The Dawson Academy, provider of dental seminars, is proud to participate in the 2012 American Academy of Cosmetic Dentistry’s Annual Scientific Session in Washington, D.C this May.

Joan Forrest, President and CEO of The Dawson Academy, shares, “The AACD meeting is our favorite meeting to attend because all the attendees are focused on becoming better dentists.”

Drs. Peter Dawson, John Cranham, and Scott Finlay, three Dawson Academy Faculty members will be presenting on the “Timeless Principles in Cosmetic Dentistry”.

Each of the three presenters has received many accolades to their name. Dawson is recognized internationally as one of the contemporary iconic leaders in modern dentistry. Cranham, clinical director of The Dawson Academy, is an internationally recognized speaker on the esthetic principles of Dentistry. Finlay is not only a senior faculty member at The Dawson Academy, but is also a fellow of the AACD and an examiner and board member of the American Board of Cosmetic Dentistry.

“This will be the third time Dr. Dawson has presented at the AACD. He rarely presents at outside meetings and this level of participation reflects on how positively he views the work of The Academy and its members,” explains Forrest.

The three presenters will teach attendees the essential relationship between function and esthetics.

“The true foundations of quality, predictable and beautiful dentistry lies within the understanding of this sophisticated system. It is the application of the functional matrix that modulates smile design. Great smiles can only be a mirror for great design,” said Finlay.

The American Academy of Cosmetic Dentistry’s (AACD) Annual Conference is undisputedly one of the premier dental conferences in the country. It presents a blend of the top national and international experts in dentistry with a culture of elegant camaraderie.

Finlay shares, “This year, in Washington DC, there are already over 1600 registrants and the staff at AACD has one of the best program line ups ever. You will not want to miss this remarkable meeting.”

To attend their lecture, make sure to register with the American Academy of Cosmetic Dentistry at http://www.AACD.com.

About The Dawson Academy
The Dawson Academy is an international provider of science-based dental continuing education, teaching dentists to comprehensively diagnose and treat dental problems with excellence and integrity. The Academy has taught dental courses to the dental industry for over 30 years and is dedicated to teaching the principles and skills necessary for the successful practice of complete, quality, and predictable dentistry. The Dawson Academy’s goal is to make good dentists even better.

The edentulous space must be documented pre-operatively with a radiograph. The examiner’s focus is limited by definition to the replacement tooth and any areas that that candidate has treated. It is not necessarily a case type in which comprehensive smile design criteria are heavily weighed, unless the treatment rendered encompasses a broader field in the smile zone.  The candidate must keep in mind that if a limited scope of treatment is elected, the balance of the smile zone should not be visually distracting to a reasonable extent that may otherwise indicate the need for additional management. A common modifier in this case type is underestimating the time required in establishing ideal tissue architecture.

The candidate’s case selection and abilities to treatment plan are particularly magnified in this case type. It is in the candidate’s best interest to find a patient with reasonable periodontal architecture that presents the optimal environment to create excellence. Our goal is to achieve a result that challenges the observer’s eye in discerning that a natural tooth does not otherwise occupy the edentulous space.  Working with a mentor, who has been calibrated as an examiner, is strongly recommended with every Accreditation case.

Successful management and treatment planning demands a mastery of not only prosthetic concepts, but also the parameters of health imposed by the periodontal architecture. Although some restorative dentists may provide advanced surgical procedures to their patients, in many cases effective treatment involves an interdisciplinary team.  This team would typically consist of the restorative dentist and the surgeon who may be involved in site development or the placement of the implant. Regardless of who performs the surgery if it is indicated, the key responsibility remains the orchestration of the treatment planning by the restorative dentist with a protocol that will hopefully provide predictable, durable and esthetic results.

A predictable protocol begins with a complete understanding of the options to restore the health and function for the patient. This protocol starts with a visualization of the desired solution that is then studied and modulated in 3 dimensions through the use of diagnostic models and a wax up of the intended result.  From this dental blue print, stents can be fabricated and utilized in both the surgical and restorative phases to effectively reproduce the designed anticipated results.  The restorative dentist will find great value in methodically and patiently manipulating the prototype restorations to help establish the best possible periodontal architecture.

Dr. Chan should be commended in his fine demonstration of each of these elements of case management and the final result. His conservative approach in limiting his treatment to the edentulous areas #6/11 was well within the parameters of this case type. His model analysis and diagnostic wax up allowed him to make key decisions in managing the spaces and develop the appropriate stents to be used during treatment.  His understanding of the biology of the system facilitated his planning in the ideal placement of the implant in 3 dimensions.  His attention to detail in managing the prototype insured the predictability of the tissue architecture and what appears to be a healthy and sustaining result.  His keen eye identified those elements of macro and micro esthetics that allows the restorations to invisibly disappear into the surrounding dentition.

The examiners as a group identified very limited criteria that were at fault. Most examiners awarded the case a plus one because of the excellence that it demonstrated.  The case passed unanimously.  Those criteria that accounted for minor deductions included:

Criteria 53- The opacity is slightly high in the cervical 1/3 of the cuspids
Criteria 87- Minor dissymmetry’s are noticed in the contra lateral teeth #6 & 11

The Accreditation Process represents the ultimate challenge in your growth in the mastery of dental esthetics.  Achievement of this gold standard of excellence will provide immeasurable rewards for you and your patients.

Accreditation Examination Criteria, American Academy of Cosmetic Dentistry, Madison, Wisconsin, March 2009.

Garg AK, Finley J, Dorado LS., Single-tooth implant-supported restorations in the anterior maxilla.   Pract Periodontics Aesthet Dent. 1997 Oct;9(8):903-10.

Hu XL, Li H, Luo J, Qiu LX, Lin y;  Multidisciplinary management of congenitally missing teeth with osseointegrated dental implants: a long-term report. Chin J Dent Res. 2011;14(1):29-36.

Simeone P, De Paoli C, De Paoli S, Leofreddi G, Sgrò S.; Interdisciplinary treatment planning for single-tooth restorations in the esthetic zone.  J Esthet Restor Dent., 2007;19(2):79-88.
Dawson PE. Functional Occlusion: From TMJ to Smile Design.  2007, St. Louis, Mosby, Chapter 31, pp366-377.

Jansen CE., Guided soft tissue healing in implant dentistry. J Calif Dent Assoc., 1995 Mar;23(3):57-8, 60, 62 passim.
Lewis S, Parel S, Faulkner R., Provisional implant-supported fixed restorations.,  Int J Oral Maxillofac Implants. 1995 May-Jun;10(3):319-25.

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!

The examiners evaluate cases based on a point system that identifies minor, major, and catastrophic faults. A passing score is -7 or better. The examiners are also given the latitude to reward the candidate with a +1 point, in situations where the result deserves additional merit. Dr. Shimizu’s case passed unanimously with scores that ranged from -5 to -7. Almost all of the criteria faults were identified as minor and two examiners rewarded Dr. Shimizu with a +1. No case is perfect; the goals of Accreditation are to create a vision and demonstration of excellence, not perfection. Dr. Shimizu achieved a wonderful result for his patient. The preoperative indications for treatment supported the final treatment plan. Dr. Shimizu extended treatment to include eight teeth because of the clinical indications. The indications for treatment are driven by the functional and health needs of the patient. Dr. Shimizu followed an established treatment protocol that helped to ensure a predictable result. The examiners identified several common deficiencies in this case; often, these criteria are inter-related:

• One of the initial observations was the excessive length of connectors and the effect this had on the periodontal health and architectural harmony (Criteria #64, #71, and #72). An accepted guideline that is observed in nature relates to the proportion and size of the apparent contact zone or connectors between adjacent teeth. Typically, the ideal connector zone between the central incisors is 50% of the length of the centrals.The size of these connectors decreases in a symmetrical fashion as you move posterior. The effect of excessive connector length in this case appears to contribute to the impingement upon the cervical embrasures and the blunting of the papilla. The Illustration by Dave Mazierski The comprehensive understanding of materials, preparation designs, and adhesive techniques should facilitate conservation of tooth structure while still meeting the parameters of function and health.

• Criteria #87 focuses on the visual harmony of contralateral teeth. The examiners identified a lack of symmetry of the visual width of the lateral incisors. This requires the careful management of the facial line angles and can be readily identified from the occlusal view. Although the occlusal view is not how teeth are typically viewed in a social setting, it is a valuable perspective in helping to appreciate the impact that these line angles have on the reflective surfaces of the teeth. In this case, the occlusal view is helpful in visualizing why the facial plane of #10 appears narrower compared to #7. The cuspids also lack similar balance in contour and shape.

• Criteria #56 identifies the effectiveness in utilizing translucency to mimic nature and to harmonize with the balance of the smile. Several of the examiners found the intensity, volume, and pattern of the translucency to be slightly excessive and not reflective of what would otherwise be observed in nature. Accreditation presents a consistent measurement of excellence in providing esthetic functional restorations of our patients’ smiles.

Dr. Shimizu has demonstrated his ability to meet this standard. He should be very proud of the result he achieved for his patient.

Dental Implants Can Replace One or All Missing Teeth
Dental implants can be used to replace one tooth, missing as a result of trauma or congenital defect. For patients missing several teeth, dental implants may also be prescribed either alone or in combination with a dental bridge. Some patients who are missing or at risk of losing all of their upper or lower teeth may also be candidates for dental implants. Using the Teeth In A Day procedure, a patient can have all of their teeth replaced using dental implants and a fixed denture to restore natural function and esthetics.

Failing to Plan is Planning to Fail
Ninety percent of all failures are a result of improper, inadequate or absence of planning. Treatment planning is especially critical in the dental implant process. Most dental implants procedures are a coordinated effort between a restorative dentist or cosmetic dentist and an oral surgeon or periodontist. It is important to select restorative dentist or cosmetic dentist who has specific experience working with dental implants. During this process, the restorative dentist will act like a quarterback, mapping out a plan for the whole team to follow to ensure predictable and successful results.

Technology is Great…If You Know How to Use It
While the latest and greatest technology can be very helpful to dentist when performing a dental implant procedure, if you don’t know how to use the technology correctly or interpret the data it transmits, then the technology is useless. Technology can not replace education, practical training and hands on experience. Used inappropriately, technology will only get you into trouble faster.

Dr. Finlay: The Right Training, The Right Experience and The Right Tools
Dr. Finlay & Associates have over 25 years experience treating patients successfully with dental implants. Dr. Finlay can replace one tooth using dental implants or an entire set of upper or lower teeth using the Teeth In A Day process. Comprehensive treatment planning is at the heart of Dr. Finlay’s practice. He carefully evaluates each patient, considering all factors – esthetic, functional and financial to determine the most conservative and appropriate treatment modality.
Never satisfied with the status quo, Dr. Finlay is dedicated to post graduate training and excelling in the field of modern dentistry. He is a Senior Faculty member of The Dawson Academy where he teaches and collaborates with the nation’s top dentists. Dr. Finlay is also an Accredited Fellow of the American Academy of Cosmetic Dentistry, an esteemed title held by fewer than fifty dentists in the entire United States. He is the only Accredited Fellow in the Annapolis area.
To remain on the cutting edge of dental implant technology, Dr. Finlay works with the finest dental laboratories in the country and the leading oral surgeons in the Baltimore Annapolis region. This team approach ensure the best results for each patient. Dr. Finlay employs state-of-the-art technology including iCat radiographs for 3-D imaging and CAD/CAM, computer aided design and manufacturing for creating precise restorations. His training, experience and collaboration with other top professionals within the dental industry ensure he has the skills to put these technologies to their best and fullest use.

If you have missing teeth, contact the office of Scott Finlay, DDS & Associates, PA to schedule a consultation and learn more about what treatments, including dental implants, are right for you.

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.

“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

“Candy is wonderful! Enough said! She caters to use cowards! It’s always a pleasure to see Wendy! She’s a favorite of mine. The girls at the desk are so friendly and so nice to talk with.”
     Carolyn DeVere

“You guys are great!”
     Anonymous

“Everyone was great-you are all the BEST!”
     Terry George

“All members of the staff are super. Your office is lovely and relaxing and I wouldn’t change a thing, not even moving it to the lower level, need the exercise!”
     Vesta Phiel

“Christine always gives me little hints about caring for my teeth. She is helpful- she doesn’t lecture. I appreciate having her as my hygienist.”
     Corinne Baker

“Just keep doing what you’re doing!”
     Bob Nasteff 
“As always, everyone was wonderful.”
     Kathleen Sharkey

“Everyone takes such good care of me. Thank you.”
     Dave Sacks

“I appreciate the cordial atmosphere that has been established at the office. I guess if you have to go through pain, this is the best place to do it, lol.”
     Tom Smith

“I always enjoy coming to Dr. Finlay. The dental hygienists are always honest and direct.”
     Nina Lattimore

“Unlike some, I LIKE to go to the dentist! It is always pleasant to see all of you and gee, I get my teeth cleaned at the same time!”
     Brett Polley

“Mary and Connie are extremely helpful with setting my family’s appointments. Candy explains my dental needs thoroughly and professional I am very pleased.”

Scott Finlay DDS & Associates, is a general dental practice in the Annapolis area that handles the comprehensive dental needs of patients from age 2 to 102.  We pride ourselves in customizing your dental experience with your complete health and comfort in mind.  For more information visit www.AnnapolisSmiles.com.