Dr. Dunavant has extensively studied the anatomy, physiology, diagnosis and treatment of Temporomandibular Joint (TMJ) and Occlusion (bite relationship) disorders. He participated in fresh cadaver TMJ dissections at Scripts Clinic San Diego during his post graduate residency at Balboa Naval Hospital and was the TMJ therapist when later stationed at Portsmouth Naval Hospital. While still in college, he completed 1 year of a dental laboratory technology program at the VA Hospital Birmingham, Alabama before being accepted to UTCHS Dental College, Memphis, Tennessee where he learned all about fabrication of crowns, bridges and dentures. After countless hours of continuing education of varying philosophies of treatment later and having affiliated closely with world-renowned facial plastic surgeon, Gaylon McCollough, Dr. Dunavant arrived at his unique philosophy for smile and bite design termed “Facially Generated Cosmetic Dentistry”, which he has practiced and taught for several years now. Here are but a few examples of cases he has completed to the delight of patients.
His technique allows these kinds of cases to be completed usually in just two major visits and two to three minor visits including the comprehensive examination, preparatory treatment and a try-in preview visit.
This patient wanted to change the fit and appearance of his teeth and fix where he was trapping food between his teeth. He couldn't get his front upper and lower teeth to come together to tear lettuce. He had a front tooth open-bite and back tooth cross-bite that had worn and cracked his back teeth so that he lost the contact between them trapping food. He also had a crowded out (longer looking) upper left cuspid (eye tooth) and he refused to undergo orthodontics. He was treated with extraction of an upper wisdom tooth followed by full mouth restoration with combination ceramic and porcelain-to-metal crowns to correct his back tooth cross-bite, level his bite plane and smile line allowing him to bite his front teeth together. The crowded-out upper left cuspid was reduced as much as possible to realign it and a gingival (gum) advancement performed later to eliminate the long tooth look.
This patient said his teeth "were all different colors, uneven, chipping and worn and generally old looking" and he wanted "youthful appearing teeth to compliment his youthful vitality and help stay competitive in his occupation. He also knew he had gum disease. He was treated with periodontal (gum) surgery followed by full mouth ceramic crowns of uniform color. His smile and bite were designed according to the "Facially Generated Cosmetic Dentistry" approach.
This patient was unhappy with the variety of old crowns and bridges she had over many years. Her front teeth were different sizes, shapes and colors and her gums were uneven with "holes" between her teeth at the gumline. She also had some loose and missing teeth and gum disease. She was treated with non-surgical gum therapy and chemotherapeutics as well as recontouring of her gumline followed by minor orthodontics to allow missing tooth replacement, correction of a collapsed bite, leveling of the bite plane and smile line with a combination of uniformly white ceramic crowns and porcelain-to-metal crowns and bridges according to the "Facially Generated Cosmetic Dentistry" approach.
This patient wanted straight, uniformly white teeth (without having to undergo orthodontics). He alluded to how important it was to him in his very public occupation, for his clients to not be distracted in any way by his smile. He had a missing upper back tooth, several old deep defective silver fillings and his lower cuspids (eye teeth) were almost completely crowded out of his lower arch with cross-bite of his right teeth. He was treated with extraction of the lower crowed-out cuspids (eye teeth), gingival (gum) recontouring of the trapped upper front tooth, root canal of one deeply filled tooth followed by full mouth combination of ceramic crowns and porcelain-to-metal crowns and bridges to correct the cross-bite, replace the missing teeth, level his smile line and bite plane and uniformly whiten his teeth.
This patient was unhappy with her two front crowns and the receeding gums around them, her bite with some old bridges and the multiple colors of her teeth. She was treated with a root canal, gingival (gum) grafts, some ceramic crowns, replacement of all bridges, replacement of some old silver fillings with composite fillings and Natural Teeth Whitening. Her smile was evened out and the gaps between her front teeth eliminated.
This patient's initial concerns were toothache and headache pain, gap between front teeth, discoloration, receeding gums and chewing difficulty. She was treated with an extraction, a root canal, frenectomy, correction of a collapsed bite, crowding and gaps. This was accomplished by leveling of her bite plane and smile line according to the "Facially Generated Cosmetic Dentistry" approach with a combination of uniformly white ceramic crowns and porcelain-to-metal crowns and bridges.
This patient was in tears of anguish describing how her granddaughter was too frightened to sit in her lap because of her pointed teeth. She was congenitally (from birth) missing two upper front teeth and her cuspids (eye teeth) had erupted in their place. She was also missing four lower molars and her bite had collapsed. She had numerous defective old silver fillings and a stained old failing bridge. She was treated with extraction of a wisdom tooth, placement of two lower molar dental implants and full mouth combination ceramic crowns and porcelain-to-metal crowns and bridges to replace missing teeth, recreate natural shape, size and symmetry of all teeth and reestablish proper smile line while correcting the collapsed bite, all according to the "Facially Generated Cosmetic Dentistry" concept. She was in tears of joy afterward describing how her granddaughter now falls asleep in her lap.
This patient said he wore and broke his teeth down over the years through clenching and night-grinding and wanted a great smile with white teeth to compliment his business encounters. He had usual dental work over the years but his bruxism (night-grinding) had drastically altered his occlusion (bite relationship) triggering even more intense grinding. His natural teeth shape and length as well as his smile line, bite plane and relationship were all corrected according to the "Facially Generated Cosmetic Dentistry" concept with uniformly white all-porcelain crowns and a mouthguard fabricated to protect his teeth from the destructive effects of further bruxism.
The gingiva (gums) plays an important role in smile esthetics as well as their vital role in health of the teeth. Teeth struggle to survive without healthy gums and the gums suffer likewise from unhealthy teeth or a faulty traumatic bite relationship. Gingiva without the infection of periodontitis, can still recede down the roots of teeth. When this happens, the exposed root structure, which is not covered with enamel, becomes more prone to decay, attrition (wear) and sensitivity. Gum grafts are often necessary, in the case of recession, to re-cover as much of the root as possible while thickening the gingiva making it more resistant to inflammation, infection, abrasion and further recession. Esthetically, the gingiva is analogous to the matting in a picture (the teeth and lips being analogous to the picture and frame respectively). Too much gingival reveal in a full laughing smile is just as disturbing to the admirer as too little or asymmetrical gingival reveal. A “smile lift” shortens the gingival reveal of a “gummy” smile to bring the elements of the smile into more ideal proportion. Sometimes a combination of smile lift and gingival grafting is necessary to achieve this goal.
This patient was unhappy with her smile that was dominated by her front teeth and was “crooked” with one front tooth much “shorter” than its counterpart. She said its looks like she’s missing a tooth on her upper left. She had severe crowding of the lower teeth with retained crowded wisdom teeth on her left side forcing her upper teeth to appear the way they did. She was treated with extraction of two wisdom teeth and one other lower tooth that totally missed her bite. The gingiva (gums) were recontoured around the shorter upper front tooth and she was restored with a combination of composite fillings to replace some old silver fillings, ceramic crowns on seven upper front teeth and porcelain-to-metal bridge replacement of the extracted tooth. Her lower front teeth were recontoured and a complete bite adjustment performed to “unlock” her restricted bite.
This patient was very worried about losing her two lower front teeth which had old root canals and seemed to be “disappearing”. She also had a lot of gum recession with sensitive roots of those teeth as well as debilitating TMJ pain with popping and chewing dysfunction because her bite was “off”. She also wanted her teeth whitened. She was treated with TMJ orthopedic appliance therapy and complete occlusal (bite) adjustment followed by extensive gingival (gum) grafting, Natural Teeth Whitening, some ceramic crowns and veneers as well as composite fillings to close the gaps and even out her smile.
This patient was unhappy with the inconsistent lengths of her front teeth crowns and uneven gumline when she smiled and also said the gums around those old crowns itched. Her upper front teeth had super-erupted because of her overbite and brought the gums with them. She was treated with a “Smile Lift” including repositioning of the gums higher up the roots of the two front teeth in combination with gum grafts of the remaining four front teeth followed by replacement of her old porcelain-to-metal crowns with all-porcelain crowns to level her smile line and reestablish the proportionate lengths of her front teeth.
Single Tooth Gum Graft.
This patient was congenitally (from birth) missing one of her lateral incisors and the other one was an underdeveloped (“peg”) lateral. She also exhibited altered eruption of her front teeth where the erupting teeth “drag” the gums with them resulting in over-coverage of those teeth by the gums. She wanted less of a “gummy” smile and better proportioned teeth. A smile lift was performed through crown lengthening and the teeth were restored with a crown and “Maryland” bridge.