Face Lifts via Cosmetic Dentistry
Cosmetic practitioners have found yet another route to better looking, younger, and more refreshed faces.
Via the teeth!
It's not too widely known, but in many cases, dental techniques that buff up lackluster smiles can also remove wrinkles, facial sagging, and the deep skin folds associated with advanced aging. Some cosmetic dentists now offer facial rejuvenations through cosmetic dentistry to improve your smile and make your midface look better, all in addition to gaining those new pearly whites.
"In many cases, worn or misaligned teeth can be the reason for midface sagging and other health problems," says Bruce Hartley, D.D.S., a cosmetic dentist in Los Altos, California.
Natural teeth can be ground down due to normal aging or through a condition known as sleep bruxism in which patients grind their teeth at night. Left unchecked, the teeth become shorter, causing the lower jaw to travel farther to meet the upper teeth while chewing.
A Natural Smile
Given enough time, the tip of the nose starts to noticeably dip. Imagine a sketch of a Halloween witch in where her chin and nose almost touch and you've got the worst case picture. Additional health woes resulting from short and misaligned teeth include problems and pain in the joints, neck, and muscles of the jaw, and headaches.
"If the dentist rebuilds the height of the tooth, the facial structure also starts to improve," says Dr. Hartley.
Facelift via Dentistry
In one case, a 56-year-old homemaker visited Orange County, California, cosmetic dentist Joseph Henry, D.D.S., for a cleaning. Dr. Henry found the woman had small, worn teeth, an overbite, and some of her teeth had moved from their natural position. The patient did not want to wear braces but agreed to mouth rejuvenation with veneers and crowns, which restored the optimal shape, size, and position of her teeth. Additionally, her overbite was corrected. The patient received a beautiful smile but did not expect the bonus that came along with correcting misaligned teeth -- a beautifully elongated face.
"I look like I've had a facelift," says the patient who only wants to be identified as Karen. "Friends are sure I had cosmetic surgery."
Adds Dr. Henry: "Restoring the bite to optimal position also defines the jaw line, making the patient's profile more appealing."
A 52-year-old woman, left, shows her smile and face before receiving a full mouth reconstruction. Four months later, the same woman shows the results of her mouth rejuvenation and the changes it has made to her mid face. (Photos, courtesy of Bruce Hartley, D.D.S.)
Good candidates for Dr. Henry's Dental Mid-Face Lift include people in their 20s to those in their 60s and 70s who have worn front and back teeth. But before cosmetic work begins, Dr. Henry usually recommends taking care of any periodontal disease, cavities, and other dental woes.
"Patients go under a local anesthetic for the procedure," says Dr. Henry. "It usually takes four, two-hour appointments to return their teeth to proper heights."
In the past, most dentists would crown the back teeth without rebuilding the height of the tooth. Crowns allow for much better chewing, but the patients' faces remained the same. Now, some dentists have learned that replacing 20 to 40 percent of the original teeth can greatly affect the appearance of the face.
Five to 20 Years Younger
In London, England, general dental practitioner Nick Mohindra, D.D.S. studied 96 patients whose facial aesthetics had been improved by increasing the vertical dimension of occlusion, the point where the teeth come together when biting down.
The study subjects and an independent panel of dentists analyzed the patients' before and after pictures. Results? They found about 80 percent of patients looked five to 20 years younger.
"The subjects' improvement in their dental condition is related to the whole range of facial features -- including the eyes, nose, cheeks, lips, and skin," says Dr. Mohindra. "Not just the lower face."
One part of Dr. Mohindra's study -- later printed in the British Dental Journal -- found almost 37 percent of study subjects noticed an improvement in the loose skin of the upper eyelids and less bagginess under the lower eyelids. The wrinkling at the corner of the eyes also lessened somewhat, causing the subjects' eyes to appear brighter, more open, and refreshed.
But how could dental procedures affect the areas around the eyes?
Dr. Mohindra thinks it's due to increased fat metabolism taking place when facial muscles are working harder and properly.
Writes Dr. Mohindra on his Web site: "Worn teeth can make the entire face age. Missing and ground down teeth result in a sucked in and collapsed appearance around the mouth, which causes vertical lines on the skin of the upper and lower lips and all around the mouth."
Sam Muslin, D.D.S., M.A.G.D.*, in Santa Monica, California, has trademarked the terms "Face Lift Dentistry" and "Dental Facelifts." In his office, Dr. Muslim uses high technology measurements to tell exactly how much a patient's teeth should be built up and where jaws should be repositioned. Consequently, he refers to himself as the "high-tech dentist." At his practice, patients stretched out prone in dental chairs watch television screens affixed to the ceilings. Patients are also attached to heart monitors and enjoy doors to the operatories that automatically open. Both air and water lines to chair side sinks are filtered to screen out any possible contamination.
"It requires the most precise scientific measuring to properly adjust the tooth length and where a patient's bite should be," says Dr. Muslin. "Without imaging, you are just guessing."
Dr. Muslin's office uses his office CAT scan to precisely measure teeth and then reshapes them with porcelain and radiant veneers, lumineers, dental implants and porcelain crowns.
"Teeth play a huge role in the support of your face," he says. "At the best possible length and angle, teeth make a positive impact upon the shape of the face."
Other plastic surgeons have joined the trend by concentrating on the tissues around the mouth to provide some facial rejuvenation.
For instance, George Weston, M.D., co-founding plastic surgeon at the Austin-Weston Center for Cosmetic Surgery in Reston, Virginia, says he invented the Mouth Lift about two decades ago.
"With age, the edges of the mouth tend to turn downwards, suggesting a frown that makes us look unhappy, sad or not as young looking as we may feel," says Dr. Weston. "Many patients who have had the surgery say they are tired of people asking if something is wrong."
A mouth lift requires about one and one-half hours; scars are concealed in the red part of the lips so they can't be spotted from inches away. Technically known as an angioplasty, lifting the corners of the mouth also corrects the marionette lines, the deep creases that travel from the corners of the mouth down the chin and advertise advancing age.
Other practitioners, some with lasers, offer gum lifts to make smiles less gummy.
Before Facial Surgery
If you're planning on any facial plastic surgery, New York City dentist Carmen Schuller, D.D.S. says you'll have the best possible result if you first take care of your oral health.
"I specialize in 'integrative dentistry,' which combines oral health and the rest of the body's systems in the head and neck," says Dr. Schuller. "A dentist can create the ideal substructure for a plastic surgeon's work."
Dr. Schuller noted that some less-than-perfect outcomes in rejuvenation surgery were due to the following:
- The patient's jaw not being in balance and weak core facial muscles.
- The patient not being able to chew well. Missing teeth in the back of the mouth can cause an unnatural sinking of the cheeks.
- The distance between the nose and chin not being adequate. Restoring teeth to the natural height and shape balances that relationship.
- Patients who grind or clench their teeth developing headaches, neck and lower back pain, not the ideal environment for cosmetic surgery.
Dr. Schuller, like many dentists, uses computer-assisted design/computer-assisted manufacturing (CAD/CAM) to accomplish everything in one visit. No temporaries and a wait for the lab to return finalized teeth are required.
"The most natural results of plastic or cosmetic surgery happens when the two medical specialties collaborate," says Dr. Schuller.
Having a better looking face, along with brighter teeth is, of course, the best of two worlds.
*Master of General Dentistry