Using dental crowns to both repair and straighten teeth.

The upper teeth in this digital smile makeover provide an opportunity to illustrate how dental crowns can be used to make repairs for teeth and simultaneously straighten their alignment.

The lower arch provides an example of how the replacement of missing back teeth can help to complete the look of a makeover.

Case issues and concerns:

Here are some of the points we notice when looking at this case's "before" picture.

The upper left central incisor has an area of darkness where it overlaps its neighbor. This is probably tooth decay.

Most of the upper right central incisor has a similar dark coloration. This might be a sign of extensive decay and/or an indication that the tooth is in need of, or has had, root canal treatment.

Tooth alignment - The upper center teeth are crooked. The lower left eyetooth is in crossbite.

On both sides, in back, there appear to be some teeth missing.

Crooked teeth that also show signs of tooth decay.
After dental crown and veneer placement on the upper teeth.

Photo submitted by website visitor.

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Treatment solutions:

1) The upper teeth.

Our "after" picture shows how placing dental crowns on just 3 upper teeth could go a long way toward resolving a lot of this smile's problems.

We've also illustrated how making minor shape and color changes for two other upper teeth (the left lateral incisor and eyetooth) helps to complete the makeover.

a) Dental crowns.

Crown placement makes the best choice for the upper right teeth due to the fact that they require substantial repair and/or shape changes.

Crowns are routinely used to rebuild and strengthen teeth that have had extensive decay, as well as those that have had root canal treatment.

In regard to making alignment changes, if each crown is made slightly narrower than the tooth was before, the dentist can create the illusion of having straightened these teeth.

b) Porcelain veneers.

Veneers would probably make the best choice for making changes with the upper left teeth. They can provide the same type of appearance change as a crown, but their placement involves much less tooth trimming.

An even more conservative approach might be to make the color and shape changes needed for the lateral incisor by placing dental bonding. And then using teeth whitening treatments to make the color change needed for the eyetooth.

2) The lower eyetooth.

The biggest obstacle on the lower arch is the lower left eyetooth that's in crossbite. In this position, it detracts significantly from the smile. And with some techniques, it makes replacing the missing back teeth somewhat more difficult.

a) Orthodontic treatment.

Our "after" picture illustrates how orthodontic treatment might be used to move this tooth to its normal position.

In terms of cost, time needed and even method used, there's a big difference between full-mouth orthodontic treatment and moving a single tooth. So, possibly repositioning this tooth can be included in this person's treatment plan.

If not, making alignment changes for this same tooth by way of placing a dental crown might be a possibility. However, this would be a lesser choice, and doing so would not give as nice of a look as we show in our "after" picture.

3) Replacing missing lower teeth.

We've illustrated how replacing the missing back teeth also helps to complete the transformation of this smile. Placement of dental implants, dental bridges or even just a partial denture might each be considered.

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Input from site visitors.

Long tooth.

The left center tooth in the after picture still looks longer than the right one. Can this be corrected? I have this same problem.

Yes and no.

Dental crowns and veneers can't be used to adjust the position where the tooth comes out of the gum line. But gum surgery can be performed to make such an adjustment.

The common approach is for the gum line of the shorter-looking tooth to be repositioned further up, so the crowned portion of this tooth is longer and therefore matches the look of its neighbor. This is often referred to as gum sculpting and we explain this procedure here.

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