Can Dental Procedures Make You Look Younger? - WSJ.com http://online.wsj.com/article/SB1000142405270230382830457518...

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A Younger MouthTips for dental cosmetic surgery:

Choose a dentist with extensive experience. Make sure the dentist isn't in a hurry and will take the time to make sure you are happy with the results.

Be sure of what you want, since most procedures are difficult or impossible to reverse. Some dentists make temporaries so you can live with them a while.

By L AU RA J OH AN NE S

Some dentists are marketing cosmetic dentistry as an alternative to a face-lift. By adding length or bulk to

teeth, dentists aim to reshape the facial structure to smooth wrinkles and give a younger appearance.

With age, faces can shorten, chins move back, cheeks hollow, and wrinkles appear. Those changes can be

at least partially reversed by remolding teeth, part of the scaffolding of the face, to create a new look,

cosmetic dentists say.

"When the teeth are in the right position it fills out the volume [of the face], you see more teeth, and it is a

more youthful appearance," says Nicholas Davis, an associate professor at Loma Linda University School of

Dentistry in California and past president of the American Academy of Cosmetic Dentistry. But Dr. Davis warns that dental surgery doesn't work on all aging faces. "It's hard to predict how much of an improvement

you are going to get," he says.

Indeed, scientific studies on the procedure are scant. Dentists say they get good results in many patients

and often rely on before-and-after photographs as evidence that the procedure works. The pictures,

however, often feature different lighting, hairstyles or make-up—making an objective comparison difficult. Dr.

Davis says that while adding to teeth often does create a more-youthful experience, he doesn't promiseresults comparable to cosmetic surgery.

Cosmetic dentistry techniques for shaping the face, while decades old, have been refined in recent

years, and a number of dentists are now marketing

their procedures as an alternative to face-lifts or

botox. "There's a paradigm shift in cosmetic dentistry. We are focusing more on face shape,"

says Manhattan dentist Jeff Golub-Evans.

Procedures vary widely, from changing a few teeth

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Dr. Sam Muslin

Dentist Sam Muslin uses these photos of Barbara Scolaro to show results of his 'Dental Face Lift.' Ms. Scolaro before the procedure, left, and after, right.

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Ask whether your existing teeth need to be ground down and if so, how much. When the goal is to make your teeth larger, grinding can be minimized.

To protect the new dental work, consider wearing a night guard, particularly if you know you grind your teeth.

Budget for repairs or redos in a decade or two. Porcelain can chip or crack.

Source: Dentists and patients

to a total remake of a person's bite. Most

procedures involve adding length or bulk because teeth tend to shorten from normal use with age

and, in some patients, years of night grinding,

dentists say. Slightly thickening side teeth, for

example, can create a wider arc over the lip, smoothing wrinkles, says Dr. Golub-Evans.

Santa Monica, Calif., dentist Sam C. Muslin offersa procedure he calls the "Dental Face Lift," a name

which he trademarked. He uses medical imaging to analyze a person's bite and then restructures the entire

mouth—often working on all 28 teeth—to improve the bite and create a younger appearance. With age,

many people's jaws recede and their faces shorten, Dr. Muslin says, so opening the bite can make a personlook younger.

Dental cosmetic surgery, unlike face-lifts, doesn't require an incision and drilling is minimal. But it requiresmultiple visits—usually over a few weeks and months—and can cost $5,000 to $80,000 or more, depending

on the dentist and how many teeth you have done. In general, the procedure isn't covered by insurance, but

some plans may cover repairs and structural problems such as a bad bite.

Typically it involves placing porcelain veneers or crowns over existing teeth, but some dentists use a

white-colored material that can be added to teeth to re-sculpt their shape. Take your time before deciding to

have surgery, dentists warn, as porcelain work can be difficult or impossible to reverse.

Short in the ToothLengthening front teeth is a key component of many procedures. People under 29 show an average of 3.37

millimeters of their upper teeth with lips gently parted in resting position, compared with less than half a millimeter when they reach their 50s, according to a 1978 study by scientists at the University of California

School of Dentistry, Los Angeles.

"When you lengthen the teeth, people immediately look younger," says Manhattan dentist Irwin Smigel, who

calls his procedure the "Dental Lift."

Scientific studies on adding to teeth to create a younger look are rare. In a 96-patient study published in 2002

in the British Dental Journal, by London dentist Naresh Mohindra, a five-person panel, consisting of an artist,

a dentist, a dermatologist, a journalist and a patient who had the procedure, concluded that 81.2% of patients

looked younger after a procedure to open the bite and lengthen the face. However, the panel knew which photos were taken before and after the procedure, and the shots weren't taken using standardized lighting

conditions. Some panel members complained new hairstyles made it difficult to draw conclusions.

Some patients say the results look more natural than those of botox or face-lifts. Actress Barbara Scolaro,

who has appeared in various television shows and movies, and gives her age as in her 40s, decided to have a

Dental Face Lift after years of teeth grinding had shaved down her teeth. Before-and-after photos used to

promote the procedure on Dr. Muslin's Web site show a more youthful profile, longer face and a clean smile with no droop at the corners of her mouth after the procedure.

"It is stunning, and I'm very happy," says Ms. Scolaro, of Hollywood, Calif., who dipped into her 401(k) last year to pay for the $25,000 cost. She now wears a night guard so she doesn't grind down the new porcelain.

Karin Schwalb, a 61-year-old retired ballerina from Bernardsville, N.J., says Dr. Schmigel's work filled out her facial structure and made her look 10 years younger. "I didn't want that look that everybody has where they

can't move their face," she says.

In the initial consultation, some dentists use a clear wax inside the mouth to approximate the changes to the

face after the procedure. Another option is to create temporary structures that let people considering the

Dr. Irwin Smigel

Kate Turnball, 52 years old, had her teeth redone by Manhattan dentist Irwin Smigel last year for $50,000.