What is a “Cosmetic Dentist”

I was once asked, “If a dentist does not advertise as being a cosmetic dentist, does this mean they only do ugly dentistry?” The answer, of course is, no. To my thinking dentistry is multidimensional requiring a good understanding of mechanical principals, functional challenges, biologic health, dental materials, and aesthetic principals. One solution doesn’t fit all as might be suggested by the “extreme makeover” approach to dental treatment sometimes seen on television. Celebrity dentists often offer no diagnosis or evaluation of risk/prognosis, and too often the treatment is predictably the same—teeth whitening and “Let’s see…will it be 10 or 12 DaVinci veneers this time?” This approach is bound to be hit and miss depending on factors the patient brings to the equation. For instance, how is the patient’s hygiene? Is this treatment increasing the potential for future decay or aggravating existing gum problems? Does it enhance the patient’s oral health as well as looks? Is the patient a tooth grinder or is the bite off? If so, then lengthening worn teeth based solely on appearance may force a constriction upon a chewing or grinding pattern that will predispose the cosmetic work to chipping, fracturing, or loosening of the underlying teeth. Not to mention it could result in discomfort for the patient. This is sort of like rebuilding a trailer park in a known tornado pathway. It is usually only a matter of time before the destruction recurs and the patient becomes unhappy.