By Eric Nelson, AACD Director of communications 

Times can change pretty quickly, cant they" My beloved Brett Favre is now a New York Jet. Both major party Presidential candidates are campaigning on the platform of "change" And the age of patients demanding bright, white, "Hollywood" smiles is moving toward a more natural, individualized approach to each smile makeover. 

So says The New York Times, in an article much discussed throughout the profession titled, "Avoiding Dental Perfection With a Slight Twist," published in the August 28th edition of one of the worlds most respected newspapers. AACD Past Presidents Dr. Jeff Goloub-Evans and Laura Kelly were both interviewed for the article, which also cited the AACD and our 2007 State of Cosmetic Dentistry study.

According to Ms. Kelly, "In the beginning of veneers, patients wanted teeth all white and straight," She goes on to explain that they now are requesting more translucency, graduation of color, and slight rotations of the teeth.  

Dr. Goloub-Evans adds, "What I’ve noticed is that if someone has perfectly symmetrical features and you put perfectly symmetrical teeth on that face, you ruin that face."  In case you missed the article, you can read it online at: www.nytimes.com/2008/08/28/fasion/28SkinOne.html 

The article underscores the fundamental shift in the definition of cosmetic dentistry made by the Academy’s leadership at our summer 2008 strategic planning meetings. The new definition reads "Cosmetic dentistry is a comprehensive approach to oral care that combines art and science to achieve optimal dental health, function and esthetics."

It was just a few years ago that we were discussing the "Extreme Makeover" phenomenon that was sweeping America and the dental profession. Make no mistake about it, "Extreme makeover" had a profound impact on cosmetic dentistry. Suddenly dentists were portrayed as life-changing professionals as the bright lights were shown on beautiful smiles. Practices’ business around the country boomed. AACD itself nearly doubled in size during the years the program was on the air. "Ttreatment" by unqualified cosmetic dentists. The next phase of the ever-evolving cosmetic dental profession seems to be taking shape.

The toothbrush from a tree

A toothbrush made from a twig can kill some bacteria without even touching them, a study suggests. Swedish researchers studied the Miswak also called the Siwak and chewing stick a twig used for oral hygiene in several areas like Saudi Arabia and Sudan. Most miwaks come from the twigs or roots of the Arak tree (Salvadore persica), which is also known as the toothbrush tree. They can also be made from olive and walnut trees. In the past, researchers tried to extract compounds from chewing sticks, but didn’t find they killed bacteria very well. In this study, researchers used small pieces of Miswak of less than a hundredth of an ounce. They embedded some pieces in plastic lab dishes (Petri dishes) that were growing different kinds of mouth bacteria, and suspended others above the dishes. Both strategies killed bacteria, with the Miswak pieces best at killing the two bacteria linked to periodontal disease. They also killed bacteria causing tooth decay, but to a lesser degree. Other studies have found that Miswaks remove plaque and kill bacteria in the mouth. The full study appears in the August issue of The Journal of Periodontology.

Diabetes and gum disease

Chicagos University of Illinois has received a two-year grant to continue a study on the link between periodontitis, diabetes and obesity. "The prevalence of type-two diabetes has risen dramatically as the result of an increase in obesity from a high-fat diet, junk food and a sedentary lifestyle"," said Dr Keiko Watanabe, associate professor of periodontics at the university. Although the association between obesity, type-two diabetes and periodontitis is recognised, she said, the underlying causes remain poorly understood. Watanabe said the goal of the new study is to identify the causes by which periodontitis influences insulin resistance, diabetes and organ damage, so clinicians will be able to screen predictable individuals. Periodontal inflammation treatment will also be developed to stop insulin resistance accelerating to diabetes.

Watanabes initial study was published in the July issue of The Journal of Periodontology. The $432,000 grant is being funded by the National Institute of Dental and Craniofacial Research, one of the National Institutes of Health.  

(Article published in Bite Magazine November 2008)