Cosmetic dentistry makeover simulation photos
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Using cosmetic dentistry to harmonize a smile.
About this cosmetic dentistry makeover:
This person wrote and stated that they had had their upper teeth restored. Now they were at a point where they were considering having some dental treatment performed for their lower teeth.
When you look at this "before" picture it is easy to notice that there is a color discrepancy between the upper and lower teeth. While it is not uncommon that a person's lower teeth might be a little darker than their uppers the shade that was chosen for the dental work placed on the upper teeth makes the color difference between the two very obvious.
The other thing we notice is the gap between the two lower teeth. A dentist would use the term "diastema" when referring to a space between two teeth.
Our suggestions for a cosmetic dentistry solution:
- Perform a professional dental cleaning.
- It seems quite likely that a great deal of the discoloration seen on the lower teeth might simply be surface staining. People who consume coffee, tea, and use tobacco products often accumulate this type of staining between dental cleanings. Just polishing the lower teeth might whiten them significantly.
- Perform teeth whitening treatments.
- Even if cleaning this person's lower teeth does lighten their color it still seems unlikely that they will be as white as the upper teeth.
Teeth whitening treatments, such as those discussed elsewhere on Dental-Picture-Show.com, might provide a solution. And while it is probably unrealistic to think that teeth whitening treatments will lighted the lower teeth as much as we have illustrated it is certainly worth a try.
- Place dental bonding in those regions where the teeth whitening process was unable to make a color improvement.
- Even if the color improvement achieved by teeth cleaning and teeth whitening has been satisfactory neither of these process can be expected to make a significant change in the color of the teeth down by the gum line where root surfaces show.
If you look at the "before" picture above you will see that that portion of the teeth nearest the gum line seems a darker shade of yellow-brown than the upper part of the teeth. That's because this portion of the tooth is technically the surface of the root. Root surfaces are not covered by dental enamel (hence the reason why teeth whitening processes will not change their color) and therefore have a darker coloration. If a completely uniform tooth color is required then dental bonding will need to be placed in these areas.
There can be reasons why a decision to not place dental bonding might be made. As you can see in the pictures above, so to show their lower teeth this person has pulled down their lip. Quite possibly the root aspect of the lower teeth is simply not a concern because it is not visible to others. Additionally, this person seems to have a propensity to accumulate tooth staining. The same events that cause tooth staining will with time cause staining of the dental bonding also.
In comparison to trying to achieve a color change with the lower teeth so they more closely match the color of the restored upper teeth, closing the gap (the diastema) between the lower two teeth is relatively straightforward.
Here are four ways it might be accomplished:
- Close the gap with dental bonding.
- White filling material (dental bonding) could be placed onto each of the two teeth framing the diastema so to close it. Dental bonding would be the quickest, easiest, and least expensive solution. The downside would be that the dental bonding would have a tendency to stain with time. However, if the bonding ever broke or did become very stained it could be easily replaced.
With this case the positioning of the lower right center tooth seems rotated a little. The addition of dental bonding to this tooth in an effort to close the diastema might result in a tooth that looks somewhat strangely shaped. The dentist performing this work would have to make an evaluation as to the expected outcome of this approach.
- Close the gap by way of placing porcelain veneers.
- Conceivably porcelain veneers could be placed on the two lower teeth. If each veneer was made just a little wider than the teeth were originally then when the veneers were bonded into place the gap would be closed. Once again the slightly rotated positioning of the lower right tooth might present an obstacle to this approach. The treating dentist would need to evaluate and make a determination.
Porcelain veneers have a reputation for being brittle. The dentist providing this treatment would need to decide that veneers were an appropriate type of restoration for this location in the mouth. Unlike dental bonding, porcelain veneers resist staining well (with the possible exception that sometimes the edges of porcelain veneers accumulate stain). Typically people think that porcelain gives a more natural appearance than dental bonding. If a porcelain veneer does break it usually cannot be repaired, only replaced.
- Close the gap by way of placing dental crowns.
- In similar fashion as with porcelain veneers, dental crowns could be placed on the lower teeth so to close the space between them. Dental crowns have a porcelain surface so they resist staining well. They are also very strong and lasting. The downside with dental crowns is that unlike when porcelain veneers or dental bonding are placed, during the process by which dental crowns are made the teeth must be ground down significantly. In this case however, if the rotated positioning of the lower tooth is an obstacle to the dentist, dental crowns are a means by which the apparent alignment of teeth can be changed.
- Close the gap using orthodontic treatment.
- Now that you know some of the downsides with different types of dental restorations possibly the obvious might provide the best solution. If there is a space between the lower two teeth, and if one of the teeth is rotated out of position, why not just reposition the offending tooth back into proper positioning orthodontically and close the gap that way. Then no dental restorations are needed.
Per usual, the treating dentist would need to determine that this would in fact close the gap satisfactorily. There is another concern with this approach and that is: How is the dentist going to insure that the tooth stays in place? Quite possibly a retainer will need to be worn at night. Another note, orthodontic treatment isn't just done with braces. If simple tooth movement is required possibly the treatment could be accomplished with a removable appliance rather than a fixed wire.
Additional notes about our cosmetic dentistry treatment plan.
Many of the treatment suggestions above involve steps taken so to get the lower teeth more uniform in color and also to a shade that more closely matches the upper teeth. If the upper/lower color discrepancy not a major concern to this patient then this treatment plan becomes very straightforward.
The coloration of the lower teeth could of course be changed by way of placing dental crowns on all of them. We'd be hesitant to suggest this. A large amount of good healthy tooth structure would be sacrificed in doing so. It doesn't seem that this approach would be in the best interest of the patient.
In hindsight a good way to approach this case might have been to use teeth whitening treatments on the lower teeth first. Then close the lower diastema with restorations that match the new shade of the lower teeth. Then restore the upper teeth using a shade that does provide for whiter teeth yet more closely matches the lower teeth.
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