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.1 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 comprehensive understanding of materials, preparation designs, and adhesive techniques should facilitate conservation of tooth structure while still meeting the parameters of function and health.

The apparent contact zone between the centrals is ideally 50% of the visual length of the centrals. Connectors between the centrals and laterals are 40% of this length, and the connectors between the laterals and cupids are 30% of this length (50/40/30 rule). The management of the facial line angles can have a significant impact on the visual reveal of the tooth. examiners noted the asymmetry of gingival zeniths, papilla heights, and inflammation of the tissue.

• 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 vie).2 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.3 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.

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!

Fortunately, these problems can be fixed and a beautiful smile can be just around the corner. Braces are no longer just for pre-teens and teenagers. More people are taking care of their teeth and beautifying their smile later in life with various methods of cosmetic dentistry. It is not unusual to see adults in their fifties and later, with braces.

Today the finest orthodontic alternative to metal braces is Invisalign. The method is simple, gradual and comfortable. Invisalign custom makes clear plastic aligner trays to fit the client which pop on over the teeth. Every two weeks, the client pops on a new set. Office visits are required only every four to six weeks saving more time. The beautiful smile starts immediately because the aligners are invisible. Most people will not know the client is in orthodontic treatment. Although the end result, that beautiful and confident smile, is the same and the cost is about the same as metal braces, the advantages are hard to ignore. Because the Invisalign trays can be removed, the client may eat any type of food desired and then brush and floss normally. For Invisalign Teen, six replacement aligners are provided free if lost or broken.

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

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.

Question 1: Just because I see it (diagnosis it) doesn’t mean my patients will want to treat it (even acute, painful, or blatant problems they are aware of gets put on the back burner).
Question 2: How much of the first course can I use immediately to make me a better clinician?
Question 3: If I am not able to take all of the courses will I still be better than if I took none of the courses?

Scott Finlay, DDS, FAGD, FAACD
The philosophies that are the core of The Dawson Academy are not about practicing a different kind of dentistry, but practicing better, more predictable, complete care for your patients. The understanding, skills and protocols that you will master as a student in the core curriculum will improve your efficiency, productivity and profitability as a dentist.

You are correct that every patient that has treatment needs, may not elect to pursue treatment: some due to financial reasons, some due to personal reasons, some due to value reasons.  In your practice you will initially experience a large percentage of patients that will be seeking general care, but there will be some that elect comprehensive care.  You need to be patient.  Over time you will find increasingly, more and more of your patients will begin to transition to comprehensive solutions.  It is their role to make those decisions and not ours.  It is our role however, to educate them and to be their advocate for the best care possible.  I think you will be surprised by your patient’s interest in seeking quality care.  That doesn’t mean a full mouth reconstruction with ceramics every time.  Whether treatment is provided with plastic or glass; with implants or removable dentures, the principles are the same in providing predictable care.

Predictable care at any level will improve your profitability and efficiency by reducing time wasted with remakes or fractured restorations that are never practice builders or make patients happy.  Your experiences with the Dawson Academy will help you make recommendations to your patients that are in their best interest.

You will find the information you learn from the very first program to be infectious and very useful to return to your practice.  The entire Senior Faculty of The Dawson Academy are wet fingered dentists that each have full time practices.  That is unique to our organization.  The knowledge is practical and allows you to return to the chair on Monday with a fresh vision.  I can tell you this from personal experience, because this changed my professional life and laid the ground for my success in dentistry.

The pace you pursue your education is up to you.  If you want to be efficient, I would recommend staying with a single teaching academy and focus on a continuum that is consistent.  Hopping around from day program to day program from varying academies, gives you very little opportunity to get down to the real nuts and bolts and actually make a difference in your practice.  The Dawson Academy offers this opportunity in our core curriculum that builds upon each successive program.

Doing nothing would be the only mistake.  You will become what you learn.  By failing to make the initiative to learn, you are losing a tremendous opportunity.

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

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