Dento-Facial Aesthetics: The Art and Science of Rejuvenation Dentistry
Feb 25, 2015
As seen in Glow Magazine’s Fall 2014 Issue
If you have ever invested in improving the interior of your home, you will no doubt identify with what is referred to as “the domino factor” of design (also known as “all-I-did-was-buy-a-new-duvet-and-now-the-whole-house-needs-hardwoods.”) One improvement, however seemingly insignificant, only accentuates that which is unimproved. This same premise applies to facial aesthetics. Whether we are talking about a full face and neck lift or a simple non-surgical procedure, like fillers, the result will be a refreshed, rejuvenated appearance. You will look in the mirror and smile. But what will you (and others) see?
THE RELATIONSHIP OF TEETH TO OVERALL FACIAL SYMMETRY
Dento-facial aesthetics is the evaluation of teeth as they relate to other facial structures with consideration given to the overall facial symmetry. Since the teeth support the lips and lower third of the face, a restorative decision can have a dramatic effect on a patient’s appearance. According to Dr. Gerry Curatola, one of the premier leading edge rejuve-nation dentists in the country, your teeth are not only part of facial aesthetics, but should be fixed prior to any surgical or non-surgical facial procedures. “The face, teeth and mouth are not mutually exclusive. They are more integrated than you might guess both in form and function. If you think about your smile as being the cornerstone of your expression, you begin to recognize the importance of investing in strong, beautiful, healthy teeth as part of improving your facial features and appearance.”
It’s important to first understand the pivotal relationship between teeth and facial structure. The analogy Dr. Curatola uses is borrowed from architecture. “If the face was a building, think of the teeth as providing the steel skeleton supporting the structure. They influence the walls and floors from both an aesthetic and foundational point of view. Teeth can change the features of a face, for better or for worse. Rejuvenation dentistry gives us a quiver full of options to offer patients.”
OVER BITES, UNDER BITES, AND CROSS BITES
One of the first areas of dento-facial aesthetics crosses all age and gender boundaries — orthodontics. Even teenagers who are far from fighting age related concerns experience the positive influence of orthodontia. Overbites, under bites and cross bites, once corrected affect the profile of the face and complement the facial features. Dr. Curatola makes the point that straight teeth are not the only benefit of orthodon-tics. “The correction will also prevent gum problems and pre-mature wearing of the teeth. Healthy gums and a properly aligned bite are two vital elements of a healthy mouth. Braces are not just for teens anymore. Today we are able to do things less invasively and more conservatively with Invisalign. It’s never been easier or more convenient. No brackets, wires or cement, and the results are fantastic. Creating a firm foundation yields a lifetime of benefits on so many levels.”
RESTORING THE HAPPY FACE
As we age, misaligned, missing or otherwise damaged teeth can have profound effects on facial structure. Volume loss and subsequent sagging begin in the lower half of the face where the teeth play a critical role in supporting the sur-rounding tissue. Dr. Curatola explains. “Your front teeth wear down first, making the side and back teeth longer. This causes the shape of the mouth to take on an inverted smile. The sagging chin, collapsed upper lip, nasolabial folds and mari-onette lines all become exaggerated. Most people panic and run to a plastic surgeon to lift their features — not realizing that facial rejuvenation starts with the mouth. Facelifts, eyelid lifts, browlifts, lip lifts — none of them will restore a ‘happy face’ if the teeth are not in alignment.”
A visit to a rejuvenation dentist prior to facial enhancement is right in step with the trend toward a “less is more” philosophy regarding surgical intervention. In fact, Dr. Curatola believes when a facelift is done be-fore teeth are restored, the surgery will have to be more extensive to make up for the support lacking in the mouth. In some cases, surgery can be sidestepped altogether and/or fewer injectables will be nec-essary. Dr. Curatola has restored and rebuilt lips just by improving the teeth. If the angle of the teeth is causing a thin upper lip, plumping the two front teeth results in a fuller upper lip. By correcting the bite the lower jaw is tightened and a retruded or double chin is minimized — all without surgery.
HOLISTIC LIP AUGMENTATION
One of the most popular non inva-sive aesthetic treatments is lip aug-mentation. This procedure, more than any other will bring focus on the teeth, so it’s imperative you are not calling attention to a less than perfect smile. Dr. Curatola stresses his role in a holistic lip augmentation. “Lips should be done after the teeth are done. In fact many dentists are well trained and well suited to pro-vide lip enhancement as an adjunct service. In any case, we are uniquely qualified to frame the teeth to create the perfect picture.”
Dr. Curatola circles back to the interior design analogy. “As a rejuvenation dentist we can optimize many anti-aging therapies. The greatest benefit to the patient is realized if they plan to visit us first. But if they come after the fact, we can complete their new look. What I hate to see is beautiful cheekbones, high brows and full lips framing bad teeth. It’s like layering exquisite draperies over a broken, dirty or cracked window. There should be no compromise.”
It’s never too early to consider role of teeth and never too late to start taking care of yourself. In your 20’s teeth whiten-ing may be all you need to ramp up your smile. Be sure your teeth are healthy so you are confident there is a good foun-dation for the future. By the 30’s and 40’s many of us are picking up parafunctional habits. In other words, our stress is causing clenching and grinding. In extreme cases the wear on our teeth translates into fractures and TMJ pain. A reju-venation dentist can build up broken teeth with crowns and veneers or alleviate TMJ side effects with something as sim-ple as a night guard. If precautions are not taken prior to midlife, the 50’s and 60’s will not be much to smile about according to Dr. Curatola. “It all starts with loss of bone around teeth, then gum recession. It’s unfortunate when you see a patient with premature loss of teeth, whether due to wear and tear or periodontal problems. This situation makes the entire face age prematurely as well. This unsightly expression is oftenreferred to as ‘long in the tooth.’ We now have implant reconstruction which promotes regrowth of bone around the implant fixture which reconstructs the mouth and provides whole new support for face.”