"Armchair" diagnosis and cosmetic dentistry treatment plan.

• History: Over time teeth often become worn and misshapen. The biting edges of this person's center two teeth have lost their original rounded contours and are now worn straight. The next tooth over on this person's upper left (her lateral incisor) has worn down even more extensively, to the point of being noticeably shortened.
  
  As teeth wear in this fashion, it is typically considered that a smile's appearance loses some of its "youthfulness." This type of wear is typically a symptom of a person's bruxing activity. "Bruxing" is a term dentists use to refer to teeth clenching and grinding habits.
  
  
• Cosmetic dentistry treatment plan: The changes we've illustrated in our "after" picture could be accomplished by placing dental crowns on the three teeth that show the most wear. Dental crowns are very strong restorations and would probably be the only type of dental restoration that could withstand the forces generated by this person's bruxing. The crowns would restore the length and contours of the teeth to proportions similar to those that existed before they wore.
  
  The "before" picture shows that this person has a diastema. A "diastema" is the term dentist use to indicate that there is a space between two teeth. This diastema has always existed (ever since the two teeth flanking it initially came into place) and is unrelated to the previously described wearing of these teeth.
   
  In our "after" picture we have illustrated how this person would look if her diastema was closed. Whether her diastema is closed, left open, or just partially closed is simply a matter of this person's personal preference. From a dental aspect it is of no consequence.