Full Mouth Makeovers

Full mouth makeovers or reconstructions are indicated for patients who have generalised severe breakdown of their teeth.  Esthetics and function can often be improved in the same breath.  This is reserved for patients with very heavily-restored teeth. 

See the gallery for lots of before-and-afters of my patients including this one!

Click here to see examples of my porcelain veneers!

» See the Full Mouth Makeovers photo gallery

Other services

About Clarence


Clarence is originally from Toronto, Canada, where she completed her Doctor of Dental Surgery and General Practice Residency at the University of Western Ontario and the University of Toronto, respectively. Clarence's practice is mostly limited to cosmetic and restorative dentistry. She is well-published to both the local and international dental press, writing articles, reviewing and developing prototype products and techniques in clinical dentistry. She frequently and continually lectures throughout New Zealand and Australia. Clarence is the Chairperson and Director of the New Zealand Academy of Cosmetic Dentistry. She is an Accreditation Candidate and Sustaining Member of the American Academy of Cosmetic Dentistry and seeks to be the first in New Zealand to gain Accredited Status with them. Clarence is an Opinion Leader for multinational dental companies Henry Schein Shalfoon, 3M ESPE, Kuraray-Morita, GC Australasia, SDI, Coltene-Whaledent, Dentsply/Triodent/Rhondium and Voco. She is a passionate and approachable individual, and is committed to having an interactive approach with patients in all of her cases to maximize predictability.
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Patient testimonials


Case study: A patient’s story

 

A cycle has finally been broken: A multi-dimensional psychosocial approach needed to support dental care

 

Pseudonym of patient: Huia (Māori female, aged 55)

 

When I was a child my mother used to tell me "a woman has to take care of her teeth and hair". These were symbols of beauty in my mother's culture. My mother is an indigenous woman from Aotearoa New Zealand. It was only as an adult that I learned that she is the great, great, granddaughter of one of the last paramount chiefs of our iwi (tribe). I respected her mana (authority and status) greatly. But unfortunately, I could not follow my mother’s wise advice. At 84 years she has managed to keep most of her own teeth and they are strong and white. Now aged 55 I have had at least 6 extractions (not including wisdom teeth) due to poor oral health care. Why wasn’t I able to follow my mother's advice?

 

I was born in the early 1960s when children's oral health care lay in the hands of dental nurses. My earliest memory of walking to school involved walking past the little brick building nestled among the dark trees on the slope of a hill; as we passed by the building the older children would whisper "that's the murder house". I had no idea what this meant until it was my turn to go... Actually, at first it wasn't that bad, but in time I associated the experience with intense nerve pain (drilling without pain relief) and like others, I too began to dread these visits.

 

By the time I was in my late 20s I completely avoided the dentist and only visited one if a tooth decayed so badly it required an extraction or worse, a root canal. Each time I visited a dentist I got the lecture "if you don't start flossing you will get gum disease and you will lose all your teeth." Visiting the dentist not only triggered fear of nerve pain but was now associated with fear (i.e. the judgemental lecture) which quickly turned into more guilt.

 

Reflecting back, I now realise that ignoring my teeth and gum care was actually part of a self-defence mechanism (unfortunately this ended up fulfilling the prophetic words of well meaning (but also guilt-tripping) dentists). Not being able to afford the money to have my teeth fixed may have been relevant 20 years ago but to be truthful, this has not really been the case in the last 20 years; so what’s the reason I haven’t had regular dental check-ups or sought help for early dental decay or gum issues? FEAR -- I have been gripped with fear and guilt, so much so, I never prioritised my teeth, full-stop.

 

So by age 54 my gums and teeth were in a bad state. I visited the dentist at the end of last year and found out that I required gum scraping before she could work on my teeth; what was the point of spending all that money if my gums were unstable? Now that I am quite a way through my treatment program I reflect on my experience. Specifically I want to highlight the importance of having good psychosocial care; after all, my emotions (fears) drove me to neglect my oral health and so a healing would need to take place in my emotional core to enable me to seek help and maintain treatment.

 

The following is a brief summary of the things that I believe made a difference to my self-seeking behaviour, engaging with the dentist and receiving dental care. My aim is to show that a number of different variables coalesced to enable me to change my perception of dentists, dental treatment, personal oral hygiene and future engagement with dental care.

 

1. Encouragement (to see a kind and skilled dentist):

Prior to starting to work with Dr Clarence Tam my partner received support for her dental problems. My partner was probably more traumatised by dental nurses and dentists than I had been and sadly lost her top teeth. Clarence cared for her and restored her bottom teeth. All the way through her treatment programme my partner encouraged me to see Dr Tam. She spoke about her kindness and naturalness (no high-brow airs and graces and despite being an ‘expert’ I was led to believe this expertise would not be lorded over me; I would not be made to feel guilty about my teeth.

2. Dental surgery environment and atmosphere:

On my first visit to the dental surgery I noticed the premise had a homely (as opposed to clinical) atmosphere; a small waiting room had windows which looked over the city; a toilet set off to one side was comforting (I didn’t have to ask where it was and get a key and walk down a maze of steps to find a loo as is sometimes the case these days).

 

The receptionist was also very friendly, calm, natural in her approach with me, and efficient. This gave me confidence in what was about to happen. When Clarence came out to get me (big smile) she greeted me and spoke to me as if I was a person (not a job). She took me to the room where I was introduced to the dental technician, Wilson. Another big smile and some banter ensued; this settled my nerves (i.e. these people were relaxed, they weren’t rushing my job. I immediately noticed the room - high tech equipment and a large television on the roof.  Both Clarence and Wilson welcomed me (they felt genuine); for example, they were interested in my partner and asked how she was. They enquired about her recently fitted false teeth and her recent mastectomy. Their concern for her was genuinely compassionate. Everything in the room that was happening seemed very calm and relaxed. I started to feel the tension melt away.

3. Personal Dentistry Style: I’ve come to realise that no matter what profession you’re in, everyone has their own personality and way of working (style). The following are things I observed about Clarence and her team that gave them their own particular dentistry style. It worked for me:

·        Sharing information: At the start of my treatment programme and during individual treatment processes photographs were taken; these images were shared with me. Clarence used lay-person language to explain the issues with my teeth and gums and at no time was I given a lecture or made to feel guilty. Nor was I questioned about my poor dental care or admonished for neglecting my teeth. Everything was explained in simple terms and with the greatest care and respect.

·        Caring team working with me:  Being cared for by a dentist and technician that worked well together engendered a sense of confidence in them as a team. They worked harmoniously together; they liked each other and everything was in sync. This sense of equality rubbed off on to me as a patient.  In my culture we call this way of being aroha (love, compassion, care, concern).

 2. Dentistry equipment: Everything seemed new, quick and efficient (the less time in the room the better for me and the modern tools provided me with a sense of confidence that Clarence knew what she was doing)

 3. Good anaesthetic procedure: The gums were well numbed prior to being injected (yes this took a few seconds longer but resolved 98 per cent of my worries)

 4. Choice of movie to watch (and headphones). My job was to keep my mouth open, use hand movements to indicate if I needed anything (different signals for different hands) and watch the box - how hard is that?

 5. Being informed of progress: As Michel Foucault has said “knowledge is power”; I felt as though the power was shared between the dentist and myself; I was included in this dental process and was not merely there to be growled at and judged by a so called ‘expert’ who had the power to hurt me physically and emotionally.

 

Impact - Moving into the future

 

Providing the right environment, atmosphere and health care require multiple things to happen simultaneously and with such subtle synchronicity that everything that happens seems to occur, almost naturally. 

 

Clarence and her team’s holistic ‘style’ of dentistry achieved a good outcome for this reluctant patient. My satisfaction is the result. Kindness, compassion and non-judgemental care are the key. So too are expertise in dentistry, good gum numbing techniques and the latest equipment and resources to prevent pain and trauma. Attending to the psychosocial needs of the patient through providing a healthy distraction like television was also helpful. Providing information every step of the way kept me informed about what was happening. After all, this is my body, my mouth, my gums, my teeth and my emotions.

 

Moving into the future?

I am nearly finished my dental work this year. I feel empowered. I am no longer afraid to have regular dental check-ups and if I have an unexpected issue I Know I will seek help immediately. This will avoid an emergency dentist visit two years later to extract a worrying stump and another dose of guilt.

 

My only disappointment is that I did not meet Clarence and her team 50 years ago.

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