Saving Smiles
 
Dentistry Patients Discuss Their Life-Changing Procedures

By Lindsay Holst

In a culture where plastic makes perfect, to cynics the word “cosmetic” conjures images of procedures representing one more costly indulgence, falling somewhere between “lip injections” and “eyebrow lifts.”

A winning smile has always been touted as the secret to many successes.

Studies have shown that an attractive smile can improve your self-confidence, get you a date and even help land you a job.

Why the obsession with straight, shiny teeth?

Chalk it up to Darwinism. Blame society’s infatuation with the smiles of veneer-clad celebrities. But ultimately, it’s undeniable: The attractive smile is a coveted fixture, and the field of cosmetic dentistry has gained considerable popularity for its range of services, which include veneers, tooth implants, whitening and tooth restoration, in addition to other traditional dental procedures.

The cynics, as it turns out, are incredibly wrong.

The art of restoring a smile has far-reaching benefits, and the work of cosmetic dentists can drastically improve not only the physical appearance of their patients, but their confidence and sense of self-worth, as well.

No Bones About It

Though patients are ultimately taken by the change in their physical appearance, those who have been experiencing chronic pain can find dual relief in cosmetic dental procedures. Dr. Chong Lee, who practices at Galleria Dental Aesthetics in McLean and is a clinical instructor at the Las Vegas Institute for Advanced Dental Studies, emphasizes the need for cosmetic dentists to take care of the functional aspect of the patient’s problem before the cosmetic aspect. If pain exists, he advised, it must be addressed first.

“I have patients who have been to neurologists and ENT’s because of their headaches,” Lee said. “They can’t function due to migraine headaches, neck pain and back pain. Many times, it’s caused by their bite.” Often, the pain is a result of teeth grinding, which Lee said occurs when a patient’s bite is not in the proper place. The muscles and the jaw work overtime, causing fatigue and pain when they are at rest.

To assess the location of a patient’s bite, Lee uses a machine to measure the muscular activity. A computer helps him locate where the natural bite will be, and sonography—which uses the sound of the joint—helps him with jaw tracking. Once he restores the jaw to its natural position, Lee said patients are shocked that the pain “simply goes away.”

He can recall one patient who came into his office with two pages of medications that she had been taking for her head, neck and shoulder pain. “The pain was affecting her everyday. She couldn’t function; she was missing work, and had to sit in a dark room constantly for her migraines,” Lee recalled. “She took a second trust on her house just to get her teeth done, because she didn’t want to live with pain anymore.”

Photography by Ken Oh

Meet The Dentist:
CHONG LEE, DDS, received his Doctor of Dental Surgery from the Medical College of Virginia School of Dentistry in 1983. As a graduate of Las Vegas Institute for Advanced Dental Studies’ renowned post-graduate aesthetic and neuromuscular dentistry study program, Dr. Lee went on to become an LVI clinical instructor and regional director. He founded the LVI Study Club in the D.C. Metro area, and frequently gives lectures around the county to hundreds of dentists. Dr. Lee is a fellow of the International Academy for Dental Facial Esthetics and an active member of the Virginia Dental Association, American Academy of Cosmetic Dentistry, American Dental Association, Association of General Dentistry and Northern Virginia Dental Society. He practices at Galleria Dental Aesthetics in McLean, where he and fellow Drs. Oh and Mortazie were voted top dentists in the Metro area by several publications, including Washington Consumers’ Checkbook and Washingtonian Magazine. Visit www.smilesva.com.

Picture Perfect

Kellie, a 39-year-old mother of three, had had problems with her teeth for as long as she could remember. By the time she was in her late 20s, she found herself with only a few remaining teeth, and she was fighting to save even those.

“Every single tooth had multiple fillings,” she remembered. “I had had at least six root canals and a bridge in the front where one of my teeth had fallen out while I was eating. I have stories that could make your skin crawl.”

Kellie, who owns a well-drilling business with her husband in Christiansburg, Va., began having such difficulty eating that she lost nearly 45 pounds. Her teeth were decaying so quickly that she found herself at the dentist’s office at least once a week. When she went out to dinner, she could only order soft foods—what she began referring to as her “baby food diet.” And yes, her smile was unattractive, she said, but that was the least of her problems.

“When I decided to get cosmetic dental work done, the vanity aspect was only a perk of the procedure,” she said. “For me, it was, I have to eat again. I have to function again.”

After two consultations at nearby dentistry practices, Kellie remained unsatisfied with the institutions’ credentials. She extended her search to encompass the entire state and found Dr. H.R. Makarita, whose credentials impressed her and prompted her to drive three and a half hours to his Oakton practice for a consultation; later, she would return for a complete smile makeover.

“I now have—no exaggeration—perfectly colored, perfectly shaped Julia Roberts teeth,” she said gleefully, adding that before her dental work, she couldn’t find one picture where she was smiling with her teeth. “Over the years, I had major anxiety issues. Now, everything has changed; the way that I eat, the way that I look, the way that I photograph.” With her new teeth, Kelly is training herself to smile again, controlling her hand from flying to cover her mouth as it used to. “No way am I going to cover these beautiful teeth!” she exclaimed.

Photography by Hana Jung

Meet The Dentist:
H.R. MAKARITA, DDS, MAGD, LVIM, FICOI, FAACD, graduated from the Medical College of Virginia School of Dentistry in 1988. He has been a member of the American Academy of Cosmetic Dentistry since 1995, receiving his accreditation in 2001 and becoming the 39th member of the academy to receive its prestigious fellowship designation in 2006. He is a master of the Academy of General Dentistry, and was awarded mastership status from the Las Vegas Institute for Advanced Dental Studies in 2006; he is also an LVI clinical instructor and regional director. Dr. Makarita has received numerous AACD Smile Gallery awards, and received the AACD People’s Choice Award in 2003. His private practice in Oakton specializes in aesthetic reconstructive dentistry. Visit www.fixasmile.com.

Emergency Makeover

Not all dental damage is the result of gradual deterioration, and on-call dentists must be ready to immediately handle urgent cases as they arise. Dr. Lawrence Singer, who serves as assistant clinical professor of surgery at George Washington University and has practices in Alexandria and Washington, D.C., is on-call for facial fractures and dentoalveolar trauma, including avulsed teeth.

When traumas arise, he goes to the George Washington University hospital to assess the patients’ injuries, and has had many unique cosmetic and reconstructive surgery opportunities. “Often, we will go into the O.R. and reset broken jaw bones, and re-implant and stabilize loose teeth,” Singer said. “This initial treatment is critical to getting the best result so that the tissues are manipulated in the best possible way for ideal healing with little defect.”

He remembered when Tanya, an on-duty Arlington County police officer, came into the O.R. Tanya, who was on foot that night, had been struck by a car traveling at 55 miles per hour. In addition to broken hands and a badly broken leg, she had broken upper and lower jaws. She had lost six upper teeth and had three avulsed lower teeth. While orthopedics reconstructed Tanya’s broken hands and legs, Singer worked on her maxillofacial region with an ENT resident. He re-implanted and stabilized the lower teeth by connecting them to adjacent teeth, and began healing the upper and lower jaw by “reducing” the fractures; that is, putting the jaws back into place with plates, screws and sutures.

“The lower teeth were all treated with root canals and porcelain crowns,” Singer said. “We are replacing the upper teeth that were lost with zirconium implants and zirconium crowns, all porcelain.” Since the initial surgeries, Tanya has had several additional plastic surgeries for her gums. “It has been seven months since the accident, and we expect her to finish up in the next couple,” Singer predicted. “Tanya is a tough gal. She has a big smile, though, and restoring it has been rewarding as any.”

Photography by Hana Jung

Meet The Dentist:
LAWRENCE D. SINGER, DMD earned his Doctor of Medical Dentistry at the School of Dental Medicine: University of Pennsylvania, where he served as assistant professor of restorative dentistry from 1997 to 2000. He currently is the assistant clinical professor of surgery at George Washington University and maintains full admitting and ambulatory center privileges at the GWU hospital. He is a member of the Academy of Osseointegration, the American Academy of Cosmetic Dentistry and American Dental Association, among others. He is a also fellow of the Academy of General Dentistry, as well as the International Congress of Oral Implantologists. His practice, DC Smiles, has locations in Washington, D.C., and Alexandria, specializing in cosmetic, implant, and reconstructive dentistry. Visit www.novasmiles.com.

Best Face Forward

Broken teeth resulting from accidents or abusive relationships can cause emotional trauma that runs deep, and cosmetic dental procedures often serve as one significant step in the victim’s recovery process. Dr. Kevin Ryan is vice chairman of the board of Second Chance Employment Services, a Washington, D.C.-based nonprofit organization that places battered, abused and other at-risk women in jobs free of charge.

“Many of these women obviously need dental work because they have broken front teeth due to an abusive relationship,” Ryan said. “I use veneers to restore their smiles so that they are presentable enough to go and get a job, and I’ve also made temporary crowns so that they can go on job interviews. The main thing is to get them ready and give them enough confidence to go out into the workforce.”

The women, who are typically psychologically damaged, find it difficult to believe that they can actually get a job, and the cosmetic dental procedures often allow them to regain a sense of normalcy in their lives. Contrary to common assumptions, Ryan said that the organization sees women of all educational and social backgrounds. He remembers a marine biologist who had a front tooth knocked out.

“She was unbelievably well-educated,” he remembered, “but she just couldn’t get a job. I made her a temporary crown to improve her appearance, and she got a job right away.”

It seems that it isn’t just the women’s appearances that change with this dental work. Ryan remembered a young French woman whose teeth were incredibly damaged as result of an abusive relationship. He created an entire case of veneers for her, which he said made a dramatic change, not only in her looks, but also in her attitude. “She’s a completely different person now,” he remarked. “She’s remarried, has a baby on the way, and is happy and smiling every time she comes in.”

Although many of the procedures would ordinarily run up to $17,000, all of the dental work at Second Chance is done pro bono. Even so, it seems a small price to pay for a life change.

“We don’t just do dentistry [at Second Chance]. We get them clothes, help with their resumes, and you can always see the difference immediately in the way they hold their heads, the sparkle in their eyes. We have story after story of people who have made remarkable changes.”

Photography by Hana Jung

Meet The Dentist:
KEVIN A. RYAN, DDS graduated from the Medical College of Virginia School of Dentistry in 1981. Dr. Ryan was voted as “highly regarded for cosmetic work” by Washingtonian Magazine, and was voted by his peers as one of the “Best Dentists in America” for 2004-2005. He completed post-graduate training at the Las Vegas Institute for Advanced Dental Studies, where he put in 200-plus hours of continuous education a year. He is a member of the American Dental Association, Virginia Dental Association, Northern Virginia Dental Society and the American Academy of Cosmetic Dentistry. He started his own practice, the Springfield Esthetic Dental Center, in 1985, and has been practicing in the area for more than 19 years. Visit www.springfielddental.com.

(November 2007)