A patient case study by Dr. Andrew Tonelli
During her recent hygiene visit, our patient Jill mentioned that she disliked her smile. She explained it was not because of her front teeth, but rather how those on the sides looked. Jill said that she would always notice the side teeth in photographs, and asked if there was a way to address the issue without a full mouth of veneers.
Jill showed me a photo with her sons where she noticed this issue, and she pointed out the dark space behind her canine.
Jill has a great smile, and while these areas are less visible, they still detract from her overall smile. In the photo below using our professional camera, the darker areas of her smile behind her canines are noticeable.
Here’s another angle that shows how this tooth is discolored and stands out in her smile when viewed from the side.
Assessment and recommendations
These particular teeth appear darker for two reasons. The first is that two of the teeth had aging silver fillings that were showing through the enamel of her teeth. The second is that these teeth are set back from her other teeth. This combination makes her smile look less full, and also lends a dark appearance to the teeth.
The old fillings in the the two teeth can be replaced using treatments that will not only brighten and re-position the teeth, but also make them stronger and more stable for the long term.
For the misaligned third tooth, I recommended a minimally invasive veneer that would change the position of the tooth without removing the outer layer of the enamel.
How would Jill’s future smile look?
After explaining my recommended plan to Jill, I offered to show her a mock-up of how the final result would ultimately look, so she could be certain she wanted to move forward with the treatment.
Next, our lab technician Ledja designed how we wanted the teeth to be shaped. Then we made a stent that allowed Jill to “wear” the teeth and visualize how the final result would look. Here is the photo of that try-in.
As you can see, the smile is fuller and the dark teeth are significantly less evident. Once Jill saw how her smile could look, she was excited to move forward with the permanent treatment.
Implementing the plan to Jill’s future smile
Ultimately, each of the three teeth we treated were in slightly different condition:
- One really warranted a crown
- Another had a filling that we incorporated into the partial veneer
- For the third tooth, we just veneered the cheek-facing part of the tooth.
In the photo below, you can see that the treatment labeled (1) covers the whole tooth, while (2) is a veneer and (3) is a veneer that also replaced an old filling.
Results achieved: Jill’s new smile
On the day the teeth were permanently cemented, the final result looked like this:
Following the treatment, the dark areas behind the canines are eliminated, along with worrying about dark areas of her smile showing up in photos. Better still, these teeth are now stronger for the long term.
Jill’s treatment was not extensive, but nonetheless achieved her desired result. We moved forward methodically to ensure the patient was happy with her end result. And she was – Jill got exactly the smile she wanted!
Have you ever wondered what you would look like with a new smile? Our smile design process capitalizes on technology to offer our patients a view of what their new smile will look like after cosmetic work has been completed — before it’s even started.
Learn more here – or reach out directly for a consultation