Cosmetic Dentistry

Do you avoid smiling? Do you cover your mouth with your hand when you laugh? Does your smile not reflect who you really are? Are you ready for a change?

If so, you’re in the right place!

Cosmetic dentistry is one the things we are best known for. Changing smiles is what we love to do, and we’re good at it! A new smile can literally change a life, and it’s extremely rewarding to see people smiling more and looking happier with their new smile.

Dr. Highsmith is one of five AACD (American Academy of Cosmetic Dentistry, accredited members in North Carolina. There are over six thousand AACD members but only about two hundred and fifty accredited members worldwide. The process is grueling, requiring razor sharp photographs of your work being scrutinized by very picky examiners trying to find things wrong with it. Most dentists who start the process do not finish it. The result is you have the option of having a beautiful smile makeover right here in Western North Carolina!

Not only that, just next door to Dr. Highsmith is Kent Decker CDT, the only AACD accredited dental laboratory technician in North Carolina! We have worked with Kent for 30 years, and use his artistry on most of our cosmetic cases. We typically send our Neuromuscular reconstruction (bite changing, TMJ or severe wear) cases to Bob Clark at Williams Dental Laboratory. Bob was the very first LVI Master dental technician, so we have the very best working on your cases!

AACD Direct Bonding case

Regardless of where you come from or what language you speak, your smile is an important form of communication. It instantly portrays your personality, self-image and how you feel about the people you’re with.

A healthy, attractive smile is an important facet of life-it impacts your health, self-esteem and relationships, both personal and professional.

  • Do you feel awkward or self-conscious about your smile?
  • Do you cover your mouth when you talk or smile?
  • When the camera shutter opens, do your lips close? Do you hate close-up shots?
  • Do you avoid wearing bright lipstick because you’re afraid of highlighting your teeth?
  • Have you ever grown a mustache or beard to help hide your smile?

Nearly half of adults surveyed say they would like to make some improvement in the appearance of their smile. – AACD Survey Findings

For most people, an appealing smile is an important part of the overall impression a person makes. An American Academy of Cosmetic Dentistry® (AACD) survey found:

  • More than 92% of adults agree that an attractive smile is an important social asset.
  • Nearly as many, close to 88%, say they always remember someone with an especially attractive smile.
  • 85% agree that an unattractive smile makes a person less appealing to people of the opposite sex.
  • 74% agree that an unattractive smile can hurt a person’s chances for career success.

Many adults want to change their smiles. Some want to correct problems they have had since childhood such as discolored, gapped, or crooked teeth. Others want to fix conditions they’ve developed over time, like cracked or worn-down teeth, to help create a more youthful smile.

If you are unhappy with your smile, contact us for a smile analysis. We now have the technology and training to improve any smile! The main criteria is what you want your smile to look like. In most cases, we can use one of several methods to show you what your new smile will look like!

Cosmetic Dentistry and Porcelain Veneers

What is a porcelain veneer?
A thin shell of porcelain that allows your cosmetic dentist to modify the shape and color of your tooth. The veneer is placed on your outer tooth surface, on teeth that show when you smile.

What is the difference between a veneer and a crown?
Like a crown for your royal head, a dental crown is a full-coverage cap around the top and sides of  your tooth. What’s bad about a crown: to make a crown, your tooth is ground down to a little nub. The nubbin is covered by a crown that extends from top down to the gumline. The strength of the tooth comes from the strength of the nub that remains. If the tooth is badly broken down with damage or has a large crack, then a full crown on top is often the only option to save the natural tooth.
A veneer is much more conservative in how much tooth it covers, so less of your natural tooth is prepped. Veneers transform smiles by improving the shape, size and color of your teeth, and can close gaps. Veneers improve your smile’s appearance by modifying what people see when you smile. The hand-sculpted porcelain shell covers only the fronts that you see, and the tongue side of the tooth is untouched. The more of your natural tooth you keep, the stronger your tooth is.
Veneers can totally transform a smile with improvements in tooth shape, color, size of your cracked or worn teeth. We’ve seen veneers improve the outlook of people who hated the looks of their smile in the mirror.

What does your AACD Accreditation mean?
It was a bear to achieve this level of cosmetic dental excellence. That’s why the world has 396 AACD-accredited dentists, and only one in western North Carolina (Dr. John Highsmith). The American Academy of Cosmetic Dentistry ( requires high skills and artistic eyes in their rigorous program for accreditation level. . Many dentists who start the AACD accreditation journey do not finish, because it’s difficult. Dentists submit to an expert panel their thoroughly-documented cases of high proficiency, each a different facet of cosmetic mastery. It takes years to complete, and the bar is set very high. Extremely picky examiners scrutinize each case, trying to find anything wrong. The Bottom line: AACD-Accredited dentists have proven themselves at the highest levels of cosmetic artistry. They deliver what they say they can, to a very high degree. This is different from running an ad saying you do cosmetic dentistry. It’s about credibility.
Dr. Highsmith works closely with Kent Decker, CDT, AAACD, the only AACD-Accredited dental technician in North Carolina. He is a ceramic artist recognized for superior and lifelike porcelain teeth.

Don’t all dentists do cosmetic dentistry?
Any dentist doing tooth-colored fillings can say they do cosmetic dentistry. Your job as an educated consumer is to have them show you photographs of patient cases they themselves have done, and more than one or two cases.

Why is it important to see an Accredited Dentist?
An accredited dentist has proved to experts that he or she can do cosmetic procedures to a very high level of expertise. Third-party validation is very important in an environment where anyone can claim anything on a website.

How many appointments do veneers require?
Four visits total to the office. Two of those where the real work is done.
Here’s the sequence.
#1. Impressions are made of your teeth, and the dental laboratory sculpts a ‘waxup’ in which the teeth shapes are designed and perfected in shape on your teeth model. We make a flexible mold of the perfected teeth. It is used to make ideal-shaped ‘provisional’ veneers. The shape is determined in consult with our patient about what they want to change or modify.
#2. In the chair, the teeth are conservatively prepared and the provisional acrylic veneers are placed on teeth. As artists, we strive to make your temporaries look as close as possible to what we hear you are looking for (and we don’t stop there).
#3. You test-drive your temporary smile for a week, to see how you like your new look. (You wouldn’t buy an expensive dress without trying it on, would you?) Here you can tweak the process before the final veneers are made. Color too light? Too dark? Just right? Too long or short? Too rounded or square? We want to make sure you feel good about your temporaries them before the finals are crafted. This is how we prevent surprises at delivery.
The laboratory gets final “marching orders” only when you’re sure you like the look.
#4. The final porcelain is tried in for your viewing. We don’t bond them in until you give us a thumbs-up. The veneers are bonded in position using a process that makes them one with the tooth. The newer adhesives are incredibly secure, so with veneers you can bite and eat whatever you would with natural teeth.

My gums look uneven from tooth to tooth. Can my gums look better?
Absolutely. A gumline that’s even and symmetrical is part of an attractive smile.
Think like this: your teeth are the players, the gums are the stage, and the lips are the curtains.
We correct an uneven gumline in several ways:
If there is severe gum recession and your roots are revealed, a tissue graft might be needed to move tissue to where it used to be.
If the gum extends low and the tooth appears short, we shape the gum line with a laser. In some situations, a surgical approach might be used to make the correction.

I’ve seen veneers that look like fake Chiclets on people. How do I avoid a bad outcome?
Finding a dentist who does a lot of cosmetic work is very important. An accredited dentist gives you confidence you’ll get the result you want. Ask for photographs of the dentist’s patient work, and look for a case similar to yours.

My last dentist said “my teeth look fine and don’t do anything,” but I still don’t like them. What can I do?
If a dentist doesn’t feel he or she can give you what you want, they may simply say ‘nothing can be done,’ instead of referring you to someone who can. You can only see what you know about; and if you’re not trained to do something, you may not even know it can be done.

My teeth are worn down, they look too short. Can that be fixed?
Absolutely. Vets judge the age of a horse by how ground down their teeth are. No one likes the look of worn-down teeth, and they automatically make you look older. A more youthful smile has teeth of the proper proportions to your face.
It is super-important to determine why the teeth were wearing down in the first place, so the cause can be corrected at the same time the teeth are fixed. Often the process of wearing down can cause severe TMJ pain, which can generally be corrected by getting back into a proper physiologic bite position.

Can I eat regular food with veneers?
Properly made and applied, veneers can actually add strength to a tooth. So you can eat whatever you would eat with natural teeth, including apples, corn on the cob, and steak. (Your dentist still frowns on opening chip bags,  stripping wires, or opening bottles with your teeth, however.)

How do I take care of veneers?
Same as taking care of teeth, which is brushing and flossing. We do recommend that you avoid any very abrasive toothpaste, because over years it can take the shine off your teeth or veneers.

Do veneers stain? Can I drink coffee and tea?
One of the best things about porcelain is that they do not stain. Think of your grandmother’s old porcelain teacups. You wash them out and they’re still white!

How long do veneers last? 
A landmark study showed over 95% success over 15 years with veneers placed with conservative prepping. If too much natural tooth structure is removed, then the success rate for these goes down, which is why training is so important.

Are veneers as strong as crowns?
A properly-done veneer is actually stronger than a crown, since less of the tooth is removed. We lose enamel from our teeth over time, after decades of brushing with abrasive toothpaste. Veneers have been shown to restore the original strength lost from brushed-away enamel. For more information on veneers, click here.

Dental Library: Cosmetic Dentistry

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