Rechavia Dental Center

Repair or Remodel? The best way to achieve the perfect smile



By Dr. Daniel Kaszovitz DDS, FAGD

Rechavia Dental

Over the years people do a lot of quick patch up jobs in their homes. For instance, when your kitchen countertop cracks you fill it in and when your cabinet starts coming away from the wall you put in additional screws to hold it up. As the patches and fixes add up, what was once a house by design has become a patchwork of temporary fixes. Over time the question of repair or remodel becomes more relevant.

“Repair or remodel?” isn’t just a question about home décor, however. Surprising as it may seem, it can also be a question for your dentist. Over the years most people get cavities or have teeth wear down unevenly. While a competent dentist can take care of different dental problems as they occur, after a few decades the patient may be left with a mouthful of teeth that are not harmonious. They don’t look like they belong in the same mouth, and often no longer follow the natural lines of the smile.
The most common cause is years of patchwork tooth repair. Each time the dentist fills a tooth or places a crown he matches the size and color of the repaired tooth to the adjacent teeth. However, as other teeth continue to wear down and change color over the ensuing years, the patient may ultimately wind up with a mouthful of teeth of various colors and heights. What was once a beautiful harmonious smile may now be uneven and unbalanced.
Another common problem occurs when one is missing a tooth for an extended period of time and the opposing or adjacent tooth drifts to partially close in the space. When the dentist puts in a new tooth, he will fit it to the size of the smaller opening. Over time this can lead to a roller coaster type of bite where the teeth do not follow the smile line but ride up and down across the jaw.
An uneven bite can also occur when tooth enamel erodes. Enamel is the hardest substance in the human body, much harder than bone, and seven times harder than the underlying dentin. Once the enamel has been worn down, the softer dentin will wear down much faster. Since the dentin is the inner layer which protects the nerves, it is important to make sure to treat the condition before it progresses too far. Look at your mouth in the mirror. If you see small yellow circles on the edges of the chewing surfaces of your teeth you have already worn through your enamel and, if you notice it on one tooth, there are probably others like it that you may not be able to see. Porcelain or other modern materials like zirconium that not only mimic the look of, but are actually harder than enamel, are used in making the crowns to replace the enamel and protect the remaining dentin and nerves.
The length of your teeth also determines the height of your face. Over the years, as the teeth become shorter through wear, the face can also become shorter and wrinkles become more pronounced. In severe cases people no longer show any top teeth when they talk, giving the impression that they are missing teeth. Restoring the teeth to their original height can make for a more youthful and healthy smile. An additional benefit is that as the face is restored to its proper height, facial lines may smooth out slightly.
If you are concerned about your smile or bite, it may be time for you to consider remodeling. Today’s cutting-edge equipment and techniques offer many options for dental restoration and remodeling. In addition, patients who have been previously told that they do not have enough bone for an implant can now take advantage of new methods of placing implants. These new procedures are often quicker and less invasive then those of the past.
After a thorough exam, including digital x-rays and a functional and aesthetic analysis, your dentist should be able to offer a variety of solutions for your particular dental concerns and help you choose those that best suit your needs and desires.

Dr. Kaszovitz graduated from New York University (NYU) Dental School in 1996. He then completed a two-year residency in dental and oral surgery at Brookdale University Medical Hospital and earned his fellowship in the Academy of General Dentistry. Dr. Kaszovitz completed a one-year joint NYU-Brookdale hospital program in implantology, as well as traveling overseas to complete the “All on Four” certification course in Lisbon. He continues to take courses regularly to improve his expertise in both general and specialized areas of dentistry, including aesthetic dentistry. Rechavia Dental Center is a full service American dental and orthodontic clinic in Jerusalem. They can be reached at 02-561-9770 or through their website

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