Unhappy with your smile??

 Studies have been done using some very clever equipment which have been able to plot out where we look to first when we see a picture of someone’s face and they have backed up what has been believed give true for a while now; that being that we tend to look at someone’s eyes and then their mouth. 

If someone doesn’t like their smile it can really be quite debilitating. It can really lower a person’s confidence, make them never want to smile, then get paranoid everyone thinks they are a misery guts as that’s how they can come across but it’s not the real them.  If someone falls into this category, fixing whatever the problem was with their smile can really change their lives; boost confidence which can then help people with jobs, relationships, all sorts. I am in a very lucky position that I sometimes get to do this for people and I can’t tell you how nice it is.

Obviously no two cases are the same. Not only that but certain imperfections may not bother one person but then keep someone else up at night. All I can do hear is run through the sort of things that can be done these days to help improve your smile if you don’t like it. 

So there are two elements, the dental side of it and then the soft tissues around it so we’ll break it down that way.

Dental aspect

Treatments include:

• Stain removal
• Tooth whitening
• Tooth straightening    
• Contouring of incisal edges
• Restorative treatments – such as white fillings, crowns, bridges veneers etc

  

      

•  Surgical procedures – implant placement, crown lengthening
• High aesthetic dentures
• Gingival veneers – direct or in direct to replace where the gum line has shrunk back 

Soft tissues 

First thing that comes tomorrow people’s minds is having filler in the lips: 
 
Obviously this can make a big difference – extra volume, even out asymmetry, extra definition etc – but there is so much more that can be done….

• Intra orally filler can be used to remove the dark triangles that can develope between teeth when the gums have shrunk back. This creates false pocketing of the gums though so oral hygiene must be amazing and it’s not to be entered lightly!!
• Corners of the mouth can be raised with botox and/or filler if you feel you have a droopy smile.
• If you feel you have a gummy smile then the upper lip can be lowered down with just a couple of botox injections.
• Any lines around the lips can be smoothed and softened.
• Botox injections can also plump up the top lip, done alone or in combination with filler.

So you see there’s all sorts of things that can be done these days. Just one or a combination of things can really transform people’s smiles.

Dermal fillers

  

So what are fillers? 

Generally resorbable hyaluronic acid which replace lost volume in the face where needed and also attract water and provide the skin with deep moisturisation from within. Both of these together can give a fresher, more youthful appearance.

Is temporary better?

To sum up, yes, it is. It may seem like it would be better to have something permanent so you’re not having to have the procedure done again down the line but it’s not. For starters they’re safer. Secondly, if you don’t like the effect or something goes wrong a reversal agent can be injected to break it down. Thirdly, no matter how much you may love the look now, will it look appropriate forty years down the line?? Probably not.

What can they do for you?

• Fill in deep creases that are there at rest. For these you need fillers rather than botulinum.
• Give extra shape and definition – for example lip fillers, changing the shape of the nose, jaw line definition.
• Replace volume where it has been lost over time – as we age we can get a hollowness under the eyes, tear trough fillers can restore this and give a more youthful appearance.
• Cheek augmentation – this is the most impressive thing that fillers can do in my opinion. The change is remarkable. Filling out the cheeks has an effect on the whole of the face beneath helping to lift the jowls and nasolabial folds and even make the lower half of the face look a little slimmer, as well as obviously improving the cheek bone definition. The extra volume beneath the skin can also help to smooth out the finer lines under the eyes and the cheek areas from within. I would recommend cheek augmentation over having fillers in the nasolabial folds as when they go straight into the fold it can then look flat which gives the face a slightly strange and unnatural profile.
• Fill in scars – any hypotrophic scarring – so those which dip in, can be filled out with fillers. 

  

Are there any risks?

Yes there are. It is incredibly rare that there ever is a problem but it is possible. As it’s based on a product naturally found in the body, risk of allergy is basically zero. Hence patch testing isn’t required.

But because filler is a thicker product there is a risk that if some were to go into a blood vessel it could block it at some point as the vessel gets thinner. This could lead to necrosis of the area of skin that the blood vessel in question would normally supply and this can look like a scabbed area. Utter worst case scenario is that if it were to block a vessel which supplies blood to the eyes it could impede your vision or even cause blindness.

Now like I said it has hardly ever ever happened, and if you’re in safe, well trained hands then the chances are practically zero. We know where and where not to inject, techniques of how to tell if you have injected into a vessel, the signs of any blockage and know what to do to try to break it down before there’s even a chance to do any damage. If that fails, a responsible practitioner will have the reversal agent on hand which can be injected into the area and break down the blockage.

Due to this fact though you are best to make sure you are with an appropriate trained medical professional and that reputable FDA approved products are used. And it’s also why certain medical councils and the like are trying to make fillers a prescription only product so it can only be prescribed by medical practitioners.

What does it feel like?

On its own, not great, but it depends where you have it. Some areas would be fine with some topical anaesthetic cream applied, others I wouldn’t suggest having without full local anaesthetic injections first, particularly lips and cheek augmentations.

Some products have an anaesthetic in them but I don’t really see the point, it’s only going to numb things up afterwards!

Generally as a dentist I’m more comfortable getting people nice and numb and knowing that they are as comfortable as possible. But a lot of people prefer to go without and just think “no pain, no gain”. And it’s not the most unusual and uncomfortable things that have been done in the name of beauty, check these out:

   

    
    
  

Yikes!!