Dr. Neil Zane, New York City’s Smile Architect, receives many patient requests for smile rejuvenation or dental veneers.  This type of treatment typically involves cosmetic and restorative services that not only enhance esthetics, but also alter how the upper and lower jaw come together to function.  After over 25 years of working to enhance patient smiles, Dr. Zane employs the treatment philosophy that “Form Follows Function.”  Dr. Zane explains that a great looking smile is only achieved by insuring the teeth and jaw are working harmoniously together.

In the video and interview transcript below, Dr. Zane shares insights about how he approaches smile design and crafting a smile that looks as great as it functions.

Factors that Impact Smile Makeovers

Question: When a patient comes to you inquiring about a smile makeover, what factors do you examine and what goes into your consideration for which treatments (veneers, crowns, implants, etc.) may be appropriate?

Dr. Zane: I first listen closely to the patient to determine exactly what they are trying to achieve.  Once I understand their goals, I perform an exam, in which I pay particular attention to how the teeth come together and how the jaws function.  By observing the wear on the teeth, and what, if any, restorations are present in their mouth I can understand the patients needs more profoundly.  Neglecting a patients’ bite and focusing only on the esthetics may lead to many problems later on.  I always try to treat patients with a long-term view.  I want to provide them with a smile that looks great and lasts the rest of their life.

Assessing and Responding to Patient Smile Goals

Question: What do you typically hear from patients about their overall smile goals?

Dr. Zane: Patients are usually focused on wanting their six front teeth to look great.  They are particularly concerned with the size, shape and color of the front six teeth.  My job is to achieve their esthetic goals, while still creating an optimally functioning smile.  While the patient is focused on the ‘front porch’, I look at the entire jaw, especially how the teeth come together in the back.  Once I understand the anatomy and occlusion of a particular patient, I then can design a smile for them that has ideal function and achieves their esthetic goals and longevity of the dentition.  Just designing a smile around the esthetics of the front teeth would only be doing less than half of the job that would likely lead to future complications for the patient.

Complications that may Result

Question: What types of complications can occur if a dentist neglects the functional aspect of the smile?

Dr. Zane: Patient may experience many issues if their smile and back teeth aren’t  functioning properly.  At the most basic level, the teeth may wear excessively chip or perhaps even fracture.  Patients would likely have to undergo additional dental treatment to treat these issues. In addition, improper bite and jaw function may also cause headaches, migraines, and shoulder and back pain.  Another aspect which almost always is overlooked or ignored, is the interrelationship of the bite and posture.