In view of these results, one is tempted to raise the counter question: Is aesthetic dentistry still considered a medical discipline? Are we moving too far away from the core objectives of dentistry when we apply novel treatment options? Maybe we are slowly reverting toward the status of being barbers? It is well known that the former barbers turned toward cosmetics after they had abandoned dealing with dental problems.
Of course, a treatment that primarily creates an aesthetic improvement is not essential. By the same token, are flowers in an apartment, pictures on the walls, or new clothes essential? Obviously not! However, if you are surrounded by pleasant things or you are fulfilling a wish or a dream, this makes you feel good. Well-being is a crucial part of being healthy. From this point of view, the opinion of many is that aesthetic dentistry is essential!
Health, arguably, is mankind's most precious gift. However, when we are healthy we like to rate our looks very highly. Only, beauty is a phenomenon that cannot be measured. The following example needs no further explanation: In 1996, the people in Germany spent approximately 10 billion dollars on cosmetics. This is roughly equivalent to the amount of money the German dental insurance system paid for dental services. For this reason-and based on my own experience—I do not believe what I am frequently told by my colleagues, which is: “My patients are not willing to spend money to make their teeth more beautiful!”
In my humble opinion, the real reason for the skeptical attitude resides mainly in dental education. In many countries, dental education still focuses on teaching students how to relieve patients from pain, how to replace lost tooth structure, and how to stop further tooth destruction. Furthermore, students must fabricate a full denture during their initial preclinical studies. In my opinion, this is comparable to having a medical student attend a funeral as the initial requirement of their education! There is no doubt that such a therapy-oriented training significantly affects practical thinking.
It is no surprise that in many of my seminars colleagues frequently complain that they are unhappy in their job. Those dentists who only treat caries and practice at the level of their dental education must feel bored by their job!
Please, reassess your personal situation and take a more progressive stance! The history of aesthetic dentistry is very young. It is only since the introduction of the new adhesive techniques a few decades ago that anterior and lateral teeth could be restored successfully with thin ceramic veneers, and that tooth-colored composite fillings could be placed. Today, any restorations can be bonded with almost insoluble cements (resin-reinforced glass ionomer cements and composite cements).
This atlas shows the possibilities of aesthetic dentistry. As already mentioned, many of the methods presented here are not performed for the treatment or prevention of disease. This atlas deals exclusively with dental aesthetics and the positive effects resulting from its application, which contributes decisively to the well-being of the patient. Today's patients not only expect us to provide them with healthy teeth, a healthy periodontium, and an undisturbed neuromuscular function; many also desire beautiful teeth.
Fortunately, there will always be a sufficient number of dentists who will provide basic therapeutic services. Therefore, I would recommend all readers of this atlas to free time in your schedule that will allow you to offer dental services that are truly desirable.
However, the services must be offered in a novel way and must be actively sold. A dynamic internal and external marketing concept is part of this new dentistry. We don't need product marketing, but we do need promotion of services.
In short, we, the dentists, also sell beauty as a service. Beauty is essential for the general well-being and it boosts self esteem. Beauty can enhance the professional career of the patient. A beautiful smile may be a decisive factor during the critical moments of a first meeting. The dental product—a crown or a veneer—is nothing but a stepping-stone to success. Our marketing effort must show the patients that we are concerned about their needs and have superb techniques available with which we can help them achieve their goals.
In a modern dental practice, the patient no longer is just a petitioner who seeks relief from pain—the patient is your client. The patient selects the treatment modality, and we, the dentists, deliver the service as requested. The patient can decide freely between amalgam, gold, composite, or ceramics as the material of choice for a posterior tooth restoration, and between several processing methods for its fabrication. The patient can choose between a clasp-retained denture and a fixed prosthesis supported by implants. Last but not least, the patient can request having something done that will improve their looks.
I hope you will enjoy reading this book and that you will come up with many new ideas whilst doing so.
Josef Schmidseder
Acknowledgements
Aesthetic dentistry looks at conventional dentistry from many different angles. Since it was not possible for me to cover all aspects and include all sub-disciplines by myself, I would like to acknowledge the following authors who have contributed to this work.
Dr. Heinz Claus, Director of the Research and Development Department of Ceramics, Vita Zahnfabrik, Bad Säckingen, Germany, has contributed the chapter Evolution of Artificial Tooth Replacements From an Aesthetic Point of View.
Kevin B Frazier, DMD, Department of Oral Rehabilitation, Medical College of Georgia, Augusta, and Monika Wawra, dental hygienist in Munich, have contributed the chapter Basic Principles of Aesthetic Dentistry.
Robert F Murray, DDS, American Academy of Restorative Dentistry, private practitioner in Anacortes, Washington, made his sound knowledge available in the field of photography in the chapter bearing this name.
Gordon Christensen, DDS, MSD, PhD, founder of Clinical Research Associates, Provo, Utah, gave his support by writing the chapters Intraoral Cameras and The Future of Dentistry.
My thanks go to Dr Eward P Allen, Professor at the Department of Periodontics, Baylor College of Dentistry, Dallas, Texas, for his technical support on the chapter Aesthetic Periodontal Surgery.
Karl-Johan Söderholm, DDS, MPhil, OdontDr, Professor at the Department of Dental Biomaterials, College of Dentistry, University of Florida, Gainesville, is thanked for his contributions to the chapters Composites—Background, Direct Posterior Restorations, and Composite Inlays.
James Dunn, DDS, Professor at the Department of Restorative Dentistry, Loma Linda University, Loma Linda, supported me on the chapter Direct Anterior Restorations— Aesthetics and Function.
For their help with the development and content of the chapter Metal-Ceramic and All-Ceramic Restorations and for providing technical support, I thank: Kenneth J Anusavice, DMD, PhD, Professor and Chairman of the Department of Dental Biomaterials, University of Florida, Gainesville; Edward A Reetz, DDS, Professor and Chairman of the Department for Restorative Dentistry, Dean for Clinical Issues, Nova Southeastern University, Fort Lauderdale, Florida; Charles F DeFreest*, DDS, Willford Hall USAF Medical Center, Lackland Air Force Base, Texas.
For their help with the development and content of the chapter All-Ceramic Systems—Clinical Aspects of the All-Ceramic Crown and for providing technical support, I thank: Takeo lwata, DDS, MSD, Director