Hollywood Smile is a total makeover of your smile, i.e. a complete prosthetic reconstruction of both jaws using caps, veneers and, quite often, implants. Hollywood Smile involves placing dental crowns on all teeth, or at least on all visible teeth in both jaws, which means up to and including premolars. The term comes from the eponymous movie mecca and is used to evoke the brightly bleached teeth of Hollywood celebrities.
The bleach colour comes in four shades on the scale of 1-4, 1 being the brightest, and 4 the least bright but still completely white. In most everyday situations, it is quite difficult to distinguish between the four shades, and they are only visible against very bright light or when a person gives a really broad smile. On the other hand, the patients who wish to retain the natural yellowish hue of teeth may go for the standard colours A1, A2, A3, B1, B2 and B3. These, however, are not considered a Hollywood Smile, because Hollywood Smile means bleach white.
Available colour shades for crowns
Hollywood Smile using veneers
A perfect white smile, i.e. Hollywood Smile, is achievable using veneers when the patient’s teeth are generally of sound quality, including the chipped ones, or having fillings or yellow colouring. A great number of celebrities will undergo this procedure. However, in practice, a common situation is that a patient would like a Hollywood Smile treatment using veneers, but are unaware that their teeth are not healthy enough, or properly aligned, or sufficient in number to wear veneers. The requirement is that all teeth including molars are present and that they are properly laid out. If they are not, we recommend getting fixed braces beforehand.
We take immense pleasure in creating a Hollywood Smile for patients using veneers, because it is the least invasive procedure possible which gives a remarkable transformation to your smile. But in reality, we are not given that opportunity very often.
Hollywood smile – veneers
Achieving a Hollywood Smile with crowns and bridges
A more common case is having a Hollywood Smile by placing crowns and bridges onto natural teeth, which has a medium level of complexity, halfway between using veneers and using implants with dental crowns. We go for this technique when the patient has at least half of their teeth in sound condition, with the other half having a healthy root and enough bulk to mount them with crowns. In a space where there are one or two teeth missing, a bridge may be placed without major complications, but if there are more teeth missing, then we have to introduce implants, which will serve as a preparatory procedure for a more complicated piece of prosthetic work.
Hollywood smile – crowns
Implants and Hollywood Smile
In our day to day practice, the Hollywood Smile is most commonly achieved using implants, since most patients do not have a sufficient number of teeth, and especially not enough healthy teeth for a veneer, crown, or bridge produced Hollywood Smile. First, the roots and teeth designated for extraction are pulled out because they will not be usable in the final work. This means that the patient will be partially or totally without teeth before placing implants into sockets where the teeth used to be. You can read more about the procedure of creating Hollywood Smile using implants in the following section.
Esthetically, the best effect is gained if the patient has, which is often not the case, their own teeth because the transition between the crowns or veneers and the gums is then the most natural. When it is estimated that the bone and gum defects are substantial, we make use of pink porcelain as a camouflage and to imitate gums, which is almost always the case in complete toothlessness where the level of bone deterioration is too great.
Choosing implants and crowns
Depending on case to case circumstances, which involve jaw bone condition, position of sinuses, nerves, and other parameters, at Cvejanović Clinic we will offer a number of options to choose from regarding the type of implants and crowns, where the doctor will assist you in choosing the best option. In most cases the patient chooses between two brands – either Implant Direct, representing mid range quality, or Nobel Biocare, which is a premium class label.
The model which will be used is rarely a deciding factor, with the focus being more on the position of implants and their number, the vitality of bone tissue and gums around the implants, as well as the choice of adequate abutments. The bond between the implant and the abutment is also important because the gum tissue around the abutment is the major barrier against bacteria. The quality of abutments improves significantly with premium brands like Nobel Biocare.
On the other hand, the patient is given carte blanche to choose crowns for themselves. The price for nonmetal, zirconium crowns is €200 per crown, whereas the price for metal-ceramic crowns (having a metal core) is €100, which means a patient may save more than €2000 if they opt for metal-ceramic crowns. A good compromise may be to use metal-ceramic crowns in rear areas which are less visible, and nonmetal ones in the front area, but this is all left to the patient to decide.
a set of 28 zirconium crowns
Limitations to using the Hollywood Smile procedure
We have to emphasize that the success and longevity of any complete prosthetic reconstruction, like the Hollywood Smile, lies in securing the functionality of the teeth and the jaw first, and providing esthetic satisfaction second. If we wish to render any prosthetic work long-lasting, to be able to vouch for it and give warranties, we have to cover the teeth at least down to the first molars, in both jaws and on both sides. Sometimes the patients lacking back teeth want to reconstruct only the front ones, but this is very hard to achieve and possible only by using multiple implants, certainly not against crowns and veneers, because front teeth need to be supported by back teeth. It is also not uncommon to have younger patients, who have excellent teeth, wishing to get veneers or caps on all teeth for esthetic reasons. We tend to talk them out of the Hollywood smile procedure, because despite the fact that the veneers are minimally invasive, there will still be some damage (abrasion) to the teeth involved.
The misunderstanding may arise when discussing the possibility of combining veneers, crowns or other types of Hollywood Smile on one jaw, and whitening of teeth on the other. By whitening your teeth you cannot achieve the level of whiteness that the Hollywood Smile provides, but you can make them slightly whiter than the natural hue. Furthermore, the white look gained by whitening must be maintained, or otherwise the former colour may return.