USC Health Now

Advances in aesthetic dentistry are beginning to put an emphasis on a natural looking smile. Here, USC experts leading the way in this growing trend explain how and why.

April 28, 2008
by Veronica Jauriqui

Aesthetic dentistry has gotten a bad rap in recent years. Glamour magazines and extreme makeover television have transformed a smile into the latest fashion accessory. Many celebrities sport a smile that can outshine even the brightest designer bling.

And the American public is taking note. A survey of American Academy of Cosmetic Dentistry members found that the demand for cosmetic dental treatments—including tooth whitening and veneers—increased 12.5 percent over the past five years, with some private practices seeing a nearly 40 percent increase.

What the beauty industry and Hollywood do to warp our sense of a healthy body image, they also have done to skew our perceptions of what constitutes a bright and healthy smile. But a movement brewing in the field of dental aesthetics hopes to give us a little perspective. Its members find charm in imperfection and beauty in the flaws. It’s what makes us human, after all.

Perfectly Natural

The theoretical principle is called biomimetics, and its philosophy has inspired Pascal Magne, D.M.D., Ph.D., in his practice and research into dental restorations. He and brother, Michel, a dental technologist and director of the USC School of Dentistry’s Center for Dental Technology, want to shift aesthetic dentistry away from the gaudy notion of “cosmetic” and its images of brazenly white, chunky caps and veneers, into a specialty that pays tribute to the smiles nature gave us.

“Nature is perfect and why mess with perfection,” Pascal Magne says. Biomimetics in its truest sense goes hand-in-hand with tissue engineering, the repair or replacement of body parts with materials developed in medical laboratories. Artificial hearts and prosthetic legs are examples of biomimetic devices that literally “mimic nature” and allow the body to perform its tasks, like pumping blood or running a marathon.

Prosthetics in dentistry means replacing worn or decayed dentin and enamel. Though enamel is the hardest and most mineralized substance in the human body, it is also sensitive to outside forces, genetic disorders and fluctuations in the environment that can leave the enamel brittle, pitted and discolored. Staining from antibiotics like tetracycline or over-fluoridation of drinking water, problems in post-natal development, and decay that comes with age are all issues faced in aesthetic restorative dentistry.

But over the years, restorative dentistry has become more obsessed with the whiteness of the tooth, its symmetry or the even curve of the tooth line, rather than its function.
Proponents of the biomimetic principle hope to change that.

“In biomimetics, it’s not aesthetics that is the driving force. If you respect the biology of the tooth and copy its material properties and its functions, it will work like a tooth and therefore look like a tooth,” Pascal Magne says.

Modern Design

Magne’s theory captures the spirit of modern design. In biomimetic restorative dentistry, form follows function. Dentists following the biomimetic principle must work like architects, constructing with glass, metal and ceramics to refurbish or build the patient’s smile. They also must consider the surrounding environment, integrating the new veneer or dental implant seamlessly into each patient’s face, as well as his or her personality.

“What you usually see in aesthetic dentistry is what people consider perfection. Everything is symmetrical, uniform. There is none of the charm of imperfection, the variations in color or the differences in height. I think that is what is important about what we’re doing,” he says.

In fall 2006, Pascal and Michel Magne opened what has become the first of its kind at an American university. Located behind the USC Oral Health Center, the school’s faculty practice, the Center for Dental Technology is a 1,900-square-foot laboratory and classroom facility that puts Magne’s philosophy into practice.

“In this center, we talk about harmony, about balance and about art,” Michel Magne says. “I show them what is nature and after that, they see a smile completely differently, with other eyes. The vision of beauty is so distorted. We see little flaws and we think it’s terrible. But there is a golden proportion in nature and in our smiles. That proportion can be flawed but also elegant.”

A Smile and More

Form and function aside, there’s more to aesthetic dentistry than a beautiful smile. There has long been a connection between oral health and overall health. But a smile can mean so much more. It’s how we greet the world. It’s a handshake, a nod hello. Mothers know the joy of baby’s first smile. And when words fail us, sometimes a smile is all we need.

“If you’ve been holding your hand over your mouth since you were a child because your teeth are crooked; and you can get treatment and your hand moves away; and you can express everything that is within you, isn’t that a valuable service to an individual?” says Harold Slavkin, D.D.S.dean of the USC School of Dentistry. “To be able to smile and be free of pain, to have a healthy outlook and fully engage… that is what it’s really all about.”
Slavkin acknowledges the fierce connection between oral and mental health. Everyone wants to feel good about themselves, and a nice smile is part of that.

“We acknowledge that teeth are parts of the key elements that generate an expression of who is inside, of people’s souls, their animation, their passion and their despair. A smile can have all of those ingredients,” he says.