Written by Louis Malcmacher, DDS Thursday, 31 August 2006 19:00
How many times in dentistry have you wanted a magic wand? So many times patients come in and expect their dentist to have exactly that-a magic wand to fix all of their problems and make their teeth look great. They may have a simple broken tooth or some chipped and stained teeth. They would like to know about the options available to them. But what they really want is a magic wand. They want you, the dentist, to wave the magic wand across their mouths, and all of a sudden they will have nice, white teeth without the head-ache of going through any kind of treatment procedure.
There is now such a thing as a magic wand in dentistry the Snap-On Smile (Trident Dental Laboratories). The Snap-On Smile is a 10-unit removable splint that covers the facial and the lingual surfaces of the teeth with the occlusal surfaces of the molars cut out. This interesting and patented design allows patients to snap the splint into their mouths and be able to eat and chew while wearing it.
In Figures 1 and 2 you will see occlusal and facial views of the Snap-On Smile 10-unit temporary splint. It is fabricated to be placed over the buccal and lingual surfaces of the teeth and somewhat into the interproximals, which accounts for its unique retentive abilities. In Figures 3 and 4, you can see the same views of the Snap-On Smile on a model. You can now clearly see how the occlusal areas of the molars are uncovered in order to allow the patient to chew while wearing the device.
Figure 1. An occlusal view of the Snap-On Smile appliance.
Figure 2. Facial view shows the typical device covering 10 teeth.
Figure 3. Snap-On Smile on the patients model demonstrates the occlusal openings that allow patients to chew and function while they wear the device.
Figure 4. The 10-unit smile on a patient model. Retention is a function of how the device is specially made and literally snaps into place.
Uses for the Snap-On Smile are limited only by our imagination. I've been impressed in the year or so since the Snap-On Smile has been available to the broad dental market by the uses dentists tell me they have developed for this product.
SOME SUGGESTED CLINICAL APPLICATIONS
Here are a few suggested uses for the Snap- On Smile:
Figure 5. This patient is missing teeth in the upper right quadrant and also desires whiter teeth.
Figure 6. After a polyvinyl siloxane impression, this patient has a brand new, white smile that fills in the missing teeth.
(1) Partial denture replacement. Many times a patient is missing 1 or 2 teeth and would like a replacement for these teeth without taking up any palatal space (Figures 5 and 6). A Snap-On Smile is a good choice for this patient. What I really love about the Snap-On Smile is not only that it replaces the missing teeth, but it can also give the patient an idea of what overall aesthetics can do. This will be true with just about every use presented in this article. One of the main benefits that you get from this device is that it gives patients a generally great-looking appearance, which then motivates and drives them to do some aesthetic dentistry in the future. That does not happen with a typical partial denture.
(2) Bruxism appliance. Who says a bruxism appliance has to be an ugly piece of plastic that just takes up a lot of room in the patients mouth and is difficult and not fun to wear? The Snap-On Smile can be designed as a bruxism appliance that gives patients equal occlusal contacts to grind on while showing them what a new smile can look like if they need or want to go through a reconstructive phase. A Snap-On Smile bruxism appliance is also much more fun to we ar for the patient, and it is possible that compliance will be much better simply because patients will want to wear it all the time.
(3) Flipper or temporary bridge replacement. Many times we are faced with the question of what to do with an implant integration site, where an implant has been placed and we need to use either a flipper or a temporary bridge to fill the space. The Snap-On Smile device is perfect for this situation because it can easily fill in the space temporarily while the implant is integrating. The patient then thinks about the final options of perhaps placing the implant crown or making the implant crown work with other aesthetic needs he or she may have.
(4) Trying out some aesthetic dentistry. In my mind, this is probably the most common use for the Snap-On Smile. The patient wants to get an idea of what final aesthetic result he or she can achieve, and this device is an easy way to do this. To patients, it is better than a diagnostic wax-up, because they can go home, try the teeth out, and get a real sense of what it would be like to lengthen and alter the shapes of teeth while getting feedback from others before they make a final decision on aesthetic crowns or veneers. An impression can then be made of the Snap-On Smile and used to make a temporary matrix. The model taken of the Snap-On Smile can also be given to your laboratory for the final fabrication of crowns and veneers. The cost of the Snap-On Smile can be incorporated into the final case, which is an effective way to incorporate it into the patient's treatment plan. Because this device requires no modification of tooth structure, it is a perfect fit with the patient's desire to have no-prep or minimal-prep veneers (LUMINEERS [Den-Mat]).
Figure 7. This 30-year-old woman was never happy with her smile. Her bleaching options are limited because of the anterior crown.
Figure 8. A Snap-On Smile gives her the fuller and whiter smile she has always wanted.
Figure 9. A 55-year-old man with small, tetracycline-stained teeth is fearful of dental work but desires a whiter smile with no invasive dentistry.
Figure 10. The patient describes his new smile as a miracle!
Figure 11. This woman has always hated her diastema and doesnt feel her teeth are white enough, but she cannot afford veneers at this time.
Figure 12. Her Snap-On Smile gives her a functioning, aesthetic smile while she saves her money for LUMINEERS.
Figure 13. This 32-year-old man has worn down his teeth but has always been afraid of the dentist. He desires a great-looking smile at a cost he can afford.
Figure 14. The Snap-On Smile fulfills his desire for minimally invasive dentistry and a great-looking smile at a reasonable cost.
If the patient has misaligned teeth (Figures 7 and 8), tetracycline stains or any kind of stained teeth (Figures 9 and 10), diastemas (Figures 11 and 12), or a gummy smile (Figures 13 and 14), the Snap-On Smile will instantly correct the abnormalities and give patients a beautiful, white smile they can go home with. Sometimes, because of circumstances or finances, this device may also be the end aesthetic result for the patient at any given time.
I talk to hundreds of dentists and their staff every week at different seminars I present. This snap-on device has been available for approximately a year now, and I don't recall anything else in recent memory that has received such widespread recognition so quickly. The uses I have listed are what I think are the primary ones for this unique device. As its use becomes more widespread, I am amazed at the many other uses that dentists are developing for this device.
In terms of laboratory costs and costs to the patient, it breaks down like this. One of the reasons this technique is quickly growing in popularity is the very affordable laboratory price of $320 per arch. If I have a patient who is interested in aesthetics, I can make a Snap-On Smile and charge approximately $500 to $600 to cover the laboratory costs and our chair time. If the patient goes ahead with aesthetic treatment, I will then apply the money paid to the final case if it is 8 units or more. If the Snap-On Smile is used as a partial denture replacement, then I would charge the typical partial denture fee. If I am doing an implant case, many times I will incorporate the cost of the device into the cost of the case so that I will have a serviceable and ready temporary for the patient while the implants are integrating.
I love new technologies and products that our fellow dentists have developed. I know that a dentist who has developed any product has worked long and hard to make it work in his or her own practice on real patients. He or she has gone through a lot of trials and tribulations to get the product just right. Dr. Marc Liechtung, inventor of the Snap-On Smile, is to be congratulated for putting the time and effort into this technology, which affords us the opportunity to give patients a beautiful smile in a short period of time at a reasonable cost.
The Snap-On Smile device opens up completely new possibilities for our dental practices. It is innovative and exciting, patients love it, it adds a new line extension to the office, and it positions the patient for further elective aesthetic treatment. Snap a smile on some of your patients and you will quickly find many uses for this interesting new device.
The author would like to thank Dr. Marc Liechtung for providing Figures 5, 6, and 9 to 14.
Disclosure: Dr. Malcmacher is a consultant to Trident Dental Laboratories and the Den-Mat Corporation.
The second (and third) molars are already gone.
This makes me a Kennedy class II with limited or rather inferior options for cosmesis over the year or so until the restoration is complete (assuming it succeeds, knock wood).
Would a SnOS work for me?
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