Esthetic Dentistry Education Center Helps Students, Dentists Keep Up with Public's Demand for Perfect Smile

BUFFALO, N.Y. -- Frederick W. McIntyre, D.D.S., has seen firsthand the psychological impact that an impaired smile can have on a patient.

"The smile is very important in your presentation, in your ability to get a job and function in society," says McIntyre, clinical professor of restorative dentistry and director of the Esthetic Dentistry Education Center in the University at Buffalo School of Dental Medicine.

The public's demand for the perfect smile has prompted a revolution, of sorts, in the field of esthetic, or cosmetic, dentistry, and UB is providing some of the most comprehensive training in esthetic dentistry in the country to both students and practitioners.

"The whole crux of why we're here is not only to teach esthetic dentistry, but to stay current with the latest and best practices to protect the public," McIntyre adds. He defines esthetic dentistry as "dentistry that the patient has elected to have performed and is not required for the treatment of disease."

"We're developing a standard of education -- we're the only university dedicated to teaching esthetic dentistry at all levels. Dentistry tends to be slow to change," adds McIntyre, who anticipated the demand for more lifelike restorations as early as 1987 and developed the first undergraduate course in the world in esthetic dentistry at the UB dental school. The esthetic dentistry center was established at UB in 1998.

Esthetic dentistry -- one of the fastest growing areas within dental medicine -- was a 1970s outgrowth of restorative dentistry, which historically was concerned with the function and biologic compatibility of the teeth. Initially, it was only cosmetic; dentists were doing it purely for the smile, McIntyre says, noting that out of that grew today's esthetic dentistry, which merges traditional dentistry with new materials and techniques developed because of demands for teeth that function well, as well as look pleasing.

UB's Esthetic Dentistry Education Center uses state-of-the-art materials and technology to enable dentists to update their skills and knowledge base while gaining invaluable clinical experience in incorporating the latest materials and techniques into their practices.

Practitioners can obtain proficiency certificates through the dental school's continuing education program.

The extensive hands-on experience with real patients and access to the top clinicians and lecturers in the field give students and practitioners unprecedented contact with the most up-to-date technology in a rapidly evolving field.

Some of the procedures performed in the 16-chair center include bleaching, veneers, anterior composites, direct composites, ceramic crowns, fiber-reinforced composite bridges, indirect porcelain or composite inlays and onlays, anterior crowns and microabrasion treatment.

The center has two full-time residents who see patients every day, as well as work with the dental students and the practitioners in the continuing-education program. A major focus of the center is teaching dentists to develop a multidisciplinary treatment plan that integrates the use of new materials "with a classical approach to functioning properly."

"All of these things have some impact -- not only does it have to look nice, it has to function right," says McIntyre. The goal for much of the work that takes place at the center is to lessen the impact of esthetic dentistry on the underlying tooth structure -- in short, cutting less of the tooth and surrounding gum tissue while making restorations as lifelike as possible.

"We want to give them back their smile while protecting the enamel and the underlying integrity of the tooth. The goals are esthetics, function and conservation of the tooth," says McIntyre. He notes that some of the new direct bonding materials are much more color-stable and long-lasting -- with a more natural look -- and allow the dentist to maintain the underlying tooth structure.

The center has been involved in community outreach activities as well, working with middle school-aged children who have become behavior problems due, in part, to their peers taunting them about the condition of their teeth.

"We have helped 12-14-year-olds with dental problems such as staining and discoloring that were severe enough to become a distraction and contributed to poor self-esteem; the kids didn't want to go to school. With some very conservative bleaching and bonding, these children can smile again with no one taunting them."

The center also is the only university-based program that participates in the American Academy of Cosmetic Dentistry's (AACD) "Give Back a Smile" program for battered women who are injured through spousal abuse. At no cost to them, women can utilize the center's services through a referral from the AACD to restore the damage to their dentition.

McIntyre sees the center as a resource for other universities looking to develop similar programs in esthetic dentistry and is working with the University of Minnesota in this capacity. Simultaneously, he is working to gain recognition from the various dental societies and their governing bodies that these programs are integral for training and setting standards in the field.

"General dentists have had a difficult time being recognized for their training and abilities. We're trying to have the governing powers recognize the importance of what's happening so that dentists can better compete when they establish their practices."

The end goal, however, is that all of this benefits the public, the patients," says McIntyre.