Our first priority is always to save the tooth, health before aesthetics

What always shocks me is the tendency of colleagues and patients to remove a tooth that could have been saved

At the last Smile of the Year dental contest in May this year(2015 – editor’s note), Dr Rosen Venelinov won the award in Composite Restorations Category. The decision was taken by an international jury– Prof. Nitzan Bichacho (Israel), Dr Sascha Jovanovic (USA) and Prof. Francesco Mangani (Italy).

Dr Rosen Venelinov was born on 23 April 1973 in Varna. He has graduated Dentistry in Plovdiv. In 2001 he began his private practice, and since 2003 he has specilized in endodontic therapy (root canal therapy), and a year later – in cosmetic dentistry, also. He has been a member and founder of the Bulgarian Endodontic Society since 2006. He has completed courses of education in Endodontics and Cosmetic Dentistry organized by leading professionals in Europe, Ukraine and the USA. He has been a recognized lecturer participating in numerous Bulgarian and international dental forums in and outside Bulgaria since 2006. A consultant, opinion leader and lecturer in Bulgaria and Eastern Europe for GC ЕЕО – Japan since 2007. Dr Venelinov’s articles have been published in various Bulgarian and international journals. He has been involved in the development of composite tools with one of the reputable US manufacturers– Paradise Dental Technologies. Together, they have developed Dr.V – composite set made after his design.

Dr Venelinov, at the ceremony when receiving the Smile of the Year award, you noticed the strong competition in Composite Restorations Category. What do you think made the prestigious international jury tip the scales in your favour?

When the patient came to us referred by an orthodontist to find a cosmetic solution to her problem, nothing predicted that this case would be worthy of Smile of the Year Award. The truth is that we seek to treat each patient as if we will participate in a competition with the result of the treatment. And I believe that this approach can be seen in the detailing and the sustainability of our achievements over time.

My approach to the patient was the same as to all other patients who came to me seeking a solution to a specific health or cosmetic problem. We put our heart, all our knowledge and experience to get an excellent result. The strive for excellence is always evident, efforts bear fruit. When, years ago, I was on a training with Dr Zemriev, I heard this advice: „When you do something, you do it in the best way possible. Nex time, you try to achieve even more”. That’s a good advice by an exceptional colleage.

The colleagues that were my competitors in Composite Restorations Category demonstrated work, which on my opinion, was on a world class level. It makes me very proud and happy, my work was selected among cases of true masters of composite. The competition in our category was, in my opinion, the greatest- there were young dentists who already are exceptionally good professionals and they demonstrated great solutions and results.

Is there a time when dentists decide to rely entirely on their experience?

If a dentist thinks of himself as “the best” in a particular field and decides that he/she has learned absolutely everything, this will put an end to his work. Our profession is extremely dynamic. Developments in dentistry on a world scale are being „updated” every 2-3 years and, if a dentist stops learning that would be a huge mistake. Although I have been lecturing for almost 10 years now both in Bulgaria and in Europe, and I provide trainings to my colleagues, I keep learning. I am constantly integrating more and more new methods of treatment of our patients and I always primarily  consider their health and the beauty of their smile. They are the most important things.

How do you keep the balance between the two areas in which you are a reputable specialist– endodontics (root therapy)  and cosmetic dentistry?

To be honest, in this case „a balance” is not the right word – it denotes that we have two sides of a scale. The truth is that  endodontics and cosmetic dentistry are one inseparable whole. They always stand on the same side of the scale. If we do not have a good basis, i.e. healthy roots and tooth tissue, we can hardly achieve a good look. And vice versa – what’s the point of making uniquely beatiful teeth on diseased roots when there is a risk of losing them in few years?

Our philosophy is to provide the patient with beauty not only now, not for 2-3 years ahead, but a beauty on strong foundations with long lasting effect. This, however, means many check-up visits over the years. At least 1-2 times a year to maintain the good result of the therapy or cosmetic correction.

What are your observations – do Bulgarians make oral health decisions easily?

Recently I have noticed that people pay more attention to their health- not only to their beauty. Before the financial crisis, they were willing to spend their money with ease. Then, however, even Bulgarians with more financial resources, own businesses, etc. began requiring from their health care professionals increasingly high quality of health and beauty care.

Comparatively small number of people realize how important it is to keep a natural tooth. If you get into a situation, in which they tell you: „This tooth has to be pulled”, you should start looking for options to save it. What always shocks me is the tendency of colleagues and patients to remove a tooth that could have been saved. I still meet people who have insisted that the dentist should extract a tooth to stop the pain. They reject the expected outcome of the treatment because they want an immediate result. They say: „Well, we will put an implant on that place”, as if a prothesis would replace an arm cut off at the elbow because of inflamed fingernail.

Unfortunately, for years the internet has been spreading the myth that you have your tooth killed, in several years there will necessarily be a granuloma or cyst. And if you have a granuloma or cyst of the tooth, it has to be extracted. Gosh, this is insane. We have treated thousands of teeth for 15 years of practicing in root canal therapy- and we always first make an effort to save the tooth. And the following-up of cases through the years show that soon after a properly made endodontics there is shrinkage, and then a complete removal of a cyst.

However, there are cases of large destruction of the tooth, poor splitting of the root- then an extraction is needed. But these are the minority of the cases. Good root canal therapy can provide the tooth with over  20-30 years of life. There is nothing better than the natural tooth.

However, the implant is the best solution for a missing tooth. Even I have an implant in the place of a chewing tooth pulled when I was only 14. I do not want to comment on the decision of my colleage taken nearly 30 years ago. But it is 21st century now- dentistry offers modern and reasonable treatment solutions.

Well, in already solved health problem you proceed to aesthetic corrections. Is the wish of the patient leading in choosing between bonding and porcelain veneers, for example?

The opinion of the patient is alwats important. I have colleagues who think that being specialists gives us the right to take firm decisions. I do not think so. The perceptions of beauty are as many as are the people on this earth. Sparkling white and even as tiles teeth are the perfect teeth for the Americans, but totally unacceptable for the European patients. The emphasis here is on the maximum closeness of the artificial tooth to the appearance of the natural tooth.

Dentists should explain, they should have patience and their approach to the patients must be aesthetic, not financial. If we have to choose between bonding and veneers, we are always driven by the patient’s interest– to achieve beauty with least possible damage to dental tissue. If I am able to achieve beauty without drilling a tooth- my goal is achieved. Because, keep in mind, that a crown requires losing up to 70 percent of the tooth tissue. And sometimes, with minor corrections we can achieve a great result. Beauty – yes, but not at the expense of health.

Published in Woman Today Magazine