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
"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
"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
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
Successful cosmetic procedures are rewarding for the dentist as
"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
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.