Although esthetics, in the past sense, is a subjective experience open to artistic interpretation, it is first important to establish a universal set of objective, systematic criteria allowing us to measure and guide our evaluation process.

The revised Guide to Accreditation Criteria seeks to provide information about those criteria. This revised Criteria Guide: Contemporary Concepts in Smile Design, to be released in mid-to late 2012, will be equipped with new diagrams, updated photos and a simplified re-organziation of the criteria.

The original Criteria Guide was published by the AACD in April 2001. The guide is a potpourri of universally accepted parameters of smile design recognized and vetted over the past several decades. In an effort to remain on the cutting edge of our understanding and mastery of smile design, it is the current charge of the American Board of Cosmetic Dentistry (ABCD) to edit and republish a revised update to what has become accepted as the gold standard in dental esthetics. The revised guide will be equipped with the new diagrams, updated photos and a simplified re-organization of the criteria.

The guide begins with the broadest strokes of smile design and the focus progressively narrows to critique the individual characteristics in our attempt to emulate nature. We first introduce the concepts of global esthetics, which focuses on those criteria observed in un-retacted smiles and how the smile orients to the face. As our study continues to narrow, attention is aimed toward the elements of macro esthetics. Macro esthetics identifies the shapes and contours of teeth and their relationship to each other. Our final frame of reference converges on micro esthetics, those criteria related to the sublte intricacies fo shade, textures, translucesies and surface effects to make teeth look like teeth. These criteria aid us in fooling the eye and allowing restorations to blend invisibly into the smile.

The revised guide will continure to serve as an educational tool and provide common language in the assesment of smile design. It will provide measurable criteria to aid in our analysis and reasons for failure or success of a smile. The fianl application of these accepted gold standards will be invaluable, not only for those pursuing Accreditation, but for clinicians and laboratory technicians in creating common ground for interpretation and implementation of excellene in dental esthetics.

Watch the AACD Print Shop for the revised Criteria Guide: Contemporary Concepts in Smile Design!

-The ABCD takes this opportunity to offer special thanks to Dr. Scott Finlay for the countless hours he spent working our new Criteria Guide. His articulate and organized revison will not only be meaningul to our Members in the Accreditation Process (MIPs), but to everyone interested in cosmetic dentistry, for years to come.

Thank you Scott, for this priceless, updated revision!

Allison Cole

If you can’t imagine going to the dentist and having an enjoyable experience then you should definitely visit Dr. Finlay’s office. His staff is not only professional but courteous and friendly too. They go out of their way each and every visit so that your experience is as enjoyable as can be. From the point of walking in the door and being greeted by friendly staff to the dental chair and the comforts of his state of the art equipment gives you the comfort and feeling they know what they are doing. You know when you sit in the chair you have no worries about the process and great result that Dr. Finlay and staff will perform. I would and have recommended Dr. Finlay and his staff too many people.  -

Steve Dannemann

I guess you could say that I have a “love-hate” relationship with Dr. Finlay and his staff! From my very first visit about 16 years ago, everyone in the office has treated me with the utmost respect and has been very sensitive to my needs and fears relating to my dental work. From Mary, Connie and Cindy at the front desk, to the hygienists to Dr. Finlay-they all take the time to listen to what I have to say and always make me feel like I am not just a patient but a friend as well. Believe it not, they make me WANT to go back! That is the highest praise they could ever get from me! As much as I dislike just walking into the dentist office, I realize that without their complete and thorough care, ongoing encouragement, wonderful chairside manor and humor, I would not have the smile that I have today! Thank you, thank you, thank you!

Susan Schmicker

I love the improved me. The entire experience with Dr. Finlay and his staff was exceptional. I can smile again!

Edith Barton

“She always has a smile and a friendly greeting for you,” would be consistent comment from those who know me. Through the care and precision of Dr. Finlay & Associates I will continue to smile confidently and won’t be able to contain my joy over my new smile.   Thanks,

Dawn Carter

Smile design, without careful consideration to functional and biological health of your smile can only be wrought with failure in the longer term. In the proper hands, training and experience, esthetic enhancements to your smile should not only improve the appearance of your teeth, but also improve their health and longevity.    It is our mission to identify these critical issues that are causing this deterioration and listen to what your concerns are to improve your smile.  It is only with this information that we can design a plan that is best for you to create the most predictable results for the long term and improve your dental health.

So how is this process completed, and how do you know what it is going to look like in your mouth when it is completed?  How long will it take and how much will it cost?  How do I pay for it?  Is it the right thing to do?  These are often questions that patients have that create hurdles in achieving the smile that they desire.

The process all begins with a complete exam.  We start with an interview to listen to your concerns and understand what your goals are in achieving a great smile.  After a review of your medical history, we begin to collect data through the use of a clinical exam, dental radiographs, digital photography, diagnostic mounted models and computer assisted technologies to help quantify occlusal forces on your teeth that often result in wear and fractured teeth and restorations.  From a study of this information, the restorative dentist can create a Dental Blueprint that begins to marry the functional health design requirements with the desired esthetic result.  This Blueprint can then be evaluated by the dentist and the patient through two modalities: imaging of dental photographs and a diagnostic wax up of the patient’s actual smile.  This diagnostic wax up is essentially a simulation in 3 dimensions of your smile that allow us to test our design.  From this 3 dimensional study we can then create a series of templates that allows us to be efficient and conservative when we begin that actual preparation of teeth.  All the steps in treatment up to this point are completed without implementing any actual changes to the teeth.

Once the dental blueprint is created, and all the aspects of treatment are understood and anticipated, the definitive treatment can be completed.  We want your visit to be as comfortable as possible.  We understand the anxiety that is normal with every procedure whether it is a single tooth or an entire smile.  We will discuss those protocols and options that are available to you to insure that your time spent in the dental chair is a pleasant one.

The baby boomers are coming of age.  They represent a significant demographic with very special dental needs.  They enter our offices asking to improve their oral health and their smiles.  Many have done their online research and are requesting veneers, whitening and Invisalign.  Our challenge becomes the restoration and repair of these smiles with plastic and glass, predictably and durably. The economy has influenced the mindset of the consumer and has resulted in more educated shoppers who put great value on having it done right the first time.  Will they choose you for the investment that they are about to make?

The focus of this program is to create a perspective and illustrate, through lecture and clinical video, a protocol that is essential is creating predictable esthetic results with modern ceramics.  As dentists, we are flooded with the commercial hype from manufacturers about the latest and greatest materials and products.  We are pressured by the allure and demand of dental esthetics in our communities and by the media.  Who are we to believe?  How do we make the best decisions in materials and techniques that will help insure excellent results for our patients?  What are the key ingredients to our success?

Learning Objectives:

•Understand the critical relationship between function and esthetics
•Learn the four key steps to creating predictable anterior restorations
•Designing exquisite provisional prototypes and understanding their importance in creating predictable ceramic restorations
•Understanding the key elements in lab communication
•Comparing the myriad of dental ceramics available today and understanding the properties inherent to each that will help us choose the best materials to insure our success
•Understanding proper preparation designs and when to use a veneer and when not to
•Learning how to assess the restorations that are received from the lab and when to cement and when not to
•An overview of dental adhesion and the decisions in choosing the best cement and adhesive system to retain your restorations
•Understanding the critical steps in delivering beautiful esthetic restorations
For more information, visit http://www.udel.edu/dental/speakers/finlay.html

Kavita,
 
You certainly speak for us all about how generous Scott was with his time, knowledge and energy. It is always so refreshing to see both humility and excellence in an individual and he certainly is a fine example of that combination. We are lucky to have had him speak at a DSCCD meeting and I hope that we have another occasion to host him.
 
It is very gratifying for both Raj and myself to see DSCCD grow into a place where quality minded professionals get together and learn- not just about dentistry but about life in general as well. That was the vision and mission. You add grace and class to the study club and hopefully will be a big part of our future growth and development.
 
And yes, we could’nt do it without Lydia. She’s the best.
 
Thank you for your feedback,
 
Have an awesome weekend!
Sunita

Dr. Sunita Merriman was recently voted as one of NJ’s Top Dentists in 2010!

Composite fillings are made up of a resin that contains tiny pieces of quartz. This can be sized and shaped to imitate the surface of a tooth. The result is very natural looking and many people are electing to replace old metal fillings with composites.

The first step to a composite filling is removing the current filling and any other decay or weakness that may be present. The composite is then molded into shape, adjusted for bite and sealed into place with a bonding material. The procedure takes longer than a standard filling but generally has longer lasting results, as a composite can restore a tooth to near its original integrity.

Composite fillings are very durable and will last for years. They provide comfort while eating and will blend with the other teeth to make a nice, bright smile. Many patients feel more confident after receiving composite fillings and have far fewer problems in the long term than with old style metal fillings, which have a tendency to leak or fall out especially if the tooth is further damaged or just weakens with age.

Any cosmetic dentist can install a composite filling, however, it is in the patient’s best interest to research and choose a dentist that is very experienced and only uses the very best materials. Everyone deserves a healthy, beautiful white smile and composite fillings are a good step toward this goal.

 In the simplest sense, the hope would be that every dentist would be a cosmetic dentist.  After all, the ultimate goal in dentistry is to make teeth look and function like teeth.  The reality is however, that some dentists have had more training than others focusing on those criteria related to the health, function and appearance of the smile.  As with all professions, the journey to become proficient in one’s field requires a lifetime of learning.  In dentistry this learning continues from the day the dentist begins his or her practice until the day they retire.  Materials, procedures and knowledge evolve everyday, and it is the responsibility of the dentist as an advocate for the dental health of their patient’s to separate the hype from reality and seek those advances that will improve the predictability, durability and the absolute best esthetics possible. 

 The United States is undisputedly the leader in dental esthetics.  Dentists have the opportunity from all over the world to seek post-graduate education related to esthetics at centers that offer lecture and hands-on programs from coast to coast.  Those blue chip, founding continuing education centers that focus on a comprehensive vision of esthetics/function without the influence of hype and marketing include the Dawson Academy, the Kois Center, the Pankey Institute and the Spears Education Center.  Each center may present slightly differing concepts related to philosophy and techniques, but they represent the respected mainstream of literature-based knowledge for the practice of quality care today.  There are many other centers that offer advanced dental education as well related to dental esthetics.

 Currently, dental esthetics is not a specialty.  Any dentist in practicing in the US can perform these types of procedures.  However, there are credentials that are awarded on a peer review basis that designate those that meet a level of excellence that is recognized as the gold standard in dental esthetics.  These credentials or accreditation are measured by the American Board of Cosmetic Dentistry (ABCD) through the American Academy of Cosmetic Dentistry (AACD), which is the largest academy related to dental esthetics in the world.  These credentials, Accreditation and Fellowship, are simply a measurement of the dentist’s ability to create an excellent result through their clinical skill and knowledge.  The actual accumulation and training of this subset of skills may have been learned from a variety of sources.  Because of this anonymous and open examination process, the credential is not available for purchase or award simply because someone has attended a program.  It must be earned.  The achievement typically takes years to accomplish and requires written examinations, clinical documentation of actual cases and oral exams.  In the level of Fellowship, it represents a lifetime body of work demonstrating the skills related to esthetic care.  Currently there are less than 350 dentists and laboratory technicians that are Accredited by the AACD, and only 53 that have been awarded it’s highest honor: Fellowship.  Any dentist that is licensed certainly has the potential to provide an excellent result, with or without the credentials.  Credentialing only provides an irrefutable measurement by other dentists and lab technicians that are recognized experts in the field of cosmetic dentistry, who endorse those that avail themselves to this evaluation to confirm that candidates are who they say they are: qualified to provide excellence in cosmetic dental care.

 In providing restorative esthetic dental care, one of the team members that the dentist will rely on heavily is the laboratory technician when creating restorations like veneers or crowns.  This same credentialing process is available for the lab technicians.  Information related to locating a credentialed dentist or lab technician can be found at http://www.aacd.com/index.php?module=aacd&cmd=memberreferral.  The synergy of the team of the restorative dentist and the ceramist/lab technician is the key element in creating a predictable and beautiful result. 

 Our goal is obviously to have the smile you desire the first time it is done.  Improper care can result in:

• Bulky unnatural appearing restorations.  In a social setting, the desire is to have others observe your smile as natural and beautiful, and not be able to perceive that any dentistry was completed.  Bulky restorations can also result in tissue (gums) that bleed and are infected.
• Restorations that break or fall off.
• Restorations that are in the wrong position or are too big that affect speech or give the appearance of “bucked teeth”.
• Restorations that are monochromatic (one shade) that don’t reflect what we would normally see in nature.

Proper care can involve a significant investment.  Veneers or crowns delivered by a qualified provider can range from $1500 – 2500/ tooth depending upon the economic conditions of an area and the experience of the restorative dentist.  Finding the right dentist is the beginning of a long-term relationship to help insure the health of your smile.  Cost and insurance coverage can often be a limiting concern, but always keep in mind that having something done twice, because it didn’t meet expectations the first time is always far more expensive, often yielding a compromised result.  Some practices tout themselves as a destination practice for cosmetic dental care.  These are practices that offer cosmetic treatment without providing maintenance and recurring care with periodic check ups and visits with the “in house hygienist” after treatment is completed.  They provide the restorative care and you return to your “regular dentist” for “cleaning visits”.  This is a concern.  Ideally, you want the dentist that completed your care and has been intimately involved in what was done, to monitor and help maintain the result.  It is beneficial to find a professional, if possible, within a reasonable distance that you will be willing to travel to on an ongoing basis for maintenance and evaluation.

 So how does the public find a dentist that has the training, experience and tenure to predictably deliver the results they are seeking? Here are some recommendations in gathering information to help make this important selection:

•Contact friends and family and ask who their dentist is and what their experiences are. ?

•If you are looking for a cosmetic dentist, contact other dental specialists (such as an oral surgeon, orthodontist or periodontist) and ask for a referral.  Ask for the best in your area, who they would seek care from if they had an immediate concern. ?

•Call perspective offices and ask questions about the types of dentistry that the practice provides.  Is the staff member friendly and inviting?  Are they willing to take the time to answer your questions? ?

•Set up a visit to the practice for a visit.  Is the facility up to date, clean and reflect the professionalism that you expect.  Does the team enthusiastically support the doctor? ?

•Ask to look at photographs of examples of the treatment that the doctor has completed. ?

•Has the doctor made a career commitment to continuing education?  Is he passionate about the care he provides? ?

•Has the doctor earned additional credentials related to his field of practice?  Have other professionals recognized him as a leader in his field? Some potential resources on the Internet are www.AACD.com and www.MyNewSmile.com.

 In the end, you want to put yourself in the hands of a team of providers that has the training, credentials, experience and tenure to meet your needs.  The patient does not want to be overly focused on veneers, crowns or implants.  These are only products on the shelf that a qualified restorative cosmetic dentist has at his or her disposal.  Allow the dentist to design a plan that is best for you. It often will involve a variety of techniques and procedures. This will allow for the most conservative, predictable and durable result possible.

“This was my first time having Candy as my hygienist (ever or in a long time? – that I can remember) and I really enjoyed her. She was efficient, thorough and gentle. And not overly chatty! Thank you.
    March Bishop

“Your Dentist office is exceptional. I am always impressed by the professionalism, cleanliness, and aesthetically pleasing environment. It is quite evident that your staff anticipates the needs of your patients. I particularly like the fact that you are prevention focused. On more than one occasion I have had my blood pressure checked in your office. This is health care at its best…integrating health promotion into your specialty practice. I am also impressed by the up to date, current knowledge of your staff. Again, thank you for keeping your office in such wonderful condition and for your expertise.”
    Kim Stauffer

“Candy is the best. She does an outstanding job. Mary and Connie are also extremely helpful and go out of their way to resolve any issues.”
    Scott Priebe

“I’ve found everyone on your staff to be friendly, courteous, and very professional. I’ve been a patient for close to two years now, and I wouldn’t think of going anywhere else! I really like everyone there, and its always a good experience.”
    Tony Hawkins

“As always, great to be greeted by name by all the people at your office. I feel my family and I are not just patients but friends also.”
    Cecilia Flores

“Each person I met during my visit was professional and friendly. I appreciated the atmosphere of the office.”
     Janet Loveless

“Team Finlay constantly exceeds expectations in every way, from the greeting from Mary and Connie to their goodbyes. And Dr. Finlay had me at “hello”.”
     Martha Coster

“Candy is amazing. I have always appreciated her friendship, her kindness and professionalism over the years. Dr. Dan is wonderful too! Did I mention the office staff…I love you too!”
     Sandi Reiger Stultz

“Being in the military I have had my teeth worked on all over the world. I can honestly say your office is the cleanest and friendliest office I have ever used. Dr. McLellan explained everything so thoroughly, and at a level I could understand that is the most comfortable I have ever felt in the dentist chair. Thank you again for a great visit, my family and I will be using this office only for our dental needs.”
     Richard Romanowski

“Excellent, most friendly, and very pleasant. Thank you so much!”
     Rev. Stephen Gosnell

“Candy continues to do a terrific job and really cares. She’s a great asset!”
     Skid Heyworth

“Pleasant visit as always. Very professional and efficient. Thanks.”
     Leo Wilson