Dr. K. WIlliam
aesthetic mock-up is placed directly over the patient's own teeth.
K. William Mopper, DDS, MS
Dr. Mopper, the 2003 recipient of the NYU Irwin Smigel
Prize in Aesthetic Dentistry, is Cofounder and Chairman of Cosmedent,
Inc., an Illinois-based corporation dedicated to training dentists
in the field of aesthetic dentistry and to developing and marketing
aesthetic dental materials to the profession.
Global Health Nexus (GHN): Based on your 30 years in practice,
what would you say has been the biggest boon to dentists in their
quest for aesthetic perfection?
Dr. Mopper: That would have to be composites. I
am convinced that composites are dentistry’s most versatile
material. Not only in the quest for aesthetic perfection, but in
all areas of restorative dentistry, I believe that composites yield
the best possible results.
I have found composites to be more biologically compatible than
all other dental materials, when used properly. In observing the
effects of composites
in patients over decades, I have found minimal recession of tissue,
no appearance of toxicity, and that the gingival tissue responds
to the direct composite resin in a manner similar to normal tooth
structure. Another benefit of using composite resins is that they
allow the dentist to fabricate the tooth structure directly in the
patient’s mouth, without sending it to a lab. This puts the
dentist in control of the material and minimizes the need for laboratory
fabrication. Since lab fees are always going up, this is a practice
Composite resins are here to stay; they are getting stronger all
the time; and they offer many more uses than just veneers. Dentists
should be able to use them for virtually any restorative or aesthetic
procedure, including class 3, 4, and 5 restorations, a diastoma
closure, to invisibly restore an enamel defect, or for any desired
restorative orthodontic technique.
GHN: Are there any problems using composites?
Dr. Mopper: Problems arise because many dentists
don’t have a sufficient understanding of the science of composites
and how to use them to achieve consistent, reliable, durable results
every time. Instead of mastering one system, there is a tendency
to switch every few years, whenever a new system comes along. This
is a case where overreliance on new technology can be counterproductive.
Another problem is the belief that there’s one material that
can do the job. The reality is that no one material can produce
a perfect aesthetic result. What’s required is a combination
of multiple composite materials that have different properties in
order to achieve an optimal aesthetic result. For example, microfill
is a very important part of the system because it replicates the
enamel structure beautifully. Hybrid is a necessary component as
well, because it replicates the dentin both in strength and opacity.
So the use of the two materials in combination provides the best
possible results. I’m very proud to have played a role in
producing many of the composite materials now available that allow
dentists to achieve any color, any opacity, any translucency necessary
to create a realistic tooth surface and accurate morphology.
GHN: How would you sum up your philosophy of aesthetic
Dr. Mopper: My philosophy is very simple: Aesthetic
dentistry is both an art and a science. The art depends on the skill
of the dentist and the science on understanding composites and the
proper application of these materials.
The key is continuing education based on materials that are systematic
and concepts that are presented in a cookbook-type format that demystifies
the process and makes it easily accessible.
GHN: Now, let’s say that the dentist has
mastered the art and science of composite resins. The next step
is getting the patient to say yes. What is your approach?
Dr. Mopper: Patients select a dentist because they
believe that person to be an expert in the field. Show the patient
that you care. Listen to the patient and to the patient’s
expectations. Then express confidence in your ability to give the
patient what he or she wants and outline the benefits of your proposed
treatment plan. Show the patient many examples of your treatment
results and especially those that relate to the treatment that you
have proposed for the patient.
But actions speak louder than words, so I also recommend
demonstrating your expertise by creating a mock-up of the
aesthetic results directly in the patient’s mouth. You can
do this with an intraoral camera and imaging, but I don’t
think it has the same impact. Using a material called “show
off,” which self-adheres to the tooth structure, I prepare
a three-dimensional mock-up that very rapidly shows patients what
they will look like. Fully 99 percent of my patients say yes on