Meet Dr. David Mastro of Alluring Cosmetic Dentistry

Episode Transcript

Speaker 1 (00:00):
This is the Good Neighbor Podcast, the place
where local businesses andneighbors come together.
Here's your host, StaceyPoehler.

Speaker 2 (00:14):
Hey everybody.
I'm very excited to be chattingwith Dr David Mastro from
Alluring Cosmetic Dentistry.
Welcome, dr Mastro.

Speaker 3 (00:23):
Thank you, glad to be here with you, stacey.

Speaker 2 (00:26):
The first thing we want to know is a little bit
about your background and howyou got into the field of
dentistry.

Speaker 3 (00:33):
Okay, basically I didn't start out going into
dentistry.
I went to school and I thoughtI wanted to be an accountant and
I went into it it and after twoyears in college in accounting,
I decided I really hatedaccounting and I didn't want to
do that.
And so I wound up taking abunch of tests and it said I had

(00:55):
a high manual dexterity with myhands and mind and visual,
spatial relationships and things, and that I would be a great
surgeon, dentist, carpenter,anything that you would use your
hands and mind.
And so I said I think I mightlike to do that and that's what
started me thinking about goinginto dentistry.

(01:16):
All right, so I didn't want tobe a physician.
I didn't want to do a lot ofother things that they said I
could do.
Anyway, like I didn't want tobe a carpenter, because it just
sounded too hard.
Anyway, I worked inconstruction one summer down in
South Florida doing a bunch ofwork in the hot heat out there.
I decided I wanted to be in airconditioning.

Speaker 2 (01:39):
As good a reason as any.
Where did you go to dentalschool?

Speaker 3 (01:43):
I went to Emory.

Speaker 2 (01:47):
Nice, here in Atlanta , what made you want to
specialize in cosmetic dentistry?

Speaker 3 (01:50):
Yeah, I was always real good at making teeth look
like teeth.
Even in dental school I couldcarve teeth that really looked
like teeth.
They actually used me as aninstructor at Emory to teach the
other students how to carveteeth.
Wow, that's how it starteddoing that.

(02:11):
And then I just it came verynaturally to me to make teeth
look like teeth and it soundslike it'd be easy, but it really
isn't easy to do that.
So that's how it started.
And then I got into practice anddid an internship and did all
the residency things, all thespecialties and that was in the
military, and got out of themilitary and I was able to do

(02:34):
cosmetic dentistry in the armybelieve it or not.
I was in a little clinic indowntown st louis but we got to
do all the special, all thebranches of the military there
in St Louis, and so I had allofficers that I worked on and so
they asked for cosmeticdentistry and I was able to do
it and I did it and got a lot ofexperience in the military

(02:56):
doing it.
Then I got out of military and Ijust started doing what I did
in the military and I had someassistants who worked with me
and they saw some of the workthat I did and they'd worked in
other offices and they commentedto me, like you're really good
at cosmetic dentistry, that'swhat you ought to pursue.
And I says, yeah, I reallyenjoy doing it and that's how I

(03:19):
got started doing it and then Ijust progressed from there and I
do all phases of dentistry, butmy most favorite phase is
cosmetic dentistry because itcomes very natural to me as well
.
My assistant today I said whywould I have gone into cosmetic
dentistry?
She says because you're anartist.
Okay, that that's a big part ofit.

(03:40):
You do have to be an artist todo it.
And that's what I do is artworkon patients.

Speaker 2 (03:49):
That's great.
I imagine you've been in thefield quite a while.
What changes have you seen overthe years?

Speaker 3 (03:54):
I've been a dentist about 45 years total, with Army
and everything, so I've been init a long time.
Tremendous changes in the lastdecade or so.
The technology in dentistry haschanged so much that what I
learned in school, it's justantiquated compared to what's

(04:15):
out there today.
So we embrace the technology.
I started doing all thetechnology parts of this when it
first started out Computerizeddigital dentistry oh, this was
over 20 years ago.
They started doing digitalx-rays, so we always bought the
latest technology andincorporated it into the
practice.

(04:36):
But back then you had to prettymuch have a lab to do the work,
send your work out to the lab,put patients in temporary things
and then wait for the cases tocome back.
And it was always a nuisance tome and it always required me
fixing what came back from thelabs because it wasn't very
artistic.
I didn't think so I wouldre-carve everything that came

(04:58):
back to me.
But then I saw the technologystarted improving and they came
out with a machine from theCEREC company.
It's called a CEREC machine andyou could actually do your own
crowns with the machine and Isaid, wow, this would be great
if I could.
Just if I've got a car of itanyway.
Why don't I just do it on thecomputer and we'll build it and

(05:22):
make it and be able to put itall in one day.
And that's where we started.
Well, we started doing that,and that made dentistry a lot of
fun for me, because I was ableto do what I wanted to do
without having to ever use a lab.
And that's how we got into thetechnology side of dentistry,
and it's tremendously changed inrecent years.

(05:42):
Everything's changed.
The root canal procedures havechanged.
How, recent years, everything'schanged.
The root canal procedures havechanged.
How you make your crownschanged.
The materials that are usedtoday are so much superior to
what they used to becosmetically too, but also
strength-wise and so it's justtotally different from what it
used to be, and I love it.

(06:03):
I love doing the dentistry.
I'm an artist.
When I'm doing it, I'm creatingand I see the instant results,
like I'm a sculptor with theteeth and can do it, and the
machinery lets me do it.
We have the full lab here inthe office, so we make
everything right here on thespot with it.
I do preliminary work withmodels and things that we 3D

(06:27):
print, and it's all thehigh-tech stuff too, but then
from these models.
We'll do wax ups on the modelsand I'll change people's mouth
on the models.
They'll tell me what they wantand I'll give it to them on a
model and show them on themodels what this is, what you
will look like when we do it.
And then the technology allowsus to copy that model and

(06:50):
duplicate it and make the crownsout of it to look just like the
model, and so there's noguesswork with it, because they
can see it and we produce it thesame way.
Patients thoroughly enjoy it.
They love coming in and gettingtheir work done in one visit.

Speaker 2 (07:06):
That's very convenient oh yeah, it's amazing
.

Speaker 3 (07:09):
Less anesthetic needs to be used, less visits, but
the end result is super good.
I'm so pleased with how wellthe fits and everything finishes
and everything that you alwayswanted in your work and this
technology does it.
We've embraced that and it'sbeen wonderful.
Patients love it.

(07:30):
We love it.

Speaker 2 (07:32):
And how do you go about educating yourself and
training yourself on all thatnew technology?

Speaker 3 (07:37):
Yeah, that was a big deal.
That's a there's a big learningcurve to do that, I would say.
For a dentist to be able toreally do good cosmetic
dentistry on that it's about athree-year process of really
practicing with it and learningand just doing it and learning
from.
This can go wrong or that cango wrong, but when it does go

(07:57):
wrong you know how to fix it.
There's courses that you takewhen you purchase this
technology, which we spend a lotof time going to classes and
courses and training on it too,and they come into your office
also and they train you in yourown environment.
And unfortunately not a lot ofdentists do it because the
learning curve is so long toreally get good at it.

(08:21):
And so a lot of dentists willuse the technology but they'll
still send it to a lab and havethe lab be able to do it instead
of good at it.
And so a lot of dentists willuse the technology but they'll
still send it to a lab and havethe lab be able to do it instead
of them doing it.
But I like doing it my waybecause I'm the artist that's
doing it and I'll get what Iproduce in my mind and the end
result is there and I visualizethese cases for patients before

(08:44):
I ever start them.
If they tell me this is what Iwant, I will then start in my
mind saying I'll look at theirteeth and I'll begin to
visualize what will this endresult look like if I do this
and this to it, and will thispatient like it?
And what I do is I'll makeseveral sets of models and we'll

(09:05):
change one set.
We'll make all the changes thatthey ask for as I'm looking at
their teeth that might becrooked or spaces or missing
teeth or decayed teeth, all kindof problems, and then
visualizing what we have to doto get it there and then
producing it on a model, usingwax and things to actually carve

(09:26):
these things, just like asculpture would carve something,
doing it on the model, and thenthe computer will take it from
there after I do the work in thepatient's mouth and reproduce
what I've done on those models.
And so you've got to be able toartistically visualize the end
result before you ever startsome of these cases, because

(09:48):
some of them are reallycomplicated.
They come in with somehorrendous problems and they
want to have this beautifulsmile and you've got to be able
to visualize.
How can I get up from thispoint to that point?
I've tried to bring in someassociates along the way and I
will give them a set of modelslike that and I'll say what
would you do to fix this?
You have to have that naturalartistic ability and spatial

(10:13):
relationships to be able tovisualize things and turn it
into something else it's like agift or talent.

Speaker 2 (10:22):
It's not something that you can teach're very lucky
to have it and have been ableto tap into it.

Speaker 3 (10:28):
It is a talent and it is a gift.
You can train some people to beable to do it, as long as they
have the natural ability to bean artist too.
If you take a person that's notan artist, I don't think they
can do it, because they'redependent on a lab to do it.
You've got to still visualizeand give the lab the work that

(10:48):
you need.
The preparations and everythinghave to be correct for the lab
to be able to produce somethingfor you.
So you still have to be able todo that in cosmetic dentistry,
and it is a gift and it is atalent that goes hand in hand
with a lot of artistic work thatgoes in it and a lot of science
behind it too.

Speaker 2 (11:10):
I imagine that when you finish with a patient and
they see the transformation, itcan be very emotional for them.

Speaker 3 (11:18):
Yeah, we've had patients cry because they were
so thrilled that what they looklike.
I had one patient who got upand danced up and down the
office hallways.
He was so thrilled of hischange and he never would smile.
And he was out in the publiceye in the movie industry and he
never would smile in any of hisphotographs.

(11:40):
After he got his teeth fixed hesmiled like a storm.
Every picture you ever see ofhim he's always smiling real big
and beautiful smile.
He's thrilled with it.
So it does change.
It's a life-changing experiencefor patients and it's almost
instant.

Speaker 2 (11:54):
Yeah.
It goes from oh really bad towow, and that's what we try to
do is give them that wow factor,which we do do a lot of
cosmetic dentistry wow factor,which we do do a lot of cosmetic
dentistry, yeah, and I imaginethat through the artistry you're
really trying to keep itlooking natural and to
compliment someone's facialfeatures.

(12:15):
Can you talk about that alittle bit and how you make sure
things really fit the personRight?

Speaker 3 (12:20):
Yes.
So when we do our first consult, I ask the patient what is it
you want me to do for you?
What don't you like about yourteeth?
Is it you want me to do for you?
What don't you like about yourteeth?
What would you want me to do tomake it look like what you
think it should look like?
And they'll begin to tell me Iwant you to do this, lengthen
this, or change that, or make itwide or make it narrower, do
all these things.
And then I take notes andeverything.

(12:41):
They're telling me what theywant and I would go in and make
those models and I would startmaking the changes and visualize
what they just told me, whatthey want, and start creating
those teeth on the model.
And then I'll go back to thepatients and then say here is
what you told me you wanted.
This is what you look like nowon this model.
Now, this is where you're goingto go with these teeth.

(13:02):
Is this what you're thinking?
That's what you wanted.
99.9% of them take it.
They say, yes, that's what Iwant.
Once in a while I'll getsomebody real fussy and they
might say can you do a littletweak here?
Yeah, we can always tweak, dothat kind of stuff.

Speaker 2 (13:20):
Yeah, folks have misconceptions about cosmetic
dentistry.
What are some of the ones thatyou see that you feel like
people just maybe aren'tunderstanding the process and
what you're doing.

Speaker 3 (13:33):
Yeah, cosmetic dentistry is more than just the
teeth.
A lot of times cosmeticdentistry can be just something
as simple as a filling inpatient's mouth.
To me, cosmetic dentistrystarts at the back of the mouth
and it's the entire mouth.
It's not just the front sixteeth, it's everything, anything
that might show.
But you've got gum tissue.

(13:54):
The gum tissue has to lookbeautiful when you're done.
You can't have gum tissuethat's going up and down and up
and down across the front.
It needs to be even across thewhole front to complement the
smile.
The gum tissue is the framearound the picture, so to speak,
and that highlights the teeththemselves.
So you got to treat the gumsproperly.

(14:14):
You got to take care of that.
You got to make sure that whenyou're done with the teeth you
don't have long teeth on oneside, because the gums are
receded, and short teeth on theother side.
And you got to make the teethflow with the eyes.
They're not.
Teeth are going crooked thisdirection, sloping down on one
side, and their eyes are slopingthe other one.
You got to match everythingwhen you're doing it.

(14:36):
Some patients have high liplines, some patients have low
lip lines.
Some patients hardly show theirgums.
Other patients.
They show their gums all overthe place.
So you know every patient'sdifferent.
But yes, you do have to matchthe teeth and the gums to the

(14:56):
overall facial features of thepatient.
There's things like a woman'steeth might have little
different shapes to the edgesand things a little softer, a
little rounder in the corners orthings like that.
And then some men you want nicesquare teeth on them, just more
of a masculine look.
You don't want to put a bigmasculine look on a lady and you

(15:17):
don't want to put a femininelook on a man.
You want to go with what looksbest on that particular patient.
If a patient asks me I wantthis or I want that, I'll have a
lot of patients that they say Iwant my teeth totally straight
across the front.
In other words they're all thesame length.
In other words they look likepiano keys, okay, all the way

(15:38):
across.
And I tell them that's not veryaesthetic, that's not very
cosmetic, that's an old look.
People get teeth like that whenthey get older and they wear
their teeth down to flat teethall the way across.
You don't want to do that toyour teeth.
It's not going to improveanything for you.
And so I begin to teach themwhat is aesthetic, what is

(15:58):
cosmetic, and then we takepictures of them and I can show
them, patients, that we here'stheir before, here's their after
, do you like that look?
And we'll go from pictures andthings, so to speak, and let
them say, yeah, I like the lookof that.
So I want those lateral teethup a little bit shorter than a
central's, and that's a youthfullook.

(16:20):
The thing teeth come in not flatand square, but they come in
with lobes on them naturally,and these are called mammulons.
In nature they're formed.
That's what forms the teeth.
And you have that on theseteeth and we put in detail and
anatomy on the front of theteeth.
It isn't just a flat, shiny,white surface, there's all kinds

(16:42):
of details and carving thatgoes on the front of these teeth
.
And that's the beauty of thetechnology that we have.
I'll put it in wax and it'llduplicate that and it'll carve
it in the porcelain we have.
I'll put it in wax and it'llduplicate that and it'll carve
it in the porcelain, and then.
So that's another part ofcosmetics is you got to make

(17:02):
teeth look like teeth and notcrowns.
The biggest compliment I getfrom patients is everybody tells
me what a beautiful smile Ihave.
It's not what a beautiful,beautiful teeth, so much is what
a beautiful smile you have.
Or, boy, you sure look a lotyounger than you used to.
What'd you do?
And they don't really pick upthat the patients have had their
teeth done.
This is what I try to achieveis teeth that look like teeth

(17:27):
and they don't look like crowns.
I want them to be as natural aswe can possibly make them.
The thing I fight most withpatients is the color.
They want them to be as naturalas we can possibly make them.
The thing I fight most withpatients is the color.
They want them as white as youcan get them, and sometimes we
do it, and sometimes it dependson the patient and their
complexion, their eye color andthings like that that they can
get away with super white.

(17:48):
But some people try to go superwhite and they shouldn't.
You know, it's just it's thefirst thing you see when you
walk in the room and they smileis always a mouthful of teeth.
We don't do that to patients.
If they can't carry that color,I'll tell them that's going to
be a mistake for you.
I can make your teeth beautiful.
You can have white teeth andwe'll get them as white as you

(18:09):
can naturally get them, butdon't go overboard and make it
toilet bowl white, because itlooks awful.
Yeah, that's true.

Speaker 2 (18:17):
Yeah.

Speaker 3 (18:19):
So, anyway, that's the color, but we everybody
wants whiter teeth and weusually do give them whiter
teeth, but there's a fine linebetween two white and a natural
white and we try to stay in linewhere it's.
Yeah, I really do want them tolook like beautiful teeth when
I'm done, but more than that,even just a beautiful smile,
that changes their life.

(18:40):
And it's Diane, my wife, is acounselor and she says I've
worked with patients for yearstrying to improve something and
you can do it in one afternoon.
You change their entire livesand their whole, their whole
personal perception ofthemselves changes instantly.
So it is, it's a life-changingexperience for patients when

(19:00):
they do this kind of work.

Speaker 2 (19:02):
Yeah, it definitely helps people build confidence oh
yeah, it's a big confidencebuilder.

Speaker 3 (19:08):
Very much, yeah, but I always loved the thing.
Did anybody notice your teeth?
And they say, no, they don'tknow.
They just say you have a prettysmile.
I said that's the biggestcompliment you could ever have
right there, not somebody saying, oh, I see your new crowns.

Speaker 2 (19:24):
For sure, that's not what you want so what are the
common procedures that you'reperforming there in the office?
Okay, and maybe beyond that too, to give us an idea of the full
scope of everything you do yeah, dennis, there's different ways
to do cosmetic work.

Speaker 3 (19:45):
One is orthodontics you move teeth around, which we
do with clear trays, and that'sone approach.
If patients have really niceteeth but they're a little
crooked or something, you can doit with some minor movement
here and there and straightentheir teeth out with that.
The other way is bleachingteeth, just whitening their
teeth with common bleachingagents that are available today

(20:08):
that can when them up a littlebit.
We do veneers, porcelainveneers, we do full crowns, and
these are areas that usually,when patients have worn teeth
that are really flattened downor really short now because
they've worn them down, some ofthose patients really need to be

(20:29):
rebuilt.
Their mouth need to be openedup some.
I had one patient recently thathe had worn his teeth down so
flat he probably removed abouthalf of the length of his upper
teeth and half of the length ofhis lower teeth.
His lower jaw startedprotruding forward and turned

(20:50):
into what we call class threeocclusion, because his lower jaw
, because it closed down so much, it's swinging on an arc back
there.
As it kept closing more andmore, his jaw kept going further
and further out and his lipswere now bunching up in the
front and he had all kind oflines on his face and everything

(21:10):
because his vertical dimensionof his face was squished.
In short, we opened his bite upby re-lengthening all his teeth
.
We had to do it with crownsbecause he'd worn all his teeth
down anyway.
We opened his bite and his jawwent back into position.

(21:31):
His lips became built out likethey should have been, all the
lines and creases around hismouth disappeared.
His wife couldn't believe it.
She says you do look 10 yearsyounger.
Honestly, it totally changedhis facial features.
And people tell him all thetime boy, you look a lot younger

(21:51):
.
And that's the kind of work Ienjoy, doing that kind.
But we do other things bondinglittle composites and we do
implants and restoring implantswith all kinds Root canals.
We do all that.
The new technology in rootcanals is amazing what can be
done and how smoothly andquickly and efficient they are

(22:11):
and how predictable it is todaycompared to what it used to be.
And then your regular old whitefillings just fillings and
teeth.
They've taken out the oldsilver things that were used
years ago and some still usethem.
People usually don't want those, but every phase of dentistry
we do here.

Speaker 2 (22:30):
And is there some tips you can give people maybe
on how to maintain their smilesor prevent some of these
problems?

Speaker 3 (22:38):
Yeah, one of the things that causes a lot of wear
on patients is they usetoothpaste with silica in it.
It's sand.
So when you brush your teethwith paste with silica and it's
real finely ground sand and yougo to bed at night, you got
these fine sand particles inyour mouth and people like to

(22:59):
grind on it in their sleep andthey grind their teeth down.
And that's usually the numberone cause of what causes the
loss of the vertical dimensionof patients faces is they're
wearing their teeth flat anddown and their face sinks in.
And so I tell patients try toget a toothpaste that doesn't
have silica in it, which isreally hard to do anymore

(23:22):
because almost everyone has itnow, so you have to go out of
your way.
I'm not going to give you anynames of pastes, but I just say
look on, look on the box.
If it says silica, I wouldn'tuse it.
That's number one cause of thatcauses more destruction to
people's mouths than cavities.

Speaker 2 (23:41):
Wow.

Speaker 3 (23:42):
Yeah, it really is, and I see that more than
anything is how much wear is onpatient's teeth.
So we use night guards onpatients that they can sleep in,
so they can't grind against thesand at night.
That's another thing that helpsa lot with cosmetic work.
What other things do we havethe tips on?
Oh, how to floss, right, do youknow how many people don't know

(24:03):
how to floss?
They?

Speaker 1 (24:05):
say oh yeah, I know how to floss.

Speaker 3 (24:06):
You show me and they show me.
And they wrap the string allaround their whole hands and
everything.
They're trying to get two fistsin their mouth and trying to
floss.
So there's a technique to floss.
That's a proper way to flossand I show patients how you hold
it, what finger to wrap it on,how you control the string, the
distance between your fingers,so you can get into every

(24:27):
surface of every tooth in yourentire mouth.
And it's easy to do.
And probably 95% of thepatients out there don't know
how to floss.
So I'm one of these days I'mgoing to do a floss video on,
put it on YouTube on how tofloss, because nobody knows how
to floss.
Yes, I recommend water picks forpatients.
It really keeps their gumshealthy.

(24:49):
A combination of floss andwater picking together.
Nice, light pink gums looks waybetter than beefy, red, swollen
, purpley looking gums.
And patients have crown workand they have that purpley, dark
red color that does not enhancethe cosmetic look of anything.

(25:10):
But if their gums are light,pink and healthy, stippled and
look nice, that's beautiful.
That's what creates a beautifulsmile too.
Home care is real important.

Speaker 2 (25:22):
Yes, what advice might you give to someone who's
considering a career in cosmeticdentistry?

Speaker 3 (25:29):
Okay, I would say they've got to have some
artistic ability.
Okay, I would say they've gotto have some artistic ability.
If you can't visualizesomething, take it from here to
there in your mind before youever do it.
You're going to struggle withit.
So that's the number one thing.
I think they do need to havesome artistic gifting and
abilities yeah you can teachtechniques and things like that.

(25:50):
But if you can't visualize it,there's other areas of dentistry
that you could go into.

Speaker 2 (25:57):
It's like a plastic surgeon is an artist.

Speaker 3 (26:01):
Oh yeah, very similar , in fact.
That's amazing, there's arelationship.

Speaker 2 (26:05):
there they inherit the artistic abilities.

Speaker 3 (26:09):
Yeah yeah, that's a big part of dentistry.

Speaker 2 (26:11):
Anything you haven't had a chance to share that you
want to make sure our listenersknow.

Speaker 3 (26:16):
Diane, you give me some ideas.
Let me just say, as far asgiving somebody advice to go
into the dentistry, if theyenjoy working with their hands,
their minds and they enjoy beingaround people and they have a
good people rapport, they willlove dentistry.
I enjoy doing dentistry morethan almost anything I do and

(26:39):
it's because it's a fun field,because it's easy for me to do
and if you really enjoy whatyou're doing then it's not a job
anymore.
People say why don't you retire?
I enjoy doing what I do so muchI don't really want to retire.
And then my patients tell me wedon't want you to retire, don't

(26:59):
dare retire.
So if they have the abilities,definitely go into it.
They will enjoy it.
The technology makes it so muchmore fun to do.
Even if it is a learning curveto do, it's worth it to do if
you have that ability.

Speaker 2 (27:14):
This was just fantastic.
I think it was so great to beable to hear from you and really
see this passion.
That you've had to be doingsomething for 45 years and to
still love it and to still wantto get up every day and do it is
just a testament to yourabilities and your artistic
talents.
So thank you, Dr Masho.
It was great chatting with youtonight.

Speaker 3 (27:35):
Enjoyed it.

Speaker 2 (27:36):
Yeah great, you did a great job.

Speaker 3 (27:38):
Okay, thank you.

Speaker 2 (27:39):
All right, thank you.

Speaker 3 (27:41):
Okay, bye-bye, bye.

Speaker 1 (27:45):
Thank you for listening to the Good Neighbor
Podcast Milton Moore.
To nominate your favorite localbusinesses to be featured on
the show, go to gnpmiltoncom.