Blog

Every month you can listen to Smile Artistry's Dental Team discuss featured Smile Makeovers as published in the Brisbane News Magazine.

January 2010

Dr Paul McKay - Brisbane Dentist - Dr Graham can you please tell us about this Gentleman, his concerns and his treatment program, particularly in regards to Smile Artistry's Quality Assurances.

Dr Graham McKay - Brisbane Cosmetic Dentist – Alan is a business person and works with the public during everyday, so he needs a good presentation. He came to me to improve the appearance and alignment of his teeth. His teeth are overerrupted because of the arrangement of the teeth. In this sort of bite arrangement, the teeth are overclosed.
To improve the quality of his bite we need to open his bite, so that in eating, speech and sleep he has a better area to function. The planes were also very irregular and off. His front tooth had a vertical fracture with no bone around it, so this tooth needed to be removed.
By opening his bite, his teeth could be repositioned and and the planes corrected. You can see where the tooth is removed, the gum area has been healed and grafted into a better position.
Our aim is to create a natural looking result, not something artificial. We want to create something that looks relaistic and you can see the false tooth emerges out of the gum just like a natural tooth would. Spaces were closed and tooth shapes corrected.
This is a wonderful case because it shows how many disciplines of dentistry can come together and create such a great result.

Dr Paul McKay - Brisbane Dentist - Thankyou Graham. Graham there is a trend in dentistry to discuss same-day crowns with Cerec, can you please elaborate on this and why this is not a technology that Smile artistry is ready to adopt? We are concerned withthe accuracy, but also that it takes time of gums to heal and this cannot be rushed.

Dr Graham McKay - Brisbane Cosmetic Dentist – When you are talking about biology, in any other field of medicine you talk about time for tissue healing and recouperation. When we do our gumlifts and gum movements we need time for the tissue to stabilise. We have to work with the biology of the tissues and by respecting this we can assure our patients that their result will be very cosmetic in the longer-term.

Dr Paul McKay - Brisbane Dentist – Dr John Bacalakis, can you please talk about our plans and programs in terms of our quality assurances and how we may differ from other practices?

Dr John Bacalakis – Dentist Brisbane – I think that is important Paul. When we look at a case like we are today, it is all the careful planning and assessment we do that makes such a difference. Our Hygeinists were involved in some very important gum health issues before active treatment began. They also performed a decay maangement program. There are bite assessments to assure a good bite remain healthy and functional into the future.

Dr Graham McKay – Brisbane Cosmetic Dentist – We are in a unique postiion because we have our own on-site laboratory, and we can create great cosmetic results inside our practice.

Dr Paul McKay – Brisbane Dentist – Our patients will also spend at least two weeks in provisional teeth so they try out the final shape. We will alter these shapes to ensure the patients are entirely happy, and try these shapes out. Elsewhere, the provisioanl teeth may not be used and patients have to live with these shapes in the long-term.

Thankyou Dr Graham McKay and Dr John Bacalakis from Smile Artistry.  

December 2009

In November's Smile Artistry Blog Post we are discussing a recent Smile Makeover on our Office Coordinator, Ms Tina Olsson, as featured in The Brisbane News Magazine. Dr Paul McKay interviews Dr John Bacalakis - Brisbane Dentist and Ms Tina Olsson - Office Manager.

Ms Tina Olsson – Smile Artistry’s Office Manager – For many years I have been unhappy with the shape, positioning and colour of my teeth. Working within a cosmetic dental practice highlighted to me what could be achieved. My two front teeth were on an angle and on the left side the tooth was positioned backwards. Food kept getting caught in behind that tooth.

Dr Paul McKay - Brisbane Dentist - Dr John can you please tell us about the treatment, Tina's concerns and treatment program, particularly in regards to Smile Artistry's Quality Assurances.

Dr John Bacalakis - Brisbane Cosmetic Dentist – Tina’s case is one of many performed in our practice. As with all cases, Tina’s case began with a full consultation and assessment on the health of the mouth. The presentation of the smile involved worn, biting edges, discolorued teeth and gumline imbalance. On the right of screen there is gumline imbalance. When we look at a smile we want to remove all asymmetries in the gumlines.
Tina shows her smile all the way back to her molars, so this is important. There were a number of complex issues, but by creating a Smile Artistry Smile Plan we were able to know what was required.

Ms Tina Olsson – Smile Artistry’s Office Manager – It was reassuring to know there was a Smile Plan in place that has thought through all areas and everythign flows through in a systematic way with no surprises in time or cost.

Dr Paul McKay - Brisbane Dentist – John, the first stage of treatment?

Dr John Bacalakis - Brisbane Cosmetic Dentist – Teeth Whitening to bring the shade of the teeth down and whiten back teeth that did not require any further treatment.

Dr Paul McKay - Brisbane Dentist – Tina, how did you find Zoom Teeth Whitening?

Ms Tina Olsson – Smile Artistry’s Office Manager - Great, it made such a huge difference to my smile, even without any further treatment I was very happy.

Dr Paul McKay - Brisbane Dentist – John, the next steps, being a diagnostic waxup to determien tooth shapes?

Dr John Bacalakis - Brisbane Cosmetic Dentist – In Tina’s case we prior balanced the gumlines with a minor gumlift. We do place an emphasis on conservative treatments also. The first appointment after this involved preparing the teeth for Porcelain Veneers, taking the impression and placement of the provisional veneers.

Ms Tina Olsson – Smile Artistry’s Office Manager – It was a huge change. I was constantly looking at my smile in the mirror.

Dr Paul McKay - Brisbane Dentist – I recall coming into the review appointment and you were making some adjustments to one of the provisional veneers.

Dr John Bacalakis - Brisbane Cosmetic Dentist – Yes, at the review appointment we did make an assessment and with Tina’s feedback there was to be a slight correction of one the the provisionals. This change was then recorded and relayed to the laboratory so to give Tina a qaulity assurance that this informaiton is what gives our technicians the exact shape of teeth for the final Provisional Teeth.

Dr Paul McKay - Brisbane Dentist – Thankyou to Tina and John.

November 2009

In November's Smile Artistry Blog Post we are discussing the latest feature article in The Brisbane News Magazine with Dr Paul McKay - Brisbane Dentist, Dr Graham McKay - Brisbane Cosmetic Dentist, Dr John Bacalakis - Brisbane Dentist, and Eliza - Brisbane Dental Hygienist.

Dr Paul McKay - Dr Graham, can you tell us about the Feature Article, the patient, her presenting concerns and how she was treated at Smile Artistry?

Dr Graham McKay - Brisbane Cosmetic Dentist -  The attractive lady featured in the article is a patient of about four to five hundred patients that I have treated at Smile Artistry to help improve their smile.  This lady has a beautiful personality, but her smile did not augment this.  Her concerns were that were teeth were worn which made them looked aged and old. 

At first our program involves assessing the general health of her mouth, and in particular her gum health.  We found her gum health was good.  Her decay rate was particularly low and she had no fillings on her visible teeth, however she did have significant tooth erosion and tooth wear. 

Her dental history revealed Orthodontics when she was 16 years of age.  This did not expand her premolar regions and her smile subsequently is narrow and sunken in on the sides.  Unfortunately, her eye teeth were not aligned correctly and they were not protecting her grinding patterns, and therefore the front teeth have worn down.  As a result of this assessment, we knew to create a successful long-term transformation, this will need to be corrected.

The initial stage of treatment invovled a pain-less gum-lift procedure to reduce the excessive gum showing. 

A treatment omf Laserbrite - Insurgery Teeth Whitening whitened the back and lower teeth.  

Detailed models were taken and our own on-site dental laboratory was able to make a diagnostic wax-up (mock-up) of what the smile makeover will create.  This enabled us to predicatbly show and discuss with the patient her final result even before her porcelain veneers were started.  The technicians, Peter and Peter both worked on this case.

To properly reconstruct a protective bite setup, porcelain crowns could better strengthen the inside of the teeth and provide better resistance to grinding over that inside surface of the tooth.

The porcelain crowns were performed in two main appointments.  Temporary Crowns were placed for only three weeks while the permanent porcelain crowns were being constructed.  During this period we were able to reassess theat the temporary crowns were in harmony with the bite and her smile, and at that stage, an impression was made, and the shapes duplicated.  At the seond main appointment, the transformation was complete, with beautiful new porcelain crowns inserted and a great new smile created!  The technician Peter did a fantastic job in this case.

Dr Paul McKay - Dentist Brisbane - and in this case you mentioned the patient is a grinder, so how did you guarantee such a long-term result?

Dr Graham McKay - Cosmetic Dentist Brisbane -  By recreating canine guidances so that the canine do protect the front teeth in grinding movements this lady will experience less risk that her porcelain crowns will be damaged in teh future.  Because of her jaw structure and history of grinding, we use a night-time guard to protect all of her teeth with a thin film of plastic worn on the top teeth.  At her future six monthly appointments, the night-guard will be checked and altered where grinding is evident.

Dr Paul McKay - Dentist Brisbane - A question for Dr John Bacalakis Dentist Brisbane, Can you please discuss the cosmetic properties of the newer zirconia porcelain materials used in porcelain corwns, porcelain veneers, and porcelain bridges?

Dr John Bacalakis - Dentist Brisbane - The older technologies with metal inside our crowns usually resulted in a grey area around their margins and a slight greyness to the teeth.  By using zirconia inside our crowns, not only is zirconia a stronger material, but it is a far lot more cosmetic.  It has vastly improved the cosmetic appeal that we can offer patients of Smile Artistry, and is definitely the future of porcelain dental work.

Dr Paul McKay - Dentist Brisbane - A question for Dental Hygienist Eliza -  What was your role in treatment for this patient?

Brisbane Dental Hygienist Eliza - My initial role was the stabilise the gum health for this patient.  This is particularly important because good gum health will make her cosmetic procedures more predictable and effective.  As this patient did have tooth sensitivity, I was able to discuss and offer assistance with reducing her tooth senstivity. Tooth Sensitivity is largely related to an ultra-acidic diet with lots of juices or sports drinks. The types of toothbrushes and toothpastes will also have an impact on tooth sensitivity, and in many cases, using GC Tooth Mousse, Colgate Sensitive or Sensodyne Toothpastes will decrease sensitivity dramatically.

I was able to perform in-surgery tooth whitening using the laserbrite teeth whitening system.

After the new smile is complete, I play an important role in ensuring that we a re able to maintain healthy and strong teeth, healthy gums and maintenance of the teeth whitening of her lower and back teeth.

Dr Paul McKay - Dentist Brisbane - Thankyou everyone.