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Test Drive Your Teeth

When making any purchasing decision, such as buying clothes or cars, it’s nice to be able to try something on, or at least see what you’re getting before you actually pay for it.  We encounter a few problems in dentistry:

  1. People generally don’t know how good teeth can be made to look.
  2. People generally don’t know what options are available to them.
  3. The costs of potential treatment are unfamiliar.
  4. The sequence of treatment and time required are unfamiliar.

This is where we come in!  Especially in cases where there are multiple problems, it can be a daunting task to try to self-diagnose and then self-plan a course of treatment.  Dentistry is not a do-it-yourself endeavor, and unless you are in the dental industry, it is difficult to appreciate all the mechanical, let alone biological, considerations and priorities that come into play when devising a treatment plan.

We’ve written here about the importance of comprehensive dentistry, which can be described as dentistry that takes into account all the factors and takes a long-term view of oral health (as opposed to tooth-by-tooth dentistry or break-and-fix dentistry).

We’ve written earlier about the need for you, the owner of the teeth, or a trusted partner, someone who’s going to have to look at your teeth, to give us a vision for what you want your teeth to look like.

How do we translate that into something meaningful?  It’s a nice tool called a wax-up.  This is analogous to before and after computer simulations of surgeries that are done before any actual surgery is done – only better!  We take plaster models of your teeth and send them to a dental laboratory with your instructions on how you would like the teeth to appear.  The lab then produces a wax simulation of the final result that they feel can be achieved.  This is why we call it test-driving your teeth!  While you can’t have the actual final result before you proceed with the dental work, this is a way for you to preview and critique the proposed result.  There is something about holding a model of your own teeth in your hand that a computer screen cannot provide.

To illustrate, here is a case that is straight from our office.  The original request was to improve the appearance of front teeth.  Here is a natural photo of the mouth:

Pre-operative smile photo
Pre-operative photo of smile. Patient dislikes appearance of upper and lower front teeth.

Not only are the teeth poorly aligned, but there are severe gum problems surrounding some of them that make them non-salvageable.  Here is a retracted view of the same mouth:

Pre-op retracted view
Same mouth as above, with cheek retractors in place to show teeth more fully.

First, we obtain the abovementioned plaster models of the patient’s teeth:

Impression of pre-op dentition
Stone model of pre-operative teeth

We then compile a list of the patient’s complaints, and request that the lab produce a waxup of a bridge across the upper front teeth.  For the sharp-eyed, we also requested a simulation of the appearance of the lower front teeth if one tooth were removed and the remaining teeth straightened with braces:

Pre-op waxup
Wax-up of same mouth requesting a bridge across the front teeth.

Amazing, no?  By carrying out this waxup, the patient can then see what type of result we think can be achieved.  Any changes made to the waxup would of course be easier than after treatment is started (or completed).

Now, the wax-up is not the only step at which you can make changes – please stay tuned for a future installment about the importance of temporary crowns and veneers.

Hopefully this gives you some insight into the early stages of comprehensive treatment planning.  As always, please contact us for customized advice on your own mouth!  Happy waxing!

Dr. Elston Wong Portrait

About Dr. Elston Wong

Dr. Elston Wong completed his dental degree at The University of Toronto in 1999 before arriving in Barrie in 2002. After graduating, he continued to learn everything he could about dentistry. Now he has taken the time to share important information for anyone to read.

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