Dr Nathaniel Podilsky
For the last 34 years, Dr. Nathaniel Podilsky has served the people of Edmonton, Alberta with General, Cosmetic and Implant Dentistry. His practice focuses on implants, smile design, tooth replacement and orthodontic treatment. He graduated from the University of Saskatchewan in 1982 and went ahead to open his general dental practice in the “ice district” of downtown Edmonton, Canada.
Dr Podilsky’s Smile Design program involves both the white esthetics (teeth) and the pink esthetics (gums). It is focused on gum architecture, proportion and relation of the teeth to one another, color and shape of the teeth and the length of the teeth. Before a dentist can put Porcelain veneers into a person’s mouth, there will be a number of things he has to consider to ensure you get that smile you are yearning for. Dr Podilsky says the process usually takes anywhere from four to six weeks depending on the patient’s time, his time and the lab’s time. During this time, he schedules multiple appointments to review the patient’s expectations, choose the best smile design for the patient from a “smile” catalog, decide how many teeth the patient should show and their color and review the patient’s teeth in relation to their face and smile.
Dr Nathaniel Podilsky says while this process is quite complex, there is nothing more rewarding for a dentist than to give a patient a new smile and essentially change the person’s life. And he enjoys every minute of it.
Once the patients have undergone a restorative smile transformation “they (patients) tend to no longer hide their smile, they tend to smile more often, they tend to show more self-confidence, and so it changes their lives,” Dr Podilsky says.
When constructing Porcelain veneers, Dr Podilsky considers the positioning of the teeth to determine how to prepare the tooth. He then takes the patient through a smile catalog and discusses their expectations. After that, impressions of the patient’s teeth are taken; the impressions are then made into models. The models are used to make a wax up to determine what the teeth are going to look like, how long they will be and their relationship to one another. This takes around 10 days. After this, the patient is required to go in for a fairly lengthy appointment where the doctor determines how many teeth they should have prepared, usually eight teeth on the upper jaw. Sometimes porcelain veneers are placed on the bottom front teeth if they show when a person smiles or speaks.
From the “wax up”, a guide is used to form temporaries which are then placed on the patient. The doctor uses the temporaries to determine what the smile will look like and how they will function with the patient’s current bite. Dr Podilsky calls this “test-driving the smile”. At this stage, he discusses with his patient their preferred color of teeth. As a general rule, teeth are never one shade. They are made in multiple shades, usually lighter towards the biting surface of the tooth with some translucency and darker towards the gum line.
Once the patient has decided on the shades preferred, the dental impressions are sent to the lab for fabrication. Fabrication of porcelain veneers takes between 10 days to two weeks. The patient returns for another appointment during which the temporaries are removed and the doctor fits the veneers and checks them in natural light and in the dental operatory. Once Dr Podilsky counter-checks everything and gives it a green light, he bonds the Porcelain veneers on to the natural dentition and polishes them. The patient goes in for one more appointment where the doctor checks the occlusion (bite) as well as tissue healing around the veneers.
Dr Podilsky recommends people who have had Porcelain veneers fitted to have a night guard fabricated. The night guard protects the veneers from teeth grinding while the person is sleeping. This is also known as bruxism and is often involuntary. For people who are actively involved in sports, Dr Podilsky recommends that they also get a custom sports guard fabricated. The sports guard protects the Porcelain veneers from damage during active contact sports. Dr Podilsky explains of one of his patient’s veneers that are still in perfect condition over 12 years later even though the patient is very active in bob sledding. He says the secret to the Porcelain veneers’ longevity is the use of a sports guard, a night guard, good home care and regular hygiene visits at the dentist.
“This lady, that was active in bob sledding, would crash every single day. She wore a sports guard throughout her bob sledding career. Her Porcelain veneers are still bonded on and that’s at least 12 years old,” commented Dr Podilsky.
Dr Nathaniel Podilsky also does full mouth reconstruction. This typically involves replacing missing teeth, replacing old crowns and closing gaps between the teeth. He says the majority of the time he tries to be very conservative. Porcelain Veneers are more conservative than full crowns since they require less tooth preparation. For that reason, whenever possible, Dr Podilsky prefers to construct veneers in the front rather than fit many crowns.
There are instances when Dr Podilsky might decide to fit crowns rather than veneers. These include replacing an old existing crown which has decay under it, if the tooth is weak because it has an existing root canal or if there is not enough enamel around the tooth for bonding because of acid erosion or wear. Dr Podilsky says the reason he prefers veneers to crowns is because today people are living longer; up to eighty and ninety years old. There is a good chance the veneers or crowns will need to be replaced over this time.
Most people who undergo these dental procedures become more confident and outgoing, they stop putting their hands over their mouths while talking and they smile more often. Getting a brand new smile may also improve in interpersonal relationships.
Dr Podilsky says, “Smiling is one of the major factors when people look at other people and it’s the first impression. The smile is one of the first things that most people will see other than the eyes. So it’s crucial to have a very good smile.”
Dr Podilsky also emphasizes the importance of replacing missing teeth. All teeth are important in function and in the longevity of other teeth. According to Dr Podilsky, front and back teeth have functions which are unique to each of them. The front teeth cut the food and make sure that the back teeth don’t touch when one functions or chews sideways and in a forward direction. So if you are missing the front teeth, the back teeth become worn out and become very flat. On the other hand, if you are missing the back teeth, the front teeth are forced to grind, a function they are not designed for. As a result, the front teeth start chipping, cracking and eventually break off. Ultimately you may lose the front teeth due to the stresses on them. Implants are a great alternative to tooth replacement if you are missing any teeth. By replacing the missing teeth you are preventing movement of the other teeth and you are protecting your natural teeth from wear and tear in normal everyday function.
According to Dr Podilsky, it is extremely important for a person to replace a tooth within the first year of losing a tooth. When you lose teeth, the bone around the area with the missing teeth begins to disappear or resorb away. The bone disappears in width, height and even quality throughout a person’s life. This can never be fully replaced even with the new surgical techniques currently used in dentistry.
“It’s very much like if you go to the gym and one arm gets exercised and the other one doesn’t. The one arm that’s not exercised the muscles become atrophic or very weak while the other arm becomes very muscular, very strong. Bone is the same way. Bones responds to and needs function.” Natural teeth and dental implants provide for this function.
It is great news for patients that they can enhance and improve their smile at any age and in any condition. Dr Podilsky says there is no age limit when people can get veneers, crowns or even implants. His mother received implants at the age of 88. She is now 92 and eats better and functions better. Because of this, her overall general health is better.
To keep your teeth healthy, Dr Podilsky recommends that you watch your diet, employ proper nutritional practices and watch the amount of sugar you ingest daily. He also recommends using electric toothbrushes to brush your teeth. In fact, he says clinically they have been found to be a thousand times better than manual toothbrushes. Dr Podilsky also recommends regular visits to your dentist’s office for teeth examinations and oral cancer examinations.
To get in touch with Dr Podilsky, you can visit their website at https://www.cosmeticdentistryedmonton.com/. His practice is now open on alternate Saturdays in addition to weekdays (Monday to Friday).