IF YOU HAVE EVER invested in improving the interior of your home, you will no doubt identify with what is referred to as “the domino factor” of design (also known as “all-I did-was-buy-a-new duvet-and-now-the-whole-house needs-hardwoods.”) One improvement, however seemingly insignificant, only accentuates that which is unimproved. This same premise applies to facial aesthetics. Whether we are talking about a full face and neck lift or a simple nonsurgical procedure, like fillers, the result will be a refreshed, rejuvenated appearance. You will look in the mirror and smile. But what will you (and others) see?
THE RELATIONSHIP OF TEETH TO OVERALL FACIAL SYMMETRY
Dento-facial aesthetics is the evaluation of teeth as they relate to other facial structures with consideration given to the overall facial symmetry. Since the teeth support the lips and lower third of the face, a restorative decision can have a dramatic effect on a patient’s appearance. According to Dr. Gerry Curatola, one of the premier leading edge rejuvenation dentists in the country, your teeth are not only part of facial aesthetics, but should be fixed prior to any surgical or non-surgical facial procedures. “The face, teeth and mouth are not mutually exclusive. They are more integrated than you might guess both in form and function. If you think about your smile as being the cornerstone of your expression, you begin to recognize the importance of investing in strong, beautiful, healthy teeth as part of improving your facial features and appearance.”
It’s important to first understand the pivotal relationship between teeth and facial structure. The analogy Dr. Curatola uses is borrowed from architecture. “If the face was a building, think of the teeth as providing the steel skeleton supporting the structure. They influence the walls and floors from both an aesthetic and foundational point of view. Teeth can change the features of a face, for better or for worse. Rejuvenation dentistry gives us a quiver full of options to offer patients.”
ORTHODONTICS: OVER BITES, UNDER BITES, AND CROSS BITES
One of the first areas of dento-facial aesthetics crosses all age and gender boundaries orthodontics. Even teenagers who are far from fighting age related concerns experience the positive influence of orthodontia. Overbites, under bites and cross bites, once corrected affect the profile of the face and complement the facial features. Dr. Curatola makes the point that straight teeth are not the only benefit of orthodontics. “The correction will also prevent gum problems and premature wearing of the teeth. Healthy gums and a properly aligned bite are two vital elements of a healthy mouth. Braces are not just for teens anymore. Today we are able to do things less invasively and more conservatively with Invisalign. It’s never been easier or more convenient. No brackets, wires or cement, and the results are fantastic. Creating a firm foundation yields a lifetime of benefits on so many levels.”
RESTORING THE HAPPY FACE
As we age, misaligned, missing or otherwise damaged teeth can have profound effects on facial structure. Volume loss and subsequent sagging begin in the lower half of the face where the teeth play a critical role in supporting the surrounding tissue. Dr. Curatola explains. “Your front teeth wear down first, making the side and back teeth longer. This causes the shape of the mouth to take on an inverted smile. The saggingchin, collapsed upper lip, nasolabial folds and marionette lines all become exaggerated. Most people panic and run to a plastic surgeon to lift their features — not realizing that facial rejuvenation starts with the mouth. Facelifts, eyelid lifts, brow lifts, lip lifts — none of them will restore a ‘happy face’ if the teeth are not in alignÏment.”
Subject is a 52 year old female, who presented with an anterior open bite, flared incisors, and
retruded lower jaw (Class II malocclusion) resulting in “sagging” below the neck, and a “gummy
smile.” The treatment plan included occlusal (bite) rehabilitation and opening the posterior
vertical dimension with E-max crowns, followed by crown lengthening on the maxillary anterior
teeth to eliminate the “gummy smile.” (Periodontal surgery performed by Rejuvenation Dentistry
Periodontist, Navid Rahmani, D.D.S.) This was followed by the final placement of Porcelain
Laminate Veneers on the anterior teeth. The after photos show improved facial profile and
elimination of “sagging” neck and “gummy smile.”
A visit to a rejuvenation dentist prior to facial enhancement is right in step with the trend toward a “less is more” philosophy regarding surgical intervention. In fact, Dr. Curatola believes when a facelift is done before teeth are restored, the surgery will have to be more extensive to make up for the support lacking in the mouth.
In some cases, surgery can be sidestepped altogether and/or fewer injectables will be necessary. Dr. Curatola has restored and rebuilt lips just by improving the teeth. If the angle of the teeth is causing a thin upper lip, plumping the two front teeth results in a fuller upper lip. By correcting the bite the lower jaw is tightened and a retruded or double chin is minimized — all without surgery.
HOLISTIC LIP AUGMENTATION
One of the most popular non invasive aesthetic treatments is lip augmentation. This procedure, more than any other will bring focus on the teeth, so it’s imperative you are not calling attention to a less than perfect smile. Dr. Curatola stresses his role in a holistic lip augmentation. “Lips should be done after the teeth are done. In fact many dentists are well trained and well suited to provide lip enhancement as an adjunct service. In any case, we are uniquely qualifiedto frame the teeth to create the perfect picture.”
Dr. Curatola circles back to the interior design analogy. “As a rejuvenation dentist we can optimize many anti-aging therapies. The greatest benefit to the patient is realized if they plan to visit us first. But if they come after the fact, we can complete their new look. What I hate to see is beautiful cheekbones, high brows and full lips framing bad teeth. It’s like layering exquisite draperies over a broken, dirty or cracked window. There should be no compromise.”
Subject is an 18 year old male, born with underdevelopment of maxillary (upper) jaw and missing and malformed maxillary incisors,
resulting in poor upper lip support. Dental reconstruction performed with E-max ceramic laminate veneers and E-max ceramic crowns.
Post operative photos reveal improved facial profile with increased upper lip support.
It’s never too early to consider role of teeth and never too late to start taking care of yourself. In your 20’s teeth whitening may be all you need to ramp up your smile. Be sure your teeth are healthy so you are confident there is a good foundation for the future. By the 30’s and 40’s many of us are picking up parafunctional habits. In other words, our stress is causing clenching and grinding. In extreme cases the wear on our teeth translates into fractures and TMJ pain. A rejuvenation dentist can build up broken teeth with crowns and veneers or alleviate TMJ side effects with something as simple as a night guard. If precautions are not taken prior to midlife, the 50’s and 60’s will not be much to smile about according to Dr. Curatola. “It all starts with loss of bone around teeth, then gum recession. It’s unfortunate when you see a patient with premature loss of teeth, whether due to wear and tear or periodontal problems. This situation makes the entire face age prematurely as well. This unsightly expression is often referred to as ‘long in the tooth.’ We now have implant reconstruction which promotes regrowth of bone around the implant fixture which reconstructs the mouth and provides whole new support for face.”
ANTI-AGING NUTRITIONAL PROTOCOL
Feed your smile with Dr. Curatola’s alkaline promoting/low acidic diet. “Establishing a favorable eating protocol is an essential part of maintaining overall health and longevity. Sugar and carbs are acidic and cause breakdowns in the ecology of the mouth, interfering with existing dental work. Poor eating habits can also lead to systemic issues and chronic disease”, says Dr. Curatola.
Recognizing the link between nutritional habits and good oral health, patients of Dr. Curatola are provided complete nutritional analysis, and customized programs , by Dr. Fran Gare, who is an integral part of his team. Dr. Fran Gare is a Clinical Nutritionist and Naturopathic Physician, well known in the field of complimentary nutrition.
THE A-LIST DIET
A proactive approach begins with diet and eating natural foods that are important “A’s” of the A List Diet.
Often chronic conditions are worse when the body is acidic. Choosing foods that can have an alkalizing effect helps to alleviate a propensity toward infections. Choose alkalizing fruits such as watermelon, tangerine, pineapple and raspberry and take supplements such as Quercitin, a bioflavonoid, and buffered vitamin C.
Many foods can serve as inflammatory triggers. The most common are dairy and gluten. These triggers can vary for some people so a food allergy/ sensitivity test can help to tailor you own person anti-inflammatory diet. Turmeric and ginger are great natural anti-inflammatory spices. Also supplements such as omega-3 essential fatty acids contain eicosapentaenoicacid (EPA), which
is a natural anti inflammatory.
Eating foods that are high in important antioxidants such as vitamin C, vitamin E, coenzyme Q-10, vitamin B, Panthothenic acid, Quercitin and vitamin A are all essential when your immune system is “on high alert.” Stress or allergies can wreak havoc on the body putting you at greater risk for some cancers. Again, Quercitin is a powerful antioxidant that has also been shown to block the release of the body’s own histamines. Antioxidant-rich foods are many of the leafy greens, and apples remain a gold standard for health. Other powerful natural foods are cherries, broccoli, avocados and pears.
Dr. Gerald P. Curatola practices from offices in Manhattan and East Hampton. Schedule a consultation by calling 212-355-4777 / 631-324-6800 or visit http:// www.RejuvDentist.com
GLOW SPRING/SUMMER ‘11 Th e Ma g a z i n e A b o u t B e a u t y , H e a l t h A n d We l l n e s s