Before & After Gallery

Before

After
Totally embarrassed by her appearance, these front teeth were sorely neglected, two of them, in fact, requiring root canals.Notice how in the before picture the one front tooth is rotated 90 degerees. After the root canals were done on the two front teeth it gave me the capability to make the tooth not look rotated with all-ceramic crowns. The lateral incisors, which were pointy (misshaped) were replaced with veneers. Only 4 teeth treated, but a world of difference I’m sure you’ll agree.

Before

After
This woman needed a correction so that she could look good in the pictures of her child’s wedding. Problem was, she didn’t give us enough time to get the treatment done, so we let her know we’d give her a gorgeous set of temporaries for the wedding. The pictures you see here are her temporaries!

The trained eye sees a lot of things wrong with this smile. There is excessive wear and chipping to the edges of this man’s teeth, as well as spacing. The teeth make this smile look like one of a much older man, and cosmetic dentistry certainly will make the smile younger, more vigorous-looking. Notice the thin brown crack lines in the front teeth, and how the line connecting the edges of the teeth is not a flat plane (which is desirable to enable the teeth to come together simultaneously) but rather, quite a roller-coaster occlusion. Also notice how the two front teeth drop down much lower than any other teeth in the arch at the gum line.

Something very important to realize is that when we work our cosmetic/porcelain magic, we talk about the porcelain being the picture, the gums being the matting, and the lips being the frame. In the after pictures, the roller coaster is gone, and thanks to a little lasering of the gum tissues, we have enhanced the “matting” around the picture. Observe how this is a very masculine smile. The front teeth and the ones next to them, the lateral incisors, all have square edges. Rounded edges would be more effeminate.

So what do you see when you look at the before smile of this executive? Obviously, the plane of the smile isn’t straight, it’s a roller coaster. Maybe not so obvious is the fact that the way the two upper front teeth come together is not at right angles to the floor, or the line drawn between the pupils of his eyes. This is called a midline cant.

There is a lot of wear to the teeth, because the jaws just don’t fit together properly. Look at the eye tooth on top, on the left side of the screen and look how flat that is. That has come from him grinding his teeth.

He wanted VERY white veneers, something you see more on the West Coast, than on the East. But he knew what he wanted, and our lab techs in California have the know-how to make this happen, and still keep the smile very natural looking.

In the after photographs, look at how everything is now straightened, and edges are very natural looking. Look at how the wear on the eye tooth has been restored to a very strong (pointed is more masculine there than rounded) virile appearance. Look at how the laterals and central incisors are all much squarer, and far more in proportion to one another than they were before treatment was initiated.

This entire case took less than a month from consultation, to delivery of the finished product. Essential, in the fabrication of smiles like these, is insuring that each tooth is properly reduced to allow the laboratory to create perfection. To do this, trained cosmetic dentists use something called a reduction guide, to insure the absolutely gorgeous results you see here.

After completing orthodontics in less than 6 months, and some bonding to make the front teeth look beautiful.

Here, the trained eye sees very fat, bulbous-looking front teeth, and nobody reading this wouldn’t be happy missing a front tooth like she is.

The broken tooth was replaced with a dental implant, and just three front teeth were treated to make this exquisite woman, gorgeous again. Here is what she had to say about us: http://www.youtube.com/watch?v=DhYUEzJFLR8&list=UUXExMD-eaWGm9PQz22AUQWw&index=3&feature=plcp

A young woman with a smile problem. The teeth are, shall we say, “majestic”? There is also an issue with too much gum tissue showing, which is easily remedied by using our diode laser to recontour the way the teeth come out of the gum. This was a very interesting makeover, because of the size of the teeth, we needed to make the temporaries absolutely perfectly, and then get the lab to duplicate the exact shape and size of the temps to guarantee the patient’s satisfaction with the permanent results. Numerous revisions of the temporaries were required until everyone was happy with the results.

The techniques for doing this were developed by Dr. Markus, and other cosmetic dentists like him in the AACD and are further explained on Dr. Markus’ educational website, www.TheEdgeSmiles.com.

Notice the dramatic change in the shapes of the teeth, the natural looking way they flow out of the gums and the gorgeous contours given to the porcelain to make them duplicate nature.

A very difficult case, because this woman’s midline (the spot where the two upper front teeth come together) doesn’t match the midline of her face. However, research has shown that the untrained eye, and most dentists’ eyes aren’t going to catch this disparity until the deviation is more than 3 mm.

The teeth are obviously very dark, with large fillings in them. Notice the step up on the right side of the screen between the lateral incisor, and the eye tooth, which really should be longer than the lateral. The same is true on the left, with the cuspid tip having been flattened due to grinding.

In fact, the lateral incisor next to it is longer than the central (very dark front tooth) and the reverse should be true. There is a black hole between the two front teeth. The midline is canted and the edges are uneven and amber colored.

While the after pictures of this case wouldn’t win any prizes at a Cosmetic Dental meeting, they are nothing less than sensational. We have moved the midline back almost to the middle of the face, and the edges are spectacular.

One of the things the cosmetic dentist would recognize here is that the matting (gums) and the frame (lips) are nearly perfect. It's the picture, in the matting and the frame that has been left out in the rain, on the street, being run over by traffic on a daily basis. Dentists who care need to be, among all other things, a psychiatrist, a nutritionist, and a forensics expert.

How did things get to be this way? She was obviously someone with high dental fears. So, you might ask, "If that's the case, shouldn't she have been limiting her intake of sweets?" Well maybe she had an addictive personality, maybe she had a problem with certain brands of soda (especially Mountain Dew) that she couldn't stop sipping? Finances play a role too. The amount of treatment she was facing, in her own mind, was more than she could afford, and since she couldn't afford to treat it, maybe she should just keep going the same way she was going until they all rotted out?

As luck would have it, she came to see us when a front tooth snapped off, she couldn't bear looking at herself in the mirror. Cases like these require a compassionate and understanding dentist, who also can provide a financing package for the patient. Empathy also plays a role. If she had been charged for this case on a item by item basis, the fee would have been much higher, and she couldn't afford that, so I set aside a day for her to be sedated, and I would get as much dentistry done for her as I could, at a price that was manageable for her, and satisfactory for us. I engaged my lab to discount their rates, because this was a compassion case, and they did.

Without changing the shape drastically, the restoration now matches the lips and gums (which are beautiful, healthy and pink. As a cosmetic dentist, this is what makes it all worthwhile, changing lives, one smile at a time.

Apologies for the before pictures on this case, but it was done with one of the original digital cameras. Substantial wear and chipping from bite issues were corrected in the 1990’s with porcelain laminate veneers. Our porcelain artwork has gotten much better as products have improved, but I think you will agree, looking at a recent picture of how well his cosmetic dentistry has held up, that the restoration has stood the test of time.

A simple 4 veneer case to restore form and function.

What do you see when you look at the upper teeth?

Do you see:

1. The half-moon shaped wear on the front teeth? That might come about because the patient is a nail-biter, or the opposing lower tooth might be too far forward, and interfere with the way the teeth close together.
2. One upper lateral is way behind the curve of the front teeth, the other is way shorter than the central next to it.
3. The teeth are yellow-ish.
4. The lower front teeth are not only crooked (especially if you were able to look at them from above), and there is no level plane, rather, the tips of the teeth, if connected by a pencil line, would be another one of those roller coaster occlusions we talk about.

This is the advantage of being able to blueprint a case. Everything planned out well in advance of starting treatment. The lower plane of occlusion is established first, and then the way the teeth come together in front is built off of that plane. Note in the after photography:

1. The Edges of the upper front teeth are uniform, symmetric, and natural looking.
2. The lateral incisors are all just slightly shorter than the centrals. Look how nicely all the porcelain emerges from the gum tissue.
3. The shade is much improved. Although many dentists would look at a case like this and treat a minimum of 20 teeth, we treated this case in accordance with the patient's wishes to minimize expenditure. When we are not changing the "height of the bite", cases can be done in phases, as long as the patient can tolerate the two-toned nature of things until they are happy.
4. The lowers and the uppers fit together, without interferences in any of the jaw's movements.

Looking at the photograph of the edges of the four upper front teeth in the mirror, you can see how these teeth come to the front in a V rather than the typical gentle rounded form. This is why the teeth look so overlapped in straight on view.

In the picture that has four images in a split screen, you get an idea about the planning process. Digital images of the appearance of the front teeth were enhanced using custom dental software, to provide a stronger, more masculine appearance to the edges, which the laboratory was obviously able to capture in the final porcelain design. The eye teeth have been made a little softer (more rounded than pointed), and the laboratory outdid itself on the edge treatment, given that this case was treated over a decade ago in 2001.

A college student who never had the advantage of wearing braces as an adolescent came to us with a request for a straighter, whiter smile. This case was done with a combination of the 6 Month Smiles Adult Cosmetic braces, and a veneer or two. What an advantage his smile will give him into the future!

This woman sought to undo the ravages of time and adverse forces which caused the significant chipping of the teeth. She also had a roller coaster bite, like so many of the other smiles you’ve seen here, where the objective is to develop a flat plane of occlusion so that all the teeth come together simultaneously.

This problem was solved with multiple Edge crowns and 6 Edge veneers on the six lower front tooth. An exquisite result.

Here’s a fun exercise: Look only at the pictures with the lips in them. How old is the patient with the yellow teeth? How old is the patient with the white teeth? They are actually both in their mid 50’s, but you’d never guess that looking at how yellow her teeth had gotten, would you?

We had a lot to deal with on this extensive case. Foremost, there were bite issues which the layman would be able to tell looking at the lower front teeth, but did you know that those tell-tale notches at the gumline are related to clenching issues?

The dark grey teeth were because of all the mercury fillings in them. This was an extensive Edge porcelain case, with great looking results.

A quick, 6 unit porcelain case to straighten out the smile in two weeks. The lower arch is still untreated, but pending.

A teenager, just out of braces by a specialist with a lot of compromised results. It’s very difficult to take eye teeth which have been moved next to the central incisors, and make them look like laterals.

We achieved a gorgeous result for her, in time for her to leave for college!

A miraculous conversion, aided by the vision of the dentists at “The Centre”. Listen to his ringing endorsement, by following this link:

Our March 2013 Case of the Month

Our patient had been through braces twice in her life, and thought that it was time for a third go-round. She wasn't anxious about the prospects of wearing braces for another year or more. My consultation with her showed her that even after orthodontics was completed, the teeth were still misshapen, and would need some cosmetic help. Her complaint was obvious: the teeth were crossed-over, and the front two teeth were much longer than the lateral incisors next to them.

Using our Smile BluePrinting technique (link to www.TheEdgeSmiles.com ) I was able to show her, in advance, what I thought the smile would look like on completion of our Edge Porcelain Veneers (look at the detail in the two edges of the veneers, where they meet the gum, and where they meet the eye). The results took 3 weeks for the lab to return, and she tells us, she keeps getting complements on her new smile). There are many dentists who look at a case like this, and think 8 or 10 veneers to straighten it out. We took care of it with just 4.