August 19, 2018

Hodgepodge teeth transformed with new all porcelain crowns and veneers

Photo below: Leslie’s unattractive smile with unnatural looking porcelain crowns on her six upper front teeth. The very dark bicuspid side teeth dramatically contrasted with the color of her front teeth and something needed to be done to correct that. Photo above: Leslie’s new smile with six new all ceramic crowns on her front teeth and four porcelain veneers on her bicuspid side teeth. This dramatic improvement was completed in just over two weeks time.

Leslie is a graduate student in her late 20s.  She was raised in the mid west where she also graduated from college.  As a young lady she had numerous cavities and her parents took her to a dentist who placed porcelain fused to metal caps on both six of her upper front and six of her lower front teeth.  But the sad thing was that even though the cavities were “fixed” the appearance of Leslie’s teeth had much to be desired.

Now in graduate school here in Southern California where people are much more conscious of their appearance, Leslie began to hate the way her teeth looked.  When she came into Dr. Huefner’s office for a cosmetic dentistry consultation Leslie had much to say about what she didn’t like about her teeth and the way she wanted them changed.

Leslie said that her front six caps were ugly and didn’t look natural. One of the porcelain fused to metal crowns had chipped and a dentist tried to repair it. However the repair filling became discolored and started chipping off.

First, she said that she asked for “really white teeth”, and that is what the dentist gave her.  However, they were so opaque with no translucency that they “fake.”  The  color was white all right, but certainly not a natural looking tooth color.  Second, when she turned to the side the extremely dark bicuspid teeth that weren’t treated showed a marked contrast to her front teeth, making it obvious that she had “caps” on her teeth.  Third, because the porcelain caps had metal underneath, the edges or her crowns at the gum line showed an unattractive black line.  And last, the porcelain on one of her front caps had chipped off.  A dentist had tried to fix it, bonding some filling material over the metal.  But it was starting to peal off and discolor, making it the worst looking tooth in her mouth.

By replacing the six ugly porcelain fused to metal crowns with natural looking all ceramic crowns, and then placing porcelain veneers on her four side bicuspid teeth, Leslie got the beautiful smile she wanted. Her teeth were white and yet looked “real” and she can now smile with confidence!

After clearly understanding Leslie’s concerns and expectations, Dr. Huefner recommended replacing the six upper porcelain fused to metal crowns with all ceramic crowns.  Then, covering up the four dark bicuspid teeth that showed on her side teeth with porcelain veneers.  But doing that she could still have the white teeth she wanted, but they would have natural translucency and look like clean, white teeth!  Also, from the side all of her teeth would be the same uniform natural-white color.  Dr. Huefner promised her a beautiful smile that she would love and enable her to smile with confidence!

Leslie agreed to Dr. Huefner’s treatment recommendations and her entire treatment was completed in just over two weeks time, before she returned back to graduate school after her holiday break.  Because Dr. Huefner didn’t use crowns with metal underneath, there were no black lines around her gums.  All ten of the teeth treated were of the same white color, but the new crowns and veneers done by Dr. Huefner looked very “lifelike” and natural, clearly giving Leslie the beautiful smile she really wanted.

Dr. Norman Huefner, Orange County cosmetic dentist, serving Laguna Niguel, Mission Viejo and Irvine

Making a Black Front Tooth Look Normal Again

black line around porcelain crown

After Peg’s tooth had abscessed and turned black her family dentist treated the infection with a root canal and tried to make the tooth look normal by placing a porcelain fused to metal crown over the underlying black tooth. It was a big improvement, but over the years Peg’s gums receded a little and she became increasingly dissatisfied with its appearance. She came to Dr. Huefner to see if he could improve upon the results.

Peg had a blow to her front tooth when she was in high school.  It hurt for a couple days and then turned into a black front tooth.  This was horrible and she was really embarrassed!  Peg was really upset with the way it looked.  Her mother took Peg to the family dentist and he told her that it had abscessed, and that she needed to have a root canal to to stop the infection and prevent her from losing the tooth, and then she would need a porcelain crown to strengthen the tooth, hide the black front tooth and make it look the same color of her other teeth.  She had the treatment her family dentist had recommended and was very relieved with the improvement.

However, over the next ten years she became less and less satisfied with way the crown didn’t exactly match the color of her other teeth.  Then her gums started receding around the crown and there was a black line around the gums and she could see part of the root below the crown and it was very dark.  Finally she decided she couldn’t like with the way it looked any more and came in to see Dr. Huefner to get his opinion as to whether there was any other treatment that would make the ugly crowned tooth look like the rest of her teeth?

When Dr. Huefner looked at her crown he could see her concerns.  When the old crown was done years ago dentists often used a type of crown called porcelain fused to metal.  A gold crown was made to fit the remaining tooth, and then porcelain covered over the outside of the gold crown.  This type of crown is still popular today, especially for back teeth.  However, due to the nature of having a metal understructure, the light doesn’t go through the porcelain-metal crown in the same way it does natural teeth, and thus oftentimes these types of crowns look a bit artificial because of their opacity.  In addition, after Peg’s infection, the root had turned black.  In order to make a new crown for Peg Dr. Huefner would have to change the black color of the underlying black tooth to a normal tooth color, and then use an all ceramic rather than porcelain fused to metal crown.

“Wow, I didn’t think it would be that complicated,” Peg told Dr. Huefner.  “But if that is what you have to do to make my front teeth look good again, I’m ready to have you redo my front crown.”

Black front tooth

After Dr. Huefner removed Peg’s crown he could see the challenge. In order to use a natural looking all-porcelain crown (with no metal understructure) Dr. Huefner would have to use a special technique to turn the black tooth into a more normal colored tooth. He did this using tooth colored composite resin filling material.

The first thing Dr. Huefner had to do was take off the old porcelain fused to metal crown.  It actually came off pretty easy in about five minutes.  And when the crown was off Dr. Huefner could see the challenge he was really up to with the black front tooth!  The technique Dr. Huefner used was one he had learned while training at the Las Vegas Institute for Advanced Dental Studies some fifteen years ago.  He had to drill away the black part of the underlying tooth and the replace the black with a normal colored tooth filling material.  After than was done Dr. Huefner prepared the tooth for an all porcelain crown, one that would not have any underlying metal this time!

Of special concern was that Peg had unique pigmentation and more than normal translucency in her natural teeth.  Therefore Dr. Huefner needed to instruct the laboratory on how to duplicate those colors so that Peg’s new all porcelain crown would match her other teeth as closely as possible.

Black front tooth corrected with all-porcelain crown

The final results of Peg’s new all-porcelain crown was outstanding. No more metal in the crown, no more black tooth, no more black line around the gums. Her tooth looked natural again and matched her other teeth. Peg was very pleased with the results Dr. Huefner achieved for her.

The results came out great.  Peg was ecstatic!  Finally no more black front tooth and she could smile again with confidence.

Dr. Norman Huefner,  Laguna Niguel cosmetic dentist

BL3 shade porcelain veneers for Heidi

BL3 porcelain veneert shade

After much discussion and thought, Heidi chose BL3 shade for her six porcelain veneers and two porcelain crowns

BL3 shade porcelain veneers

Heidi is a very sweet lady who had just turned sixty.  She has been a patient in Dr. Huefner’s dental practice in Laguna Niguel for twenty years.  Her teeth were healthy, but she a lot of “old dentistry” that over the years became more aged and unattractive.  Heidi is relatively conservative, and although neat and well groomed, isn’t someone who spends a lot of effort on her appearance trying to impress anyone.  She has a “natural smile” , but the natural way her teeth looked was starting to concern her.  She didn’t have that “fresh look” any more.  In the back of her mind she knew that one day she needed to redo much of her old, unsightly dentistry.  Finally one day something happened that she never would have predicted.  She was babysitting her granddaughter and seemingly out of nowhere, her granddaughter said “Grandma, how come your teeth are so dark and yucky?”

She knew that over the years she had taken the way her teeth looked for granted.  But if her granddaughter thought that, how many other people were thinking that same thing but were just too polite to mention it?  I love being a grandmother, Heidi thought to herself, I just don’t want to look old.  Heidi had her dental cleaning coming up in a few weeks.  She decided it was time to talk with Dr. Huefner about replacing her old dentistry and improving the way her teeth and smile look.

Heidi loved being a grandmother, but didn’t want to look old. When her granddaughter commented about how dark and dingy her teeth looked she realized it was time to upgrade her old dentistry and give herself a more more attractive smile.

At her appointment Dr. Huefner and Heidi discussed her dental problems.  She had a couple crowns, but they didn’t match the color of the rest of her teeth and the gums around the crown on her right front tooth had receded over the years showing the unsightly black line of the metal edge of the crown around her gums.  Also, she had chipped her left front tooth about twenty years ago, and the bonded filling had really discolored.  Dr. Huefner explained that if that was all she wanted corrected, he could certainly just redo the old dentistry on those two teeth alone.  However, was she just looking to correct those two problems or were there other things the she also wanted improved?  Heidi was a bit shy about answering Dr. Huefner’s question, as she certainly didn’t want for him to think she was vein.  She said, “If I decide to do cosmetic dentistry I think I’d really like to know what else could be done to give me a much nicer smile.  I’m not a beauty queen and I’m certainly not a young lady any longer, but it would sure be nice to have teeth that when I smile make me look a bit more attractive and a few years younger to boot.”

With that Dr. Huefner knew precisely the cosmetic dentistry that would best serve Heidi.  He recommended replacing two of Heidi’s old porcelain over metal crowns with all porcelain crowns, and then place porcelain veneers on six of Heidi’s other upper front teeth.  When she smiled the eight upper front teeth that she showed would all be straight and uniform, and certainly make her smile look ten to twenty years younger and definitely much more attractive!  After talking at length with Dr. Huefner, Heidi said that she needed to go home and discuss this with her husband George.  “This all sounds good to me Dr. Huefner, but this is a big decision and a big investment for me.  I usually don’t make decisions like this very quickly, but after speaking with George I’ll let you know,” she said.

A week later Heidi called very excited!  George knew this was something that was important to her, and he was very supportive of her getting the smile makeover that Heidi and Dr. Huefner had discussed.  But before beginning, Heidi wanted to discuss one more very important decision.  How white would Dr. Huefner make her teeth?

Dr. Huefner explained to Heidi that in his cosmetic dental practice in Laguna Niguel the patient chooses the color of the crowns or porcelain veneers.  He went on to tell her that he would certainly recommend the color of the new porcelain crowns and porcelain veneers he thinks will look best for Heidi, but the ultimate decision will be hers.  He showed Heidi the tooth shade guide, and held up several of the colors tabs next to her teeth.  Right away Heidi eliminated the sixteen colors in the natural color range and focused her decision to the four color tabs in the bleaching shade range, BL1, BL2, BL3 and BL4.

Dr. Huefner went on to explain more about what colors other patients had chosen and their reasons.  The most popular tooth shade by far for porcelain veneers and smile makeovers was BL2, the second from the whitest.  The second most popular was BL1, the whitest natural tooth color in common use by cosmetic dentists.  Knowing that Heidi is a pretty conservative when it comes to her appearance, Dr. Huefner and his assistant Kathy felt that BL1 would be “over the top” for Heidi.  Heidi appreciated hearing that.  “I’ve seen people with really white looking teeth when I see that it really looks fake to me,” she told them.  “I’m too old to look like that.  The color I choose has to look much more natural.”

BL3 porcelain veneers and porcelain crowns

BL3 shade porcelain veneers and crowns used by Dr. Huefner to give Heidi a much more youthful and attractive smile. Although Heidi’s old dentistry could have lasted years longer, it was time to replace the “old looking dentistry” and upgrade her smile.

After much discussion and thought, Heidi chose BL3 shade porcelain veneers from the bleaching shade guide.  It’s definitely whiter than most natural teeth, but not over the top.  Also, she though it would be much more age appropriate than BL2 or BL1.  Dr. Huefner and his assistant Kathy agreed with her decision, but saying that they also told her that they thought she would look great with shade BL2 porcelain crowns and porcelain veneers.  However, since Heidi was only doing eight teeth, and actually showed ten teeth when she smiled, the BL3 shade would blend in less conspicuously with her other darker back crowns that she wasn’t going to redo.  The BL3 shade porcelain veneers porcelain crowns was an excellent choice for Heidi.

Heidi got her smile makeover with BL3 shade porcelain veneers in just a couple dental appointments over a three week period.  She loved the results, and has never again heard those dreaded words from her granddaughter about having such dark, dingy teeth!

Dr. Norman Huefner, Laguna Niguel cosmetic dentist


Fixing black lines around old crowns and bridges

black lines around old porcelain-fused-to-metal crowns and bridge

Lower photo: Sonia didn't like the black lines around her old bridge and crowns. She also wanted straight, white teeth that would give her a beautiful smile. Upper photo: Dr. Huefner replaced her crowns and bridge with all-ceramic non-metal crowns and bridge. He also placed several porcelain veneers. The end result was a beautiful smile, something she had wanted for years!

Sonia from Mission Viejo had always tried to take good care of her teeth.  As a youngster she didn’t have much professional dental care.  So as a young adult she had much catching up to do.  She lost one front tooth and over the years had to have a porcelain-fused-to-metal bridge and many porcelain-fused-to-metal crowns.  Her smile finally got to the point where it looked pretty good.  But over the years she started slacking off with her dental hygiene and visits to her dentist.  By the time she was fifty her gums had receded, and there was a visible black lines around most of her crowns.  She started noticing that her crowns were quite yellow compared to her friends’ teeth and Sonia became increasingly self conscious about the appearance of her teeth.  It was time for Sonia to see a cosmetic dentist about replacing much of her old, unesthetic dentistry and getting a beautiful smile.

In addition to hating the black lines around her bridge and crowns, Sonia didn't like the space between her front teeth.

She came to our cosmetic dental practice in Laguna Niguel to get Dr. Huefner’s opinion as to what was needed for him to make her beautiful looking teeth.  Dr. Huefner’s dental assistant Kathy took digital photographs of Sonia’s teeth and smile, and then together Sonia and Dr. Huefner looked at the photos on the computer monitor screen.  “Tell me Sonia, when you look at your teeth what is it that you don’t like and want changed?” Dr. Huefner asked Sonia.

Sonia had been closely looking at all her teeth for months and was able to quickly list several things:

  • “I especially don’t like the black lines around my old crowns”
  • “My teeth are yellow, I want my teeth to be much whiter”
  • “My teeth are crooked”
  • “I hate the space between my two front teeth, it looks dark”
  • “My back-side teeth lean in and look darker than my front teeth”

Sonia's new cosmetic dentistry gave her a gorgeous smile. Her teeth were white, straight and very evenly proportioned. The porcelain veneers on her side teeth didn't lean in like or natural teeth did and gave her a much more attractive and full smile.

After carefully listening to Sonia it became apparent that she didn’t want to just correct her bridge and a few old crowns, she wanted a “smile makeover”.  Dr. Huefner recommended replacing her porcelain-fused-to-metal bridge with an all-ceramic bridge.  He also recommended replacing her porcelain-fused-to-metal crowns with all ceramic crowns.  On her back and side teeth he recommended placing porcelain veneers.  Thus, when she smiled she would have white, straight teeth, all uniform in color and proportion.  It was very clear to Sonia that Dr. Huefner’s recommendations were well founded in order to get the results that she asked for, especially eliminating the black lines around her bridge and crowns.

But Sonia had one more very important question that needed answering.  “Dr. Huefner, as I get older if my gums recede, will there be black lines showing again that I will have to contend with?” she asked.  Dr. Huefner answered with a resolute “No”, that he would be using all-porcelain restorations without any metal whatsoever underneath the porcelain.  The metal underneath the porcelain crowns were the black lines that she was currently seeing in her own mouth.  She would never see black lines like she has now around any of her new dentistry that Dr. Huefner would be placing for her.

Sonia preceded with the cosmetic dental treatment that Dr. Huefner recommended, and got a terrific result.  A beautiful smile, straight white teeth, no space between her front two teeth, no side-back teeth leaning in, and most importantly, no black lines around any of her crowns.

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


San Diego cosmetic dentist helps Donna look younger and more attractive

Lower photos: Donna felt her teeth were crooked and yellow and desperately wanted a whiter, more youthful and attractive smile. Upper photos: Dr. Huefner did a smile makeover for Donna with all-ceramic non-metal porcelain crowns, giving her white, straight teeth.

Donna is an attractive professional lady in her 40s, married and the mother of two and lives in San Diego.  In her profession she knows that her appearance is important and has always worked hard to look her best.  Fifteen years ago she went to a San Diego cosmetic dentist because she chipped her front teeth.  Her dentist saw that she also had large discolored fillings in her teeth and recommended that he put porcelain-fused-to-metal crowns on her front four teeth.  She followed his advice and the metal based porcelain crowns were placed.  Since then she has been very aware of her teeth, especially her own.  She started realizing that although her teeth were healthy, they just didn’t look very attractive.  Something needed to be done to give Donna a better looking smile.

She came to Dr. Huefner, San Diego cosmetic dentist as he was recommended to her by one of her colleagues.  She wanted Dr. Huefner’s recommendations on what could be done with modern techniques in cosmetic dentistry to give her a younger looking and more attractive teeth and smile?  Before rushing to make any recommendations Dr. Huefner asked Donna what younger and more attractive looking teeth look like?  She answered:

  • Teeth are white, not yellow like mine
  • Teeth are straight, not crooked like mine
  • Gums are even and there isn’t a darkness around the teeth in the gums
  • Teeth look “real”, not fake like my caps

Lower photo: Donna's old crowns were yellow, lifeless and unattractive. Also they produced dark lines around Donna's gums. Upper photo: Donna got the beautiful straight, white teeth she wanted. Also her gums returned to normal and there were no black lines around her gums with the all-ceramic non-metal crowns.

In Donna’s case it was easy to see what she was talking about.  Her dentist probably only looked at her four front teeth, not her entire smile, when he made his recommendations.  She had some very yellow and crooked side teeth, but he didn’t address them at all.  Since he was only doing crowns on four teeth, he matched the color of her other teeth.  Also, he used a more generic type of crown, porcelain on the outside and metal (usually some type of gold) on the inside called porcelain fused to metal crowns.  Although these types of crowns are very functional they frequently have problems matching the esthetics of natural teeth.  The gold underneath the porcelain doesn’t allow natural light to partially transmit through the teeth like natural teeth do.  That is why most teeth with porcelain fused to metal crowns look flat, lifeless and unnatural.  Also many of these types of crowns have a dark line at or under the gums so the gums end up looking unnatural as well.

The answer to solve all of the problems Donna expressed to Dr. Huefner was for him to remove the four old porcelain fused to metal caps and replace them with all-ceramic non-metal porcelain crowns.  Also, to do four additional crowns on the visible cuspids and bicuspids that were so yellow colored and crooked.  This would enable Donna and Dr. Huefner to choose a tooth color that was much whiter and not yellow like her previous dentist has utilized.  The end result would be straight, white, “real looking” teeth and natural looking gums.

Donna liked Dr. Huefner’s approach, especially since he felt extremely confidant that he would be able to achieve all of her goals and give her  younger and more attractive looking teeth and smile.  She scheduled her first appointment for two weeks later and her entire smile makeover with non-metal all-ceramic crowns was completed just two and a half weeks after that.  The end result was just what Dr. Huefner had promised and Donna’s new smile looked gorgeous.  San Diego cosmetic dentistry comes through for Donna!

Dr. Norman Huefner, Orange County and San Diego 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

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