch, orange county, porcelain veneers, santa margarita

For some people who have misshaped, discolored or otherwise misaligned teeth, smiling can be embarrassing. Absolutely hating and embarrassed with her crooked teeth, Diane wanted to know what could be done for her with cosmetic dentistry. Not only were her teeth crooked, spaced at the gumline and discolored, but worst of all, her one front tooth was turned and stuck out. Not a pretty smile that she could be proud of.

BEFORE
What could Diane do? Did she need braces? The answer more than thrilled Diane, she could have a new smile, a sensational smile, in three weeks and two dental visits with porcelain veneer cosmetic dental treatment.
AFTER

Above is the gorgeous results that we got for Diane. She asked that her teeth be whiter, but have a natural look. She also wanted her porcelain veneers to last as long as possible, hopefully the rest of her life. So, we utilized a semi-translucent Empress porcelain, one that really looks natural and is extremely strong and durable. Many cosmetic dentists believe that Empress porcelain is one of the very strongest porcelains available for porcelain veneers.

Dr. Norman Huefner, General and Cosmetic Dentistry, Laguna Niguel, CA

Labels: cosmetic dentist, laguna niguel, porcelain crowns, porcelain veneers, san clemente, san juan capistrano