The Snap-On Smile Removable Appliance
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Today’s dental patient is increasingly aware of the possibilities of esthetic smile enhancement. While more options are available today than ever, many prospective patients are unwilling to choose traditional restorative solutions, such as veneers, crowns, or implants. Most dentists have presented a treatment plan that was turned down; it is, therefore, critical to have an alternative ready. Many patients find that economic considerations play a limiting role in their decision-making. Fear of pain and cost seem to be the most common causes of declined treatment plans, as well as the “not knowing.” The eventual outcome of the treatment is a large pushback.
Paramount to the appeal of the Snap-On Smile is that, regardless of the treatment modality, it remains fundamentally non-invasive. Unlike almost any other cosmetically oriented procedure, use of the Snap-On Smile is always completely contingent on a patient’s ongoing desire to wear it—of course, with the treating clinician’s approval. This feature is core to its utility, though it is in no way intended as a substitute for, or in lieu of, appropriate oral hygiene practices. In fact, the stability of the appliance is enhanced by gingival health and this is important to stress when discussing the Snap-On Smile with prospective patients, some of whom may already exhibit significant challenges with oral hygiene. The author has noted that, in his practice, patients with previous oral hygiene issues have been known to step up their initiative because of the Snap-On Smile.
It is important to recognize that the appliance is flexible yet strong and is designed to expand for a close fit over the patient’s existing dentition. It does not impinge on gingival tissue, nor does it cover the palate. Retention is completely toothborne; hence, the appliance is easily removable. There are no palatal clasps or adhesives and no interference with mastication or speech occurs. In fact, many of the author’s patients report forgetting that they are wearing it. Due to its unique material properties, the settling of the material creates great comfort for the patient.1
Statistics show that 50% of the population is unhappy with their smile,2 but are unwilling or unable to invest in permanent restorative treatment choices. Many patients have learned to live with, or without, missing teeth. For these patients, the Snap-On Smile is frequently accepted as a viable smile enhancement option as well as a cosmetic removable partial denture that helps them to escape the trap they live in. It is also not unusual for a patient to seek a “pretty smile for my wedding this spring” or a “better appearance for my son’s graduation.” These patients are often aware for traditional options and, for one reason or another, including timeliness, do not elect to pur sue those options. Many of these patients are often surprised to learn about Snap-On Smile and frequently elect to pursue this treatment. This is due to the fact that it is skillfully waxed-up and manufactured as if it were a fixed bridge, and not fabricated using a generic “suck down” technique.
A 35-year-old woman presented with spaces and discolored teeth, looking to improve her smile (Figure 1 and Figure 2). While she expressed a desire to have a more attractive smile, she was not prepared at the time to pursue an option such as veneers. When presented with the Snap-On Smile as a consideration, her immediate response was positive. She was very pleased with her appliance and wore it successfully for 13 months.
After initial consultation, the patient was prepared for the proper impressions. Using a polyvinylsiloxane or polyether material, an impression was taken of the patient’s upper arch, as well as a bite registration (Figure 3). After impressions, consultation determined the patient’s preferred shape and shade of the Snap-On Smile appliance. Engaging the patient at this stage ensures greater levels of satisfaction with the outcome and creates a more predictable result (Figure 4 and Figure 5).
Clinicians should familiarize themselves with the various customization options available with this appliance. It can be fabricated with varying thicknesses throughout the appliance to more closely approximate the contour and appearance of natural teeth. For instance, if the clinician and patient want to fill out the buccal corridor as a preview for veneers, this is easily achieved with this appliance.
After her routine check-up 13 months post-fabrication, this patient made another appointment, expressed her satisfaction with her Snap-On Smile, and indicated her readiness to move to the more permanent solution. She was presented with many options, from conventional veneers to the less-invasive LUMINEERS (Den-Mat, https://www.lumineers.com). Because the patient was initially attracted to an appliance that was practically non-invasive, she was excited about the LUMINEERS treatment plan. The LUMINEERS were placed using the LUMITray system and she was elated with the outcome (Figure 6 and Figure 7).
As a completely resin-based appliance, it is very durable and stain-resistant, and patients can eat while wearing it, as well as feel comfortable that they are able to drink red wine and eat red meats without the staining or breakage.
Cosmetic dentistry is fundamentally patient-need-based, which is to say that it is most commonly elective and driven by the individual patient’s interest in having an esthetically enhanced smile. The Snap-On Smile appliance represents another clinical option in the range of veneers, crowns, and implants. Many patients see Snap-On Smile as a long-term solution; others see it as an intermediate cosmetic device that provides them with a “trial run” with regard to available and appropriate permanent options.
It is important for clinicians to recognize, however, that the Snap-On Smile appliance is not exclusively a short-term solution. Many of the author’s patients are on record as regular long-term Snap-On Smile patients. These patients typically cite its convenience and the added confidence it brings to their business or social activities. In the author’s practice, approximately 25% to 30% of all Snap-On Smile patients elect to transition to permanent restorative options, and about 40% of new Snap-On Smile patients are planning for permanent restorations.
For clinicians seeking either an intermediate esthetic or diagnostic treatment option or for patients seeking a longer-term solution, the Snap-On Smile represents a significant addition to the clinicians’ armamentarium. It is also important to bear in mind that this appliance often performs as a convincing “trial run” for future treatment plans.
Marc Liechtung, DMD
Private Practice
New York, New York