Dr. Josh Muir 0:05 Welcome back, everyone. My name is Josh Muir, thanks for joining us. This is the Smile Reconstruction Dental Implant Podcast, the podcast where we talk about everything involved with dental implants. And I’m here with Tanner Townsend. Thanks so much for joining us with this episode. For this episode today, we’re going to talk about looks good versus works good, and functionality versus artistic approach to the human smile.

Dr. Tanner Townsend 0:31 All right. Well, just like you said, there are a lot of different teeth out there, and sometimes they look better than they actually function; work. So if it were you, which would you choose, function or esthetics? And why?

Dr. Josh Muir 0:49 Boy. Oh, boy. Well, I am a little bit of a foodie. So I like to eat. I like to try all the different flavors and textures. And so for me, it would have to be function. But I am married, and my wife, I know, would require some esthetics, also.

Dr. Tanner Townsend 1:07 That’s a that’s a fair answer. Okay, so walk us through. I think this is something that we commonly run into in our practice of, you know, how do we marry that, that relationship between function and aesthetics. And if we have to lean one direction versus another, which direction do you lean?

Dr. Josh Muir 1:27 Yeah, it’s, you know, it’s, it’s interesting the scenarios we get into, because just on Thursday, I had a patient, and a lot of times in these consults, it’s difficult to know for sure what the patient is thinking. And they may have some ideas, but they don’t want to share too much. They may say, I really want this, but I’m sure I’m not going to be able to afford it, so I’m not going to say that. I’m going to say something else. And there are all these games that psychologically patients will play without even knowing it, rather than just tell us what they’re thinking. And so I’ll often use some lines, such as I’ll say, so I want to paint a little picture of some directions that we can go with this. Some people come in and they say, Doc, I don’t care if it even works, I just want to have the most beautiful smile ever. I’m going to be in this beauty pageant, or my daughter’s getting married, or I’m getting married, I just want it to look nice. Other people say, Doc, I don’t care what it looks like. I just want to eat. And most people are somewhere in the middle. And so, sir, you know, where, where do you fall here? And the guy that I had on Thursday, he said, Well, Doc, I’m too old for all that stuff. It probably doesn’t matter how it looks. I just need to eat like, Okay, well, that really helps, because he’s, he’s more focused on the function and ease of maintenance and all of that kind of stuff. So that’s, that’s how I run into it.

Dr. Tanner Townsend 2:59 And I think, I 100% agree with you, that we kind of want to meet somewhere in the middle. Whenever I have a patient who says I only care about the way they look, I get a little nervous because I know that you’re going to want to eat at some point down the road, and so function has to be in my mind, tied in there in some way, shape or form, to allow you to be able to eat your food?

Dr. Josh Muir 3:20 Yeah, some patients, even though this wasn’t exactly the question, but some patients are mostly concerned about the cost. Well, I don’t care what you do. I just want the cheapest option. Well, that’s an equally as big of a red flag. I mean, at our office, we don’t do cheap dentures, because we know what happens with cheap dentures. People will say, Hey, I just want the cheapest thing, but they actually still expect the same good function and aesthetic result that others with a nicer denture, more expensive denture would have. Yeah, and so I’m really careful with those as well.

Dr. Tanner Townsend 4:03 And I think that’s an excellent point because when you go cheap on the treatment, you’re sacrificing both aesthetics and function.

Dr. Josh Muir 4:11 Right.

Dr. Tanner Townsend 4:11 And as you ramp up in price tag, the aesthetics, and functions get better and better and better. And so I think just helping patients realize that if that’s what you want, or what are your goals, then let’s tailor your goals to the treatment that you get. Not to say that you’re going to have a bad-looking denture if it’s just a denture, but you’re definitely sacrificing function. So with that being said, how have you seen the aesthetic side of it play a role in someone’s confidence when you take them from, you know, starting with the teeth that aren’t they’re breaking down to final teeth when they have their new smile.

Dr. Josh Muir 4:54 Yeah, I mean, then this is the easiest question to answer because this is truly what we get to see. All the time, when people don’t have smiles that they like, they hide them. You know, they won’t open their mouth. When they talk, they’ll they’ll keep their lips together a little bit. Or when they talk, they’ll always find a reason to cover their mouth, especially if they yawn, if they take a bite of food, or they won’t eat around people, and pretty soon they’re hiding their smile starts defining how they interact with people and where they interact with people. They won’t, they won’t go to anything or participate in anything, where people are going to see their teeth, parties, birthdays, anniversaries, and they have this more secluded lifestyle, but once they get the new teeth, it’s amazing, even during a healing phase where they can’t chew. And if it is a denture patient, for example, it may be a denture that they got just after they have their teeth taken out, but my goodness, they smile and smile and smile and smile and the confidence and self-image really just skyrocket.

Dr. Tanner Townsend 6:10 Yeah, I couldn’t agree more. I think just seeing someone change over the course of the treatment of smiling and being confident in themselves, like when you take before pictures, I see this in a lot of your pictures that you take, you take a before and an after. When you look at that person in the before picture versus the after, they’re just glowing like it’s different in their eyes, you can tell that they feel different about themselves just from the way they are reacting about their teeth, and they’ve gotten accustomed to with their temporaries and so on. So it’s really amazing to see how the shift in the person happens with the aesthetics as well.

Dr. Josh Muir 6:55 Yeah, yeah. I mean, you know, kind of funny. We tell people, Hey, you just got your All-on-4, you’re All-on-X, and you are now healing. You’re in a temporary set of teeth, and you can’t chew on this, mashed potatoes, cottage cheese, yogurt, that’s what you can eat. So how does confidence increase? Well, we know it increases because after a while, they get used to it, and they start loving it, and they start chewing, yeah, and they’re breaking the rules. So confidence is a huge thing when you have your teeth back. Why don’t you tell us a little bit about the functionality. When we say, you know, I want it to function. What are we even meaning?

Dr. Tanner Townsend 7:41 Yeah, it’s a great question. So when we’re talking function, we’re talking about being able to eat the foods that you desire to eat and being able to sound the way you want to sound. So those are the two things that with function that I really pay attention to, is sound of your voice and also being able to masticate or chew your food, and so I want to make sure all my patients sound good by the proportions and the size and the shape of the teeth, but the chewing is sometimes like we had mentioned earlier, it’s the hard part. With a denture, your ability to chew is not going to be as good as if you have all your teeth, or if you have implants that screw into your fixed prosthetic or an overdenture. So I want to make sure that my patients are able to shred to mash up their food enough that they can eat it without a problem. And so that’s what I’m always focusing on, do you have anything else that you would add to that in terms of function?

Dr. Josh Muir 8:44 You know, as we consider function, everyone assumes that once you have new teeth, you can suddenly eat and chew.

Dr. Tanner Townsend 8:54 Yeah.

Dr. Josh Muir 8:56 But we know that a person goes from natural teeth to a denture. If we compare those two, the person with a denture can only chew with about 20% of the force that someone with natural teeth can chew. And so they think they’re going to be able to bite through some meat, or, I mean, even hamburger, you know, salad vegetables, but with only 20% of the force, a lot of times they can’t bite through that. So understanding the functionality side is huge, and just helping the patient see that what they think they want they may not want, what they think will do the job they need, really may not do it. And of course, there are those cases where some patients get along very well with the denture, so it is still a good option. However, you know, functionality side. The other part of it is functional. As we’re speaking, we want our teeth to stay in our mouths. And there are multiple types of options, even with implants, where something snaps in, and depending on what they’re doing, it may dislodge, or if it’s not snapping in, and it’s just a regular denture of some kind, yeah, they can sneeze. The teeth come out. They blow out their birthday candles, the teeth come out. And so function-wise, yeah, that’s not the ideal function. So there’s a lot to consider there. So when people say, All I care about is looks like, okay, let me you’re gonna look pretty silly if you’re blown out your birthday candles and your teeth come out. Yeah, if you’re if it’s your 100th birthday, everyone’s gonna laugh together with you, and it’ll be a wonderful memory, but if it’s your 45th birthday, it’s going to be humiliating. So those are some important things.

Dr. Tanner Townsend 10:47 Yeah, I agree. So have you ever had a case that you felt like you met the patient’s expectations in terms of aesthetics, but not function and vice versa?

Dr. Josh Muir 10:57 Yeah. So I had a patient that came in. This was a veteran and oh, 18 months ago or so, but his teeth looked beautiful, and he had had some treatment done years ago, and it had worn out. We still used his same implants. We repeated the same treatment, but functionally some of the components of his implants had worn out, and so it looked great. But when he would bite down, his teeth would un-snap, and it was his front teeth, and every time he bit down, it would move and move and move. So aesthetically, it was a great smile. He loved it as we tried it in he’s like, Oh, this is so much better than the other ones ever looked and so we really, really did a good job on that side. But functionally, even though the other ones didn’t look as good, they locked in there.

Dr. Tanner Townsend 11:51 Yeah.

Dr. Josh Muir 11:51 And so that was something we had to work through. We also have the flip flop, and maybe you can share that with us. You know someone that you meet the function side, but you don’t meet the aesthetic side. And I’ve got one after you go,

Dr. Tanner Townsend 12:08 Yeah, I’ve got a few that I’m thinking of where we like I it was a denture I designed when I was learning how to design some dentures. And I was like, wow, I got this. It looks, it looks okay, you know, and then I make it, and then I’m like, ooh, doesn’t look as good as I was hoping. But turns out, like, we had the denture redesigned, and it looked better, but the patient liked the one that I had made, because they could chew better with it, and the teeth were more flat, and they could stay in their mouth a little bit better because of that, and the teeth weren’t as sharp, but they could really mash their food. And so I was like, This is so crazy to me. This denture didn’t look good at all, but they could function with it, and that was their goal. So it worked for them. Interesting. Really interesting. What about you? What was yours?

Dr. Josh Muir 12:57 So I have a patient who after having a denture for quite some time, needed a new lower denture, and she wanted the lower one, of course, to match her upper one, but over time, materials change, and so they can look a little bit different. And so we had, we had made a denture, and it was just, it was so close, you really wouldn’t notice it, unless you’re trying to notice but she could notice it, and she would hold the mirror up and it fit beautifully. It, you know, she could chew with it. Everything was good. It stayed in. It was wonderful, but it was just barely off, and it just didn’t meet her aesthetic needs. And so, well, we really can’t perfectly match what you’ve got. So instead, we are remaking the top one now to match the new bottom one. And I told her, function-wise, it’s gonna be just fine. You know, it looks nice. It’s just barely different. But because that was what was important to her, that’s, that’s what she needed.

Dr. Tanner Townsend 14:06 Yeah, it’s just so interesting how like, if patients have their stock in, in the function side or the aesthetic side, if you’re missing that component, even if it’s barely off it, it doesn’t work for them. And so it’s just really interesting that aspect. So what we really kind of want to do and encourage our listeners to do, as we kind of wrap up here, is making sure that you have your priority strict when you come to a console of what you’re looking for. And then that helps us determine, Okay, do we need to have more esthetic focus or more of a function focus, or like we had mentioned earlier, we want to mesh both of them together ideally and have something kind of in between. So we really want to encourage our listeners to do that and to consider what their goals are as they come and visit us for a consult. For what’s going to be best.

Dr. Josh Muir 15:01 We hope, you know, we hope that as patients come in for a consult they view us as part of the team. I tell patients every day, we’re not salesmen. My job is not to tell you what treatment you need. My job is to educate you so that you understand what your options are.

Dr. Tanner Townsend 15:20 Yeah

Dr. Josh Muir 15:20 What the pros and cons of each option are, and give you the tools to make the decision that’s right for you. And aesthetics will play a role. Function will play a role. Cost will play a role. There are so many factors there, but we give it to them to make that decision, and so I hope that by presenting that way, patients will view us as teammates, and because of that, they’ll share that information with us, if it is function and not aesthetics, or if it is aesthetics and they don’t care about function, well, talk to us. That’s how we can get these expectations just right. And I think by doing that, we have a lot more happy patients, rather than trying to fix things after the fact.

Dr. Tanner Townsend 16:05 Yeah, and I think that’s one of the things our office does really well, is trying to have that good communication with the patient or potential patient, regardless of who it is and the circumstance.

Dr. Josh Muir 16:15 Well, thanks for joining us. That was a good conversation. I hope that was helpful. This has been the Smile Reconstruction Dental Implant Podcast with Josh Muir and Tanner Townsend. Thanks so much.