Cosmetic Dentistry School?

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brittnylee

brittnylee
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Hi, I have just applied to dental school this summer, and I was hoping someone could educate me a bit about cosmetic dentistry and the best schools to attend for the most up-to-date training in this area of dentistry. I am aware this is a pretty new branch of dentistry, so is there really a good school for this or does focus in this area consist mostly of post DMD/DDS classes? Any info is welcome! Thanks so much! 🙂

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brittnylee said:
Hi, I have just applied to dental school this summer, and I was hoping someone could educate me a bit about cosmetic dentistry and the best schools to attend for the most up-to-date training in this area of dentistry. I am aware this is a pretty new branch of dentistry, so is there really a good school for this or does focus in this area consist mostly of post DMD/DDS classes? Any info is welcome! Thanks so much! 🙂

I don't think that any school stands out for learning cosmetics as a dental student. To learn it well, you're going to have to do one of the following: 1) do a prosth residency, 2) do a 1 year esthetics fellowship, or 3) take a hell of a lot of continuing ed after you graduate.
 
It has been stated many time previously, ALL dentistry is cosmetic. You will learn the basics in school and you can move forward how you want, but you will learn the aesthetics anywhere you go.
 
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Cosmetic dentistry isn't a "new branch" of dentistry at all. There isn't anything new that dentists haven't been doing in the past. More and more patient's are concerned with their smiles these days, but other than that it's the same old stuff.
 
What Gavin just posted above is 100% true. Dentistry has essentially always had a cosmetic role, from the age of the ancient egyptians and dentures for their leaders, all the way upto todays rage of a full rack of over the top "extreme makeover" porcelain veneers. The recent explosion of cosmetic dentistry can be attributed to a few things:

#1 Better, easier to use materials for us as dentists(i.e. we can make people smiles look better - sometimes inspite of our techniques 😱 😀 )

#2 The baby boomers being healthier and wealthier - i.e. more teeth, bigger desires to look younger longer, and more disposable income to do it

#3 Over the counter bleaching - hands down this may be one of the biggest booms to the economics of dentistry ever. More people after bleaching at home and then wantimg to improve the rest of their smile after they whiten them up

#4 The media. Shows like Extreme Makeover and just litter teasers on the news and in papers and magazines peaks people interests and makes them ask you for the service you can provide.

As for getting training. First off you need the basics that every dental school teaches. Then, experience, and continuing education. You NEED continuing education from the day you graduate dental school until the day you retire, with the speed that this profession is progressing/changing the day you think that you've got it all figured out is the day you become an inferior dentist.

You do not have to be a trained prosthodontist to be an esthetic dentist, many of the acknowledged greats in the field of cosmetics are just "lowly old GP's" 😀 What you really need is the desire to keep pushing yourself and what a material can do.
 
brittnylee said:
Hi, I have just applied to dental school this summer, and I was hoping someone could educate me a bit about cosmetic dentistry and the best schools to attend for the most up-to-date training in this area of dentistry. I am aware this is a pretty new branch of dentistry, so is there really a good school for this or does focus in this area consist mostly of post DMD/DDS classes? Any info is welcome! Thanks so much! 🙂
may be upon graduation from dental school, you could attend like a 1 year certificate program in esthetic/cosmetic dentistry like the ones in Las Vegas, UCLA, Buffalo, NYU etc etc.,,,,if not you need to become a Prosthodontist to understand the entire concept of restorative and cosmetic reconstructions..
 
simpledoc said:
may be upon graduation from dental school, you could attend like a 1 year certificate program in esthetic/cosmetic dentistry like the ones in Las Vegas, UCLA, Buffalo, NYU etc etc.,,,,if not you need to become a Prosthodontist to understand the entire concept of restorative and cosmetic reconstructions..

I really have to disagree with the entire concept that only a prosthodontist can handle restorative reconstructions. Look at some of the acknowledged leaders in the field of cosmetic dentistry, David Hornbrook, Bill Dickerson, Bill Dorfmann, Lorin Berlind, Larry Rosenthal, Ross Nash. Look at the vast majority of the fellows of the American Academy of Cosmetic Dentistry, GP's. If as a GP you don't think that you can do as good an esthetic reconstruction as anyone in the field, then quite simply you haven't applied/pushed yourself enough.

While I'll agree that many prosthodontists do some fabulous esthetic reconstructions, they are by no means the only ones that can
 
simpledoc said:
may be upon graduation from dental school, you could attend like a 1 year certificate program in esthetic/cosmetic dentistry like the ones in Las Vegas, UCLA, Buffalo, NYU etc etc.,,,,if not you need to become a Prosthodontist to understand the entire concept of restorative and cosmetic reconstructions..

yep what he just said. there are some dentists who are very capable but there will always be some gaps in ones knowledge. eg: i could do endo every day but ill never be as good as an endodontist and that is a specialty less dependent upon tx planning than pros and more on doing the procedure - which is an easier predicament to be in.

regarding those generalists you mentioned dr jeff, u guys can check out baddentist.com and you ll find a whole litany of allegations against larry rosenthal, and has anyone else noticed how bill dorfmans tx planning solutions dont extend far beyond " we re gonna do 12 porcelain veneers for you from molar to molar!"

its this whole tackydental economics "lets rip the patients" off attitude that makes us look like salesmen. damn i hate that magazine, got to take a shower after reading it just to feel clean again.
 
Personally I'm much happier doing the isolated veneer or two for staining management a few times a year than a total "smile reconstruction" with 10 maxillary veneers/crowns and another 8 to 10 units of porcelain work in the mandible to correct a minor crowding/rotational discrepency. Many, many cases that you see published in "magazines" like Contemporary Dentistry are IMHO just pure overtreatment and greed to the nth degree.

When I see some of these cases, I'm honestly more impressed with the quality of the ceramics(when the ceramist has done a great job) than the actual technical merits(or overtreatment) done by the treating dentist. Some of the reasons why you see guys like Rosenthal and Dorfmann from time to time being listed on places like baddentist.com(or what ever the site is) is that the "clients" (not I didn't say patient" they deal with have utter and total unrealistic expectations from the start. The real indicator would be how many of those listed on baddentist.com have had malpractice judgements awarded against them. I'm sure that some of those complaints were made by various "high maintenance" diva's whose main complaint was that her 20 veneers weren't whiter than her friends 😕 🙄

As with any aspect of dentistry, and especially with large scale "cosmetic" cases, making sure the pateint has REALISTIC expectations of what you can deliver for them is the most crucial step.

Case in point, I have a patient who has just started their sophmore year at college. This patient due to a childhood bike incident had some very large Class IV composites on 8 and 9 that over the last 5 or 6 years have shown some of the esthetic limitations of 5 or 6 year old composite. The patient and one of her parents asked me at the start of the summer if crowns or veneers would give a better/longer lasting esthetic result (she had also chipped a very small piece of the DI corner of the restoration on #8 in May (not bad clinical wear for a tooth that is roughly 30% composite over 5+ years). After reviewing her occlusal relationship/discussing the benefits/cons of new composite restorations vs. porcelain veneers vs. crowns and having a wax up done and reviewed by the patient/her mom we decided on 2 veneers for the case. I did the case/had a lab tech from the lab I use in the office at the cementing visit to do any custom staining as needed and cemented the veneers on a Friday morning. The patient walked out of the office thrilled with her new front teeth.

I called the patient later that day to see how she was doing and I was as happy as could be with them.

Monday AM, I get a call from the patient practically in tears. Turns out her parents who had been away on vacation the previous week returned home Sunday AM and one of the first things out of her mother's mouth was something to the extent of "you have chicklet teeth". I get both her and her mother in later that day to discuss things, and the mother is insistant that I remove the veneers and redo them. I ask the pateint and now her view of them has gone from exstatic to inconsolable. In short I ended up not redoing the veneers on the patient, but actually making new crowns for mom's #8 and 9 😕 Reason being was that Mom's 10+ year old crowns looked like 20 year old crowns and she was jealous/ resentfull that her daughter's teeth looked better than her (yes if you're thinking there's some psych issues going on in this family you're correct). Until I got to the bottom of this situation and figured out what was going on, I had this mom bad mouthing me to her friends 😡 😡 Now that I've made her the front teeth that she wants she raves about me to her friends. Just some of the joys that cosmetic dentistry when done to the highest levels of our abilites can bring us 😕 🙄 😀
 
DrJeff said:
I really have to disagree with the entire concept that only a prosthodontist can handle restorative reconstructions. Look at some of the acknowledged leaders in the field of cosmetic dentistry, David Hornbrook, Bill Dickerson, Bill Dorfmann, Lorin Berlind, Larry Rosenthal, Ross Nash. Look at the vast majority of the fellows of the American Academy of Cosmetic Dentistry, GP's. If as a GP you don't think that you can do as good an esthetic reconstruction as anyone in the field, then quite simply you haven't applied/pushed yourself enough.

While I'll agree that many prosthodontists do some fabulous esthetic reconstructions, they are by no means the only ones that can
thought am inclined towards implant dentistry and prosthodontics, i've not made a concrete choice on specialization but I want to comment: is it so much against our(general dentists i mean) ego that we want to tell ourselves that we know and can do everything what a prosthodontist does?? i mean give those damn dudes some credibility, they've been through 3 additional years of training in these kind of cosmetic reconstructions and rehabs!! ive always noticed that it is only a specialist who understands the nature of a prosthodontist's work, unlike the envying general dentist who always glorifies himself as a pseudo "prosthodontist"! A buddy of mine is an oral surgeon who needed a crown on no. 8...even though his wife practices "cosmetic dentistry" , that guy chose to go his prosthodontist.....sounded wierd to me initially, but took me a while to realize the concept behind it..
 
GQ1 said:
yep what he just said. there are some dentists who are very capable but there will always be some gaps in ones knowledge. eg: i could do endo every day but ill never be as good as an endodontist and that is a specialty less dependent upon tx planning than pros and more on doing the procedure - which is an easier predicament to be in.

regarding those generalists you mentioned dr jeff, u guys can check out baddentist.com and you ll find a whole litany of allegations against larry rosenthal, and has anyone else noticed how bill dorfmans tx planning solutions dont extend far beyond " we re gonna do 12 porcelain veneers for you from molar to molar!"

its this whole tackydental economics "lets rip the patients" off attitude that makes us look like salesmen. damn i hate that magazine, got to take a shower after reading it just to feel clean again.
GQ1: i think such websites are total BS! being a professional (and you a prosthodontist) you shouldn't even be taking a glance at such sites!! 😉
 
simpledoc said:
GQ1: i think such websites are total BS! being a professional (and you a prosthodontist) you shouldn't even be taking a glance at such sites!! 😉

are you talking about baddentist or dental economics? both show the poor side of our proffession.

you dont know what you dont know is a very succinct way to summarise dental specialties. you only learn your own limitations and the abilities of other specialties by going to residency. case in point when i arrived as a first yr pros resident i thought why the hell do ppl come for 2 to 3 years for endo and ortho i can do all that from school and CE courses. but you work thru cases with them and you see the literature knowledge they possess and debate, tx planning experience from 20 faculty they gain, chances to do big cases that couldnt be done in practice due to cost, time and lack of supervision. i now have due repect for these specialties. theres a great deal to be said for 3 years of specialization.

endo guys that moonlight tell me their gp thinks theyre a psuedo prosthodontist. of course they smile and take it but they say they dont know the difference as they dont work with prosthosontists and maybe id be in a similar situation if i hadnt gone thru specialization.

one of the many differences we re lectured on how pros are different to gps was already mentioned in this thread. an anterior pfm thats not the right shade, shape a pros should have no hesitation recountouring the crown adding stain and putting it back in the oven to reglaze. this only takes a few moments, its then not necessay to return it to the tachnician and reschedule the pt. = increased pt approaval at qaulity and speed, and decresed visits.
 
simpledoc said:
GQ1: i think such websites are total BS! being a professional (and you a prosthodontist) you shouldn't even be taking a glance at such sites!! 😉

are you talking about baddentist or dental economics? both show the poor side of our proffession.

you dont know what you dont know is a very succinct way to summarise dental specialties. you only learn your own limitations and the abilities of other specialties by going to residency. case in point when i arrived as a first yr pros resident i thought why the hell do ppl come for 2 to 3 years for endo and ortho i can do all that from school and CE courses. but you work thru cases with them and you see the literature knowledge they possess and debate, tx planning experience from 20 faculty they gain, chances to do big cases that couldnt be done in practice due to cost, time and lack of supervision. i now have due repect for these specialties. theres a great deal to be said for 3 years of specialization.

endo guys that moonlight tell me their gp thinks theyre a psuedo prosthodontist. of course they smile and take it but they say they dont know the difference as they dont work with prosthodontists and maybe id be in a similar situation if i hadnt gone thru specialization.

one of the many differences we re lectured on how pros are different to gps was already mentioned in this thread. an anterior pfm thats not the right shade, shape a pros should have no hesitation recountouring the crown adding stain and putting it back in the oven to reglaze. this only takes a few moments, its then not necessay to return it to the technician and reschedule the pt. = increased pt approaval at qaulity and speed, and decreased visits.
 
just curious....i know you are a foreign graduate....which country are you from?
 
simpledoc said:
thought am inclined towards implant dentistry and prosthodontics, i've not made a concrete choice on specialization but I want to comment: is it so much against our(general dentists i mean) ego that we want to tell ourselves that we know and can do everything what a prosthodontist does?? i mean give those damn dudes some credibility, they've been through 3 additional years of training in these kind of cosmetic reconstructions and rehabs!! ive always noticed that it is only a specialist who understands the nature of a prosthodontist's work, unlike the envying general dentist who always glorifies himself as a pseudo "prosthodontist"! A buddy of mine is an oral surgeon who needed a crown on no. 8...even though his wife practices "cosmetic dentistry" , that guy chose to go his prosthodontist.....sounded wierd to me initially, but took me a while to realize the concept behind it..

Agreed 100%. Prosth is extremely undervalued by GP's. As someone else here said, they just don't know what they don't know.
 
brittnylee said:
Hi, I have just applied to dental school this summer, and I was hoping someone could educate me a bit about cosmetic dentistry and the best schools to attend for the most up-to-date training in this area of dentistry. I am aware this is a pretty new branch of dentistry, so is there really a good school for this or does focus in this area consist mostly of post DMD/DDS classes? Any info is welcome! Thanks so much! 🙂

You want to know the honest brutal reality? You will do VIRUTALLY no cosmetic dentistry on patients as a dental student given the type of patient population you get in your clinical years as a student. You will most likely learn how to do veneer preps and inlay/onlay preps on the dentoforme in the preclinical years (as I did) but not do any on patients. Unless of course you consider doing anterior crowns as being cosmetic dentistry...if you mean canine (#6-#11)to canine veneering or porcelain inlays/onlays or vital bleaching- that will be VERY rare.

Cosmetic dentistry is not a recognized speciality but you can follow courses with a certain academy as CE courses and get some sort of certification. You will find, when you graduate, that there are a lot of materials and techniques which you weren't taught in dental school which you will have self-educate yourself either through reading/CE courses/both.

AACD The American Academy of Cosmetic Dentisry

http://www.aacd.com/professionals/default.aspx
 
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