As reports circulated of a Hyderabad man dying during a surgery to improve his smile ahead of his wedding, cosmetic surgeons insisted that a “smile designing” or “smile makeover” procedure is relatively safe with few complications. Of course, according to top Delhi cosmetic surgeon Dr. Anup Dhir, the safety of all interventionist procedures is dependent on best practices and resuscitation facilities at a certified center that is prepared to handle emergencies if anything goes wrong.
WHAT IS SMILE MAKEOVER OR SMILE DESIGNING SURGERY?
A smile makeover entails some dental treatments and procedures that improve the appearance of your smile. “It typically includes simple procedures such as teeth whitening, veneers, dental bonding, and implants, as well as complex procedures in the gums and jawbone that require oral-maxillofacial surgery.” And, because your lips define the boundaries of your smile, the teeth and gums must fit comfortably within these boundaries for a natural and appealing smile. The other type of surgery is for reconstruction after an accident or complex oral cancer,” explains Dr. Suman Yadav, Head of Maxillofacial and Dentistry at Numed Hospital in Noida and a professor at ITS Dental College. “Smaller procedures can be done on a chair with local anaesthesia, but complex procedures must be done under general anaesthesia,” she adds.
CAN ANESTHESIA GO WRONG?
The man’s father has alleged that his son had died because of a faulty dosage of anesthesia at the FMS International Dental Clinic in Hyderabad’s Jubilee Hills on February 16. “First of all, any dental correction which involves surgery should not be done at a clinic but at a hospital. However, let me say that the risk of serious complications happening as a result of anesthesia is much less than one per cent. While generally safe, local anesthetic agents can be toxic if administered inappropriately, and in some cases may cause unintended reactions even when properly administered. The toxicity of local anesthetics can impact the central nervous system. Sometimes faulty administration may cause the anesthetic to enter the bloodstream and impact the cardiovascular system, triggering arrhythmia,” says Dr Dhir. That’s why he advises that any cosmetic procedure should be done at a certified centre.
WHAT DO YOU NEED TO KNOW BEFORE A SMILE DESIGNING PROCEDURE?
Dr Dhir warns against relying on perceived ideas of what constitutes a beautiful smile. “Let the surgeon evaluate, diagnose, and decide how to treat problems with a person’s smile, such as misaligned teeth, discoloured teeth, and a gummy smile. Before attempting cosmetic corrections, one must first assess the health of the gums and teeth, as well as their functionality. Before undergoing a smile makeover, it is important to ensure that the gums are healthy and symmetrical. This can have a significant impact on the final outcome of the cosmetic case. Crooked, overlapping, or gapped teeth must be straightened and aligned. In short, all aspects of dental health, including tooth dimensions, angularity, alignment, and spacing, must be considered,” he says.
A patient should undergo all necessary pre-op tests, especially if they have co-morbidities. Some surgeons require nerve conduction studies (NCS), in which a mild electrical pulse is applied to muscles in the face and head to detect areas of potential nerve damage. “As a general rule, we tell patients to avoid non-steroidal anti-inflammatory drugs (NSAIDs) and anticoagulants (blood thinners) in the days preceding the surgery,” said Dr. Dhir.