"Armchair" diagnosis and cosmetic dentistry treatment plan.

• History: This person is missing his center upper right tooth. This tooth had been replaced by way of the placement of a gold dental bridge, unfortunately the condition of this bridge has deteriorated.
        Originally the gold work of the bridge outlined the shape of the two teeth that lie on either side of the missing tooth (the two teeth which are the supporting teeth for the bridge). The gold work that occupies the space where the tooth is missing was no doubt at one time covered over with porcelain so that the artificial tooth looked white like this person's adjacent teeth. While it is hard to know exactly what course of events has lead to the bridge's current condition it is easy to see that this dental bridge no longer serves its cosmetic usefulness.
        The teeth that lie immediately to either side of the dental bridge have problems also. The tooth on the left side of the bridge has a cavity. The eyetooth that lies on the right side of the bridge seems to be chipped at its biting edge.
  
  
• Cosmetic dentistry treatment plan: It's simply time to replace this person's existing dental bridge with a new one. Gold bridges are fine if that's your taste, but we've illustrated the replacement bridge as having porcelain on its front side so all of its teeth look natural. (Please note, we've taken some liberties when creating our "after" picture. There may have been some changes over the years with this person's gum line in the area of the missing tooth. When a new dental bridge is made this person's gums will probably not fill in between the individual teeth of the bridge as fully as we've illustrated.)
        The needed repairs for the other two teeth, the decayed tooth and the tooth with the chip, could probably be made by placing white fillings (dental bonding). In our after picture, however, we've chosen to illustrate the repair of the decayed tooth with a white filling and the chipped eyetooth with a dental crown (primarily so significant changes with the shape of this tooth can be made).