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  1. 1. Cosmetic dentistry:Reasons to smile Dr. Nicholas Davis, president of the American Association of Cosmetic Dentistry, talks about recent growth and future prospects in the field.Cosmetic dentistry has developed into one of the fastest growing desire of patients to look the best they can by improv-facets of the dental industry. DE spoke with AACD President ing their teeth, and the dentist’s ability to achieve theseDr. Nicholas Davis about the current boom in cosmetics, the results, have led to an overwhelming positive awarenessAACD, and what the organization is doing to improve the by the public. These positive reactions of the patients andcosmetic dental experience for its some 7,000 members. dentists have encouraged and led to the evolution of cos- metic dentistry.DE: Through the years, how has cosmetic dentistry evolved? DE: Why is cosmetic dentistry one of the fastest growing areasDr. Davis: Cosmetic dentistry has evolved because new in the dental field?dental materials have enabled dentists to achieve superioresthetic results without mechanical retention and with Dr. Davis: Dentistry in the past has focused on fixingminimally invasive restorations. Adhesive dentistry utiliz- problems because of tooth caries, missing teeth, or othering composite materials has made it possible to improve destructive factors that necessitated restorations. Thethe esthetics and strength of teeth without destroying advent of cosmetic dentistry has allowed the dentist totooth structures unnecessarily. This has made dental pro- provide elective procedures for cosmetic improvementcedures more appealing to the general public. in addition to problem-solving. The positive feedback by Porcelain restorations have achieved ideal esthetic patients from their cosmetic dental experiences has beenresults by creating natural-looking teeth, and enhancing gratifying to dentists, and has been the impetus to furtherthe overall appearance of the patient. Patients have been treatment plans with cosmetic to see the cosmetic outcomes that we have worked so The continual development and evolution of den-hard to achieve in our operatories and laboratories. The tal materials and procedures have made it possible to20 June 2005 /
  2. 2. replicate the lifelike properties of the natural tooth 1984 by Drs. Jack Kammer and Jeff Morley. Through thestructure. Cosmetic tooth lightening, for example, has years, this organization has flourished — growing to ap-become increasingly convenient for the public, and is proximately 7,000 members this year. The AACD, withone of the most sought after in-office and over-the- members in 60 countries around the world, is dedicatedcounter cosmetic dental procedures. Tooth lightening is to advancing the “Art and Science of Cosmetic Dentistry,”an entry-level cosmetic procedure that has proven to be and encouraging the highest standards of ethical conducta pathway for smile enhancements and other cosmetic and responsible patient procedures. This process has encouraged In those early years, the founding fathers felt a need tomany patients to enhance the appearance of their smiles educate and build a network of qualified cosmetic dentistsbeyond the limits of age and nature. across the country that could be used as a referral source for patients seeking superior cosmetic dental care. ThisDE: Down the road, what do you envision taking place in cos- quickly evolved into much more.metic dentistry? Today, the AACD is the largest cosmetic dental organi- zation in the world. It offers educational opportunities forDr. Davis: I see the development of a clinical philosophy dentists while providing accurate and useful informationthat is integrated with other supporting dental and medi- to the public. It has set the standard for cosmetic dentalcal specialists as one of the keys for the future. This phi- care, and offers an accreditation process for dentists tolosophy will act as a template for incorporating cosmetic test their skills.dentistry as an integral part of comprehensive treatmentplanning for ideal esthetic and functional dentistry. This DE: Who and how can one join the AACD?philosophy will deal with long-term predictability bycomprehensive problem-solving for the most ideal treat- Dr. Davis: The AACD is unique because anyone can joinment results. This philosophy also will identify the in- the academy. Dentists, laboratory technicians, hygienists,dications and limitations of cosmetic dentistry, and will assistants, business personnel, and corporations all com-develop teamwork with all dental and medical specialists prise the membership of the AACD. Additionally, 43 den-for ideal goals. tal schools participate in the academy’s University Advi- Teamwork will be encouraged with not only the dental sory Committee, and 15 private institutions participatespecialists, but also medical cosmetic specialists to make in the Private Education Advisory Committee. The acad-cosmetic dentistry an integral part of facial esthetic treat- emy views these universities and private institutions asment planning. The involvement of the medical commu- playing a synergistic role in cosmetic dental education fornity, especially cosmetic surgeons, needs to be addressed dentists, laboratory technicians, and staff. To join, visit theso the cosmetic dentist and cosmetic surgeon have a clos- AACD Web site at or call (800) working relationship for the best esthetic outcomes fortheir patients. DE: What are some of the benefits or programs offered via The predictability of long-term results of cosmetic AACD membership?dentistry also will need to be studied. Cosmetic dentistry,as we know it, is in the infant stages of growth. There Dr. Davis: The key benefits of membership in the AACDmay be some shortcuts taken to facilitate cosmetic den- are associated with the ongoing information source avail-tistry that prove to be a problem as dental cases mature. able to its members. The annual scientific session is a five-Gingivectomies, altered axial alignment of restorations, day educational event, which has proven to be the premiernonaxial forces during parafunctional habits, and occlusal source of cosmetic dental information. The Journal ofdiscrepancies will need to be the focus for long-term suc- Cosmetic Dentistry has emerged as the members’ numbercess. This will allow us to better understand the limita- one acclaimed benefit. Other academy publications andtions of cosmetic dentistry, along with the indications andrationale for our treatment proposals. The desire of patients to look the The education of the patient and the general publicwill continue to be paramount in building the practice best they can by improving theirof cosmetic dentistry, and is part of the mission of the teeth, and the dentist’s ability toAmerican Academy of Cosmetic Dentistry. achieve these results, have ledDE: Tell us a little about the history and mission of the AACD. to an overwhelming positiveDr. Davis: The American Academy of Cosmetic Den- awareness by the public.tistry is a nonprofit organization that was co-founded in — Dr. Nicholas Davis / June 2005 21
  3. 3. REASONS TO SMILEpamphlets provide useful informa-tion for the cosmetic dental practice.The academy has established a cre- “It is important thatdential in cosmetic dentistry that is cosmetic dentistry un-known as accreditation for members derstands its niche inwho seek to pursue it and be testedto that level of excellence. For those comprehensive den-members who qualify, the academy tal care for the well-provides a referral service for thepublic on its Web site, which re- being of the patient.ceives some 500,000 hits per month. A multidisciplined ap-The academy also has a charitablefoundation, GBAS (Give Back A proach always shouldSmile), which restores smiles for be considered whenvictims of domestic violence. This establishing an idealfoundation provides the organiza-tion with a humanitarian effort. treatment plan.”DE: What makes the AACD’s scientific — Dr. Nicholas Davissession the primary source for cosmetic President, AACDdental information?Dr. Davis: This year’s annual scientific session in Nash- to reflect the protocol of traditional specialty examina-ville (held April 19-23) represented the 21st year of con- tions and testing. There are three key areas of testing. Thetinuing education in cosmetic dentistry. The academy is first is a written test to establish a basic understanding ofgrounded in education that is scientifically based, and cosmetic dentistry and its role in the overall health andprovides cosmetic dental information to attendees for function of all the oral structures.creating consistently successful results. In addition, the The second and most challenging section involves thescientific session has courses that incorporate different treatment of five specific cosmetic dental cases, which aretreatment philosophies. The AACD has developed the documented and achieved with dental photography. Thereputation of being an open forum for new and innova- cases include a direct veneer bonding case, a complex bond-tive ideas and philosophies. Exposing the membership ing procedure (diastema closure or Class IV composite res-to this type of leading-edge information stimulates cre- toration), an anterior tooth replacement case, one or twoative thinking, and cultivates an environment that often indirect anterior restorations, and six or more indirect an-leads to breakthroughs in dental materials and tech- terior restorations. This may seem like a simple task sinceniques. only five cases are necessary, but the challenge is that all five The academy brings together a collection of leading cases must demonstrate excellent dentistry. The dentistryeducators, who span the spectrum of cosmetic dentistry, and the tissues are evaluated with finite detail in this pro-for this annual meeting. It also has a myriad of other cess. The degree of improvement is not as important as theeducational opportunities. These include hands-on excellence of the final treatment. Cases are blind-judged bycourses, round-table discussions, digital photography a panel of calibrated accredited members. The pass rate forcourses, and tracks of learning for dentists, laboratory cases in the latest examinations was about 56 percent.technicians, and dental team members. Many of the ed- The final phase of the accreditation process is an oralucational presentations focus on developing an artistic examination in which the treating dentist must explaineye. the treatment procedures and defend treatment choices. When you combine this type of educational experience Treatment planning of a preselected case is the secondwith an extensive exhibit hall full of the latest in the field, part of the oral examination. There are slightly differentsocial events such as a Dolly Parton concert, which we did criteria for laboratory technicians, who also are eligiblethis case this year), a 5K run, and a golf tournament, you for accreditation.have an event that is difficult to match. DE: What is the AACD doing to enhance its accreditationDE: Explain the AACD’s accreditation program and the steps process?involved in the process. Dr. Davis: This is a great question because several stepsDr. Davis: The AACD’s accreditation process has evolved have been taken to help candidates improve the success22 June 2005 /
  4. 4. REASONS TO SMILEof their submitted cases. Courses and workshops are of-fered that demonstrate ideal treatment, and the properphotographic standards for documenting a case. Digi-tal photography is a newly accepted method of photo-graphic documentation. The details of how these imagesare to be captured and presented are also described inacademy courses. There was also a new “AccreditationTrack” at this year’s scientific session in Nashville forthose interested in seeing cases treated to accreditationstandards. In addition, particular attention has been paid to mak-ing the testing process impartial and nonbiased. Cases areevaluated by calibrated examiners without knowledge ofthe treating doctor’s name. Only a number accompanieseach case to be evaluated.DE: What are the future plans for the AACD?Dr. Davis: It is important that cosmetic dentistry un-derstands its niche in comprehensive dental care for thewell-being of the patient. A multidisciplined approachalways should be considered when establishing an idealtreatment plan. We want to establish cosmetic dentaltreatment guidelines that will help foster and maintainthe academy’s respect and confidence with other dentaland medical specialties and the public. The academy hopes to increase its public affirmationso that AACD membership represents leaders in cosmet-ic dental care who are specially trained and capable ofproviding the highest level of consistent cosmetic dentalcare. These member dentists are the experts because oftheir education, training, and skills — not because of amarketing program that stands alone without the back-ing of advanced cosmetic dental education and experi-ence. The AACD also hopes to represent all cosmetic den-tists, and to protect and gain special recognition for theiradditional training and ability. By setting standards of ex-cellence, this organization has proven to be the leader inthe field of cosmetic dentistry.Dr. Nicholas C. Davis is a 1973 graduate of Loma LindaUniversity School of Dentistry in Loma Linda, Calif. A mem-ber of the university’s faculty, he teaches esthetic courses todental students, hygienists, and graduate dentists. He hasearned a Master’s in the Academy of General Dentistrydegree as well as a fellowship in the International Academyof Dental Facial Esthetics. In addition to publishing numer-ous articles on various topics, he has lectured nationallyand internationally on cosmetic dental procedures andcomprehensive dentistry. He maintains a cosmetic practicein Newport Beach, Calif. DE