Restoring a darkened front tooth and its neighbor with dental crowns.

This digital makeover shows how the use of just a few dental restorations can sometimes make a really big improvement for a smile.

With this case, the placement of just two dental crowns (and optionally one porcelain veneer) accomplishes the transformation we've illustrated in our "after" picture.

Case issues and concerns:

When you look at this smile's "before" picture, it's the center two teeth that are its biggest detraction.

  • The right one is short.
  • The biting edge of the left one is worn, and the whole tooth seems to slant to the right.

One might anticipate that bruxism (tooth grinding) has caused some of this damage. However, instead of the typical situation (where all of the upper front teeth have down worn evenly), the prominent lower tooth seems to have worn its opposing upper tooth more so than the neighboring lower teeth have theirs.

Other issues we notice with this case are the dark color of the upper right central incisor. And there appear to be some missing back teeth.

 
  • The problem is the center teeth. One is dark. Both are worn.
    The problem is the center teeth. One is dark. Both are worn. The problem is the center teeth. One is dark. Both are worn.
  • After dental crown placement.
    After dental crown placement. After dental crown placement.
 

Photo submitted by website visitor.

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Treatment solutions:

a) Laying the ground work for the makeover.

When a dentist takes on a case like this, one of the first things they need to do is evaluate the health of the individual teeth. With this case, the dark coloration of the center tooth brings some concern.

Individually darkened teeth.

This tooth's dark color suggests that some type of change has taken place within its nerve space. And, as a result, staining has occurred (we explain why here).

It's very common that a tooth with this type of appearance has a history of receiving some type of traumatic blow, even many years previously. And while the tooth may not have any significant problem at all, as a worst case scenario root canal treatment may be needed. If so, it will need to be completed before the cosmetic work can be done.

Of course, you can't diagnose all of this just by looking at a picture. This patient's dentist will need to evaluate their situation.

The cosmetic work.

Our "after" picture illustrates how placing dental crowns on the center teeth could improve their color, shape and alignment. We've also illustrated some minor changes for the upper right lateral incisor.

It would be debatable if the changes we've shown for the lateral could be made just by trimming the tooth, or if some type of restoration (like a porcelain veneer) would be needed. Once again, this is something that this person's dentist would need to determine.

Our result isn't perfect.

You may have noticed that in our "after" picture the size and shape of the upper front teeth isn't symmetrical.

With this case, however, that doesn't seem to be a big issue. To us, it wouldn't make sense to place restorations on all of the upper front teeth just to make an improvement that almost no one would notice.

Other issues.

There are other dental issues here that our makeover didn't address. For example, the crowding of the lower front teeth.

Some type of orthodontic treatment would be needed to remedy this issue. This person would simply need to decide that doing so is important to them.

Also, there seem to be some back teeth missing. In regard to this person's long-term oral health, replacing them would make an excellent idea.

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