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Communication is key with cosmetic dentistry cases

by Dr. Hibret Hailu Benjamin

Cosmetic dental treatment has become increasingly popular for middle-aged patients who want to look youthful and improve the appearance of their teeth. Redoing dental work that was performed more than 25 years ago is not uncommon, because dental technology and materials have improved significantly since then and patients have higher expectations for the outcome of their dental treatments. Plus, through years of wear and tear, teeth can become discolored, crooked or worn down.

Procedures such as teeth whitening and veneers can help restore the appearance of the teeth and create a more youthful, vibrant look, but achieving the desired outcome can require careful communication between the patient, the dentist and, when applicable, the lab. The dentist must take the time to understand the patient’s goals and desires, as well as their ability to listen and apply the advice given to them. This requires active listening, open communication and an understanding of the patient’s lifestyle, habits and expectations.

Technological assists
Digital technology plays a significant role in modern cosmetic dental treatment. High-quality photography, for example, enables dentists to communicate with patients, laboratories and specialists. Clear, precise photographs of the oral cavity and teeth are essential for analyzing and assessing the patient’s dental problems and helping the dentist communicate possible solutions. Digital smile design, meanwhile, helps dentists create mockups of proposed treatments, allowing patients to see realistic representations of their new smiles before any work begins.

With virtual communication platforms, patients can connect remotely with their dentists, allowing for efficient communication and treatment planning that doesn’t require valuable chair time. This is especially important for patients who may not live near their preferred dental provider, and for those who have busy schedules that make it difficult to attend multiple in-person appointments.

Virtual communication platforms also provide a way for dentists and lab technicians to collaborate in real time, regardless of their physical location. Sharing digital images, X-rays and other diagnostic information leads to a more accurate diagnosis and treatment plan, so this thorough, detailed approach will improve the final outcome of the cosmetic dental treatment.

The right response
Some patients know exactly what they want in their smile makeover or upgrade. They have a keen understanding of the issues at hand and will be striving to perfect them, which can be mistaken for negativity. However, this is actually a benefit to a dentist who can really listen and deliver with reasonable and realistic expectations from the patient.

The dentist’s experience in delivering excellent cosmetic results and their ability to communicate effectively are essential in making sure the patient knows and is aware of all the possibilities, so there are no surprises at the end. Setting clear expectations is the ultimate gauge of how the case could end up, and the dentist’s ability to partner with the patient is essential for success.

Setting expectations
In conclusion, cosmetic dentistry has become a popular practice in modern dentistry, and it is essential for dentists to partner with patients in achieving their desired outcomes. The ability of dentists to communicate effectively, use modern technology and techniques, and help patients stay realistic in their expectations is essential for success. Cosmetic dentistry is not just about creating a beautiful smile but also about the psychological benefits of having an attractive smile, which can improve a person’s self-confidence and self-esteem.

This patient wanted to update his upper veneers to improve their shape and color (and also hide his receding gums). We created a digital smile design in Keynote that addressed aesthetics, biology, function and structure, and our lab technician used Exocad software to create a digital mockup, which was then printed.

On the day of treatment, the patient’s existing restorations were removed and temporaries placed to mark the ideal positioning of the gingival contour. Once the ideal zenith line had been marked, temporaries were removed and gingivectomies performed around specific teeth with a diode laser. (We ensured no biological violations with gingival recontouring by sounding to the bone.)

Final temporary restorations were created with Integrity temporary material (Dentsply Sirona) and cemented with a flowable composite. (At this point, chipping on the patient’s lower teeth was also addressed with direct composite to create better guidance for the upper restorations.)

Final restorations were created with IPS e.Max (Ivoclar) in shade B1 for aesthetics. To help the lab technicians select the appropriate ceramic shade, photos of the patient’s prepped teeth and his choice of shade had been provided.

Teeth #6–#11 were layered for translucency and natural characterization; the rest were only stained and glazed, without the layering technique. All restorations were then cemented with a neutral shade of Variolink Esthetic cement (Ivoclar).

Figs. 1–6: Preoperative photos.

Benjamin Communication in cosmetic dentistry cases

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Fig. 7: Patient’s reference photo of younger smile.

Fig. 8: Mockup of enlarged tooth surface (single).

Fig. 9: Mockup of improved upper smile arc.

Fig. 10: Exocad image of patient’s actual upper teeth.

Fig. 11: Exocad mockup of changes to upper teeth.

Fig. 12: Full-face mockup of changes.

Fig. 13: Prep work to upper teeth.

Fig. 14: Shade match of existing teeth.

Fig. 15: Preferred shade options for finished veneers

Figs. 16-20: Photos with temporary restorations in place.

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Figs. 21-26: Photos with ceramic veneers placed.

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Fig. 27: Before, mockup, final

Author Bio

Dr. Hibret Hailu Benjamin earned a bachelor’s degree from the University of San Francisco and a DDS from the University of California, San Francisco. Benjamin has a private practice in the heart of San Francisco and is an assistant clinical professor at UCSF. A member of the American Academy of Cosmetic Dentistry, she has served on the board of the San Francisco Dental Society for several years.

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September 2025

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