|A Balanced Smile, A Brilliant Story|
|Written by Dr. Kelvin Mah|
If you've read any of my previous articles, you've likely come to realize that my appreciation for dentistry goes far beyond education and expertise. When I see the end results of my patients, it's not the teeth that I admire, it's the vibrancy and excitement exuding from their new smiles. This story, I am proud to say, is one of the same.
Shilan was one of my more recent patients who, like many of my clients, was referred to my practice from a close friend. Shilan, a wonderfully respectful and charismatic woman, had recently moved to Vancouver from Calgary with her young daughter and was in need of a new dentist. She had always visited the same practitioner back in Calgary, and she had her reservations about other practices. I fully understood her concerns; having a dentist who has first-hand experience with your dental past is priceless. So, I was quick to reassure her that I would be happy to care for her smile for as long as she would have me.
During our first meeting, she expressed minor concerns regarding tooth sensitivity. As most sensitivity cases go, she had a small cavity that had gone unattended in the past. It was an easy fix. However, when she was talking, smiling and trying to colourfully illustrate her dental history, she appeared to have a few reservations beyond the new office setting. In my experience, I've come to realize that hesitancy is a tell-tale sign of something big. It generally indicates that the sentiment is, in fact, extremely significant and important. With that idea in mind, I abruptly asked her what her true dental aspirations were. She responded with, 'I want healthy and beautiful teeth”.
Now, cavity aside, Shilan's teeth were extremely healthy. They functioned perfectly and were not broken, cracked or particularly stained. Beautiful, no? Well, when I asked her to elaborate, she expressed how the color wasn't quite up to par. Of course, I suggested whitening. Shilan had never been told about all the new, safe and effective whitening options available. She was pleased to hear that a solution was so easily accessible and affordable. However, I still wasn't truly convinced that she was fully satisfied with such a simple procedure. She expressed excitement, but it was muted and, perhaps, even feigned. So, I continued asking her what else she wanted-- what she really wanted for her smile.
At this point, I questioned if I had asked a few too many times. She had become a bit quieter and I was worried that I may have annoyed her. However, after a short moment of silence, she abruptly said, “it's too gummy”. Her voice was meek yet playful, as if she were trying to avert from the gravity of the situation. But after her initial explanation, her confidence began to grow and she continued into an expressive, honest and genuine declaration of how her teeth were too small, gums were too large and how the combination left her extremely unhappy. “Ever since I was 13, I would stare at my face and teeth for hours in front of the mirror to see how I could fake a smile. I’ve always been hesitant to smile,” she explained.
But recently, Shilan had embarked on a self-improvement exploration which included weight loss, healthier living choices and an all-over life make-over. And yet, she still found her overall improvement was being hindered by her “gummy” smile. “When I’m about to smile or laugh, I make sure to cover my mouth with my hands, scarf or just put my head down. In photos, I often look sad or serious,” she described.
Being limited by a smile is a common issue, and I reassured her that her feelings were shared by many. A smile is like a physical resume. People often believe that they can tell everything about a person based purely on the appearance of their smile. Of course, Shilan was a fun and intriguing woman, but the small stress marks and muscle strain around her face gave off hints of displeasure; a common feature on individuals who are self-conscious of their teeth.
We all have unique interpretations of 'beautiful' and it was crucial that I listened to exactly what she wanted, not to what I assumed she wanted. To me, it is absolutely vital that I actively listen and fully understand what my patient's concerns are. The psychological effects of a physical concern are profound and can create immeasurable stress and it's my duty to alleviate or minimize such stresses to the best of my ability.
During our next consultation, Shilan asked about porcelain veneers. She wondered if they would be a solution for her but was concerned of the cost. However, although veneers are often an ideal solution for addressing smile concerns, I suggested that she consider a different option. Veneers would allow her teeth to look larger but it wouldn't make her gums any smaller. I then explained that her teeth themselves weren’t causing the problem, and that her teeth were, in fact, wonderful. It was actually her gums that were causing the unbalanced proportions. I suggested she consider a minimally-invasive gum reshaping procedure. This plan would be significantly more conservative and less expensive than the veneers while also eliminating the “gummy” appearance that was so clearly bothering her.
As it turned out, an ‘ideal’ result would entail a visit with a specialist and would involve reshaping both the gum and bone around each of her front teeth. However, I suggested a more conservative approach that would give her a nice result that would not involve affecting the bone. After all of our long consultations, I knew she didn't want to spend a fortune, didn't want a myriad of different doctors and wasn't looking for a super-star, 'wow, where did that come from?' smile. She wanted her own personal smile, merely enhanced.
As presented, we completed the reshaping of her gums in under an hour, with no pain, or complications.
When we initially gave Shilan a mirror to review her results after the quick procedure, there was a long silence. I looked over to my assistant and my heart sank thinking that Shilan was unimpressed. My heart sank further when she broke into tears. Seeing a new smile can be devastating if it doesn't look like what you imagined, and I thought that she was unsatisfied. But then, unexpectedly, the tables turned. Shilan jumped out of her chair and gave me a huge hug!
“This has been bothering me since I was a little girl! You’ve given me my smile!” she proclaimed. She then gave my assistant a hug and continued to smile and weep as if a miracle had just taken place. It was then that we realized the gravity of what had just occurred. Not only was she pleased, but her entire life had changed, for the better.
When Shilan returned a few weeks later, it was as if a veil had been lifted. She smiled with the vibrancy and energy of the whole world and there was no longer any strain around her lips. Her smile truly reflected how she felt about herself; confident, proud and beautiful. She commented that she has never smiled as much as she had in the past few weeks, ever. “Now, I simply smile without thinking about it anymore. I am more confident and I get more compliments about my smile. I don't have to think when I smile or laugh. I just smile!”
Shilan’s experience was a powerful reminder of why I started working in dentistry so many years ago. There’s nothing more fulfilling than making a lasting impact on a person’s life. And there’s nothing more gratifying than seeing the difference standing and smiling right in front of you. Thanks to Shilan and my other inspiring clients, I’m driven to continue “enriching lives, one smile at a time”.
Photo credit: Ashley Drody Photography (www.ashleydrody.com)