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Set your smile free
Cosmetic dentistry procedures produce life-changing results

By NAN BIALEK

Mention the word "dentist" to Carol Gerard of Milwaukee, and sheís likely to flash you a million-dollar grin. But she wasnít always enthusiastic about sitting in a dentistís chair. "Theyíve come a long way with dentistry," Gerard says. "I used to have a dentist I (jokingly) called ĎDr. Yankum.í"

During the 10 years Gerard has been one of Dr. Roumiana Stoychevaís patients at First Place Dentistry in Milwaukee, she has become a fan of painless cosmetic dentistry procedures. Missing teeth are a thing of the past as far as todayís dentists are concerned, Stoycheva says. Modern procedures to create attractive smiles include veneers, ceramic crowns, implants and whitening procedures. She says smile makeovers begin with a detailed consultation and a realistic assessment of the patientís overall dental health, budget and lifestyle.

"Carol had slightly discolored and misaligned teeth that she was unhappy with for years, and some missing teeth," Stoycheva says. Gerardís old bridges were replaced and the misaligned teeth were covered with eight ceramic crowns. "Nobody had ever offered to improve Carolís smile without braces," Stoycheva says.

The crowns on Gerardís upper and lower front teeth not only corrected the alignment issue, they also made her smile noticeably cleaner and brighter. Stoycheva says contemporary ceramic materials look so natural, itís almost impossible to tell whether or not a patient has had crown work done.

Gerard, who has been a widow for six years, says she has started dating again and her new smile has boosted her confidence: "I know a lot of people think at my age, why am I doing this? I did it for me.

"Iím 65 years old now, but people tell me I look like Iím in my 40s," Gerard says. "Itís made a big difference in my life."

Corrective dental procedures made a big difference in Dr. Christopher Blakeís life as well. "My two front teeth didnít actually come in until I was 12 or 13," Blake says. He hated to have his picture taken and endured the teasing of his peers.

An orthodontist not only treated the condition, he inspired Blake to consider dentistry as a career and became his mentor. By age 14, Blake says, "I was really turned on to dentistry."

Blake, with offices in Brookfield, has been practicing aesthetic dentistry since 1984. He says both materials and the knowledge dentists bring to the procedures have greatly improved over the years.

The process begins with an extensive interview with the patient, he says. They discuss what the patient would like to change about the smile. Blake continues with a thorough evaluation of the patient, where he points out "some additional things that they might or might not have noticed. For example, they might come in with a crooked tooth, but they havenít noticed that their gums are uneven.

"We need to identify what they donít like and then educate them on potential other problems that might be occurring. And let them decide, once they see that. Itís a communication process."

Armed with a list of issues that the patient wants corrected, Blake creates a treatment plan to address those objectives. The plan may include items such as straighter teeth, whiter teeth or teeth that look more natural. It could include functional items, such as improved chewing, better speech or correction of muscle issues. He looks at the bite, because when top and bottom teeth are out of balance, the result may be chipping, wear and headaches.

A detailed examination follows. "The foundation of successful cosmetic dentistry is proper diagnosis," Blake explains. If gums and bone are not healthy, those problems need to be corrected before any cosmetic procedures are begun. Any functional issues must be addressed as well.

The next step is working with a dental lab to create a series of three-dimensional models of the proposed cosmetic work, including "before and after" models so that both dentist and patient have a clear idea of how the transformation will look.

The patient is then fitted with temporary plastic versions of the veneers, bridges, bonding, crowns or other corrective devices. Blake says he spends a lot of time during this "test drive" refining the installations to make sure that everything is functioning properly and is aesthetically pleasing.

"We donít go to porcelain until the patient is happy with the temporaries that theyíve been wearing in their mouth for weeks or months," Blake says.

Because of the time involved, the process can be costly, Blake says, "but if done right, it can be life-changing for people emotionally."

Successful cosmetic procedures are rewarding for the dentist as well.

"I never get a hug when I do a root canal, but I do get a hug when I change somebodyís smile and set their smile free," Blake says.

For one of Blakeís patients, a college student, the smile makeover was so dramatic that it pointed her in a new career direction. She has just been accepted into the Marquette University Dental School program, and Blake has become her mentor.