August 15, 2018

Archives for August 2011

Judgment In – Two Orange County Porcelain Veneers to Fix Crooked Teeth Before Rebecca Goes to Law School

orange county porcelain veneers

Aspiring attorney Rebecca needed just two crooked teeth fixed with porcelain veneers to get her "perfect smile" with straight, white teeth.

Orange County porcelain veneer patient Rebecca just graduated from college with honors and aspires to be an attorney.  After speaking with her for just a few minutes you’ll note she a hard working, intelligent, totally committed young lady who won’t stop until she achieves her goals in life.  There was no doubt in our minds that she is going to be a successful attorney one day.

One asset we didn’t mention was that Rebecca is also very attractive, dresses professionally and is exceptionally well groomed.  She clearly works on every aspect of her personal life to be the best that she can be.

orange county cosmetic dentist porcelain veneers

Rebecca was particularly bothered by her two upper lateral incisors that were crooked and really stuck out (photos on the right). Otherwise, she had beautiful teeth that were straight and white. All she needed was to make the two crooked teeth straight. After having just two porcelain veneers (photos on left), which took only two weeks, she got the beautiful smile with straight, white teeth that she had always wanted and without any orthodontics or braces.

Crooked Lateral Incisors

However, according to Rebecca, she has two flaws in her appearance that she was pretty self conscious about – she had two crooked lateral incisors (the teeth next to the two front teeth).  The one on her right was particularly bothersome to her, as it really stuck out.  From the side you could really see it and it protruded so much that it would hang up on her lip when she was speaking.

So Rebecca was very determined to get those two teeth fixed and have a perfect smile.

Porcelain Veneers or Braces, Orthodontics, Invisalign?

Now, knowing a bit about Rebecca you wouldn’t be surprised that she started her research and that’s something she is also really good at!  She told us that she was on the internet for months researching cosmetic dentistry and orthodontics.  Very quickly she decided that orthodontics (braces or Invisalign) weren’t for her.  Her next decision was to find an great experienced cosmetic dentist in Orange County to consult with.  We were extremely pleased and flattered that she said that after visiting hundreds of cosmetic dentists’ web sites, and then going back and reading our cosmetic dentistry and porcelain veneers blog over and over, she knew our Orange County Cosmetic Dentistry practice was the right one for her.

When she came into our dental office for her first cosmetic dentistry consultation she was very specific about what she wanted us to do for her.  “I love all my teeth except for the two crooked ones.  I just want those two straightened with porcelain veneers,” she emphatically said.

Upon examining her teeth it was obvious why she only wanted those two teeth fixed.  Other than those two crooked teeth, all the rest of her teeth were beautiful!  They were straight, white, and had no chips, fillings or cavities.  Her gums were even and very healthy.  She really had a stunning smile except for the two crooked lateral incisors.

lateral incisor porcelain veneers

Rebecca's two crooked lateral incisors (lower photo) were made straight and even by placing two porcelain veneers on them (upper photo). Her entire treatment was completed in just two weeks, avoiding 9-12 months of braces.

We agreed that we could give her a perfect smile with porcelain veneers, but medically and legally we still had to inform her of other treatments options to achieve her goals.  We were specifically talking about the alternative treatment of orthodontics, either braces of Invisalign.  After mentioning that to Rebecca she was very quick to point out that she already understood that, had already researched it as well (of course), but because she’s not a youngster and is extremely busy orthodontic treatment was out of the question for her.  She wanted her two crooked teeth corrected with cosmetic dentistry!

Perfect Smile with Straight White Teeth in Two Weeks

To her delight we immediately scheduled her treatment to prepare her two lateral incisors for porcelain veneers.  Two weeks later her two porcelain veneers were bonded onto her teeth and her smile makeover was completed!  Her teeth were all straight and even and her two porcelain veneers perfectly matched her other teeth and it was almost impossible to tell that they were porcelain veneers and weren’t real teeth.  She got what she wanted, finally a perfect smile without crooked teeth, and ready to pursue her aspirations of being a successful attorney.  And knowing Rebecca as we do now, we are certain that when she’s in law school that she will shine both academically and with her beautiful smile.

Please feel free to comment or ask questions about Rebecca’s porcelain veneer treatment.

Dr. Norman Huefner, Orange County Cosmetic Dentistry and Porcelain Veneers. Serving the surrounding cities of San Clemente, Laguna Niguel, Irvine, Newport Beach, Mission Viejo, Coto de Caza and Rancho Santa Margarita

Replacing an old Porcelain Veneer that Broke with a new one that is stronger and more natural looking – Cosmetic Dentistry for San Clemente

San Clemente porcelain veneer

Fifteen years after having one porcelain veneer on Mandy's left central incisor she bit down on something hard and broke off the edge (lower photo). It was very important to Mandy that we make her a new porcelain veneer that not only was stronger but looked much more natural than the original porcelain veneer did. By evening out her gums with the dental gum laser, noting the specific shades in her teeth, matching both the amount of translucency and surface texture we were able to get a very good match with Mandy's new porcelain veneer (upper photo).

Broken Porcelain Veneer in San Clemente

Mandy from San Clemente said that she broke her left front tooth fifteen years ago.  Her dentist placed a porcelain veneer and thankfully she didn’t have to go around with a broken front tooth any more.  “I was so embarrassed with having a broken front tooth that I was happy with my old dentist’s veneer treatment.  But the color really never looked right, it looked like I had a cap on it.  I thought porcelain veneers were supposed to look more natural,” she said.  “In the back of my mind I could hardly wait to get a better looking one.”

Finally one day Mandy bit down on her sandwich and there was a bone in it, which broke off the edge of her old porcelain veneer.  When she came into to see us she was somewhat anxious, really wanting to make sure that the porcelain veneers we made for her looked a lot more natural than her old one. We explained to Mandy that when her dentist did her porcelain veneer years ago that cosmetic dentistry was really in its infancy.  In the last decade and a half, since it was first done, cosmetic dentistry has really evolved.  Newer materials and techniques, along with completing very sophisticated training programs for cosmetic dentists now enables us to fabricate porcelain veneers that should very closely match her other teeth.

Getting the most natural looking match on her new porcelain veneer

Right away we noticed that there was more gum tissue around her broken tooth.  In order to match the adjacent tooth the best it is important that the length of both teeth be the same.  Therefore we started by doing some very minor gum reshaping with the dental gum laser, removing the excess gum tissue, thereby making the gum level on both of her front two teeth the same.

Next, we looked very closely at the shade or color of her natural front tooth, the one we were trying to match.  We noted that her front tooth actually had three different colors, a main color and a smaller zone of a more translucent color near the edge of the tooth and another smaller zone of a slightly darker color near her gum line.  We needed to specifically note those different colors and communicate it with our ceramist who will be custom building Mandy’s new porcelain veneer.

Two other things that we needed to specifically note to get the best match for Mandy was the amount of translucency that her natural tooth has and how light reflects off of the surface, called surface texture.  It was obvious that the amount of translucency wasn’t matched at all with Mandy’s first porcelain veneer, which was made much more opaque (no translucency).  However her old dentist’s ceramist did match the surface texture reasonably close.

We went ahead and made Mandy’s replacement porcelain veneer.  The match was very close and she was very pleased with the result!

Stronger Porcelain Veneer

Then she asked if it would break as easily as her first porcelain veneer did.  Actually the fact that her first porcelain veneer lasted fifteen years was an indication that it was made pretty strong.  But, we were pleased to inform Mandy that her new porcelain veneer was made with a different process, called pressed ceramics, with a stronger porcelain material called IPS Empress.  So not only did her new porcelain veneer look better than the old one, but being made of a stronger material it is reasonable to assume that baring that she isn’t in an accident, that it probably will last longer and give her many more years of service than her first one did.

Please feel free to comment or ask questions about Mandy’s porcelain veneer treatment.

Dr. Norman Huefner, Orange County Cosmetic Dentistry and Porcelain Veneers. Serving the surrounding cities of San Clemente, Laguna Niguel, Irvine, Newport Beach, Mission Viejo, Coto de Caza and Rancho Santa Margarita

When a Newport Beach “Perfectionist” wants a “Perfect Smile” with Porcelain Veneers Artistry and Dramatic Attention to Detail an Absolute Must!

Newport Beach Cosmetic Dentist

Alicia didn't like the appearance of her old (lower photo) porcelain veneers. She wanted whiter teeth, smoother front surface, thinner teeth and a more "perfect" smile. We replaced her old veneers done by her previous dentist with new ones made of IPS Empress (upper photo) and achieved her goals of a "perfect" smile.

Newport Beach Cosmetic Dentistry

Alicia from Newport Beach is a perfectionist and readily admits that!  “In my business I have to be perfect or I lose clients and money.  I know that they expect me to always be there with the right answers, take exceptional care of my customers, act very professionally and look immaculate,” she said.  One can easily tell that Alicia obviously is in a high end business and has some pretty exclusive clients.

“I had six porcelain veneers placed a few years ago, but I just don’t like them and didn’t like them from the beginning,” she went on to say.  “I wanted them whiter, which he didn’t do for me.  They are really rough on the surface, which bothers me when I run my lips or tongue over them.  And they are crooked and too thick!  I want them replaced with really nice veneers this time so that I have a perfect smile and I really need you to listen to the things I want changed.”

Alicia was right.  Carefully listening to the patient is critical.

After paying close attention to Alicia and her concerns it was very apparent that she really did have extremely high standards and expectations about the end result of her cosmetic dentistry.  Upon evaluating her porcelain veneers it was quickly obvious that she did not get substandard dental care in any way, shape or form.  Her porcelain veneers all fit well and were well above the quality generally seen today by the majority of general dentists and even cosmetic dentists.

old porcelain veneers shade BL3

Actually Alicia's previous dentist did a nice job with her veneers that most patients would have been very pleased with. Admittedly, she just had very high standards of perfection. Note the shade (color) of her old veneers, which was BL3. She wanted her new porcelain veneers to be whiter. Also note that the veneers were pretty straight, but she wanted them in perfect alignment, which was achieved with her new porcelain veneers.

But the things that she didn’t like and want changed were all legitimate:

  • She wanted whiter teeth, and new porcelain veneers could certainly be done a whiter color that she actually gets to choose.
  • There was some roughness on the surface of her veneers, called surface texture.  The ceramist placed a moderate amount of it intentionally to mimic the natural surface texture seen in very young teeth.  The naturalness could still be achieved by toning down the surface texture, only placing a slight amount on the surface.  (An important point that I needed to communicate with Alicia that is if we didn’t put on any surface texture and made the front of her veneers too flat that light would reflect unnaturally off of the surface, giving her new porcelain veneers either a fake look or the look of older, well worn teeth.  She obviously didn’t want that!)
  • Her porcelain veneers were a little thick and new ones could certainly be made thinner
  • They were just a little crooked and uneven on one side, but in many cases that makes the teeth look natural.  It was clear she wanted perfectly symmetrical teeth.

But, by taking into consideration everything that Alicia wanted, listening very carefully to her, we redid the porcelain veneers done by the other dentist and gave her “the perfect smile” that she strived on getting.  She was elated with our results and her treatment considered highly successful by any standard.  The keys to achieving that was being very attentive to her concerns and designing her new porcelain veneers to achieve her goals.  It also involved very artistic cosmetic dentistry and ceramics and an extremely high level of communication between everyone, the dentist, patient and ceramist.  Alicia chose a BL1 shade from the tooth shade guide for her new porcelain veneers (her old porcelain veneers were shade BL3).  We utilized an “enhanced” smile style (a youthful, feminine smile design) from the Dr. Bill Dickerson-LVI Smile Library in the tooth shape catalog, along with very slight surface texture and slight incisal translucency.  IPS Empress porcelain was used because of its strength and durability, along with natural “lifelike” color and translucency.

white porcelain veneers BL1 shade

The new porcelain veneers made for Alicia utilized IPS Empress porcelain, the "enhanced" smile style from LVI tooth shape library, a BL1 shade and some slight surface texture and incisal translucency to impart a more natural look. The new porcelain veneers were also thinner, straighter and more symmetrical, and Alicia was very pleased with the more "perfect" smile design with her new set of porcelain veneers.

Alicia demanded perfection, artistry and superlative attention to detail

I might point out that although Alicia’s final smile design with new porcelain veneers came out exceptional, most people would have been very pleased with the first set of porcelain veneers done by her other dentist.  He did do a nice job but most likely he didn’t listen carefully enough to Alicia, communicate at a high level about all the details of the smile design of her new porcelain veneers or communicate that to the ceramist who actually fabricated her veneers.  It was very gratifying to us that we were able to achieve the “perfection” that Alicia from Newport Beach wanted and the end result was that she was a very happy, satisfied patient.

Please feel free to comment or ask questions about Alicia’s porcelain veneer treatment.

Dr. Norman Huefner, Orange County Cosmetic Dentistry and Porcelain Veneers. Serving the surrounding cities of Laguna Niguel, Irvine, Newport Beach, Mission Viejo, Coto de Caza and Rancho Santa Margarita

What do you do when you hate the way your front caps look? Jackie’s Orange County cosmetic dentistry story

all-porcelain vs porcelain fused to metal crowns

Jackie didn't like her old "caps" (lower photo) on her upper front two teeth. She thought they didn't "look real" and that the gums around them were darker. We replaced both old porcelain fused to metal crowns with all-ceramic non-metal crowns (upper photo) for a more natural and "real" looking crowns. By using all-ceramic material the natural pink color around her gums and her two front teeth returned back to normal. Also, take special note of the difference in surface texture. The new crowns (upper photo) has "slight texture" to match her other teeth. The old crowns were very smooth (unnatural) with no texture (lower photo). The difference in surface texture is clearly seen by how the light reflects off of the surface of the crowns.

Orange County Cosmetic Dentist

When Jackie (from Laguna Niguel, Orange County, CA) was younger she fell and chipped her two front teeth.  Her parents took her to their family dentist and he made two porcelain fused to metal caps for her.  Jackie was happy not to have to go around with two broken front teeth any more, but when she looked at herself in the mirror she thought they looked like “caps”, not natural teeth.  Thus she was always a bit dissatisfied with her cosmetic dentistry and self conscious when she smiled.

Years passed and Jackie graduated from college, got married and had a family but she never got over the way her front tooth looked.  Finally she was so dissatisfied that she came to our cosmetic dental practice in Orange County to ask us if there was any other way of remaking her “caps” so that (this time) they look like real teeth?

old porcelain fused to metal crowns before replacement with all-ceramic crowns

Jackie was self conscious about the way the two old porcelain fused to metal crowns looked when she smiled.

Before examining Jackie’s teeth we asked her specifically what she didn’t like about the way her two old porcelain fused to metal crowns looked?  She said:

  • “my gums are darker around the crowns”
  • “the color doesn’t look the same”
  • “they feel too thick”
  • “when people look at my smile I don’t want it to be apparent that my teeth have been capped”

Upon looking careful at Jackie’s two front caps it was obvious that, considering when her dentist made those crowns for her, he actually did a very nice job!  It is just that Jackie had high, but not unrealistic expectations.  Fortunately cosmetic dentistry now offers amazingly improved techniques and materials to the porcelain fused to metal crowns that her family dentist had used.  Yes, we could redo the two old caps and give her beautiful, natural looking all-ceramic (non-metal) porcelain crowns that would achieve her objectives—look like she had natural teeth that hadn’t been crowned!

Dark Line Around Gums

“But what about the darkness around my gums?” Jackie asked.

orange county all porcelain crowns

After replacing the two old crowns on her front teeth with all ceramic crowns Jackie loved her new smile!

We explained that much of the darkness was because with her old porcelain-fused-to-metal crowns the metal stopped light from going into her tooth, down the roots and gums.  We would use all-ceramic (non-metal) with her new crowns which would all light to pass through the crown, into the roots and gums like all her other teeth.  Thus her new crowns would be surrounded by healthy, pink gums, not darkened gums like she had with her old crowns.

When Jackie was assured that we could give her natural looking all-ceramic non-metal crowns that looked like “real teeth” and that her gums would look normal, without any darkness around the caps, she was ready to proceed with replacing her old porcelain fused to metal caps.

Orange County porcelain crowns

Now with all-ceramic crowns Jackie's front two teeth finally looked "real" and nobody would ever suspect that they had been broken and were anything but her own natural teeth.

Natural Looking All-ceramic Crowns

Jackie’s treatment went smooth.  The first visit we gently removed her old caps, took impressions for her new all-ceramic crowns, and made her temporary crowns.  Two weeks later she returned, we removed her temporary crowns and bonded (cemented) her two new all-ceramic crowns in place.

Natural Surface Texture

One of the special characteristics that was specifically added to Jackie’s new all-ceramic crowns to make them appear very “life like” was “slight surface texture” to match her other natural teeth.  This is contrasted by having no surface texture in her old crowns.  Surface texture can be best seen by how light reflects off of the front surface of teeth and crowns, as clearly demonstrated in the upper photo that shows both the before and after photos together.

Jackie was very pleased with the end results.  She got the natural looking teeth and smile that she had always wanted!

Please feel free to comment or ask questions about Jackie’s porcelain veneer treatment.

Dr. Norman Huefner, Orange County Cosmetic Dentistry and Porcelain Veneers. Serving the surrounding cities of Laguna Niguel, Irvine, Newport Beach, Mission Viejo, Coto de Caza and Rancho Santa Margarita

“Yikes! My Front Tooth Broke Off, What Can I Do?” How an Orange County cosmetic dentist saved his patient from major embarrassment.

broken front tooth

Amy was devastated and in tears when her front tooth broke off near her gum line. When this happens sometimes the tooth can be saved with a post and core and new porcelain crown. Other times the treatment of choice is either a dental implant or non-removable porcelain bridge.

Amy is an attractive lady, a Realtor by profession.  Back in her 20s she had chipped her front tooth badly and ended up needing to get a root canal and crown on it.  She was content until one day she was eating and bit down hard on something in her food.  Wham…..her tooth broke off near her gum line.

Amy was devastated, actually in tears!

She came into our Orange County dental office in Laguna Niguel as an “emergency” patient and in tears.  “What can I do?,” she asked.  “I can’t go out in public or to work missing my front tooth.  There must be some treatment you can do to give me back a front tooth.”

What happened to Amy is unfortunate, but not all that uncommon.  If a tooth has a large cavity or substantial amount of tooth broke off, then root canal and crown treatment are often the two treatments to save the front tooth.  The only problem was that Amy’s tooth was already very weak, and then she suffered additional trauma when she bit down on the hard object.  That was way more than her weak tooth could handle.  Thus, breaking off the crown.

How much tooth is left is a major consideration when treating a broken tooth

When trying to salvage the tooth for Amy our first consideration was how much tooth was left ABOVE THE GUM LINE?  If there is 2-4mm or tooth ABOVE the gum line, then with some heroic dentistry a new crown can oftentimes be made.  But the patient must understand that there is absolutely no guarantee that the tooth won’t break again.

If the tooth breaks at or below the gum line, then it is unlikely that the tooth can be saved.  In that case, the tooth would be extracted and either a dental implant, fixed porcelain bridge or some cases a removable partial denture made to give the patient back their front tooth.

laguna niguel porcelain crown

Amy was fortunate that she had already had a root canal on her tooth and there was a minimal amount of tooth left above her gum line. A post and core and new porcelain crown were fabricated, saving her from the humiliation and embarrassment of not having a front tooth.

In Amy’s case, as one can see in the photo, there was some tooth left above the gum line.  So she was in luck!  Since her tooth had already had a root canal we explained to Amy that we could try to save her tooth by placing a post and core into her root canal filling and by doing that we could create enough tooth above her gums to place a new porcelain crown on.

Amy tears began to stop.

“When can you do that for me?” she asked.  “I have to go to work today and I can’t see clients looking like this?”

To Amy’s delight we said we could build up her tooth with the post and core and make her a temporary crown right then and there.  We would do what we needed to do, make her a new tooth and she would be done in just over an hour’s time and be able to go to work as normal.  In two weeks time her porcelain crown would be completed by our ceramist and we would then remove her temporary crown and cement on her final porcelain crown.

We were able to do everything exactly as planned and Amy got her new crown on her broken front tooth two weeks later. However, that being said, it must be stressed that this kind of heroic dental treatment to save a broken tooth cannot always be done and oftentimes it is not the best long term solution.  Again, alternative treatments options like a dental implant, fixed porcelain bridge or sometimes (but rarely) a removable partial denture are better ways to treat a patient with a broken off or missing front tooth.

Please feel free to comment or ask questions about Amy’s treatment.

Dr. Norman Huefner, Orange County Cosmetic Dentistry and Porcelain Veneers. Serving the surrounding cities of Laguna Niguel, Irvine, Newport Beach, Mission Viejo, Coto de Caza and Rancho Santa Margarita

Long Overdue for a Great Smile, Kirk from Irvine Now Looks Like a Million with New Porcelain Veneers

irvine porcelain veneers

After over twenty years Kirk was sick and tired of the yellow, unnatural look of his plastic veneers (lower photo). We replaced them with eight porcelain veneers utilizing a BL2 tooth shade and an masculine smile design (upper photo).

Kirk from Irvine was long overdue

An ambitious dynamo might rightly describe Kirk.  A very competitive, hard working businessman, Kirk always appears enthusiastic, energetic and positive in his attitude.  He quickly worked his way up the ladder and now is the head of his department.

As a youngster Kirk always had very discolored unattractive teeth and he was always very embarrassed and self conscious about what others were thinking about him.  When bonding first came out in the early 1980s Kirk had his family dentist cover over all the defects in his teeth with composite (plastic) veneers.  Looking much better, he was happy with the results for a while.  Then, several decades past and Kirk started comparing his smile with his peers.  “You know,” said Kirk, “I realized that my smile still needed a lot of help and I am really overdue for an upgrade.  It’s time for me to get serious about my appearance and replace my old veneers with new ones and give me the nice smile that I didn’t get the first time around.”

Listening careful to Kirk’s concerns, he pointed out that he thought his teeth looked “fake” and unnatural.  He wanted them to be whiter, not so thick and look like real teeth. And most importantly, he hated the way his teeth were discolored near his gums.

discolored composite veneers

Kirk was dissatisfied with the color, shape and thickness of his old plastic veneers. He also hated the way the plastic veneers were discolored around his gums.

After examining Kirk’s teeth and smile at his cosmetic dentistry consultation, we explained to him that although he most likely had a huge improvement with his old style plastic (composite) veneers, that today he could really benefit with porcelain veneers instead.  They could certainly be made whiter and more natural looking, and over time porcelain veneers wouldn’t darken and discolor over the years like his old plastic veneers did.   Another point was that he had only had six plastic veneers, and that if we were going to whiten his smile and truly give him more natural looking teeth that we would really need to make him eight porcelain veneers this time around.

Kirk agreed, he was really ready for a smile upgrade.  So, to give him the smile he really wanted we first whitened his lower teeth with Zoom in-office teeth bleaching, followed up by a supplement of one week of home tray bleaching.  Then we placed eight porcelain veneers for Kirk.  He chose a BL2 tooth color from the tooth shade guide and a masculine smile style from the tooth shape catalog.

beautiful porcelain veneers irvine

A major improvement in Kirk's facial appearance was achieved with his new porcelain veneers. The color, shape, natural color and translucency were all a major upgrade compared to his old, discolored fake looking plastic veneers.

The results were a killer smile for Kirk from Irvine with eight porcelain veneers

What were the results?  A killer smile!  Kirk got the great looking smile that he wanted his entire life. “Wow,” he said after viewing his porcelain veneers for the first time on his teeth.  “I love them!  The color, shape and realness of them are a hundred times better than my first set.”

Dr. Norman Huefner, Orange County Cosmetic Dentistry and Porcelain Veneers. Serving the surrounding cities of Laguna Niguel, Irvine, Newport Beach, Mission Viejo, Coto de Caza and Rancho Santa Margarita

Black Lines Eliminated Around Old Crowns and Bridges Replaced with New Porcelain Cosmetic Dentistry for Victoria from Mission Viejo

porcelain fused to metal bridge with black lines replaced with IPS e.max non-metal bridge

Below, Victoria hated her old bridgework. The teeth were yellow and she really objected to the black line around the gum line of the bridge. Top, Victoria smile makeover consisted of an all-ceramic (non-metal) bridge and one crown and several porcelain veneers.

In high school Victoria from Mission Viejo was a very competitive soccer player.  One day an opponent took a cheap shot and knocked her from the side, causing her to crash her teeth into the head of another player. Unfortunately, it knocked one of her front teeth out! Devastated, Victoria’s parents had their family dentist place a porcelain on metal bridge.  It solved the problem of showing that she had a missing tooth, but it still left Victoria with front teeth and a smile that had a lot to be desired.  Most notably was the black line around her gums caused by the metal used in the bridge.

Ten years past and after graduating from college and getting her first real job Victoria was ready to replace her old dentistry and “get a nice smile”. When Victoria came in for her cosmetic dentistry consultation with Dr. Huefner she was very clear about what she wanted done.  “My front teeth got ruined when I was a young, first by knocking out my front tooth while playing soccer, and second, by the ugly dentistry.  My teeth and bridge are way too yellow, I want white teeth.  Most of all, I can’t stand that black line around my old bridge.  Can you fix my teeth so that I don’t have a black line this time?”

Victoria is fortunate that in this day and age cosmetic dentistry now has the solutions she needed.  Techniques and materials have vastly improved over what she had done just a decade earlier.

yellow teeth and bridgework

Victoria's yellow teeth and yellow bridge gave her a very drab looking smile. An attractive lady, Victoria wanted a nice smile with white teeth.

After attentively listening to Victoria and her concerns, and after doing a careful dental examination, a treatment plan was customized to meet her needs:

  • Bleach her lower teeth with home teeth whitening
  • Replace her old porcelain-fused-to-metal bridge and crown with an all-porcelain bridge (without any underlying metal that might show) and crown.
  • Place several porcelain veneers on Victoria’s other upper front teeth

A point worth noting, when Victoria had her original bridge done 15 years earlier porcelain-fused-to-metal was the treatment of choice.  Her dentist was using the usual and customary technique and materials for her bridge at that time.  But the state of the art of cosmetic dentistry has vastly changed since then.  The evolution of cosmetic dentistry led to the development of several materials that didn’t require a dark metal substructure under the porcelain.  One of the most popular alternative to the typical porcelain-fused-to-metal bridge over the past ten years was zirconia (a white metal) with porcelain fused over it.  Most recently the state of the art material that has captivated most of the cosmetic dentists and their patients is called IPS e.max®.

all-ceramic bridge and porcelain veneers mission viejo

After her smile makeover with new all-ceramic bridgework and porcelain veneers Victoria had beautiful looking teeth and wasn't embarrassed to smile any longer!

Victoria’s treatment went smooth and her entire smile makeover with an all-ceramic e.max bridge and porcelain veneers was completed in just three weeks time.  As clearly shown in the photos, she got the incredibly beautiful smile that she always wanted and a bridge that looked as if she had never lost a tooth!  Best of all, no black metal line around the gums on this bridge because it was made entirely of tooth colored porcelain.

Dr. Norman Huefner, Orange County Cosmetic Dentistry and Porcelain Veneers. Serving the surrounding cities of Laguna Niguel, Irvine, Newport Beach, Mission Viejo, Coto de Caza and Rancho Santa Margarita

Worn, Prematurely Aged Teeth Given New Life to Brent’s Smile with Porcelain Veneers Irvine

porcelain veneers irvine

Brent treated his chipped worn teeth with porcelain veneers utilizing a "softened" smile design from the LVI tooth shape catalog and a BL3 shade from the tooth shade guide. After doing his upper porcelain veneers, Brent decided to also have us place porcelain veneers on his lower teeth.

Brent is quite successful, both in his business and as an athlete.  Unfortunately his drive to being the best that he could be resulted in a severe teeth grinding (bruxism) habit.  Thus over the years he severely wore his teeth down.  The results was that his teeth and smile were prematurely aged by 20-30 years!

After years of hard work, commitment and dedication Brent achieved a lifelong athletic goal and became internationally recognized.  Along with his fame he started doing public appearances, speaking engagements and he even was scheduled to be interviewed on TV!  But someone who always prided himself on being, and looking his best, Brent realized that he needed to do something quick to get his teeth and smile into shape!

Brent came into our office for a cosmetic dentistry consultation.  He very quickly pointed out his urgency and that his cosmetic dental work needed to be completed fast!  Also, that he didn’t want “pretty boy” fake, white teeth.  He wanted whiter teeth, but it was very important to him that they look natural, “as if they were his real teeth and hadn’t had any cosmetic dentistry at all.”

worn teeth from bruxism

Being very successful in both business and sports contributed to Brent's tooth grinding habit, which prematurely wore his teeth down to be 20-30 years older than his age. When Brent started doing public speaking and was scheduled to appear on TV he decided it was time to get his smile into shape with cosmetic dentistry.

Fortunately for Brent, we happily replied that all those goals could easily be met.  Having healthy teeth that had no decay, but were just severely worn, discolored with the years and somewhat crooked and asymmetrical, he was the perfect candidate for porcelain veneers.  And best for all, his smile could be completed in just a couple weeks time.

Not being one who has difficulty making decisions, Brent scheduled his treatment right away.  We treated his upper teeth with ten porcelain veneers.  His entire treatment went smooth without any challenges and was completed on time.  A week after placing porcelain veneers on his lower teeth, Brent came back, saying it didn’t make any sense having upper teeth that looked so good and lower ones that didn’t, and that now he wanted to do his lower teeth as well.  Thus, we did ten porcelain veneers on Brent’s lower teeth, that were also completed in just two weeks time.

Brent was involved in the choice of “smile style” and tooth color.  He chose thesoftened” smile style from the LVI Dickerson smile library, which is a very natural and masculine design of tooth shapes, which were also more age appropriate for him compared to the much older tooth shape he had from his years of teeth grinding and wearing down his original teeth.  Brent also chose a BL3 tooth shade from the tooth shade guide, which is slightly lighter than the lightest natural tooth color (B1), but still has very natural translucency.  This was very important to Brent, that they “not look like Chiclets or bad crowns”.

Dr. Norman Huefner, Orange County Cosmetic Dentistry and Porcelain Veneers. Serving the surrounding cities of Laguna Niguel, Irvine, Newport Beach, Mission Viejo, Coto de Caza and Rancho Santa Margarita

Choose the Perfect Shaped Porcelain Crowns or Veneers to Make Your Face Look Its Best

Enhanced Smile Style empress porcelain veneers

Mrs. U.S.-Globe Jill Frick and her “Enhanced smile style”

If you are seriously considering cosmetic dentistry with porcelain veneers or porcelain crowns you should be aware that there are many different ways that they could be made, right? But how many different ways and how does one choose the best way for their face and smile?

Looking at the possible combinations is mind staggering!  Easily there are approximately 25 different shades (colors), three different surface textures (how the light reflects off of the front of the veneers), numerous different porcelain types which each has different translucencies or opacities (ability of the light to pass through the porcelain veneer or porcelain crown to render a “life-like” appearance), many different lengths that each veneer/tooth could be made (very short front teeth might only be 9.0mm in length, and long ones can be as much as 12.0 or 13.0mm) and at least 60 different documented smile styles. Do the math and you’ll note that there are probably 30,000 different ways that your cosmetic dentist could create your new smile. This can be pretty confusing.

larguna niguel porcelain veneer shapes

From the Loren Library this design above is round, round, pointed. It is very youthful and oftentimes used when the patient has a very round face.

mission viejo porcelain veneer shapes

Also from the Loren Library this a design quite the opposite, square, square, flat. It is a much older and oftentimes much more masculine smile style.

So how do you know if your cosmetic dentist is looking at each one of the above and choosing best combination for your face and smile?

The short answer is for the best results your cosmetic dentist should communicate on a very high level with you and communicate what he/she is planning on doing for you.  If you are going to have  your expectations met this is essential! Your cosmetic dentist wants your input because he/she certainly wants you to love your new smile. Success is dependent on the skill, care and judgment of the dentist, but also on the ability of both the patient and cosmetic dentist to communicate and work together on deciding key issues.

rancho santa margarita porcelain veneers

Another smile design from the Loren Library, this is in between the first two, being square, square-round, round, and is a very popular design

This article concentrates on one of the huge variables that there is, choosing the smile style. Most cosmetic dentists will involve the patient in this selection process, but offering input and suggestions to help guide the patient in the selection based on the shape of the face, age, personality type and other factors. There are three commonly used “smile guides” that cosmetic dentists have available to them to show patients. Dr. William Dickerson’s “LVI Smile Library” (12 different styles), Dr. Loren Berland’s “Loren Library” (18 different styles) and Dr. William Dorfman’s “The Smile Guide” (36 different styles). One question a patient might ask their cosmetic dentist is which smile guide does he use and specifically what smile style does he recommend? If the dentist is experienced in cosmetic dentistry you should be able to see one of these guides and the cosmetic dentist should discuss by name a smile style that he/she advises using.

enhanced smile style from LVI smile catalog

Using the LVI catalog, this is the “Enhanced” smile style, very popular with many of the beauty pageant contestants that I’ve created porcelain veneers for over the years. Note that the second teeth from the center are a little shorter than the front teeth. This is a youthful effect we call “the gull wing” that really looks nice on females. See first photo in this article with of Mrs. U.S.-Globe and the “Enhanced” smile style I used with her 10 porcelain veneers.

In general the porcelain veneers and porcelain crowns can be given specific shapes. For example, the four front teeth (incisors) could be either square at both corners, square at one corner and rounded at the other, or rounded at both corners. Similarly, the cuspids or eye teeth (third tooth back) could be pointed, rounded or flat. Combining these different shapes each produces significantly different smile styles.

hollywood smile dr huefner lvi smile library

The “Hollywood” style, also from the LVI Smile Catalog, is a little more “toothy” and works well for males and especially those wanting to show off a little more teeth.

It is important that both the patient and cosmetic dentist be aware of the differences in tooth shapes and smile styles and have active communication between each other in choosing the best smile style for the patient’s new porcelain veneers or porcelain crowns.

Please feel free to comment or ask questions about tooth shapes for porcelain veneer or porcelain crown treatment.

Dr. Norman Huefner, Orange County Cosmetic Dentistry and Porcelain Veneers. Serving the surrounding cities of Laguna Niguel, Irvine, Newport Beach, Mission Viejo, Coto de Caza and Rancho Santa Margarita
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