"Armchair" diagnosis and cosmetic dentistry treatment plan.

• History: This person's front teeth display a great deal of wear. Most likely this wear is a result of bruxism. "Bruxism" is the term dentists use to refer to a person's teeth clenching and grinding habits.
        Beyond the wear, also notice that the alignment of the upper front teeth is somewhat imperfect. The two teeth just to the left and right of the upper center two teeth seem positioned too far back.
  
  
• Cosmetic dentistry treatment plan: Porcelain veneers would probably not be the best solution for this person. Porcelain veneers can give an excellent cosmetic result but when they are exposed to excessive forces they can chip or break. Since this person most likely bruxes (he clenches and grinds his teeth) dental crowns would probably be the better choice. They can give the same cosmetic results as veneers but at the same time are much stronger and less prone to breaking. Our "after" illustration shows how placing dental crowns on the center six upper teeth might look. ( What is the difference between porcelain veneers and dental crowns? )
        The dental crowns that are fabricated for this case could probably be made so that the front surfaces of the two teeth which are positioned back too far are slightly over contoured so these teeth appear more in line with their neighboring teeth (as we've tried to illustrate). A determination concerning the appropriateness of this technique, both in regards to cosmetics and also the over all dental health of these teeth and the gums which surround them, would have to be made by the dentist performing the treatment.
        The minor changes we've illustrated for the biting edges of this person's lower teeth could most likely be accomplished by buffing away their irregularities with a dental drill.