A smile makeover involves some dentistry treatments and procedures that help improve the appearance of your smile. “It usually entails simple procedures like teeth whitening, veneers dental bonding and implants, as well as complex procedures in the gums and jawbone that involve oral-maxillofacial surgery. And since your lips create the boundaries of your smile, the teeth and gums have to fit well within these boundaries for a natural and attractive smile. The other kind of surgery is for reconstruction following an accident or complex oral cancer,” says Dr Suman Yadav, Head of Maxillofacial and Dentistry at Numed Hospital, Noida, and professor at ITS Dental College. “The smaller procedures can be done on a chair with local anaesthesia while complex procedures have to be done under general anaesthesia,” she adds.

CAN ANESTHESIA GO WRONG?

The man’s father has alleged that his son had died because of a faulty dosage of anesthesia at the FMS International Dental Clinic in Hyderabad’s Jubilee Hills on February 16. “First of all, any dental correction which involves surgery should not be done at a clinic but at a hospital. However, let me say that the risk of serious complications happening as a result of anesthesia is much less than one per cent. While generally safe, local anesthetic agents can be toxic if administered inappropriately, and in some cases may cause unintended reactions even when properly administered. The toxicity of local anesthetics can impact the central nervous system. Sometimes faulty administration may cause the anesthetic to enter the bloodstream and impact the cardiovascular system, triggering arrhythmia,” says Dr Dhir. That’s why he advises that any cosmetic procedure should be done at a certified centre.

WHAT DO YOU NEED TO KNOW BEFORE A SMILE DESIGNING PROCEDURE?

Don’t go by perceived ideas of what you consider is a beautiful smile, warns Dr Dhir. “Let the surgeon evaluate, diagnose and decide how to address issues affecting a person’s smile such as misaligned teeth, discoloured teeth and a gummy smile. One has to ascertain the condition of gums, teeth and their functionality before attempting cosmetic corrections. Ensuring gums are healthy and symmetrical prior to doing a smile makeover can make a big difference in the final outcome of a cosmetic case. Teeth that are crooked, overlapping or have gaps between them have to be straightened and aligned. In short, all aspects of dental health and components of teeth, such as their dimensions, angularity, alignment and spacing, have to be considered,” he says.

A patient needs to do all necessary pre-op tests, especially if one is suffering from co-morbidities. Some surgeons insist on nerve conduction studies (NCS) in which a mild electrical pulse is applied to muscles of the face and head to detect areas of possible nerve damage. “As a general rule, we tell patients to avoid non-steroidal anti-inflammatory drugs (NSAIDs) and anticoagulants (blood thinners) in the days preceding the surgery,” says Dr Dhir.