How Fixing Your Teeth Can Fix Your Face

When I reflect on the progress made by medicine during my lifetime, I give it a mixed report card. An A+ in many areas, but an F on maladies like Alzheimer's, amyotrophic lateral sclerosis, Creutzfeldt–Jakob disease, the common cold and many others. Not so with dentistry which in the past 50 years has progressed to the point where anybody with the resources to afford it can walk out of a dentist’s office with the set of choppers of their dreams. Show your dentist a magazine picture of Cary Grant’s smile, ask how much it will cost to replicate it in your mouth and he or she will immediately quote you some ungodly number like $55,000 or thereabouts. (Current movie stars and famous models are likely to cost you more.) I rarely see a pretty girl anymore who doesn’t have gorgeous teeth. But that’s because the people in my neighborhood have money or at least credit cards. But there are thousands of neighborhoods in this country where dentists and do-re-mi are as scarce as hen’s teeth. All this is by way of saying that the dentists and their money-grubbing lobbies possess a special kind of political magic, so that nowhere in all the recent discussion of health care will you find any mention at all of basic dentistry as a service that needs to be made reasonably affordable to all. https://www.washingtonpost.com/politics/the-unexpected-political-power-of-dentists/2017/07/01/ee946d56-54f3-11e7-a204-ad706461fa4f_story.html?utm_term=.f518b946f849

I hate to say it (well... not REALLY), but this sounds suspiciously like the 1950's "every child needs to have his/her tonsils removed", the 1960's "every woman over 35 needs a hysterectomy", the 1970's "you need supplementary estrogen/testosterone", and the ever present breast-implant, face-lift and liposuction industries. A lot of doctors', dentists' and orthodontists' children have been to college thanks to these fads. And, probably a lot of other peoples' children have not been able to get an education because of them. Ashes to ashes, dust to dust. There's no getting around it.

Owing to grinding, clenching, and 6+ decades of chewing, I needed either a mouth rebuild -- crowning all the teeth -- or dentures. I chose the rebuild for the sake of function, not aesthetics, and it has so far been worth the cost (24k). I had the work done at the graduate prosthodontics department at the university. It was a very long, drawn out process, but in the end was worth it. Aesthetics have been improved, but what I really appreciate is less discomfort, much less cheek and tongue biting, and better chewing. A healthy mouth means fewer oral infections and better over-all health.

Talking about Dental coverage for the aged is like talking about the weather. Everybody talks, but NOBODY DOES ANYTHING! Are there any Dems out there who will add this issue to their platform mix? Economy, jobs, fix our teeth!!!

You completely omitted the Orthodontists. They are not just "dentists" but specialists who are trained in the practice of orthodontia, They work on teeth/jaws of individuals from young children to adults, and have extensive training in re-configuring a person's mouth. A good "dentist" will not try to re-arrange your teeth him or herself, but will recommend you to an orthodontist.

In those extreme makeover shows, I always thought the most altering procedures were the dental procedures, hair, and makeup rather than the elective surgical/cosmetic procedures.

Most insurance don't cover dentist work like implants. My insurance considers the work cosmetic. Yet my dentist is telling me that because I have missing teeth its damaging others and changing the composition of my mouth since the teeth I do have lack support from the ones missing. This triggers sensitivity on the overexposure of the teeth that remain and makes them more vulnerable to cavities & infection. How is this not a health issue and considered only cosmetic? Makes no sense. I'm not into conspiracy theories but its as if this society wants to make sure those who are poor or lack resources look and feel the part, stay sick and struggling.

You would have to be the vainest person in the world to want to spend close to $10,000 to get the extremely minimal changes between the before and the after as depicted. Absurd.

It is all about airway/breathing, the improved facial aesthetics is just a side effect. My wife and I are dentists with 40 years each of experience. (We did our advanced dental education in NYC). We personally went through all that current dentistry has to offer by 2002. (braces, whitening, veneers etc.) My wife felt that she could do better. When we saw the result on ourselves, after rehabilitating our mouths with the proper nose to chin distance, we knew this was the healthiest and aesthetically pleasing results yet. We have completed more than 250 patients over the last 15 years. The importance of improved breathing with the issues of sleep apnea and an aging population have moved dentistry in a new direction. Previously it was dentures that re framed the aging face and prevented the collapse of the face and the tongue being pushed back into the airway. This generation is redefining "growing old." Remember that the "Boomer Generation" is the first generation to expect to be with a full complement of teeth for their entire life. My wife and I have embraced the idea that we are professionals role modeling the latest in healthy aging. View www.orodental.com to see before and afters.

Would be helpful to learn if women are at some disadvantage due to bone loss from osteoporosis. I had a tooth pulled -- very regrettably, after a failed root canal and a failed revision of same -- in my later 30s. Implants weren't the big thing then they are now -- thought I would always ask my dentist as they happening -- and waited for any type of restoration. When dentist finally did say ... go for an implant! -- it was both confusing and ultimately disappointing, as too much jawbone had eroded and implant dentist wouldn't do it. Ended up with a 4-tooth fixed bridge, which I know will be the death of me -- literally -- when some part of it ultimately fails due to an underlying tooth problem; it's almost a forgone conclusion. As a woman, and with even less bone now than 8 years ago, I dread whatever fate awaits me there. My biggest comfort with the reality of death is: no more dentists! What a sweet relief that will be :)

Dental tourism is an option as well. There are first rate dentists and orthodontic specialists in many countries, almost all of whom do work much more cheaply than in the USA. We have our dental work done in Mexico and the results have been very satisfactory.

My teeth but for 6 were all caps, one set of 3 composing a bridge. The caps were terribly expensive but were done over time, when I had some insurance, some money, and parents who were aware of my teeth (parental guilt for my toothy genetics, I suppose) and kicked in quite a bit too. The process was actually quite well done, very patient-friendly, and the dentist did his own manufacturing, etc. (he was the head of a dental program at a university in Idaho). Yet, the process cost somewhere around 10-15K. Alas, caps have a 'life' as does anything, and one cap gave up the ghost. I now have a nifty implant. For the cost of about 4 grand, and that was with insurance. Mind you, the dentist charges to create the fake tooth and install it, just like a cap, while the dental surgeon/etc., charges to do the implant bit, which is really only the plate/bone foundation and the post on which the "implant" sits. Probably the most pain-free, problem free dental surgery/process I have ever had. But that cost is, simply, prohibitive for most people (including myself; I'm still paying) and just untenable. And, the argument that 'it's good for life' is specious in that most folks don't need that kind of procedure until every other option is exhausted. If they intend for implants to replace tooth capping (and why?), again, it must be cheaper. But dentistry for "aesthetic" purposes - one's ego - is simply obscene (actual injury/etc., notwithstanding of course).

Dental repairs aren't always cosmetic. I replaced multiple aging and broken crowns a few years ago and my bite collapsed as a result, leaving me with a severe overbite. My upper front teeth completely covered the lower front teeth. I felt as though there wasn't sufficient room in my mouth for my tongue. I had to breathe with my mouth open like a dog and I awakened several times during the night gasping for air. The dentist suggested a couple of extractions and orthodontia (two years) might fix my bite. I had braces as a teen, I wasn't doing that again and I certainly wouldn't let that dental office to anything else to me. I was desperate. I finally found a dentist who fixed my bite with crowns of sufficient height to bring everything back into alignment. I had a number of other problems (root canals, ancient failing fillings, etc) that I fixed. Dental insurance, health insurance (breathing issue was considered a medical condition) and my own pocket paid for it - about one-third each. This was not how I planned to spend my $$$. It cost a fortune but I can breathe normally again and my mouth of old hodge podge dentistry is gone. I wear my mouthguard every night. Moral of the story: be very careful about getting/replacing crowns or any other dental work that will impact your bite. Be sure to ask a lot of questions about bite beforehand. Don't make my costly mistake!

With a messed-up bite, breaking teeth and a lot of wear and tear, I was quoted $50,000 to repair the situation -- at a dental school! Forget the cosmetic side of things -- I just want to be able to eat!

The cost of restorative dental work puts it beyond the reach of many people. I would strongly encourage such people to consider lower cost dental work overseas. My wife needed extensive dental work - extractions, implants, crowns/bridges, etc. I went with her to a top dental clinic in Budapest and was simply blown away. Of course, the cost was about one third of what we would have paid in the U.S. More importantly, the clinic was ultra-modern and immaculate beyond anything we had seen in the U.S. Their work was excellent according to our primary dentist in the U.S. As an added bonus, Budapest is one of the most beautiful and fun cities in Europe. It's no wonder the clinic is filled every day with patients from all over Europe and even the U.S.

The other option is to just accept that some things may change as you get older. (Spoken as an old person myself.)

Dental care in the U.S., like so many other treatments, is only for those wealthy enough to pay for it. I suffer from bone, gum and tooth loss but the cost of repair is well over $10,000 and dental insurance doesn't cover it. This is the reason so many U.S. citizens become medical travelers. They need to find less expensive medical treatments.

This article is important less for the "cosmetic" aspect --altho that is a legitimate concern for all-- than for the attention drawn to how vital is dental care overall! Poor dental health/infections can lead straight to cardiac infections/problems! It is one reason why as a medical social worker I advocated that government insurances begin to cover dental health. I can't tell you the number of cardiac patients I saw in the hospital who would not have been cardiac patients but for their lack of dental coverage. Similarly, government insurance for the longest time would cover surgery but not chemotherapy for breast cancer patients; ironically, later, it WOULD cover hospice care for those women whose cancer had not been treated! PLEASE everyone, support universal comprehensive healthcare.

I'm 32 and in the process of having braces for a second time. My jaw was broken when I was about 7 and my parents didn't bring me to the doctor. It healed incorrectly and now I need corrective jaw surgery. By the time I'm 50 I'll have ground my teeth to nothing and my TMJ is already pretty bad. I'm not rich and aside from the braces, my insurance (which I'm fortunate enough to be able to afford) will pay for the vast majority of it. I'm assuming this is an issue that quite a few people have and I hope they can also get it fixed, even if they are much older than me. It changes the entire face shape like the article says Invisiline will.

Nice if you can afford it. Most can't except of course those making 6 figures per year. For the average schmo we need dental insurance which usually doesn't cover cosmetic procedures and for all other procedures beyond the basic dental fillings or cleaning, either there's a 1-2 year wait and/or the coverage is only 50% at best. So smile, smile, what's the use of worrying..... it's nice to be rich.

My bite go so bad I was chewing up the tissue behind my front teeth. Orthodontia at 60 was a godsend and even changed my looks for the better in ways that I never imagined. Do your dental home care because if you neglect your gums, orthodontia at that age may not be advised.

This is cosmetic dentistry. My tax dollars will not pay for it and should never pay for it. At a time when we are figuring out how to find a sustainable system for healthcare, do we really need to see a 'before /after' a dental intervention? Get real NYT. Your reporting is slowly but surely making me feel less inclined to subscribe.

Dental care is for rich people. And you can tell who is rich among older people by looking at their faces. I need dental care desperately, but can't afford it. Medicaid should cover it.

I was losing my teeth in my 50’s and had a full upper mouth restoration, sinus lifts both sides, implants and all new teeth. It took 5 years and in excess of 35K which is a lot of money after taxes. I did this while I was still working. The cost of dental care is beyond ridiculous. I could have spent less on a face lift but, I really like chewing my food and having a nice smile.

It seems many people are disturbed by this article in a way I can't seem to comprehend. The author is relaying vital yet practical info on a subject that many are probably not aware of in relation to dentistry. With this new understanding people can look into a solution for their looks aesthetically that can be achieved with dentistry permanently and perhaps in coordination with Aesthetic and Regenerative medicine have a positive impact. This may be physically, psychological, and emotionally. The way that it is paid for if a person wants it is of little concern to the author. The other aspects of insurance and government and the ACA are not germane to the actual article. These are tangential topics that can be addressed but misses the articles point. Dentist pay an astronomical amount for dental school and most come out of school in significant debt. To start a dental practice of any type also cost a large sum of money to satisfy all the regulations that are in place. Then to appeal to patients and to have any relevant or effective marketing more money has to be spent on ads. To acquire and retain competent staff salaries must be competitive. Do you see the common theme? Dentist don't just charge people inflated prices for their skill and knowledge. It is a fair price that is reflective of the cost of doing business. Dental insurance is your friend buy it, and please brush twice a day and floss at night...

Bites collapse when posterior teeth are missing. In the natural dentition, teeth continue to extrude as they wear. As long as they are present, the vertical dimension of the face is not altered. The length of the arch may shorten because wear will cause the contact points between the teeth to move towards the neck of the tooth, but that's really a minor consideration. So, is this an infomercial for Invisilign? The loss of facial volume has nothing to do with teeth if they're present. Teeth become less convex due to wear, but nothing looks more grotesque than twenty year old teeth in a seventy year old individual. People present differently as they age because of gravity. I would suggest concentrating on periodontal health and accept that dentists do not dispense time machines.

I am so tired of all the ageist stereotypes perpetuated by the media, as with the example of the generic "grandpa" cited in this article. A silly and not relatable example considering how much more gracefully people generally age now, particularly if they take good care of their teeth. Now in my late 60s, I am increasingly aware of subtle biases I encounter day to day. Not to mention how ridiculously older people are portrayed in ads! Enough. It is not OK to stereotype and exhibit bias against any group.

Unfortunately, I was raised by Scottish parents who grew up with the idea of taking all the teeth out young and replacing them with dentures. This was done because their teeth were soft due to nutrition , the love of sweets, and the soft water in Scotland that is great for whiskey, not so great for teeth.! As a result, I always had a horrible fear of dentists in my youth and as an adult couldn’t make up for my poor dental hygiene to offset dental decline. My husband had an even worse fear of dentists. But we deliberately spent money on our children’s teeth and as a result, they have great smiles. I live with what I have as the cost of dental work is so prohibited, and not covered by many insurance plans, as pointed out by these comments. A while back I saw an article that told of the ADA’s deliberate push back on dentists fees and coverage, the explanation being they had done such a good job of preventing cavities back in the late 50’s and early 60’s, they had fewer patients! So they needed to make money in exorbitant fees and more expensive cosmetic work. I only hope when universal coverage comes to this country, dentistry comes along with that enlightenment.

I never thought about it, but the reason government workers generally have excellent dental insurance and the rest of us do not, is so that they may better put the bite on us.

It seems a little cavalier to promote cosmetic dentistry for the aging population when Medicare pays nothing towards dental care.

I realized that my Mother, now 98, looked MUCH younger in large part because of her teeth...i.e., dentures, that she got when she was in her mid-30s. The color and the shape of her teeth never changed...so, at 73, I did what I needed to do...had my front teeth redone...I am now very frequently complimented on my smile/youthfulness...and I know that my $$ investment was worth it.

how,exactly, do the eye sockets get larger and the bones of forehead recede ? Doubtful !

Most dental insurance runs out almost immediately when applied to payment for reconstructive procedures like those mentioned. Dentistry, like so much else in our world, seems to be for those who can afford it.

It should be noted that dental care is excluded from health care — unless you have a rich employee-paid plan. Why is dental and vision not a core part of all health insurance plans, part of Medicare, ACA and health care reform? Why not hearing aids? The cost of these categories of care are dirt-cheap compared to any outpatient health care, yet the payoff is huge...as this article reports.