August 23, 2017

John Gets a “Wow” Smile

John is a professional man, an x olympic athlete and is a competitive roper.  After years of seeing his smile show signs of wear and not helping him “look as good as he could” he decided it was time to have his mouth restored with cosmetic dentistry.  Dr. Huefner restored John’s smile with emax porcelain (Ivoclar NA), shade BL2, masculine smile design.  Dr. Huefner’s ceramist is Dave Stohlman, at L.K.Dental Studio.

 

John was handsome before having his dentistry, but now he has a "wow" smile.

John was handsome before having his dentistry, but now he has a “wow” smile.

Full mouth reconstruction with cosmetic dentistry.

Full mouth reconstruction with cosmetic dentistry.

Better shaped teeth, whiter in color transformed John's smile!

Better shaped teeth, whiter in color transformed John’s smile!

Q: What dental work is suggested and what is a rough estimate for cost?

Hello, I am a 40 year old with known dental work. I need 2 implants on my upper left and right 2nd molars with crowns, as well 7 additional crowns, upper right 1st molar and both bicuspids, 2 upper bicuspids on the the left and 1 on each right and left lower bicuspids. In the last 10 years, my teeth have extensively changed, they are shorter, thinner, yellow and more transparent. Bite looks different. Does the above change facial features and expressions???

Dr. Huefner’s answer:
I’m sorry, but it isn’t that easy to give an estimate based on the information you’re giving.  You are speaking of partial or full mouth reconstruction with dental implants.  “Average costs for crowns and implants” may not at all apply to your particular situation.  Dental implant fees vary considerably between dentists, and you may also need some kind of bone augmentation and custom abutments, both which also add to the fees.
So, I highly advise you have consultations with SEVERAL dentists, and I can assure you that you will get different fees from each.  Also, I would strongly recommend that you not choose your dentist solely based on the lowest fees.  Case in point, not too long ago I had a patient come to see me after a bad experience at a dental implant clinic that she chose based on “the lowest fee”, and of the seven implants she had, two had come out, three were not done properly and also needed to be redone, and only the remaining two implants were OK.
As a restorative cosmetic dentist working as a team with an implantologist (the dentist who actually places the dental implants, while I do the actual crowns or bridges on the dental implants), the experience I’ve seen this past decade is that dental implants have over a 95% success rate!  The only two patients I’ve seen with problems were diabetics or SMOKERS!!!!  Thus, if you are either a diabetic or smoker, your chances of success with dental implants is considerably less than patients who don’t smoke or don’t have diabetes.
Regarding whether or not your teeth have changed your facial features I cannot say, except it oftentimes does, especially with people who have missing or severely worn teeth or have lost all their teeth and are wearing dentures.  Generally speaking, properly done dentistry will improve your facial features and make both your teeth and face look younger.

Mission Viejo Health Care Professional Revitalizes Her Smile with New Porcelain Veneers and Porcelain Crowns

mission viejo porcelain crowns and porcelain veneers

After replacing her old dentistry with all-porcelain crowns, porcelain veneers and a porcelain bridge, Michelle had the more attractive, cleaner, whiter and more professional looking smile that she wanted.

Michelle is a health care professional in her late 60s who practices in Mission Viejo, CA.  She has always had dental problems but every few years would go to her dentist at the time and get a new filling, crown or bridge.  Then one day she realized that despite decades of her always doing what her dentist had recommend, fixing her broken or decayed teeth, she had a pretty unattractive smile.  Her gums had receded showing black lines around the roots, her teeth were yellow and few of her teeth matched in color, and she felt her teeth made her appear older.  It was time to see what could be done to give her nice looking teeth and a much younger looking smile.

When Michelle came in to our office she expressed her concerns.  “I want my teeth to look nicer, to be white and for them all to match.  I’m frustrated that after going to dentists for years and always following their recommendations that my teeth look as bad as they do,” said Michelle.

Upon examining Michelle’s teeth it was obviously clear that her concerns were well founded.  Instead of her dentists ever giving her a comprehensive plan to restore her teeth and make them look good she had become the victim of what many dentists call “the crown of the year club” or “let’s fix the next worst thing type of dentistry.”  Each year or two her dentist would find one problem, usually the worst thing in her mouth, and recommend that be fixed, usually with a porcelain-fused-to-metal crown.  He would also mention that some other things were wearing out as well and would ultimately need fixing, but they could get around to doing that dentistry in the next year or two.

yellow worn teeth before cosmetic dentistry

After years of following her dentists recommendations Michelle realized that although her teeth were healthy the appearance of her teeth and smile had much to be desired. She wanted whiter teeth, for them all to match, and she didn't want any black lines around the crowns at the gum line.

Before giving Michelle our recommendations we asked her again to tell us her goals:

  • she wanted whiter teeth and them all to match
  • she didn’t want any metal or black lines from the crowns to show around her gum line
  • she said that she was a health care professional in a very high profile office, and it was important that she look healthy, clean and professional
  • since she was in her late 60s, it would also really be nice if she had a younger looking smile

Based on Michelle’s wishes our treatment recommendations were to replace all the visible porcelain-fused-to-metal crowns that were so dark and yellow with whiter all-porcelain/non-metal crowns and one dental bridge.  The other teeth that didn’t already have crowns could be made whiter to match her new dentistry by placing porcelain veneers on them.

When Michelle heard our treatment plan for her she understood why and how our recommended dentistry would necessary to achieve her goals.  “But isn’t that going to take dozens of office visits,” she asked?  Actually Michelle was right if we were going to do her dentistry the same way that her other dentists had treated her, one tooth at a time.  In Michelle’s case we would break up her treatment into two phases.  First, we would start with her upper teeth, doing all her new all-porcelain crowns, porcelain veneers and dental bridge in just two visits.  She couldn’t believe that all of her upper teeth would done in just under three weeks time!

At the next we would place her lower porcelain veneers and all-porcelain crowns and again, that would all be completed in less than three weeks time.  Michelle was excited that her dentistry could be done in such an efficient and timely manner and scheduled to begin her treatment two weeks later.

cosmetic dentistry mission viejo

After a more comprehensive approach to having her dentistry done Michelle finally had white, straight teeth that looked clean, professional, younger and more feminine. She chose a BL2 tooth color and an "enhanced" smile style for the shape of her teeth.

During her treatment Michelle was involved in selecting the color of her teeth.  She chose a BL2 tooth color from the tooth shade guide.  We made her new teeth slightly longer and more rounded, which along with whiter teeth are characteristics of younger, more feminine teeth.  Regarding the shape, Michelle chose the “enhanced” smile style from the tooth shape library.

The end result for Michelle from Mission Viejo was beautiful, a whiter more youthful and more feminine smile.  It also achieved her goals of being “cleaner” and “more professional” looking.  As a busy professional it was difficult for Michelle to be out of her office much.  After her cosmetic dentistry and porcelain veneers were completed she told us that one of the things that she appreciated the most was that so much was completed in such a short amount of time and in only a few dental visits.

Please feel free to comment or ask questions about Michelle’s smile makeover with new all-porcelain crowns, porcelain veneers and a porcelain bridge.

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

Smile Makeover with Cosmetic Dentistry Orange County that Creates Beautiful Looking Teeth, Changes Abnormal Lip Shape, Improves Face Proportions and Reduces Over Bite

orange county porcelain veneers

Diane didn't like the appearance of her teeth. She had an "over closed bite" that also effected her lips, cheeks and the appearance of the lower 1/3 to 1/2 of her face. By increasing her vertical dimension with porcelain crowns and porcelain veneers, Diane got a terrific looking smile and better looking face.

Diane didn’t like her teeth and smile.  She had old discolored crowns that were in obvious need of replacement.  She came to our cosmetic dental practice in Orange County to find out what we could do for her?

It would have been easy to just look at Diane’s teeth and recommend replacing the old dentistry, but when looking at Diane’s face, smile and teeth it was very obvious to us that there were some other issues involved. Before advising Diane of her treatment options it was very important that Diane understood all her issues as well.

What’s wrong with her teeth?

We took photos of Diane’s teeth, smile and face and displayed them on our computer monitor.  Then we asked her to describe the things about her teeth that she didn’t like.  She was quick to point out that she didn’t like:

  • the color of her teeth
  • that her side teeth angled inwards
  • that she had a huge overbite
  • that she had many different kinds of dentistry, fillings and crowns, and none of them matched
Her lips?

Next we asked Diane to specifically look at her lips.  Did she like the appearance of her lips?  How would she describe the shape of her lower lip? Diane answered, “Well, my lips are OK, just not very pretty.  I guess I need to go to the plastic surgeon to fix that, right?”  After looking carefully at the shape of her lower lip she said that it wasn’t curved like most normal lips, that she could see that it pushes up in the front.

The lower third of her face
facial improvement with cosmetic dentistry

By "opening her bite" and making porcelain veneers on Diane's front teeth and porcelain crowns on Diane's back teeth, a huge improvement in her facial appearance was achieved.

Then we asked Diane to look a the lower 1/3 to 1/2 of her face.  She said that she didn’t like the wrinkles in her face, but really didn’t understand how that had anything to do with dentistry.

Now it was time to help Diane understand what really was going on with her teeth that effected her lips and lower part of her face and that there were two ways to treat her teeth.  One that would only address her concerns about the appearance of her teeth, and the other would address not only her teeth, but also the shape of both her upper and lower lips and the appearance of the lower  1/3 of her face.

We explained to Diane that she had what in dentistry is commonly referred to as “over closure” or “reduced vertical dimension”.  Over simplifying it, that her back teeth and/or jaw bones were too short so that when she closed her mouth and put her teeth together that the distance between her chin and nose was much smaller than normal.  This “over closure” created a huge over bite, caused her upper lip to cave in on the sides, her lower lip to bunch up in the front, some facial collapse and increased wrinkles or skin folds.  Much of this could be corrected by reconstructing her bite, making her back teeth longer, in balance with her jaw joint and facial muscles.

“You mean dentistry can not only make my teeth look pretty, but also make my face look better as well?”, she asked. Our answer was a resounding “yes.”

We further clarified to Diane what the differences in treatment were.  One treatment would be to treat only her upper teeth with ten porcelain veneers or porcelain crowns.  This would give her pretty teeth and a little better support of her upper lip only.  The other more comprehensive treatment would be to  place porcelain crowns or porcelain veneers on both her back teeth and front teeth.  This would “open her bite”, making the bottom 1/3 of her face longer.  It would give her prettier teeth as well as better face and lips better jaw support.  The end result for the more comprehensive treatment  would obviously give her a much better looking appearance.

After much deliberation, Diane chose the comprehensive approach, treating most all of her teeth with new porcelain crowns or veneers.  How did it look?  Well, you be the judge.  Look at the huge difference between her teeth, lips and lower third of Diane’s face.

Later Diane said that she couldn’t believe how much younger she looked with her cosmetic dentistry.  “I always thought that the only way to make my face look better and younger was plastic surgery.  I never would have guessed that by just making my teeth longer and changing my bite that it would have such a huge effect on my appearance!”

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

Revitalizing Charlene’s Smile – New Porcelain Veneers, Bridges and Crowns for Rancho Santa Margarita Businesswoman

rancho santa margarita porcelain veneers

Below: Charlene was unhappy with the appearance of her old dentistry which was failing. She had spacing between her upper front teeth, one tooth was very dark, the bridges on her side teeth didn't match anything. She wanted a brighter, whiter smile, more becoming of a successful Orange County businesswoman. Above: After doing some laser gum reshaping to reduce some of her gummy smile, her teeth were made slightly longer with three porcelain veneers, one porcelain crown and two porcelain bridges.

Charlene from Rancho Santa Margarita had a lot of old dentistry, but with new decay and break down her old dentistry was failing.  Over the years almost all of her teeth had crowns or huge fillings.  When she came to us to consult regarding replacing her old dentistry she listed her goals:

  • She wanted a whiter, brighter smile
  • Her teeth were too short
  • Her teeth were multicolored, and she wanted them all the same color
  • She is a professional woman with a thriving business, and she felt that being as successful as she was that her teeth should look much better than they do
  • Her upper left lateral incisor was extremely dark
  • There was spacing between some of her front teeth

When we evaluated her dentistry it was very apparent that through her entire life he dentistry had always been “problem focused” dentistry.  If she had a broken tooth, the dentist placed a single crown.  If she lost a tooth, he placed a bridge.  If she had a large cavity, he would place a large filling.  The results of doing all of her dentistry one tooth or one area at a time was that all of her teeth had different colors and none of her dentistry matched.  The way to correct that was to replace all of her old dentistry on her top teeth at the same time.  This would result in being able to give her the whiter, brighter looking teeth that she wanted and all the teeth being the same color, design and in proportion.

Another thing Charlene really wanted was longer teeth.  But on closer look she also had a “gummy smile“, meaning that when she smiled her upper lip went up and showed a lot of her gums above her upper front teeth.  We suggested that we would get the best esthetic result and eliminate her gummy smile by doing some very conservative laser gum reshaping.  Doing that in combination with making Charlene’s teeth slightly longer would give her an ideal looking smile, very proportional and symmetric.

Because of time and financial considerations, Charlene requested that we break her treatment up into several phases.  In complying with her requests, the first phase would be doing her upper teeth.  The second phase would be having several dental implants placed where she was missing numerous lower back teeth.  The third phase would be completing the dental reconstruction of her lower teeth.

Charlene’s first phase of treatment consisted of first, doing the laser gum reshaping and then redoing all her upper teeth.  We replacing the two porcelain bridges she had on her left and right back teeth.  Also, all four of her upper incisors were treated, three with porcelain veneers and the very dark one with a porcelain crown.  A “enhanced” LVI smile style from the tooth shape catalog was utilized and a shade BL2 from the tooth shade guide.

The end result for Charlene from Rancho Santa Margarita was a beautiful result and an amazingly improved smile.  All of the dental concerns that she originally had were successfully addressed.

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

Creating a more attractive masculine smile by replacing old crowns with newer cosmetic dentistry techniques and materials

masculine smile design

When we replaced Warren's old crowns we utilized a more natural looking porcelain (Empress porcelain), a whiter color and a more masculine smile design.

Warren had most all of his teeth “crowned” by another dentist.  He said he didn’t like his porcelain crowns from the beginning and came to us to discuss his options.  “If you redo them for me, how would you do them differently,” asked Warren?

After carefully looking at Warren’s porcelain crowns and smile it was obvious that the dentist was very skilled and had worked very hard with Warren’s treatment.  We told Warren upfront, all of his crowns fit properly, his bite was good and the treatment was well within the standard of care.
But to answer his question, it was obvious that Warren had very high expectations and had particular ideas of his own about what he wanted his smile to look like.  We asked Warren to explain just what it was that he was displeased with his dentist’s porcelain crown work?
He was very quick to list his concerns:

  • The teeth aren’t white enough
  • The teeth don’t look “real”
  • They are too thick
old porcelain crowns orange county

Warren was displeased with his old porcelain crowns. He didn't like the color, thought the teeth were too thick and bulky, and thought they were unattractive and unnatural looking.

We explained to Warren that the issues that concerned him were probably a result of several things:

  • The dentist and he not really communicating before treatment about what he wanted (we would make sure that we were all on the same wavelength before beginning any treatment)
  • The dentist’s choice of very opaque porcelain (we would recommend more life-like Empress and EMax porcelain crowns)
  • The choice of color (since he knew he wanted whiter teeth it would be easier for his to choose the color he wanted from the tooth shade guide)
  • The actual style of porcelain crowns done by the dentist’s technician (we utilize a nationally known maser cosmetic ceramist with three decades of experience and has also been the recipient of many awards for his outstanding achievement in cosmetic dentistry)
  • The smile style prescribed by the dentist (see tooth shapes).  Warren said he didn’t remember his dentist discussing tooth shapes with him at all, so it may be that the dentist didn’t actually prescribe a specific style of tooth shapes and the decision was left up to the ceramist who actually never met or spoke with Warren.  Most cosmetic dentists today will discuss smile design with the patient and specify a smile design for the ceramist to follow.

Further explaining to Warren, now really understanding what he wanted accomplished, if we were going to remake them for him we would use a more natural looking porcelain for his crowns that would not only be lighter in color, but also would have more natural looking translucency (Empress porcelain for the front teeth, EMax porcelain for the back teeth).

laguna niguel cosmetic dentistry

Although Warren's old dentistry (left photo) met the standard of care he was displeased with the appearance of his teeth and wanted them whiter and more naturally shaped. In addition to doing that for Warren, we utilized a more masculine smile design for him by making his front four teeth straighter along the edge and with less rounded corners (right photo).

Warren was pleased to know that our ceramist has a very consistent style of creating crowns that really look like natural teeth and don’t look “too thick” or “bulky” like Warren currently had.

The last thing we suggested was a more masculine smile design.  Warren is a very masculine looking man and his current porcelain crowns were very generic looking, especially having rounded corners on his four front teeth which sometimes is considered a more feminine or youthful look.  We suggested a more masculine looking smile design (see tooth shape library) by making the front four teeth flatter without the rounded corners.

After more discussion Warren decided that he was ready to redo his old porcelain crowns.  “I like your plan,” he said.  “I think we’re communicating well and on the right track together.  I really hate the way my porcelain crowns look so  I’m ready to go ahead and get started.”

We preceded with Warren’s cosmetic dental treatment, removed his old porcelain crowns and made new ones for him.  We met all of Warren’s treatment goals and the end result were teeth (all-porcelain crowns) that were whiter, “real looking”, more life-like translucency and a smile design that was masculine more natural looking than his previous dentistry.

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

Smoker’s Smile Gets Unforgettable Smile Transformation with Cosmetic Dentistry Laguna Niguel

dental reconstruction orange county cosmetic dentist

Joanne got a life changing smile transformation with cosmetic dentistry, as is very obvious from the before and after photos of her smile. "My daughter said that my new teeth make me look twenty years younger," she said.

Joanne from Mission Viejo was a smoker and had been for over forty years.  Her smoking had worsened her gum disease, causing the teeth around her bone to deteriorate, her gums recede and exposing the roots of her teeth. It was very obvious to Joanne that her smoking had also discolored her teeth pretty bad, especially around the roots. On top of all of this Joanne had a significant amount of decay and was already missing several teeth.  She came to our cosmetic dental practice to “get her teeth fixed.”

It was important for us to find out why she was finally motivated enough to do something about her teeth.  Joanne said, “It’s because I just had to have another tooth pulled, several more are getting looser and I don’t want to end up getting false teeth like my parents!”

We took some photos of her teeth so that we could discuss each of them, including all treatment options.  Joanne was devastated! “I know my smile looks bad but I never realized how bad I have let my teeth get,” she said.  “Is there anything you can do for me to help prevent dentures?”

After thoroughly examining Joanne’s teeth we actually had the answer that Joanne wanted to hear.  “Yes, we can treat your gum disease and restore your smile.  It’s a lot of work, but it can be done,” we assured her.

Skipping all the details of her treatment, we did do full mouth reconstruction for Joanne with multiple porcelain crowns and three porcelain bridges.  As is very evident from the before and after photos, the results we achieved for her were amazing.  Undeniably, Joanne got an unforgettable life changing smile transformation with cosmetic dentistry!  In her own words, “My daughter said that my new teeth make me look twenty years younger.”

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