August 15, 2018

Archives for March 2012

Orange County Lumineers Correct Tooth White Spots

tooth white spots

Lower photo: Courtney had white spots and blotches on her front teeth and very translucent tooth edges that showed as a grayish-black band. Needless to say, as a young lady in college she was very embarrassed and displeased with the appearance of her teeth. Upper photo: Dr. Huefner placed four ultra thin porcelain veneers to cover over her tooth discolorations, giving her even colored teeth with a very attractive natural color.

Courtney from Orange County is a beautiful young lady attending college in Northern California.  She went through braces as a youngster, so had straight teeth, but that wasn’t her dental problem.  She was very self conscious and unhappy because her teeth had some severe discoloration problems.  She came to our Orange County cosmetic dental practice in Laguna Niguel to see what recommendations Dr. Huefner had to get rid of her tooth white spots and gray tooth edges and make her front teeth beautiful.

At a glance one could see what Courtney was concerned with.  She had large tooth white sports in her teeth along with very grayish black edges.  Before making recommendations Dr. Huefner explained to Courtney exactly what those tooth white spots discolorations were.  She had two different types of tooth white spots, which were actually enamel hypocalcification marks.  One type of tooth white spots, the largest offender, occurred during the actual forming of the tooth way before her teeth erupted into her mouth around age 7-8.  Most likely it was due to some metabolic disruption, possibly due to a fever, trauma to her baby teeth or having too much fluoride.  The second type of tooth white spots occurred around the areas where she had her braces.  She didn’t brush her teeth well back then, plaque built up around her braces and started the first phase of cavities, acid from the plaque started dissolving the surface calcium out of her teeth.  Fortunately she got out of braces early enough before severe decay occurred, which would have turned the tooth white spots around the braces into brown spots.

Orange County Lumineers

Lower photo: Discolored teeth before cosmetic dentistry. Middle photo: Courtney with her four temporary veneers. Upper photo: Final smile makeover with four Lumineers on her four front teeth and buffing out the superficial tooth white spots on several of her other teeth.

The other type of discoloration that occurred in the edges of her front teeth was actually a variation of normal enamel translucency of the edges of the teeth.  In Courtney’s case she had much more translucency of the enamel than most people and that translucency shows up as a grayish black color.  Many children have this when their teeth first come in, but as they get older the edges wear down naturally and that enamel translucency around the tooth edges disappears.

After understanding what the tooth white spots and blackish-gray discolorations were Courtney asked what Dr. Huefner could do to solve her tooth-color problem and make her front teeth all one color, a natural white tooth color?  The solution for Courtney was to make four ultra thin porcelain veneers.   Lumineers, Durathin Veneers and Nano veneers and Emax ultra thin veneers are all variations of the ultra thin veneers used by cosmetic dentists when appropriate.  Courtney’s situation ultra thin veneers were definitely Dr. Huefner’s treatment of choice!

Since her severe discoloration problems were confined to just the front four teeth, Dr. Huefner only had to place Lumineers on those four teeth.  The smaller white spots on the side teeth were very shallow and superficial and to Courtney’s delight Dr. Huefner was able to remove those by just some gentle buffing out with his dental polishers.

In making Courtney’s Lumineers to hide her tooth white spots a two step process was utilized.  First Dr. Huefner prepared her four incisors for ultra thin Lumineers , impressions of her teeth were taken and sent to the lab and Dr. Huefner make Courtney four temporary veneers.  Two weeks later Courtney’s Lumineers were completed by the ceramist, she returned, Dr. Huefner gently removed her four temporary veneers, then tried on the four Lumineers to get Courtney’s approval, and then they were permanently cemented into place with the dental bonding laser.

The results Dr. Huefner achieved for Courtney was superb and she returned to college a very happy young lady with a beautiful smile!

Dr. Norman Huefner, Laguna Niguel cosmetic dentist, Orange County, CA


Straightening crooked teeth in two weeks without braces

straightening teeth without braces

Lower photo: Jennie had two crooked lower teeth and wasn't willing to undergo months of braces and years of retainer wearing. Top photo: Dr. Huefner straightened Jennie's two crooked teeth in just two weeks time utilizing two porcelain veneers.

Jennie lives and works in Newport Beach Orange County.  She had braces as a youngster, but after three decades two of her lower front teeth had become very crooked.  She remembered that her orthodontist told her she would have to wear her retainer for years, but like many others Jennie quit wearing her retainer after a year.

Fed up with her crooked lower teeth, Jennie went to a local Newport Beach orthodontist, hoping that a new retainer would straighten her crooked teeth.  But the orthodontist told her that she would need to go through braces again.  That did it!  Jennie said that at her age that she would never considering going through braces again.  She remembered that wearing braces was uncomfortable and oftentimes hurt.  Also she was just too self conscious to wear braces as an adult.  Clearly for her it was time to “check out” other alternatives to straightening crooked teeth.

Like so many people nowadays, Jennie went right to her computer to research options other than braces for straightening crooked teeth.  Her computer search led her to several articles that Dr. Huefner, a Newport Beach Orange County cosmetic dentist had written about straightening crooked teeth with cosmetic dentistry instead of braces (also called “instant orthodontics”), oftentimes in as little as two weeks time, with no need for any retainer afterwards.  That concept of straightening crooked teeth without braces really appealed to Jennie, so she called for an appointment for a cosmetic dentistry consultation with Dr. Huefner.

After hearing Jennie’s story and what she wanted to accomplish, Dr. Huefner examined her teeth.  Yes, Jennie was an absolutely great candidate for cosmetic dentistry with porcelain veneers to straighten her crooked lower teeth.  But before recommending how many teeth that he would suggest placing porcelain veneers on, Dr. Huefner needed to know if Jennie was just wanting the two crooked teeth straightened, or was she also concerned about the color, shape or position of any of her other teeth?

“No, I’m completely happy with all of my other teeth, I just want the two crooked teeth straightened!” Jennie told Dr. Huefner.  With that Dr. Huefner recommended that he place two porcelain veneers just on just those two crooked teeth.  “How many appointments and how long will it take?” Jennie then asked Dr. Huefner.

“Two one hour appointments two weeks apart, that all,” Dr. Huefner answered Jennie.  With that Jennie was very happy with all that she had heard.  Dr. Huefner said he could straighten her crooked teeth without braces and it would all be done within two weeks.  She scheduled her first appointment for the following day, and Jennie had straight, beautiful teeth two weeks later just as Dr. Huefner had promised.

The end results?  Jennie was ecstatic!  Her teeth were straight, she avoided braces and a retainer, and her entire treatment was completed in two appointments over two weeks.  How great is this today for adult patients not willing to undergo months to years of braces.  Yes, new concepts in cosmetic dentistry enable straightening crooked teeth in two weeks without braces.

Dr. Norman Huefner, Newport Beach, Laguna Niguel, Orange County cosmetic dentist

Fixing Black Lines Around Crowns and Gums With Cosmetic Dentistry by Dr. Huefner

black lines around crowns and gums

Lower photo: Melinda hated the black lines and dark gums around the crowns on her two front teeth. She wanted that fixed, but also whiter, better proportioned teeth and a less "gummy smile". Upper photo: Dr. Huefner did a smile makeover for Melinda with two new all-porcelain crowns and eight porcelain veneers. No more black lines around crowns and gums and a less gummy smile after some minor laser gum reshaping.

Melinda is a health care professional and practices in a prestigious medical office located in Rancho Santa Margarita.  When she was young she was in an auto accident and broke her two front teeth.  Of course she was devastated by the trauma she received in the accident, which quickly healed.  But unfortunately she had to have root canals, metal posts to reinforce the weakened teeth and crowns on both upper front teeth.  What really devastated Melinda was that after her dentistry was done it looked like her front two teeth stuck out too far.  The two crowns were also too thick, didn’t match the color of her other teeth, but what bothered her most of all was the darkness of her gums around the two crowns – the dreaded black lines around crowns and gums.  This most often occurs when teeth have had root canals and porcelain-fused-to-metal crowns.

Melinda thought her front two caps were too big, giving her an unnatural smile. She wanted the black lines gone, definitely whiter teeth that were better proportioned and a less gummy smile.

Fixing Dreaded Black Lines Around Crowns and Gums

So Melinda came to see Dr. Huefner to discuss cosmetic dentistry to give her back her beautiful smile.  Her main concern was “fixing black lines around crowns and gums”.  Dr. Huefner assured Melinda that this could be accomplished by utilizing a two-step approach.  First, he would gently take off the two crowns and he expected that the tooth under the crowns would be black.  Dr. Huefner would remove the metal post, which darkened the tooth, replace it with a tooth colored post.  Also he would disguise the darkened tooth by placing a layer of tooth colored composite over it. Then, the second step was to place all-porcelain crowns in place of the two porcelain-fused-to-metal crowns.  The metal under her old crowns also kept light from entering the tooth and gums, darkening the gums around the crowns.  Also, many porcelain-fused-to-metal crowns have a very light band of metal showing.  Both of these things contributed to the problem.  Since we wanted to fix the black lines around crowns and gums the all-porcelain crowns would then allow light to enter into the underlying tooth, which would also lighten the gums around the new crowns.  Melinda was very happy that Dr. Huefner felt confidant that he could solver her problem by fixing black lines around crowns and gums.

fixing black lines around crowns and gums

The end result of Melinda's smile makeover with two new all-porcelain crowns and eight porcelain veneers was a sensational smile, much better than the teeth and smile she had prior to her accident!

Now that Dr. Huefner and Melinda knew that her main problem could be corrected Dr. Huefner questioned Melinda, as he had to be sure that just fixing the two front teeth was all that she wanted corrected.  He explained to her that if he corrects just the two front teeth, then he will need to match the color of her other teeth.  However if there was anything else that she wanted him to correct that she needed to tell him.  “Well, I really want all my teeth whiter,” she told Dr. Huefner.  “And, the two teeth next to my front two teeth are a bit small and the right one has more gums around it.  Matter of fact, I don’t like that I show so much of my gums.  Can you do anything to correct that?”

Orange county dental veneers

It was obvious now that Melinda wasn’t just wanting her two front teeth fixed, but rather she was wanting a smile makeover.  After carefully examining Melinda’s teeth and smile Dr. Huefner recommended the following:

  • fixing the black lines around crowns and gums as already recommended by placing new tooth colored posts, masking the discolored underlying teeth and placing two all-ceramic crowns
  • gum recontouring with the dental gum laser which would remove some of Melinda’s excess gums tissue, making her teeth look a little longer and reduce some of her gummy smile
  • porcelain veneers on eight of Melinda’s other upper teeth that show when she smiles.  This would enable Dr. Huefner to control the color of her teeth so that they will all be the whiter color that she wants.  It will also allow Dr. Huefner to make her small teeth a little larger, as she requested, but also make all her teeth straight and in better proportion.

Now faced with two different treatment options Melinda had to do some serious thinking about what she really wanted Dr. Huefner to do for her.  Should he just work on fixing black lines around crowns and gums or create a beautiful new smile for her?  Only fix the two front teeth or the ten teeth that she showed when she talks and smiles?

Melinda said that her appearance, he smile is very important to her.  She is single and in her profession it is very important that she look her best.  Thus, Melinda chose the smile makeover over just fixing black lines around crowns and gums.

Dr. Norman Huefner, Rancho Santa Margarita cosmetic dentist and Orange County dental veneers

Aliso Viejo porcelain veneers for Denise

Aliso Viejo porcelain veneers

Denise came to Dr. Huefner to get a nice smile with straight, white teeth. Dr. Huefner gave her the smile that she had always wanted with ten dental laminates (or porcelain veneers).

Denise is one of our local patients from Aliso Viejo.  She’s a mom and “the kids are finally grown up and out of the house,” she told us.  She went on to say that she has always put her children and family first, but also has always wanted to do something to “fix her teeth”.  Now she is finally in a position to take care of her long overdue dental problems.

“Fixing teeth” can mean a lot of different things to different people.  Before Dr. Huefner would recommend any dental treatment he needed to know more, what exactly did “fixing her teeth” mean to Denise?

“Well, I’ve got yellow, crooked teeth and a lot of fillings.  I really want pretty teeth and to me that means that they should be straight, white and not show any of the fillings,” she told us.  “Can’t you fix all that with cosmetic dentistry?”

Aliso Viejo porcelain veneers solve Denise’s dental problems

Denise’s problem is very straight forward, as we have successfully treated many patients who have dental issues very similar to hers.  In days past the typical answer was to have braces to make her teeth straight or do crowns to make them straight and white.  But today cosmetic dentists will often recommend porcelain veneers or dental laminates.  They have many advantages over orthodontics, as orthodontics can take months to years and only make teeth straight.  If the teeth are discolored or chipped or have many unsightly fillings orthodontics alone will not fix those problems.  And crowns can be a solution, but crowns require a more aggressive approach to dental laminates or porcelain veneers.  Clearly the advantages of dental laminates or Aliso Viejo porcelain veneers are much less drilling of the teeth, a stronger and more healthy underlying tooth and usually a much more natural looking end result.

crooked discolored teeth

Denise had put her kids and family first for many years. Finally her children were grown and out of the home and it was time that she could do something for herself. That "something" was to fix her teeth. She always disliked the crooked, discolored teeth with many fillings. What she wanted was straight, white teeth, which Dr. Huefner gave her with ten porcelain veneers.

Like most of our patients Denise appreciated the more conservative approach of dental laminates or porcelain veneers.  And she was thrilled that her entire treatment could be completed in just a few weeks time.  But then she had another question.  “I want my teeth to be white, but how white can you make them?” she asked.  Dr. Huefner answered, “As white as you want because YOU get to choose the color.  We will certainly give you our opinion and recommendations, but you will be choosing the color of your dental laminates.”  Denise really liked that answer.

Denise’s treatment went very smooth.  Dr. Huefner did ten dental laminates (porcelain veneers) on her upper teeth. She chose a BL2 tooth shade from the tooth shade guide.  She also did tooth bleaching on her lower teeth.  The final result was that Denise got the smile that she always wanted, straight, white, gorgeous looking teeth.  Afterwards she said she only had one regret, that she would have done her porcelain veneers years ago!

Dr. Norm Huefner, Laguna Niguel, Orange County and Aliso Viejo porcelain veneers

Laser Frenectomy by Orange County cosmetic dentist Dr. Huefner

lingual laser frenectomy

Top photo: The heavy lingual frenum runs from the tip of Cassidy's tongue (black arrow) to the gums right behind her lower front teeth (red arrow). This heavy band of fiber and muscle tissue restricted her tonge movements and could potentially effect her speech. Over time it would pull the gums away from her teeth, causing advanced premature recession and possibly causing one or two teeth to be lost. Middle photo: Immediately after the frenectomy. Note there is no bleeding and the frenum has been removed between the black and red arrows. Bottom photo: Complete healing as shown two weeks after the dental laser frenectomy. Only a small band of lingual frenum remains which is close to the normal size found in most individuals. Happily Cassidy can now stick her tongue out <grin>.

Cassidy from Orange County is a beautiful 13 year old girl with great teeth and no teeth problems.  However she did have a tongue problem.  Cassidy had a overly large lingual frenum, a band of fiber and muscle tissue that attaches from the underside of her tongue to right behind her lower front teeth.  Most people have lingual frenums, but most people have frenums that are much smaller and don’t cause any problems.  But Cassidy’s lingual frenum wasn’t small, and it was causing two problems. First, it restricted her movement of her tongue.  That is where the dental name “tongue tied” came from.  In certain individuals with overly large frenums speech is impaired to some extent.  The other problem is that over the years the tongue, being the very strong muscle that it is, keeps pulling on the overly taught lingual frenum, which is attached to the gums on the inside of the lower front teeth.  Over time this strong muscle movement can pull the gums away from the tooth creating a gum problem which then leads to accelerated gum recession and potential to completely lose one or more of the lower front teeth.

Frenum problems are not restricted to the area connecting the tongue to the back of the lower front teeth, called a lingual frenum.  They are also frequent problems running as a taught fiber band from the upper lip to the space between the upper front two teeth.  This is called a labial frenum and is the common cause of a space between the upper two front teeth.  Frenums can also be found around the upper or lower side teeth, but are not as problematic there.

Laser frenectomy

As a dentist very concerned about preventing such problems with proactive dentistry I discussed Cassidy’s problem with her father who immediately wanted to know how his daughter’s large, tight lingual frenum problem could be corrected. Back in the 1970s when I was first trained in removing labial and lingual frenums, a procedure called a frenectomy, we would just numb up the gum area with local anesthetic (Novocain) and surgically cut out the muscle fiber band with a scalpel.  But over the past decade with the introduction of the dental gum laser, many dentists like me (and oral surgeons and periodontists) are finding that a laser frenectomy can be done more precisely, has less bleeding and also heals up much faster.  It can be used to treat both large labial frenums and large lingual frenums. When the laser fiber touches the frenum fiber during the laser frenectomy procedure it almost seems to “melts” the frenum away.  Cassidy’s dad was pleased that were using the dental gum laser and could treat the reduction of Cassidy’s lingual frenum so precisely and non invasively with newer dental technology.

Cassidy was excited about having the laser frenectomy procedure.  Although she didn’t have any noticeable speech problem with her overly large and tight lingual frenum, she did have obvious restriction on her ability to move her tongue.  And her father was very concerned about preventing the most certain lingual gum recession and associated problems.  Happily, the first thing she “showed off” to her father after we did her laser frenectomy was that she could stick our her tongue!

Dr. Norm Huefner, Laguna Niguel, Orange County cosmetic dentist


Crooked smile fixed with Orange County porcelain veneers and porcelain bridge

DrHuefner porcelain veneers

Marina gets beautiful straight, white teeth with Orange County porcelain veneers and by replacing some of her old dental work.

Marina is a doctor in the medical profession.  She is very successful in her profession, happily married mother of two boys, beautiful and has everything going for her.  But……Marina didn’t like her teeth!  They were yellow and crooked. Being someone who always prided herself on being the best that she could be Marina felt that the appearance of her teeth and smile were incongruent with the rest of her.  She came to Dr. Huefner’s Orange County cosmetic dentistry practice in Laguna Niguel to discuss cosmetic dentistry and her treatment options to give her a nice smile.

When she smiled it was obvious that she had crooked teeth that weren't aligned appropriately with her face and that her teeth were very yellow.

When Marina smiled Dr. Huefner immediately saw two things with her teeth that detracted from them.  First, Marina’s teeth were very yellow.  Second, they were crooked, not straight and in alignment with her face.  Three of her front four teeth angled down towards her right.  In addition when she was young she lost her left lateral incisor (the tooth next to the front tooth) and her family dentist made her a crown and a bridge.  Although solving the missing tooth problem it is obvious that her dentist didn’t take into account how her teeth related to her face, and the result of not identifying that problem and communicating it with the dental lab was that the lab inadvertently misaligned the crown and bridge.  Neither the dentist nor Marina picked up that discrepancy when the dental work were tried in for approval, so the dentist cemented the misaligned bridge and crown.  Also, over time Marina’s gums around the old bridgework receded and the metal line on the edge of the canine tooth was now above the gum line and exposed.  Her teeth just didn’t look very pretty for such a beautiful lady.

The crown and bridge placed by Marina's old dentist were misaligned, not straight with her face. The black line around the cuspid tooth on her bridge was showing and unsightly. It was time for Marina to redo her old dentistry and get a more attractive smile for this professional woman.

Dr. Huefner discussed  two treatment options with Marina.  The first option was just to redo the bridge and crown making them straight with her face, but matching the color of her other teeth.  The second option was to redo the bridge and crown but also place Orange County porcelain veneers on several of her other upper teeth on her right.  If she did that treatment he wouldn’t have to match the color of her other teeth and could make her visible upper teeth much whiter and get her out of the dreaded yellow color.  The second treatment option would also give Dr. Huefner more control over making all her upper teeth straighter and produce the best over look.

Orange County porcelain veneers and new porcelain bridge by Dr. Huefner

Dr. Huefner created a beautiful smile for Marina. He gave her the white teeth that she wanted and made her porcelain veneers, porcelain crown and porcelain bridge in proper alignment with her face.

It didn’t take Marina long to reach a decision about which treatment plan she wanted Dr. Huefner to do for her. She is the type of person who wants things to be done right and the best that they can be.  She also was very displeased with the yellow color of her teeth and really wanted white, straight teeth.  Therefore Marina asked Dr. Huefner to create a new smile for her with the second treatment option he recommended: four Orange County porcelain veneers, one new porcelain crown and one new all-porcelain non-metal bridge.

The results of Marina’s new smile with Orange County porcelain veneers, a new porcelain crown and porcelain bridge was amazing.  Her new smile brightened her face and greatly enhanced her professional image.

Dr. Norm Huefner, Orange County porcelain veneers


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