Episode 23: Maintaining Your Perfect Smile – Long-lasting Veneers and Bonding

Eon Engelbrecht ERadio SA(0:06 – 0:49)

Welcome again to “Save Your Money, Save Your Teeth” here on eRadio, the go-to podcast where curiosity meets dentistry straight from the experts. I’m Eon, and every week, I chat with Dr. Clifford Yudelman from OptiSmile. We take a deep dive into the world of dental care from a consumer’s perspective. So, if you’re looking to brighten that smile or protect your wallet, we have got you covered with practical advice and the latest insights as well.

So stick around for the next couple of minutes as we uncover the secrets to maintaining your dental health and finances. As always, a very warm welcome to you, Dr. Clifford Yudelman. Are you well?

Dr Clifford Yudelman OptiSmile(0:50 – 1:01)

I’m well, thank you. I hope you’re keeping well and nice and warm. We’re expecting some snow here in Cape Town. I don’t know what it’s like over there.

Eon Engelbrecht ERadio SA(1:01 – 1:05)

Yeah, I think all around the country. Yeah, winter’s here in full swing now.

Dr Clifford Yudelman OptiSmile(1:06 – 1:14)

It’s July. That’s great. We need the rain.

We don’t want that water shedding. You know, load shedding is one thing, but not being able to flush the toilet…

Eon Engelbrecht ERadio SA(1:14 – 1:21)

We just passed 100 days of no load shedding here in South Africa. That’s amazing.

Dr Clifford Yudelman OptiSmile(1:24 – 1:27)

I never thought we’d see that day.

Eon Engelbrecht ERadio SA(1:27 – 1:49)

I think that’s brilliant. But anyway, so today as part of Innovations in Dentistry, you’ll be talking about the advantages of injection moulded composite veneers. So, let’s start with the first question.

What is injection moulded composite bonding, and how does it differ from traditional veneers?

Dr Clifford Yudelman OptiSmile(1:49 – 3:35)

Okay, well, that’s a great question. So you can tell, I can tell even from the way you asked the question, there’s a bit of a crossover between the words bonding and veneers. Basically, starting at the beginning, it’s a precise and non-invasive technique where we use a composite resin, that’s white resin. Traditionally, those composite resins were not that great; they were like putty.

We spoke about bonding last week and veneers the week before, and traditionally, with bonding, you use a putty that you mould onto the tooth and cure it. With this one, we actually use digital designs and 3D printed models, and then we make moulds, and it’s very, very accurate. Then, we have a flowable ceramic composite that’s actually injected through a small needle into the mould. So, the injection, in this case, has nothing to do with injections like numbing.

In fact, most of the time when we do this technique, there’s no numbing, and there’s no drilling, and it fits in with our OptiSmile philosophy, which is minimally invasive, and you preserve all your natural tooth structure. So yeah, in a nutshell, you know, compared to traditional veneers like porcelain veneers, you have to remove tooth substance with porcelain veneers. With this, you’re basically doing bonding but using the mould to create a veneer made out of the same similar type of material as bonding.

Eon Engelbrecht ERadio SA(3:35 – 3:42)

Okay. Can you explain the process of injection moulded composite veneers at OptiSmile?

Dr Clifford Yudelman OptiSmile(3:42 – 6:42)

Injection-moulded composite veneers or injection-moulded composite bonding has taken the dental world by storm in the last three to four years, and we started really focusing on this technique. I personally have probably done over a thousand actual teeth. Keep in mind that some patients get eight teeth done, some get ten teeth done, and in other cases, we might even do twenty teeth.

I haven’t done a thousand patients, but we’ve done quite a few of these over the last three and a half or so years. It starts off with detailed scans. We use an Invisalign iTero digital scanner to take 3D or a virtual mould of your teeth.

It’s super accurate and doesn’t involve putty or any goopy stuff that goes in your mouth. We use this; it’s like a video camera. We’re going to do a podcast all about this type of technology, but basically, this camera goes in your mouth, uses lasers, and does a 3D scan. Then, it uploads automatically or through the cloud to our designer, and the designer then does a smile design using either ExoCAD software or 3Shape software.

There’s some amazing softwares like a virtual reality type software that superimposes the new look or the new teeth over your existing teeth and then we get a whole bunch of photos of what it will look like and this bear in mind there’s not a Photoshop like of what it may look like this is actually the 3D image overlaid on your face on your actual tooth shape to see where we’re going to build the teeth up and then once we approve it we we okay it with the designer and they create the models and then we actually something different at OptiSmile we actually get our designer to create the moulds and they they do an amazing job the moulds are like a clear silicon well not like they are a clear silicon that’s made from a material called ExaClear which has only been available the last three and a half four years along with this liquid ceramic it’s from the same company and these moulds are sent back to us and basically when the patient comes in we use these moulds to inject the material through a little hole it goes around the tooth we shine a very bright blue light I’m sure most people are familiar with that through the mould and harden the material and then we take the mould off and the tooth is almost perfect we just got to do a little bit of shaping and polishing just to get the little edges off and the part where the needle you know injected through the mould and it they look super super natural that’s

Eon Engelbrecht ERadio SA(6:42 – 6:53)

Great, so let’s look at some of the main benefits doctor,  of using injection moulded composite veneers over the traditional methods. 

Dr Clifford Yudelman OptiSmile(6:53 – 7:57)

So like I said, there’s minimal removal of healthy tooth structure. In fact, in most cases, there’s no removal at all, whereas, with veneers, you are filing away some of the fronts of the tooth to make space for the veneer. It’s not necessary with this. It’s a much more accurate fit and look. It’s created on the computer with special biological copies of actual teeth, so they look very natural. It’s very hard to shape a tooth like that by hand. It’s much quicker with fewer visits. We get the moulds back, and you come in, and we do it straight onto your teeth. We don’t have to make temporary veneers, which are sometimes a problem. We can use it for a very wide range of cosmetic issues, and it fits in with our OptiSmile philosophy of leveraging advanced technology to get optimal results. 

Eon Engelbrecht ERadio SA(7:57 – 8:02)

How does the digital smile design technology integrate with the injection moulded composite veneers, doctor?

Dr Clifford Yudelman OptiSmile(8:02 – 9:18)

it works beautifully for this because like I said you know there’s something called DSD or digital smile design which is purely 2D and we think an older and somewhat a little bit outdated version because digital smile design used to be done in something like PowerPoint or Keynote and it just gives you an idea of what the size and shape of the teeth should be looking straight from the front but with this you you can see the teeth from all angles and we can tailor the veneers or the bonding to the individual facial features and preferences we can show the patients the expected results beforehand and get their feedback that we get a very precise design and fit and at OptiSmile our patients know we’ve done a lot of these and they leave it up to us we do get certain patients that we feel we really need to to involve them very much in the process and get their feedback all the way along with a design but most of the patients leave it up to us and we’re always amazed because people absolutely love them which is not always the case with veneers that are made in the lab

Eon Engelbrecht ERadio SA(9:18 – 9:24)

Who would you say is the ideal candidate for injection moulded composite?

Dr Clifford Yudelman OptiSmile(9:24 – 12:43)

videos so for us we do a lot of this when a patient comes in and they say that they’ve had their front tooth bonded several times and they keep tipping and then we take scans and photos and we find that the back of the teeth are very worn down on the palatal surface or the the side closest to the palate or close or the inside part of the tooth and in that case putting a veneer on the front of that tooth wouldn’t fix this problem on the back in fact you can make the bite and everything worse so those patients we do 14 to 20 genuine Invisalign aligners that we’ll talk about in a few podcast time we’ll talk using aligners to to do this and once we get the teeth in the correct position we can fix those chips or the or the wear when you got acid erosion we’ve spoken about when tomorrow I’ve got a younger patient she’s in her early 20s she didn’t get Invisalign she got braces and her teeth were all misshapen and very small there’s something called peg laterals her brother also had that it’s where the side front teeth are tiny little like stubs they look like they’ve been filed down to nothing and so trying to file that down further to put a veneer would be very detrimental in this case we’re going to put the mould over her tooth and just grow new tooth for her with no injection no drilling so some people try to use injection moulding for discoloured teeth but we always make sure the patients to take home whitening and sometimes we do some in chair whitening as well because we use very translucent or see-through type injection moulded composite we always use GC universal injectable which is the one that’s designed especially for this and it looks very very natural it doesn’t mask the tooth very much so you always want to start with a nice white tooth we have a preference for it because it’s especially for patients that want to preserve their natural tooth which is almost everybody nobody really wants to file their teeth down and in cases where someone doesn’t need Invisalign first they get immediate improvement I just had a patient who came to visit relatives here she lives in Melbourne Australia and she came in on the Monday we did whitening for her and she went home with some trays did a few more days of whitening and we saw her the following Thursday for we did six upper teeth and two lower teeth and it looked unbelievable and the next day she went back to Australia so it’s very quick and it’s very effective immediate improvement and it’s particularly beneficial for younger patients and you know people that are that are having this done are generally in their 20s or 30s and they still got to keep their teeth for a long time and you know our philosophy at OptiSmile is personalised assessment to ensure the suitability and for us to advise which is best for you whether it’s veneers injection moulded composite bonding or veneers or sometimes it’s just a little bit of hand or freehand bonding like we spoke about before.

Eon Engelbrecht ERadio SA(12:43 – 12:47)

Doctor, are there any limitations or risks involved?

Dr Clifford Yudelman OptiSmile(12:48 – 15:02)

The composite may not last as long as porcelain although we’re seeing very good early results I had a patient in today that came back she had it done 18 months ago her main problem was the back of her teeth were worn down and her teeth were getting short and she’s in her early 30s and she had 14 aligners and then some whitening and then we did this for her on her six upper front teeth and six lower front teeth and they looked unbelievable so you know if they look good after 18 or 24 months and we’ve now got patients coming back three and a half years later I think one came back I think we did was one of the very first cases we did about four years ago when the material came available and if they’re looking really good after three or four years we expect them to last at least seven to ten years whereas I just saw a patient who had a ceramic or original type of porcelain veneers done 20 years ago and the veneers were fine but her gums had receded and she she had gotten some stain along the gum line and we had to replace those with new veneers but those ones lasted 20 years but they they didn’t look they didn’t look good so there’s pros and cons with everything when we took off those veneers and had to replace them she obviously lost even more tooth so I’ve been showing patients pictures of of this lady Christina we’ve been showing pictures of her teeth because it’s a good example of what it looks like when you get a veneer replaced or what teeth look like when you drill them down for veneers I mean the final result of her veneers is amazing but then I show people injection moulded cases in person and when I say in person I don’t like to post before and afters if you come to our website or our Instagram or Facebook I’m not one to put you know before and after pictures but someone who’s interested could do a video a free video meeting with me on Google or one of my other dentists or come in for a consultation and we’ve got hundreds and hundreds of cases and pictures to show people yeah it’s a fantastic treatment.

Eon Engelbrecht ERadio SA(15:03 – 15:07)

What factors influence the durability, doctor?

Dr Clifford Yudelman OptiSmile(15:08 – 16:21)

Well, that’s a great question. We’re going actually to talk about that in next week’s podcast, but things like using a bite guard if you’re a tooth grinder, a night guard or a bite plate or a splint, we call it. If someone’s had Invisalign, we normally make clear aligner retainers to wear afterwards to protect their teeth. The patient that I saw today came back and’s been wearing her Vivera retainers, which are the Invisalign retainers, every night, which is why they’re looking fantastic. Obviously, emphasise the importance of ongoing care and maintenance and avoiding very hard foods like sourdough toast and then smoking is not great, and we’ve actually found that patients that drink espressos and, you know, eat curries and strong strongly staining foods don’t actually affect this the new materials at all.

All crowns, veneers, bonding can be prone to getting some staining near the gum line like what we saw on that patient Christina or Christine yeah look let’s talk about that next week.

Eon Engelbrecht ERadio SA(16:22 – 16:32)

Doctor it’s nice to hear all these success storeys and I know that our listeners also like to hear about these storeys any other storeys that you’d like to share with us?

Dr Clifford Yudelman OptiSmile(16:32 – 19:58)

Yeah I’ve got a few favourites to be honest we had a patient that contacted us this is going back a couple of months already but if if listeners go to our Google reviews there was a lady Shireen who who went off to work on a resort in Fiji for a year to save up money to fix her teeth and we thought she was going to get veneers and she contacted us from Fiji she was coming out to visit relatives yeah in Langebaan and she had limited time she was only going to be in town for 10 days and very similar to the patient from Australia we were able to to do a cleaning for her she actually was a smoker we cleaned she’d given up she had some old fillings in the front and we cleaned her teeth we whitened the teeth we sent her home with trays we did scans we did the design and the moulds and in fact we we only why we only injection moulded her four front teeth on the top and her two lower front teeth so in the end she only had six injection moulded composite bondings or injection moulded veneers and it looked amazing she actually posted her own before and after pictures on our Google reviews and tells the whole storey and you know that’s what we live for at OptiSmile just real patient success storeys we kept whatsapping me from Fiji where she’s got so much confidence now and she’s she’s playing with some of the kids the guests on the on the resort he’s there with a couple of kids I said oh you you already had kids that was quick and she’s like no she borrows them but she’s just all smiles she just kept sending me pictures on my personal whatsapp of her new smile and it’s unbelievable you know the pictures she put on the Google reviews are not such great quality but I show patients that come in or have video consults her her case in particular and we don’t specialise only in people coming from overseas we see a lot of Cape Town patients another favourite case of mine was a young lady called Alyssa and she’s got an Instagram called house of Alyssa and she had severe erosion and wear on her forefront teeth and and they were kind of all over the show and she posted a lot of material on her Instagram so she her teeth were so bad with a wear and tear we did we did injection moulding then we straightened them further with Invisalign and then we did more injection moulding and and other dentists quoted her for 20 veneers or to actually file her teeth down and do turkey teeth or crowns and she went on to be on that programme the Bachelor in Germany she was on several seasons and yeah she’s a very beautiful girl and it’s and it’s been much enhanced by her dental care by her injection moulding and I’m very proud of that that case and especially her success and and the way it changed her her outlook on life it in fact it changed her whole life she posted a lot about that and yeah I mean it’s storeys like that that that keep us going.

Eon Engelbrecht ERadio SA(19:59 – 20:07)

And finally, what would you say sets OptiSmile apart in the field of injection moulded composite veneers?

Dr Clifford Yudelman OptiSmile(20:08 – 22:36)

Well, I mean, sometimes it’s good to blow your own horn because you don’t want anyone touching your horn. I’ve probably done more injection moulding injection moulded composite veneers or bonding in South Africa. I would say we’ve been doing it longer. I’ve probably done more than most other dentists in the whole of South Africa, and along with three other dentists alongside me, our practice has probably done. I don’t think there’d be too many practices that have done as much injection moulding as we’ve done at OptiSmile. You know it’s actually one of our specialities along with our Invisalign and our WOW! Whitening. We only use ExaClear moulds, and we only use GC universal injectable composite. These are worldwide the top quality materials and we’ve seen such great results. We’re always very pleased when we see patients coming back now,  you know, 6, 12, 18, 24 months—even longer, three years.  We’ve done extensive cases, and we do a lot of in-house training, and we just keep improving. All of our injection moulding is done under magnification. I personally do all my work under a microscope at 16 and 25 X magnification.  Some of the dentists use loups three to six power, but we have three microscopes, and if a dentist is using loups and they don’t have a microscope in their room they will book one of the rooms with a microscope. So we can clean up the edges nicely. Also, we don’t get stains. We polish them literally to microscopic perfection, so when you look at them with the naked eye, or you take a close-up photo with a macro lens they just look they just look amazing. I love injection moulding. You know, if it went away tomorrow, I might be forced to retire because it’s just, you know, I’m very biased towards it. It’s just a fantastic treatment, and it’s definitely my preference over veneers, which we talked about, and bonding, which we spoke about’s just an amazing treatment.

Eon Engelbrecht ERadio SA(22:36 – 22:49)

That really sounds amazing, and thanks to today’s podcast, we know about all of it. Doctor, as always, your interview was very informative, and we thank you for your time. 

Dr Clifford Yudelman OptiSmile(22:49 – 23:01)

Thank you very much, and I look forward to speaking to you next week about some tips on how to keep your veneers and bonding and injection moulding looking good for years

Eon Engelbrecht ERadio SA(23:01 – 23:31)

We are looking forward to a doctor. Thank you also, remember listeners while we strive to provide valuable insights, always consult with your own dental professional for advice tailored to your personal health and then don’t forget to subscribe for more enlightening discussions. Join us again next week at the same time and place as we continue to explore the fascinating intersection of dental health and financial savvy. Until then, keep smiling and taking great care of your teeth.

[Speaker 3] (23:51 – 24:36)

discover the world of dental excellence with OptiSmile. Join us for a weekly podcast featuring Dr. Clifford Ydelman a seasoned expert with 40 years of dental experience across four continents. Gain unique insights and expert dental advice by visiting OptiSmile.co.za for articles that illuminate the path to optimal oral health. If you’re seeking unparalleled dental care in Cape Town, get in touch with OptiSmile or book directly online on OptiSmile.co.za OptiSmile, where global expertise meets local care.