He has offices in Manhattan and Dubai, a patient list that reads like a Whos Who in Hollywood, and, well, hes kind of adorable. Dr. Michael Apa, DDS, sat down with ThirdAge to discuss proper dental hygiene and why our teeth are the untapped fountain of youth.
Q: What are the things that we should do every day not only for nice teeth now, but for nice teeth in the future?
A: Hygiene is number one. Youd be surprised how many people dont know proper hygiene protocol. If I was going to give percentages, I would say that 80% of the population doesnt know how to brush properly and thats being nice. Were all scrubbers. Using an electric toothbrush (twice a day) is important, followed by floss and a high-fluoride rinse. Say, brushing takes away 50% of bacteria, flossing takes away another 20%, a rinse takes away a good 30%. You really should hit all three.
Also, regular hygiene visits with a dental office at least twice a year.
Q: What products do you use/recommend?
Theres something new thats big in research in dental schools right now: MI-Paste. I recommend it to my patients who have flossing cavities the little cavities between your teeth from food getting stuck. The food collects bacteria, bacteria creates acid, acid breaks through the tooth causing those little tiny cavities. The only way to not get them is to put a piece of floss on them to break up the acid on the tooth. If you rub MI-Paste on your teeth after you brush, floss and use fluoride, it re-calcifies up all those tiny cavities. If you use it long enough it will arrest the development of the decay and youll never have to drill them.
I also recommend a high-flouride mouthwash, never anything with alcohol. I stick with the old-school Act fluoride rinse. Also, brush with something like PreviDent, which is again high-flouride. As far as bleaching products, I recommend anything with potassium nitrate. Potassium nitrate is whats in Sensodyne toothpaste. Flouride and potassium nitrate are much gentler on your teeth than straight bleach. I recommend Crest 3D White 2 Hour Express Whitestrips. The seal on these stays on your teeth much better than the older Whitestrips. Q: Receding gums can be really aging on a person. Is there anything we can do about them? Dont scrub your gums that takes gum tissue away. Use proper brushing technique, and always use an electric toothbrush with soft bristles. The other thing is grinding your teeth it causes abfraction lesions. A night guard can help with that. Q: Youre known as the master of the scalpel free facelift. Whats the one procedure you perform that guarantees a youthful smile? A: The mark of a good aesthetic dentist is to understand why a person looks the way they do. Some of it is growth and development; some of it is aging. Theres things that can be done about both. Diagnosis is key in creating something that looks great. Over time people grind and put pressure on their teeth. The first thing to go is the lower front six; they start to crowd. The second is the sides; they collapse. The third thing is your bite falls down on itself. You want to decrowd, expand and raise the bite. Imagine what that does to your skin? It puts fullness back in your face. Think about what people look like when they take their dentures out: all the support collapses.
I do something called Facial Aesthetic Design. It takes into account growth and development, environmental factors, understanding the diagnosis of why they are the way they are and trying to artistically recreate what I think they should be. Its about how your nose relates to your mouth and how it relates to your chin. Depending on where those parts are, theres a normal range of where your teeth should be and thats what Im trying to do. Q: How does Facial Aesthetic Design differ from the old-school Chiclet-like veneers? A: Thats diagnosing tooth problems on a tooth basis and recreating new teeth, which doesnt necessarily address the patient. There used to be this proportion formula for the length of a front tooth. They said, This is how long the front tooth is supposed to be, and then there were formulas based on that to build the rest of the teeth. Im saying that, that doesnt really give you a 3-dimensional positioning of where those teeth are supposed to be as according to how you really want the teeth for that patient. Its more understandingthats what it comes down to in the end. Q: How much do they cost? A: It depends. We charge on average between $25-60,000, depending on what needs to be done. The full kit and kaboodle is between $50-60,00. A cosmetic case where were just changing the top 10 teeth is between $25-30,000.
There are other people in other parts in the country who definitely charge less. But tally your botox up for 10 years and tell me whats more expensive. You fix your teeth once and its like resetting the clock for your facetheres no added fees, you get them done and you take care of them as if they were their own teeth. Thats that. Q: I read somewhere that you feel that good dental work can render cosmetic surgery unnecessary? How can dentistry fix things like smile lines, thin upper lip and thin hollowed cheeks? A: When creating a new smile, the dentist must understand how the soft tissue, (lips and cheeks) rest on the teeth. The position of the upper front teeth will contribute to most of the support of the upper lip. That means, if you want to roll the lip out, or plump it, you can push the two upper teeth out. Conversely, if the patient has something called lip incompetence, inability to close the lips at a resting position, you can bring the upper teeth in. Smile lines can be erased by broadening the smile to give support to the corners of the mouth. Thin, hollowed cheeks can appear fuller by building the smile out wider. This works simply due to the fact that over time the sides of the mouth collapse, hollowing the cheeks out (along with losing cheek fat). Although we cant add cheek fat dentally, we can bring the teeth to the position they were originally before collapse, and thus will give fullness to the cheeks. Q: Who has your favorite smile of Baby Boomer women? A: Diane Lane. She has a great natural smile. Nicole Fabian is a writer living in Brooklyn, New York. She is Associate Editor of ThirdAge.com.