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Cosmetic dentistry restores patient smiles

Wednesday, April 29, 2009
Byline: IAN HOWARTH

Taking into account the current economic crisis, it would seem the recession gives people very little to smile about. But if the current trends in cosmetic dentistry are any barometer for gauging social climate, it's clear people do like to put on a bright, white, happy smile.

Cosmetic dentistry is a booming business both here and in the United States, where people are giving dentists reason to smile by spending $2.75 billion U.S. on a variety of cosmetic dentistry procedures. (That 2007 pre-recession statistic from the American Academy of Cosmetic Dentistry also indicates a 15-per-cent increase over the previous year.) Patients are spending an average of $3,000 to $5,600, with ahefty chunk of that grand total going toward dental veneers, crown and bridgework, and teeth whitening.

At the aptly named Montreal Smiles Clinic, 19-year veteran dentist Roni Berbari heads up a team of six, including hygienists and assistants. Dr. Berbari attributes the increase in the popularity of cosmetic dentistry to the overall "complete makeover" syndrome of North Americans.

"You get a lot of things with a nice smile", he said wryly.

His clients are mostly women between 30 and 50. "Women like to take better care of themselves", he explained.

It's not all about teeth whitening at Montreal Smiles, but Berbari employs the latest in teeth-whitening technology, including the new Zoom process which involves a patient being fitted for a mouthplate which is worn at home. Results can last for years, with minimal ongoing maintenance.

It is, despite the vanity factor, about the whole mouth, Berbari emphasized. " The bite of the teeth is basic. You have to have a good foundation, so we look at overall dental health, not just the cosmetic aspect."

When Janique Laflamme was 8, she was involved in a serious car accident which knocked out her entire bottom right side molars and put her in a coma. After years of suffering from daily headaches along with chewing and digestive problems, Laflamme recently set out to make things right.

With the help of Berbari and his team, Laflamme has undergone expensive and sometimes painful dental procedures that would make even the bravest of patients cringe. She's had implants, braces, crownsand veneers, all representing about three years worth of work.

After years of chewing on only the left side, her face was out of alignment. "My face was sagging", said Laflamme. " But I credit Dr. Berbari with saving my life. I was there (at Montreal Smiles) so many times, they became like family to me."

Even after all that work, she still has to wear a mouthguard at night because of her bruxism (teeth-grinding) habit. And after 30-plus years of chewing on one side of her mouth, she has re-educated herself on how to chew properly.

"Now, finally, I can smile in family photos", Laflamme said.

Cosmetic dentistry has become an art as much as a science.

Tooth implants, for example, are a relatively new procedure in the chronology of dental techniques. At Vendôme Surgical Services, implant surgery has begun to usurp crowns and bridgework as a viable and safe alternative.

One of Vendôme's partners, Dr. Michel el-Hakim, also serves as the McGill Faculty of Dentistry's director of oral/maxillofacial surgery. Implants are now the standard of care, said el-Hakim, and are viewed as aesthetic even though it is mainly back teeth that require implant surgery.

Osseointegration, as tooth implants are known, allows bone to grow around the newly implanted tooth, thereby facilitating a more permanent connection when compared with bridgework or crowns.

Dr. Tim Head, founding partner at Vendôme Surgical Services and el-Hakim's predecessor at McGill, helped pioneer the Branemark implant technique, named after its Swedish designer.

"It's about a five-to-six-hour operation done in the dentist's office", explained Head, who began his implant work in the mid-1980s. " The success rate is tremendous." (Head, el-Hakim and others perform more serious and lengthy operations at the Montreal General Hospital, where surgery to correct malformations and fractures of the jaw can take as long as 15 hours.)

Implants are for people who are "beyond braces", Head said. "People with a serious underbite, for example are good candidates."

"The goal is to correct the function of the jaw where the bite and facial alignment are off, which can affec tthe gastro-intestinal process and the aesthetics of the face."

After all is said and done, whether the procedure takes 30 minutes for your basic teeth whitening or 15 hours in the operating room, cosmetic and surgical dentistry is done in the name of putting your best face forward.

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