What is a cosmetic wax up?

A cosmetic wax up is a great idea for anyone contemplating significant cosmetic dentistry. Study impressions are taken of the teeth (both maxillary and mandibular) and they are usually sent to the laboratory for a "wax up proposal". The teeth that need a make over are waxed to demonstrate the proposed changes for a patients smile. When I get back the wax up I usually duplicate it in another a stone model and fabricate an omnivac for my patient. This clear plastic "shell" can be inserted into my patients mouth with luxatemp composite so that they can better preview the proposed changes. Its not exact, but it usually conveys the approximate final result and a high percentage of patients undergoing this first step decide to continue with their smile makeover.

Although I have a general dental practice, I have been involved in performing cosmetic make overs for patients since the mid 1980's and I have found that appropriate planning and education for my patients in well worth the effort. There is a tendency for patients and their dentist to try to modify fewer teeth than are really needed in order to accomplish an ideal smile. This generally happens because both parties are trying to save money and hope to accomplish treatment with the fewest teeth getting altered.That being the case, the cosmetic wax up can be used to show the difference between a minimal treatment plan and a larger one. If the smaller presentation is satisfactory then fewer teeth can be involved and the dentist can be assured that the patient will be satisfied. If on the other hand more teeth are needed it will be apparent.

The thing that we want to avoid is having our patient change our treatment plan once final impressions are made and sent to the lab. This can happen when a patient wearing their new temporaries suddenly realizes that their case will look better if additional teeth are involved or even worse, that the gum positions of the teeth are in a non ideal position and need to be changed ( " my teeth look uneven" or "too short" or "too long") This can be a difficult fix if surgery or orthodontics is required and esthetic dentistry is no longer profitable for a dentist if there is a redo involved!

The fee for a wax up can vary from dental practice to dental practice, but in my case I make the fee $500 ( on the low side I believe). I don't actually make a profit at this fee, but I feel that it is a necessary step and helps both me and my patient visualize proposed changes that may eventually take considerable time and money to achieve. I want both the patient and me to be on the same page. Also sometimes after seeing this initial presentation my patient and I can see that more teeth than we originally planned may need to be modified in order to achieve an optimal result. Also it can demonstrate the need for other sorts of specialist to be involved ( a periodontist and or orthodontist). This can happen when a modifications of the teeth alone will not provide the result that the patient and I are looking for. Sometimes teeth need to be moved or lengthened in a manner that will involve the services of additional specialists.

The important reason for a cosmetic wax up is it ensures that the patients expectations match with what a dentist and his laboratory has in mind. Its always better to preview a proposed change prior to tooth preparation. Measure twice, cut once is a good way of looking at the process and its always better to exceed a patients' expectations than to fall short!




from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2018/02/what-is-cosmetic-wax-up.html - http://lspindelnycdds.blogspot.com/

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