Robert S. Minch, D.D.S., P.A.

As I wrote last week, I was at the American Academy of Cosmetic Dentistry’s convention in Dallas. It’s always an inspiring meeting that showcases the latest strides in technology and materials. This year’s meeting did not disappoint. I was in class for 3 days and heard new ideas on cosmetic dentistry as well as where technology may take us in the next several years.

But one lecturer captivated me more than the others- his name is Dr. Newton Fahl  (www.fahlcenter.com) from Curitiba, Brazil. His specialty is in the field of cosmetic bonding and I guess you could say that he is the rock star of bonding. Bonding has been around for 25 years and gained notoriety as an inexpensive way to repair front teeth. As in most areas, there are different levels of expertise and skill when it comes to cosmetic bonding. As the amount of desired change to the tooth increases (a whiter tooth, replacing a broken part of a tooth or even creating a bonding veneer that covers the entire tooth) the level of skill and artistry needed  increases dramatically. Dr. Fahl represents the  pinnacle of artistry in that he can take a tooth that has been broken off and rebuild it using layers of material to recreate the look of the tooth such that it is virtually impossible to distinguish it from its neighbor.

It is the layering technique that I learned about this past week and that has sparked a renewed passion for the treatment. The latest materials available enable me to create and/or recreate teeth that are amazingly lifelike. I have been a fan of bonding and its potential for many years. The photos above are actually of my assistant Edie’s daughter, Brooke, who I treated 6 years ago. She was 12 years old and had spaces between her teeth that she hated and that were untreatable with braces. In just an hour or two, I was able to close the spaces and give her the smile that she desired; and she has been thrilled with the result. Six years later however, the material is getting a little dated. So this summer I will be redoing the case with the new materials and techniques that I learned from Dr. Fahl. And of course I will update you with the new pictures once it is done.

But the other truly exciting news from Dr. Fahl’s course is the opportunity to study with him in his office in Curitiba, Brazil!! I will be traveling 13 hours on 3 different airplanes next February to have the opportunity to study with Dr. Fahl for 5 days. Now, let’s just say, without going into pathetic stories, that I am not the biggest lover of long flights. However, opportunities like this don’t come along very often and I know that it will be an unbelievable experience. I have always considered myself a Continuing Education nerd but this trip is the icing on the cake. I will certainly be updating my progress with new bonding techniques as well as the travel preparations. And if anyone knows a good place to stay in Curitiba………

I am writing this from an American Airlines S80 bound for Dallas, Texas for the annual American Academy of Cosmetic Dentistry (AACD) Conference. It is the premier meeting nationally for hearing all the latest techniques/ materials/ strategies for creating the prettiest smiles with ultimate comfort. Lest you view this as a boondoggle in order to vacation for the week (as some of my family believe), I will be attending classes from 8-5 each day with this years focus being on creating beautiful teeth utilizing state of the art materials.  A perfect example of this pertains to my patient, Jack, who I alluded to in my last Blog entry.

Jack has been a valued patient for 25 years and has grown increasingly disgusted with his teeth- or should I say, with the way that his teeth look. Jack is a great guy with a sense of humor that keeps him in a perpetual smile- or he would be if he didn’t hide his teeth all the time. Jack’s teeth have become crowded over time and, in an ideal world, he would get braces followed by bleaching and porcelain veneers and he would be a new man. Unfortunately, Jack is not financially stable (similar to many of my patients) so whatever we do will have to be phased over time.

So Jack was in last week for his 6 month cleaning and asked me the usual question- “what can I do to make my smile better without breaking the bank?”. And this time I had a new answer for him-  I suggested that we focus on his front 4 teeth and, because of new materials and techniques, we could be very conservative in making porcelain veneers that would enhance his smile yet blend in with his other teeth. Jack was immediately interested and true to form filled with a lot of questions (what would it look like?, wouldn’t it stand out from the other teeth?, how much tooth would be shaved away?).

As luck would have it, I had a couple of extra minutes so I pulled him to a free operatory and we did one of my favorite procedures, a “mockup”. Think of a mock up as a preview of what’s possible. I used bonding material that matched his tooth shade and roughed out on the teeth the changes I envisioned . Since this is basically making it up as we go along, it taps into creativity and artistry which is what I enjoy about it so much. In Jack’s case, it took about 15 minutes and the result was dramatic! Jack’s reaction was one of amazement and delight- until he remembered that this was just a mock up and that he would have to stick with his “old” smile until we could schedule the actual treatment. I was able to take a digital photograph of his “new” teeth, however,  so that he could show his family how good his new smile will look.

What fun it is to be able to affect a patient’s self image and self esteem by helping them realize a long held dream of a more attractive smile. And that is what makes going to conferences like the AACD meeting so exciting and full of possibilities. I don’t know what new information I will come home with but you can bet that I will be putting it into action next Monday morning. So if you have an appointment in May, make sure and ask me what new stuff we’re doing. It’s always something new and sure to make you say”Wow”!

I love chocolate!! That really doesn’t have a lot to do with much else but I felt the need to get that off my chest. I know, I know-I’m a dentist and I’m only supposed to like sugar free treats and floss immediately afterwards. But I have always had a sweet tooth (I used to keep Bazooka Bubble Gum in my car- don’t tell anyone please). I have been in a close relationship with Hershey’s Chocolate ever since my grandmother would hand out the chocolate bars after dinner on Friday nights when I was 7 years old. Plain or almond- I didn’t care. Hershey’s kisses are still one of my favorite food groups. But my other favorite candy bar from years ago was the one sold by schools and charities-”World’s Finest Chocolate”; a single dollar bill would buy you a scrumptious chocolate bar and the beauty of it has always been that the $1.00 cost never went up- it was always one chocolate bar for one dollar.

But alas that was long ago, before the schools switched their fund raising to gift wrapping paper, Joe Corbi pizzas, light bulbs (I kid you not)….no more simple chocolate bars….Now, this trip down memory lane will become more relevant at the end of this piece.

Last week I was in Scottsdale teaching . I was supposed to be there for 3 days but they were a little short on teachers for their next course and they asked if I could help them out, which of course I was happy to do. But as much as I love teaching and being out in Scottsdale, AZ I was thrilled to be back in my office this past Monday morning. I feel very blessed that I truly enjoy my practice and my patients. I am fond of saying that, at times, my office seems like one big open house with friends dropping by to say hello and catch up. After all, many of these people have been patients of mine for 25 years and we have shared many life experiences.

I was reminded of this richness on Monday with my first few patients. One example was with a long time patient, Jack , who has always wanted to make his front teeth more attractive but has lacked the funds to do what is necessary to achieve his goal of a better smile. I am actually going to save this story for my next Blog entry because it is a great story on its own…and yes, my assistant, Edie always reminds me to keep these pieces shorter so, in the interests of brevity-

Let’s turn our attention to another great patient, Mary. Mary works as a teller in one of the banks here at Green Spring Station. For years I would see Mary on a weekly basis when I would bring in my deposits and we would exchange pleasantries; she has always had a very sweet smile but never showed her teeth, apparently because of their yellow, worn appearance. To make a long story short, she became a patient and I had the privilege of restoring her smile and now she is a smiling goddess!

She was so happy in fact that she sent her friend in for a consult because she was unhappy with her smile. Jan came in and said how her goal was to be a sexy 60 year old and wanted to do whatever was necessary to get her teeth with the program. This, also, is a nice story that I will postpone for another Blog piece but suffice it to say that it is patients like Mary and Jan that make my practice such a happy, fun and satisfying place to be.

So back to Monday morning- I had a few minutes of free time and I decided to run to the bank since I had been away for a week. And as luck would have it, Mary was my teller and what did she have in front of her spot but a box of World’s Finest Chocolate!! (See, I told you it would all come together)…and it was still just $1.00!! But as luck would have it, I did not have my wallet with me so I was not able to purchase a “memory”. I went back to the office and continued to see patients until Cindy, our amazing receptionist, came back and told me that Mary had stopped by to bring me a World’s Finest Chocolate bar as well as to pick up some business cards for her coworkers.

To have patients and staff  you truly enjoy to work with, to be able to provide the absolute best, state of the art treatment as well as enjoy an open house environment on a daily basis….It doesn’t get any better than that! And so, if you will excuse me, I have a chocolate bar to enjoy- and yes, after that I will floss!

I am writing from Scottsdale Arizona where I am teaching this week at the Spear Education/ Scottsdale Center for Dentistry. The topic of this week’s course is “Occlusion” or in normal speak: “the bite”- effects of tooth grinding, uncomfortable bites, nightguards etc. In truth, occlusion, or the bite, is in play with whatever treatment that I do on every patient because, whatever I do affects how the teeth meet and function. Now being that I am a self professed nerd, I can openly say that I have been fascinated by the subject of Occlusion since Dental School where I wrote a graduate paper on the latest theories at that time….and since that time was  1982, it now qualifies as a museum piece!

One form of treatment that is commonly used to correct bite issues is orthodontics, also known as “you want me to get braces??!!” I’m thinking of a patient I saw last week, Stephanie, who I have had the privilege to treat for 25 years. And over that time I have watched her front teeth become increasingly worn and chipped. Now the temptation would be to simply suggest some porcelain veneers to replace the tooth structure that has been worn away. But that would be fixing the immediate need without correcting the cause of the problem.

The reason I love teaching at the Spear Center is that all discussions revolve around the concept of Complete Dentistry. In Stephanie’s case, if you placed veneers without any other treatment, odds are, she would continue to clench/grind her teeth and pretty quickly start to chip and/or break the veneers. A Complete Dentistry approach would be to identify the grinding habit that has created the front teeth wear and correct it before making the final veneers. And in many cases, the easiest and most effective way to “fix” the grinding is with braces.

So let’s clear up a couple common misconceptions about braces. First, in the case of adults, forget about the notion that braces are cosmetic. As crazy as that sounds, in my practice, most of my adult patients who have had braces did it to correct bite issues….it just so happens that the teeth look a heck of a lot better after the braces come off! Additionally, in many cases, by moving the teeth into better positions, much less restorative treatment is needed. Instead of needing crowns/veneers to give the illusion of straight/ even teeth, braces move the teeth into more aesthetic positions and give a much more natural result. Yes, I know that I said that most braces are done for bite issues and not cosmetics but the fact of the matter is that the two go hand in hand. If braces are utilized to straighten the teeth without sufficient regard and respect and knowledge about the occlusion, the final result will be compromised in terms of bite/chewing comfort as well as the longevity of the work itself.

The old expression that “age is just a number” has never been more true than in the case of braces. We have patients in their 50’s and 60’s who have gotten braces as a first step towards creating the smile they desired. In other words, porcelain veneers or any other cosmetic work looks more natural and less artificial if the teeth are in the right place. Additionally, chewing ability and muscle joint comfort are directly related to teeth that are aligned properly and meshing efficiently. Braces can also be used to move teeth to a better position to correct gum issues.

In Stephanie’s case, after we went over her study models and digital photos of her teeth, I walked her through some options and zeroed in on the benefits of braces. The look of surprise on her face was to be expected because she is 58 and has always thought of braces as being for kids. However, after some further discussion, she agreed to visit my favorite orthodontist for adults and listen to what is possible. I don’t know for sure if she will proceed with treatment, but I hope so because the results will be amazing.

When teeth are moved into ideal positions for these reasons, they look much better as a result! With all the options available to us today, such as clear Invisalign or braces bonded to the backs of the teeth, there is no reason not to make your teeth straighter, healthier and more comfortable. You deserve it – at any age!