FROM TOOTH TATTOOS TO PERFECT RESTORATIONS

The increased interest in and demand for aesthetic dentistry means that Ian Smith’s presentation at The Dentistry Show should be fascinating for dental healthcare professionals generally, not only technicians.

Ian is one of a few Master Ceramists in the UK and is rare in being based at a dental clinic, working in joint consultation with the dentist.  Usually, a patient will know very little about where or by whom their new smile is being created but at the Visage Dental Clinic and Laboratory in Glasgow, Ian is involved from the outset, “I’ll take photos and talk to the patient, get a general idea of what they want and learn a bit about their character which you can’t really do without meeting them in person. Then there’ll be further appointments to try out the teeth I’ve designed, and the all important bisque stage with the unglazed ceramics when I’ll do the finishing touches in the patient’s mouth with my stains palette and brushes before the teeth are fired in the furnace.”

Ian’s presentation at The Dentistry Show is based on one of his own groundbreaking cases. In this instance, a single central implant crown was made perfect, despite a high lip line by using the patient’s own extracted tooth and Ivoclar’s IPS e.max – or lithium disilicate which Ian says is perfect for accurately replicating the natural dentition, “ Lithium disilicate is my preferred material of choice. It’s all ceramic and is a far more aesthetic and predictable material than Zirconia. It’s actually unlike any other material I’ve ever used and is a huge help in providing that favourite feature of dentists – predictability!’

Using a patient’s own extracted tooth to create a customised e.max abutment is very rare indeed but Ian believes it is the way forward, “ When a tooth is extracted in order to make space for implants, the soft tissue collapses around where the root was. The root is a natural shape and is organic so can be used to create the exact abutment shape which of course, means that all the tissue around that tooth is supported as naturally as it would have been before the extraction.”

Obviously passionate about his work and a perfectionist to boot, Ian says the study of morphology, anatomy and colour is essential.  Inside every natural tooth there can be at least four colours or shades, and usually many more and he uses an artist’s palette and small brushes to perfect shade and colour but warns, “If you don’t get the surface anatomy and lustre correct, then even perfect shading and colour matching will stand out like a sore thumb.”

Of course there have been the odd patients who really do want to stand out – with a tooth tattoo, which can be created before the final firing ; “  It’s at this stage we can paint Mickey Mouse on someone’s tooth if they so wish it and yes, I have done the odd tooth tattoo but it’s usually been football related! ”

Patients who have had their teeth whitened offer a different set of challenges because of the variations in the colour of dehydrated and rehydrated teeth. By way of example, Ian talks of a patient whose laser whitened teeth changed colour between morning and afternoon because of her night time mouth breathing and subsequent dehydration. His advice is to leave a gap of around two weeks between completing whitening and shade matching.

Since graduating from Edinburgh in 1996 with multiple merit awards in Dental Technology, Ian has gained a reputation for his ability to create the most lifelike restorations and meticulous attention to detail. A popular speaker, Ian is also Scotland’s opinion leader for Ivoclar Vivadent.

The Dentistry Show is at the NEC, Birmingham March 2nd and 3rd  2012. For more information, please visit www.thedentistryshow.co.uk , call 020 7348 5269 or email info@thedentistryshow.co.uk