Repairing decay and closing a tooth gap with porcelain veneers.

This digital smile makeover provides an example of how porcelain veneers can be used to both repair the damage caused by tooth decay and simultaneously close in the gap between two teeth.

(The formal term for this type of space is "diastema.")

Case issues and concerns:

This woman has a diastema between her two upper front teeth.

It's hard to tell from this "before" picture if this gap is due to a misalignment of her teeth, or else the result of tooth decay that has formed.

Her lower teeth are somewhat crooked. Her right central incisor (the tallest tooth) is especially noticeable.

As a side note, there seems to be evidence of gum tissue inflammation, especially on top. Notice of how her gums look red, puffy and swollen.

A tooth gap that has also has decay.
A repair has been made by placing porcelain veneers.

Photo submitted by website visitor.

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Treatment solutions:

1) Better brushing and flossing is needed. -

More effective tooth brushing and flossing (possibly even including the use of an electric toothbrush) is needed here. It would both improve the health of this person's gums, as well as reduce their potential for future cavities.

2) Place dental veneers. -

Even with the presence of decay, it seems likely that the center two teeth could be repaired by placing porcelain veneers. This is the approach that we've illustrated in our "after" picture.

These restorations would both close in the tooth gap and give these teeth a more pleasing shape.

We've also shown how veneers or dental bonding might be placed on the adjacent teeth (the lateral incisors), so to give them a more pleasing shape and better alignment too.

3) Adjusting the lower tooth's height.

For the bottom teeth, our "after" picture illustrates how shortening just the tallest one goes a long way towards giving them a more even appearance. This type of minor reshaping can usually be done in just a few moments, without anesthetic.

4) An alternative plan. -

An alternative treatment approach for this case could be to repair the cavities with dental bonding and then close the gap between the upper teeth by way of realigning them using orthodontic treatment (braces) (possibly even Invisalign ®).

Overall, this second approach is a good idea and one that should be considered. If it were chosen, the misalignment of the lower teeth could be corrected at the same time. Its main drawback would be one of cost and treatment time.

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Input from site visitors.

Crown instead

To fix a big cavity, wouldn't a dental crown be needed?

* Comment notes.

You're right. Where large

You're right. Where large portions of a tooth are missing, the strength and durability features of a dental crown often make placing one the best choice.

The surface of a crown is porcelain, and that can be hard to bond dental braces to. So possibly with this case, it might be best to place bonding now, and a dental crown after the orthodontic work has been completed.

This is simply an issue that the treating dentist needs to decide.

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