I am really interested in closing my (2.5-3 mm) gap betw front 2 incisors. This is what my dentist provided me so far (Front 4 veneers). I'm concerned abt the size of the frnt 2 (They look big and fat). I tried asking if we can make the next central 2 smaller. Dentist said that we have to cut the central incisors from the lateral side&add larger veneers to the lateral incisors. Dentist said that if I am going to do so, I would end with double root canal on first 2 What should I do? Patient #13
Is There an Alternative to These 2 Front Big Veneer? (4 Veneers Here but the First 2 Are Big) (photo)
Doctor Answers (5)
Gap closure between upper incisors
Is There an Alternative to These 2 Front Big Veneers?
Judging based on the picture, it looks like your most ideal treatment would be to first have braces. Many patients do not like the idea of being in braces so there can possibly be another option called "instant ortho." That is where veneers/crowns can be used to close the diastema (gap) and make the teeth beautiful without the need for braces first. In doing only 4 upper teeth, it will be very difficult to get the ideal proportions and make those central incisors less bulky. Typically, in this scenario doing at least 8 teeth will spread out the proportions of the upper teeth, without necessarily needing the root canals or trauma to the incisors. A dentist should be properly trained to do an upper arch cosmetic case, and be trained to evaluate your occlusion (bite). Making sure your bite is properly aligned so as not to cause future problems such as chipping, wearing, breaking, TMD, headaches, etc., is very important. If the veneers are done improperly, you will end up wasting your time and money. The best way to assess your situation is to have some other opinions done by top cosmetic dentists. It's best to do this before starting any permanent treatment to save you time and money. If they can do a wax-up of your case prior to starting, you can also get an idea of your final result. Best of luck!
I would consider orthodontic treatment first to close diastema and to correct The bite. That way I would not have to cut too much structure from the laterals in order to make the centrals look smaller. It is very recommended to do a wax up and a mock up so that you can see what the final outcome is going to look like before cutting any teeth.
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In my opinion you will get a better look if you do more veneers. I think I would get a wax up with 8 veneers to see if you can make the space smaller by changing the size of 8 teeth. I have found when doing more teeth you can make all the teeth close to the "golden proportion". You can look online what "the golden proportion" is. It basically a set of measurements, of the size of the teeth , which we as humans find pleasing to the eye. When you have teeth out of proportion our eyes catch it.
However, more veneers cost more money. If you only want to do this right, you may want to make the investment? You current dentist was probably trying to be conservative. Although it is good to be conservative, sometimes it may not give us the result we are looking for. Ask your dentist to get another wax up with 8 teeth?? That way you can see what it looks like before you prepare the teeth. You can close the space my adding more porcelain to the sides of more teeth, and not having to large ones and two small ones. Another option is you can do limited orthodontics to close the space or move the teeth to a better position, and then do the veneers.
Gaps between front teeth
In my opinion it will be very difficult to close the gap given the size discrepancy between the top and bottom arches. What appears to be the problem is that you have and arch/tooth size problem. In other words your upper arch is constricted. If time and money were not an issue then ideal treatment would consist of adult expansion of the upper arch (orthodontics). If done correctly the teeth would be placed in the ideal position which would still leave some spacing which would need to be addressed by veneers (maybe only 4).
Another option would be to place porcelain veneers on the outside of the back teeth in a way that would give the appearance of a fuller arch. In other words, build the arch out with porcelain. Then the four front teeth could be veneered to the proper proportion.
The short answer is you will need to do more veneers (8-10) in order to gain proper proportion. This is basically done by adding in some areas and subtracting in others so that when your smile is complete the teeth are in the right position, size, shape, and proportion.
Hope this helps,
John Schmid DDS LVIF