INTERVIEW: Why Dental Work Is Emerging As The New Anti-Aging Procedure

Getting your teeth fixed can be more effective than Botox. At least this is what aesthetic dentist Dr. Michael Apa tells me as he explains the noninvasive “Smile Lift,” an anti-aging procedure he created as an alternative to plastic surgery and dermatology.

“The goal is to create harmony within the face and reestablish youthfulness in a natural way,” says Dr. Apa, who lists Chloe Sevigny, Lea Michele, Vera Wang and Rachel Roy among his celebrity clientele. His practice has also been named the aesthetic dentist of record for Elite Model Management and Wilhelmina Models, who rely on him to craft camera-ready smiles before Fashion Week.

I’m admittedly skeptical of the idea that veneers can create the same effect as a face lift, but he quickly makes a convincing case. Below, our conversation on creating beautiful smiles, both in the dentist’s chair and at home.

How do teeth affect overall facial structure, particularly when it comes to aging?
Dr. Michael Apa: “The skin loses elastin and collagen over time, creating wrinkles, sagging and a more hollowed-out look due to loss of cheek fat. As teeth age, they can shift, wear down—and sometimes even need to be removed. What most don’t think about is that the teeth support the lower third of the face, and over time, this support begins to collapse.”

How do you rebuild this support?
Dr. Michael Apa: “This is where the Smile Lift comes in, which essentially means changing the position of the teeth to a more favorable position that will provide the needed support to the upper lip. Think about it this way: the teeth serve as the foundation for the rest of the face. For example, a patient with collapsing teeth may elect to have a lip injection. While some fullness in the lip may be restored, this provides no support. Getting the teeth fixed restores harmony to the face and fixes the underlying issue—excessive grinding—which would come back if you opted for a quick fix with Botox or cosmetic surgery.”

What do you look for in a beautiful smile?
Dr. Michael Apa: “Restoring balance within the face is what I seek for all of my patients. When I meet with them, I carefully review all the elements of the face, and how they can work harmoniously to achieve the most natural smile. This means taking every feature into consideration: face shape, tooth color, tooth size, light refraction, age and skin tone. Together, I’m looking at how the teeth complement or detract from the overall balance. This process is part of an approach I pioneered called the Facial Aesthetic Design, which is a way of counteracting the age, wear and discoloration that happens over time through growth and development patterns. The key is to create extremely thin veneers, while removing the smallest amount of tooth material and bonding them directly over the teeth.”

How does the Facial Aesthetic Design differ from traditional dental procedures?
Dr. Michael Apa: “I don’t use a traditional method of smile design like most other dentists because it only focuses on creating perfectly symmetrical teeth. This may not be right for every patient, and can actually have a reverse disharmonious effect. After a full facial assessment and direct bonding mockup to show the patient what their smile will eventually look like, I sculpt the temporaries over the teeth, an uncommon step for most dentists. Artistic ability allows me to create these trial smiles, allowing patients to wear them and provide feedback before we finish the veneers. The ceramist will then create a line-for-line copy of my work to duplicate the temporary teeth into individual porcelain restorations.”

Teeth are structurally important as far as anti-aging goes, but on the surface, the biggest concern is whitening. What’s the most effective way to get a brighter smile at home?
Dr. Michael Apa: “First, bleach strips. I recommend Crest® 3D White Whitestrips Professional Effects, which are loaded with the active ingredient hydrogen peroxide. Since maximum efficacy of most bleach strips happens in the first 15 minutes, maximize your results by using three strips a session, changing them every 15 minutes for a total of 45 minutes a day. You should also invest in an electric toothbrush like the DiamondClean by Sonicare. Not only will this keep your gums healthier and your teeth cavity-free, but it will also keep your smile looking white and free of any stains from coffee or wine. Lastly, limit the juicing. Not only does it stain your teeth, but it also cuts down on chewing. If you plan to join the juice craze this summer, remember to always brush your teeth afterwards or chew sugarless gum, preferably one that contains xylitol. It stimulates the salivary glands to produce saliva, which not only is anti-carious for your teeth, but also has a lubricating property that stops stains from setting in.”

Sometimes whitening teeth can make them oversensitive. Do you have any tips for avoiding this problem?
Dr. Michael Apa: “Combine your pastes. While whitening toothpastes have silica in them to scrub away stains and prevent yellowing, there is some unresolved controversy about the damage they may cause to the enamel. To get the maximum stain removal effect safely, alternate the whitening paste every other day with a non-abrasive high fluoride paste. Crest® Pro Health is great because it has one of the highest amounts of stannous fluoride in an over-the-counter toothpaste.”