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Dr. Mitchell Pohl
2900 N. Military Trail Suite 105 Boca Raton 33431 South Florida Dentistry (561) 368-3440                                      
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Smile MakeoversSee examples in Extreme Makeover DentistryPorcelain Veneers and Bonded Porcelain Restorations
Porcelain veneers have become widely accepted as the benchmark of conservative cosmetic dentistry. They have been used successfully to mask teeth which are discolored and poorly shaped. Bonding ultra-thin shells of porcelain to teeth created many of those Hollywood smiles that we envy.Today, with the advancement in adhesive technology, we can achieve truly tenacious bond strengths of porcelain to tooth structure. As a result of this technology we are capable of doing more with bonded porcelain than ever before. One such application is the correction of mild to moderate crowding of the anterior teeth or what we call Instant Orthodontics. 
We call this instant orthodontics because in as little as two weeks a patient can go from teeth that are crowded to a perfect smile. Patients that decide to do instant orthodontics usually have already explored the possibility of conventional orthodontics and did not want to spend two to three years in braces to align their teeth only to find that to correct the shape and color they would have to do porcelain veneers.Orthodontics vs Instant Orthodontics
One case in point, a patient referred to me had gone through three years of orthodontics to align his teeth. The orthodontist did the best that he could, but the patient was still not satisfied with his smile.He tried bleaching his teeth, still not white enough! Something was missing. Clinical exam revealed worn edges of the teeth and what we call a reverse smile line. In other words, the edges of his upper teeth did not follow his lower lip line. Instead the edges arched down in a frown. 
Porcelain Veneer TechnologyWe created a whole new smile for him with porcelain veneers and bonded porcelain onlays on his back teeth. The patient was ecstatic! He then realized that all this could have been accomplished without the discomfort of braces and waiting three years.Instant Orthodontic ProcedureFirst, not everyone is a candidate. Teeth that are too crowded can be difficult to optimally correct and a lot depends upon the dentist's skill level. These are advanced bonding cases and they are not for novices. So ask to see pictures of cases done by the dentist.Secondly, other options of correcting the crowding should be discussed, namely conventional orthodontics. A referral to an orthodontist for an evaluation would be a good idea. Once it has been determined that doing instant orthodontics with bonded porcelain is the avenue of choice, diagnostic records are taken. Assuming that a comprehensive exam has been performed, diagnostic photos and models are made of the teeth. The diagnostic photos can be digitally imaged to give the patient an idea of what to expect. However, one must realize that an imaged photo is only 2-dimensional and is a graphic artist's interpretation of your future smile. In order to get a more realistic idea of how to correct the crowding, a diagnostic wax-up is made. 
The stone model of the patient's teeth is shaped and built back to an ideal form with white wax. By using the diagnostic wax-up we can tell how much tooth needs to be reshaped to get that perfect smile.The diagnostic wax-up also allows us to fabricate temporary veneers and crowns for the patient to wear while the ceramist fabricates their new teeth. With the temporaries in place, the patient can visualize how they will look. Additionally, it is at this time that we can confirm the length and shape. If the patient is pleased with the length and shape, an impression is taken of the temporary veneers and an index is made so that the ceramist can more accurately create what the patient is seeing. In other words, the more information we give the ceramist, the more accurate the outcome. Now that we have our blueprint, we present the plan to the patient for approval. After the patient approves the imaged photo and wax-up we schedule the preparation appointment. At the preparation appointment we reshape the teeth to bring them into alignment according to our wax-up so that the ceramist has the necessary tooth reduction to build the teeth back to an ideal shape.
Temporary veneers are placed and the patient leaves the first appointment wearing a preview of their new smile. At the next appointment, the temporary veneers are removed and the permanent veneers are tried, fitted, and tenaciously bonded to the teeth.Then comes the best part. The patient is given a mirror, and Voila!, watch their face light up as they view their new smile. Visit Dr. Pohl elsewhere on the internet at Dental Health Directory and Library, where he is a statewide and international dental consultant.
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