I get a lot of my news from Yahoo News because it is readily available and I don’t have to wait through commercials to see if it’s supposed to rain tomorrow. The other day, a feature article caught my eye entitled Why Do We Get Baggy Eyes?[1] I read it and found that we get baggy eyes because fat in the sockets expand as we become older.  I just figured we got baggy eyes because we got older and, well, things sometimes sag when that happens. In fact, if you have that patient with the short lip causing excessive gingival display, give it time because the lip will get longer as one ages.

 

Articles concerning esthetics and body image interest me because people spend big bucks in this country on their looks. Orthodontics, orthognathic surgery, and esthetic dentistry are all big players in the huge market of personal enhancement.

 

Back to the baggy eyes. It turns out that eyelid plastic surgery, or blepharoplasty, was performed more than 241,000 times in the U.S. last year and is in the top four of all surgical cosmetic procedures performed. Eyelid augmentation was the second most often performed surgical cosmetic surgeries for men following liposuction and the third most frequent for women following breast augmentation and liposuction. I wonder where laminate veneers fit into these frequency rankings?

 

In a related article, Fix Me: Nips and Tucks Soar[2], it was reported that American’s spent nearly $13 billion on cosmetic surgery in 2007 according to the American Society for Aesthetic Plastic Surgery. Surgical and non-surgical cosmetic procedures have increased 450% in the United States since 1997. These figures do not include the huge dental cosmetic market.

 

Throughout the history of mankind, there have been alterations to the human body in the pursuit of beauty. According to psychologists Diana Zuckerman, president of the National Research Center for Women & Families, nearly 90% of patients that had cosmetic surgeries report satisfaction one year after the procedure(s) including an enhanced overall body image. She warns that many people seeking cosmetic procedures have an exaggerated sense of their appearance and flaws and may even have a condition known as body dysmorphic disorder (BDD).

 

Clearly, more people are seeking cosmetic procedures and spending more money for these procedures than ever. Dentistry is a major player in this area even though not mentioned in the referenced articles.  Bleaching, orthodontics, esthetic periodontics, bonding, laminate veneers and other restorations can do more to enhance ones appearance and self-esteem than most other procedures.

 

If a patient presents to your office and wants veneers, you know that (1) they have done some research, and (2) they are not happy with the way their teeth look. If they have discolored and misshaped teeth these cases are usually very rewarding for the provider and the patient. If the evaluation reveals very few or no flaws, a careful interview with the patient is essential to define what it is they are hoping to achieve. You will find that a less invasive procedure may be warranted or that the expectations of the patient are unrealistic or unattainable.

 

A veneer preparation is a surgical procedure that necessitates that a veneer or a crown be present for the remainder of the life of the patient. The patient should know this before any treatment begins.  They should also be informed that the restorations are not forever and will eventually need replaced. Ten years is the typical timeframe but can vary depending on the patients’ homecare and habits.

 

When a patient desires cosmetic procedures we certainly have the tools in dentistry to deliver.  The patient that is informed of consequences of the treatment and has realistic expectations is the only one we should agree to proceed with for veneers or other cosmetic procedures.

 

I had a long-term patient that wanted in-office bleaching but reported that her teeth were sensitive to the at-home tray bleaching. She was informed that soft tissue burns could occur and that her teeth could be very sensitive following the procedure. After considering the consequences she elected to proceed with the in-office bleaching. She did have sensitivity for a few days but stated, “what price beauty”, meaning that she was willing to accept the risks for a reasonable result.

I just got through skimming through my August 18^th edition of ADA NEWS and noticed that Dr. Jeffery Johnston, editor-in-chief of the Journal of the Michigan Dental Association is featured under the MyView sectioned for his insightful article about “Best Dentists” advertising as well as misinformation and misinterpretation of information on websites. Your President, Dr. Radwanski and yours truly, each had articles in recent issues of the Capital Star expressing our concerns and opinions about these issues. Another sign that CADS is cutting-edge.

---