Chapter 6 The Nonsurgical Face Lift
Restoring a Youthful Appearance by Repositioning the Muscles of Facial Expression
In 45 years of dentistry, its image has evolved from one of pain relief (generally with extractions) and ungainly restorations (mostly amalgams) to the sophisticated esthetic perception the profession enjoys today.
The dental profession was mired in an esthetic quagmire for generations. In the 1950s, the main esthetic option was the acrylic veneer. Porcelain crowns, albeit available, were mostly for the very wealthy. They were referred to as “Hollywood crowns,” implying that only movie stars or the affluent could afford them. Cementation was the only binding option, and the “give” of the cement between the tooth and crown often resulted in porcelain fracture. Fortunately porcelain fused to gold was perfected by the late 1950s.
In the early 1970s, a metamorphosis occurred that changed dentistry forever—the development of bonding. For the first time the dental profession could offer cosmetic improvement quickly, painlessly, and financially within reach. Bonding was revolutionary, and its success stimulated subsequent improvements and advances.
Porcelain veneers were a natural extension, and the Maryland bridge followed shortly after. Today, porcelain crowns that are bonded to the tooth structure are infinitely sturdier and far less prone to fracture. The newest concept in porcelain crowns, zirconia, is as durable as porcelain-fused-to-metal (PFM) crowns.
Esthetic changes in the profession also are influenced by demographics. In the 1950s and early 1960s, our nation experienced an extraordinary baby boom. To meet the demand of this proliferation, many dentists became orthodontists, and after the trend diminished and the baby boomers became young adults, “adult” orthodontics came into vogue.
Esthetic dentistry has similarly adjusted. In addition to the procedures previously mentioned, some form of tooth whitening is performed by 80% of dentists practicing today. Dentists are catering to the largest patient base, the aging baby boomers. The baby boomers are educated, are well-to-do, have a long life expectancy, and are anxious to enjoy it by looking youthful and attractive for as long as possible.
Plastic surgeons have benefitted considerably from desires for a youthful appearance, but today’s esthetic dentistry offers options that are quicker, safer, and less invasive with results that are extraordinary. The revolution that occurred with the introduction of bonding in the 1970s has risen to a new plateau.