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By Candice Sabatini

If it hurts, you’re going to the wrong dentist. And if the dentist is only looking at your mouth then you’re going to the wrong cosmetic dentist.

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I met with Dr. Larry Rosenthal to discuss how cosmetic dentistry has dramatically changed as well as how it’s dramatically changed us. He should know. Dr. Larry, as he’s affectionately called, is a pioneer in the field of cosmetic dentistry and has been creating prettier and healthier mouths for 25 years. Look at the smiles of Chloe Sevigny, Natasha Richardson or Matt Damon to have a peek at his work. Along with his NYC dental practice, he runs the Rosenthal Institute for Aesthetic Dentistry at NYU and the Aesthetics Advantage School where he shares his knowledge to dentists around the world. I was gob smacked to find out that even the Brits are learning from him and interested in having pearly whites!

BN: How have the aesthetics of dentistry changed over the years?
DrR: Dentists used to look at one tooth at a time. Then it progressed to looking at the whole mouth. Now, a good cosmetic dentist views the whole person: face shape, jaw shape, length of neck, etc. The goal is to create a smile that’s both great looking and natural looking and not cookie cutter Hollywood style teeth. Also, we operate on a “less is more” philosophy and always opt for the least invasive way to achieve our goal.

BN: How has the technology of cosmetic dentistry changed over the years?
DrR: Years ago caps (crowns) were the only option which removes 50% of the tooth. Then bonding came along which was less invasive. Finally, veneers were developed and they’re far superior to bonding so no one bonds teeth anymore. Veneers drastically changed how people can look with very little tooth removal. Prior to five years ago, dentists had to remove about 10-15% of the tooth for a veneer. Now, we only have to remove only about 5% of the tooth. Also, the new ones are thinner and stronger. Sounds like it should be the opposite, but the newest and best ones are made from both porcelain plus other composite material so they look much more like natural teeth. Orthodontics has also changed dramatically with more adults opting to straighten their teeth because of the Invisalign clear braces.

BN: How has your approach changed?
DrR: People are doing so much more now to make themselves look better. The problem is they’re in the dark and don’t know what to do first. Everything you do cosmetically affects how something else will look, so you need a comprehensive plan. We have developed a Dream Team to coordinate the whole make-over. We have relationships with plastic surgeons and dermatologists that we refer the patient to and then we all can discuss how each of us is approaching the whole person. A game plan is set into place, even though a person may opt to wait years before doing something else or decide not to do a procedure at all. However, they will feel comfortable with the options they’re choosing.

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Before and After

At Dr. Rosenthal’s office, after an initial dental consultation, the patient meets with Jackie Pastore, who works with a computer simulated image which gives you the option to view virtually what your new smile will look like. After that, the patient can discuss with the dentist what type of teeth will look best. How fabulous is that Miss future pearly whites!

BN: What’s the best professional tooth whitening procedure? How about the home kits?
DrR: Zoom laser whitening is the best professional whitening. It takes an hour in the office with almost no discomfort. There’s also very little post treatment discomfort or sensitivity. People usually have it done about once a year. Home whitening can help a little bit and it’s really best for in-between professional sessions. Either whitening strips or whitening toothpaste, whichever the person is more comfortable with.

BN: Aside from having a prettier looking mouth and more youthful looking teeth, can cosmetic dentistry give people a younger look?
DrR: Absolutely! As we age, our smiles get smaller because the Vermillion Border (that’s the inside of the lip) gets thinner. So the older you are, a lesser amount of your teeth show. A person in their mid 30′s shows about 3.5 – 5 mm of tooth at “rest” and when they smile, they show over 80% of their top teeth. As people age, they show about 1mm less per decade and so by the age of about 70, they virtually don’t have any teeth showing while at rest and only about 25% of teeth showing when smiling. So there’s a visual loss of about 15-20% of a person’s smile every decade. At our office, we create the “Smile Lift” by making the veneers or caps, a tiny bit wider to slightly push out the lips. This widens the smile and slightly lifts the lip which gives a more youthful look as it mimics more of the fullness of our lips from our younger years. It’s also good for people with narrow faces to give it the illusion of more width.

BN: What’s the best professional tooth whitening procedure? How about the home kits?
DrR
: Zoom laser whitening is the best professional whitening. It takes about an hour in the office with almost no discomfort. There’s also very little post treatment discomfort or sensitivity. People usually have it done about once a year. Home whitening can help a little bit and it’s really best for in-between professional sessions. Use either whitening strips or whitening toothpaste, whichever the person is more comfortable with.

BN: Can people over whiten their teeth? Is there a danger in over whitening?
Dr.R: As it exists today, bleaching is much less invasive than in the past. The process is a chemical to be painted on and then a light is used to activate the chemical. This can be done safely once a year. For a whitening boost, people can use whitening strips or whitening trays at home about every six months for a few days without hurting their teeth. Unfortunately, some people become “bleach junkies” and overdue it. If a person feels that safe whitening isn’t enough for them, then they should look into getting veneers.

BN: What about those that may have already caused damage? Is there a way to reverse it?
DrR
: When a person over whitens their teeth, they soak out the calcium and make the teeth fragile and weak. Fluoride can make the tooth stronger and there are some OTC mouthwashes and toothpaste, such as Prevident, that contain fluoride that people can use to help strengthen the teeth. Also, there are prescription mouthwash’s that your dentist can prescribe..

BN: You’re very passionate about teeth and smiles. What are your other interests?
DrR: I love spending time with my family – my wife and sixteen year old son. We love to play sports together, like golf and tennis and we like to create vacations that involve us playing or watching sports together. We love to attend sporting events like the World Series and Super Bowl and we also build family vacations around my teaching engagements.

Rosenthal-Apa Group, 30 E. 76th Street, NY,NY 212-794-9600, http://www.rosenthalgrp.com

Originally published July 2007
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