Special Section

A Bright and Tech-Filled Future

Baltimore-area experts are open wide to advances in cosmetic dentistry.
By Sally Holtgrieve — September 2023

osmetic dentistry is evolving, and various procedures are becoming more popular as the field continues to advance. Baltimore dentists know the drill, so to speak, and are happy to fill residents in on utilizing the latest methods and technology.

Dr. Yehuda Lehrfield of The Smile Design Center in Lutherville says he “just can’t believe how fast things are moving.”

Dentists have had a reputation for being among the last to embrace technology, Lehrfield notes. However, newer graduates in the field, such as himself, grew up with computers and rapidly-changing technology, so they’ve been quick to implement new tools.

Digital scanning paired with artificial intelligence (AI) is a tactic Lehrfield uses and appreciates.

“I can scan a patient’s mouth and then merge it with a picture of their face to design a template of what their teeth could look like,” he explains. “Within a few minutes of using a software on a tablet or even an iPhone, I can show a patient a mock-up of how their mouth and smile would appear after whatever procedure we plan on doing, whether it’s veneers to lengthen their teeth a little bit or whitening them.”

There are new advances in the realm of composite veneers that Lehrfield hasn’t incorporated into his own practice yet but is keeping his eye on. Veneers turn every dentist into an artist, he says. The typical procedure involves cutting, painting, and carving the teeth, and some patients don’t want to sit for that long.

The new method uses digital scans to create a clear plastic aligner that goes over the teeth, and then the dentist can inject the composite directly into the mold, cure it, and the veneers are complete.

“These are things I never would have thought possible a few years ago and now here they are,” Lehrfield says. “On one hand, I’m surprised when something new comes out; on the other hand I’m like, ‘What took so long?’”

Regarding other advances, traditionally there has always been a trade-off in terms of beauty versus strength. The aesthetically appealing materials in dentistry are not as solid, and the sturdiest ones aren’t as attractive. But this is changing, too, according to Lehrfield.

“I think we’re moving toward a point where we will be able to get beautiful materials that will be bonded onto teeth and strong all at the same time,” he says. “I’d love to see it happen sooner, but that’s where we’re moving.”

Twenty years ago, few practices offered veneers. Now that they can be done with minimally invasive techniques, more dentists offer the procedure, and many more people are aware of the process and are getting it done, Lehrfield says. Additionally, thanks to clear-aligner technology, many more adults are straightening their teeth these days.

“People don’t want to walk around with braces when they’re in their 30s and 40s, but with aligners such as Invisalign, ClearCorrect, and others, you can have your teeth straightened in a year to 18 months without the look of braces,” he says.

Dr. Ed Lazer of Cosmetic & Advanced Dentistry, a boutique practice in Owings Mills, has been in the field for about 30 years. Two or three years into practicing general dentistry, he started looking into cosmetics and taking courses, found it the most interesting, and has specialized in the area ever since.

Lazer never tires of seeing patients’ reactions to what he calls the “smile reveal.” A patient getting veneers will first receive a temporary set to “test drive” for a week. After the temporaries are put in, they sit up and Lazer hands them a mirror.

“They’re just shocked at how nice it looks,” he says. “We get patients who are crying, give us big hugs, and are just so thankful.”

It’s careful work, studying someone’s face to create the perfect set, Lazer explains. The temporaries are a preview of the final teeth, which are even more exact.

“We had a woman come back in yesterday practically prancing, and she didn’t even have her finals yet,” Lazer shares, adding that it’s rewarding to watch someone’s self-confidence improve thanks to the veneers.

Regarding advances in the industry, Lazer is impressed with how lifelike the raw materials for the veneers look now. His goal is to make teeth look realistic, and he takes lots of pictures and designs the smile to match an individual’s facial structure. He ensures the teeth don’t look flat or opaque, rather they reflect the light in a natural way.

“And the materials make a difference because they can last, they don’t break,” he continues. “I have cases that are 20 years old now and still holding up well. With the right materials, when you get veneers friends will say, ‘What did you do? Did you do something to your hair?’ because they’re not noticing your smile has changed. It looks great but not unnatural.”

The materials have improved greatly in the last five years or so, but having a dentist with proper training is still vital, Lazer notes.

With the increased popularity of veneers came the trend of going overseas to get work done at a cheaper price, and both Lazer and Lehrfield say they’ve had patients come to them with problem sets. It might be tempting to travel for a cheaper procedure, because it is indeed expensive here, but the risk is not worth it, both dentists caution.

Cosmetic dentistry is more than just having pretty teeth, says Dr. Dana Truesdale from Innovation Dental Center in the Harbor East neighborhood of Baltimore City.

“So many people are going out of the country to get cheap dental work, and that’s exactly what it is,” she echoes. “But you want to make sure you have full function and are disease-free. You want to make sure the bite is correct.”

Truesdale has run her practice for about a decade and emphasizes the oral connection to the rest of the body. She asks her patients about their overall health and factors it into their dental care. The reverse is true, too. Perhaps a patient takes great care of their teeth but keeps getting cavities—this could point to a thyroid problem, and Truesdale will suggest they visit an endocrinologist.

“I take the whole person into consideration,” she says. “The cosmetic portion is the cherry on top.”

A noteworthy advance in cosmetic dentistry is metal-free crown implants allowing for single-tooth restorations, Truesdale says. Additionally, there are patients who have issues with loose-fitting dentures who can now get implant-retained dentures, which are permanently “snapped into place so you can go about your day,” Truesdale says.

She has also seen the rise of clear aligners for discreet straightening, though clarified that traditional braces still work best for some patients, like those who have periodontal problems that make them a poor candidate for clear-aligners. Some patients do better with brackets because they don’t need to worry about remembering to wear their aligner.

The fact that many people are still afraid to replace their teeth is surprising to Truesdale. They’re nervous about the idea of a screw in their mouth, despite the fact it will make their life easier overall. She says despite all the advances that make procedures more comfortable and with a quicker recovery time, the stereotypes about the dentist being “scary” persist.

But social media has bolstered the rise of veneers, whitening, and straightening, all three dentists say, and it will spread the word of continued advances, as well.

Lazer is proud of his lively Instagram page, which is how he gets many of his new patients. He likes showing off what can be done, and what real people look like, especially when they’re smiling so wide.

“Seeing somebody so happy about how great their teeth look, that’s what makes the day for us here,” he says.

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