A few years ago I sat in a specialist meeting. As usual there were lots of “A-ha!” moments and a few take away pearls from Frank Spear and Company that remains priceless.
One of the biggest take-a way's from that particular meeting is one I still use today: the use of a black Sharpie to block out tooth length in a patient.
Shortly after I returned to my practice, I saw this lovely lady for a new patient consult. She was very petite and beautiful, but every time she talked or smiled all I noticed were her teeth. To be specific, I kept focusing on the length of them. Again, not to beat a dead horse, but it is all about proportions sometimes, and she had a case of the “Kramers” (see my previous article on Hollywood stars' teeth).
Of course she did not care for her smile either and wanted it changed - yesterday!
I knew instantly that her central incisors were too narrow and too long. They had prominence but for the wrong reasons. They were just way too long for her. She had 6 mm of incisal edge display at rest and when she smiled all I saw were her two front teeth. The contact point was very long and the original crowns were PFM and made more than 10 years ago.
Even though she wanted to change her smile, she was very nervous about doing something new, but I knew that if I could show her what she would look like with shorter, brighter more translucent crowns, she would be happier.
So, I got my friendly Sharpie and blacked out about 3 mm of incisal edge of her crowns. I then took a photo and printed out a before and after photo of her smile.
She instantly could see that shorter crowns would look better, so I seized the moment and asked her if she would allow me to shorten them that day. To my amazement, she was as excited as I was, so I was able to get my diamond bur out.
I elected to reduce her right side first, so that she could see the difference before I reduced the left side.
She was really happy after her first appointment, and we went on to replace all her maxillary crowns. Thus we were able to rebuilt her confidence in her smile.
The moral of the story is:
- It's not about sophisticated tools... sometimes simple is all we need.
- Tools alone without a deeper understanding of fundamentals, in this case FGTP, will not work.
- There are always pearls of wisdom to pick up when you take a CE course, regardless of how knowledgeable we think we are. (So thank you Frank!)
- We have to implement the things we learn and let the magic happen.
Arezoo Bahar, DDS, Visiting Faculty and Contributing Author