Although the final look of the Hollywood Smile procedure is similar for all patients, the way Hollywood Smile is done varies based on whether veneers, crowns, bridges, or implants have been used, which is discussed in detail in the article about the Hollywood Smile procedure. Almost all patients are potential candidates for the Hollywood Smile, but the requirements that have to be met concerning the condition of teeth and jaws, as well as the readiness to undergo different types of procedures affect the way that the Hollywood Smile will be achieved.
Requirements for the veneer Hollywood Smile procedure
The most common question we get at our clinic is: “Doctor, can I get a Hollywood Smile with veneers?”
Hollywood Smile achieved using veneers is the least demanding and least invasive, and therefore the one patients are most keen on getting. Because, let’s be honest, everybody would like to have squeaky white teeth with minimal to no recontouring needed, but in practice, things do not turn out that way and patients need to get substantially informed in order to grasp the benefits and limitations of the veneer procedure.
Hollywood smile, a facet variant
Veneers can be placed on healthy teeth with a fairly good alignment so that minor irregularities are not an obstacle. The most important thing is that the back teeth are there, because the lack of teeth as well as the irregularities in the bite and tooth shape cannot be corrected by using veneers, but the fixed braces, bridges or implants need to be introduced, and sometimes even all of these together.
It is necessary to take into account the patient’s age. Today, even minors come to us wishing for a perfect smile. However, at that age, growth and development of teeth, gum and jaws has not yet been finished, so they have to let all of these fully grow in order to undergo such a serious procedure as is the placement of ceramic veneers. If a patient (i.e. their parents) wishes to proceed at any cost, we would suggest using composite veneers as a temporary solution.
Requirements for the Hollywood Smile using crowns and bridges
In a situation where a patient is missing teeth or parts of teeth, or when the alignment and shape are awkward, crowns need to be introduced to the Hollywood Smile procedure. They are placed over a whole tooth, much like caps, as opposed to veneers which cover only the front of a tooth in a form of a flake. The caps enable the use of a simple substitute for the lost teeth in the form of bridges, which cannot be done with veneers. If, after the CBCT image analysis and an examination, we conclude that there will be enough healthy roots that can support caps and bridges at least down to the first molars on both sides and in both jaws, the use of implants will not be needed.
Having the Hollywood Smile using caps is a form of the procedure most commonly carried out. A typical patient will lack a substantial number of teeth, with great irregularities in shape and alignment, and often having dead teeth, i.e. root canal treated teeth that also require crowns. There are often patients who carry old caps which need to be replaced with new, white crowns. In cases where the caps are required in one jaw but not in the other, we can combine the procedure by placing caps in that one jaw and veneers in the other.
Requirements for the Hollywood Smile by placing crowns on implants
In order to have a successful Hollywood Smile procedure requiring implants, it is very important that the planning and positioning of implants are guided by the prosthetics, i.e. that the position of crowns against the gums and bones is planned first, taking into account the lips, cheeks and facial expressions as well. Only when the position of crowns is thoroughly planned, which is often done using DSD, can we embark upon the procedure of placing implants, when we can easily identify if there is a need for gum and bone regeneration or a possible introduction of pink porcelain as camouflage.
With complete toothlessness, when All-on-6 and All-on-4 methods are used, the loss of bone tissue and gums is a common problem in getting the perfect Hollywood Smile, and here, as a rule, pink porcelain is used, because the bone and gum defects are more pronounced. Sometimes the patients presume that even though they have lost a great number of teeth they can still get a smile out of a magazine, which means a perfect colour transition between crowns and gums, just like in natural teeth. However, the moment a tooth is pulled out, there is an immediate loss of bone and gum tissue, thus automatically making the future crown put in the same place more noticeable, or “bulging” and “unattractive” in the eyes of the patient. If this is unacceptable for the patient, we will introduce bone grafting and gum regeneration or we will simply use the pink porcelain.
You can read more on requirements that the patients must meet in order to get implants and to have more chance to have them last for a lifetime in this section of our site.