What do all of these women have in common?  Yes, they’re talented, famous, and wealthy.  More importantly, they all have beautiful smiles.  Cosmetic dentists have studied what makes an attractive smile to no end.  
Some important features of a beautiful smile include:

• Tooth color 
  
• Tooth symmetry 
• Tooth shape
• Amount of teeth visible in a smile
  
• Tooth translucency 
  
• The position of the teeth in relation to the lips
  
• The shape and symmetry of the gums
  
• The amount of gum showing in the smile
  

The list goes on and on.  When I design a smile, I take into consideration all the above.  When a woman talks, the edges of her front teeth should be visible.  The length of the veneers will be determined by observing her talking and breathing.  Once the edge position is determined I prefer to create dominant central incisors.  This means I ask my ceramist to make the two front teeth 1-3mm longer than the neighboring teeth (the lateral incisors).  The amount depends on age and how youthful we want her smile to appear.  I also shape the gum tissue to make the central incisors symmetrical and more prominent relative to the lateral incisors. 

It’s a fact of life for many of us that our teeth will wear down, discolor, and become misaligned with age.  Most women in their late teens and twenties have larger and more prominent central incisors.  For many women, after years of chewing, grinding, clenching, nail biting, or other damaging habits, their central incisors flatten to the length of the lateral incisors. For some, eventually all of the front teeth flatten or become misshapen at the edges.  Males more commonly have flat edges to their teeth. Veneers allow us to recreate the shape, symmetry, and beauty that was lost.

When women with worn down, flat front teeth come in for consultations I tell them I’d like to lengthen their central incisors.  Since our patient will need to wear temporary  veneers for at least two weeks I’m able to temporarily give them longer front teeth.   I request they wear the temporary veneers for at least three days before making additional changes. This way they can get used to them.  Their teeth have been flat for so long it can be shocking to see their longer more youthful appearing teeth.  After a few days they almost always want to keep the new length and shape. 

Take a look in a magazine and look at all the beautiful smiles.  If you pay close attention to the smiles you’ll notice, not only bright teeth that fill the lips from corner to corner, but longer central incisor teeth. 

Do you recognize the smile in the middle photo?

Dr. Robert Soto is a General and Cosmetic Dentist in Downtown San Francisco.  For more information on cosmetic dental services go to www.sfveneer.com or call (415) 398-8555 for appointments. 

Many patients suffer from dry mouth.  Dry mouth can be very difficult to combat and can cause serious dental problems.  Many patients with dry mouth either experience pain and are looking for relief, or come in with multiple cavities after years without any problems.  Patients in the latter situation don't realize they have dry mouth, but it is often the cause of the decay.

Saliva is a natural lubricant. It washes away food after meals and begins to digest food by breaking it down.  Without adequate saliva flow, food clings to teeth and dental restorations.  The bacteria that cause decay and gum disease digest this food and flourish.

Our saliva can change over time. The quality and quantity can diminish naturally with age.  More often, patients begin taking medications that cause a reduction in saliva flow. Common medications that cause dry mouth include anti-depressants, diuretics, over-the counter cold remedies, antihistamines, some beta-blockers, and anti-hypertensives.  People who have had radiation treatment to the head or neck often loose proper salivary gland function. 

It is essential for those with dry mouth to clean their teeth after meals to remove food and plaque left behind.  They should also consider more frequent cleanings.  Teeth cleanings every 3 months will allow the hygienist and doctor to closely monitor the condition and reduce the incidence of decay. It is also important to drink water often, keeping the mouth moist, rinsing away food and increasing the amount of saliva.

There are many over the counter products available to help relieve the problems caused by dry mouth.  Lubricant sprays and rinses can be used to moisten the mouth and promote salivary flow throughout the day.  Dry mouth patches can be placed on the gums or roof of the mouth to promote saliva flow at night.  Xylitol sugar lozenges and chewing gums are used to prevent decay.  Prescription strength fluoride toothpaste can be used to prevent, and even reverse, areas of decay.  

For patients with dry mouth I highly recommend using a Sonicare tooth brush with a fluoride toothpaste after meals followed by flossing, and using a Waterpik at least once a day to remove food from between teeth.
I have tried many combinations of these products.

Prescription fluoride tooth paste
http://www.colgateprofessional.com/products/colgate-prevident-5000-plus/overview

Waterpik
https://www.waterpik.com

Sonicare
http://www.sonicare.com/en_US/DP/Default.aspx

ACT Dry Mouth Lozenges 
http://www.actoralcare.com/products/act-dry-mouth/act-dry-mouth-lozenges/

Xylitol Gum
http://www.epicdental.com/c-4-gum

Dry Mouth Patches
http://www.oracoat.com/products/xmdm

Biotin Dry Mouth Rinse
http://www.biotene.com/


Oasis Dry Mouth Spray
http://oasisdrymouth.com