Tony is a contractor from Lake Forest, CA, who was “fed up” with his teeth and smile. He told us the story about how he had always disliked the way they looked, especially in photos. Finally one day in his 20s he went to who his family dentist, who placed four caps (porcelain-fused-to-metal crowns) on his front teeth. He thought that his teeth looked a little better, but he still didn’t like his smile.
Years passed, and now 40 years old, Tony noticed that the black edges of the metal under the porcelain caps were now showing. Tony decided that “there must be something that dentistry could do to give him a better smile” and came to our cosmetic dental practice for a consultation.
We asked Tony what bothered him the most. He replied that the black lines around the gums on the teeth that were capped were the final straw, but what had bothered him over the many years was that his teeth were very yellowish-brown and angled down to his left. “I feel like my teeth are walking on the side of a hill.” Tony further explained to us, “Once I went to an orthodontist and he told me the only way to fix a crooked bite like mine was to do jaw surgery, break my jaws and then have braces. There is no way I would do that. Are there any options other than that?”
When we looked at Tony we noticed that the crookedness his smile had a striking similarity to Ronald Reagan‘s in that his teeth on the right side of his face were much longer than on the left, and they all angled down to Tony’s left. In dental terms it is called having a canted occlusal plane.
Tony liked what he heard when we discussed how cosmetic dentistry could correct his “Ronald Reagan smile” and give him whiter, great looking teeth without braces or jaw surgery. We could replace the front porcelain-fused-to-metal caps with all-ceramic crowns (without any underlying metal that might show a black line in the future). In addition we could make some adjustments to his lower left teeth and then place 5 mini-crowns (mini-crowns are half way between a full porcelain crown and a porcelain veneer) so that all together Tony would have nine new teeth, all straight and in alignment with his face! After a little more discussion to more fully understand the treatment Tony said, “Let’s do it!” His straight smile was completed three weeks later.
Regarding the design of his teeth, Tony chose a BL2 color from the tooth shade guide. That lighter color worked really good for Tony because he had a naturally long and full upper lip which shadowed his teeth a lot. The net result is that his teeth would always appear a little darker than someone with a very high lip line who shows the entirety of all the upper front teeth when they smile. The whiter than normal color compensates for the lip shadow and gives him a great color without appearing too white.
Another component incorporated into the smile design was more squarish incisors. This gives him a more masculine appearance. We oftentimes utilize a design with more rounded corners for women, which is a softer, more feminine design. Tony definitely didn’t want that and was very happy with the shape of his front teeth.
To break up the brightness of the BL2 color we added two more components to Tony’s smile design. First, we added some enamel-like translucency into the edges of the incisors (called incisal translucency) and second, we added slight surface texture to the front of all the porcelain crowns and porcelain veneers. Doing both those things breaks up the light reflection and makes the teeth (veneers and crowns) look much more natural and life-like.
The end result for Tony was an amazing cosmetic dental transformation. Straight, white teeth without a crooked “Ronald Reagan smile“!