Andrea Stevens, DMD

There are many opinions when it comes to “how many teeth” should be treated to improve a smile. I generally find that crowns on six teeth looks very obvious that treatment has been done, which is it the goal of most patients (Google “Matthew Perry Veneers” to see what I mean). We usually recommend patients put crowns/veneers on either the 4 front teeth, or 8-10 teeth depending on the broadness of the smile. Smile your widest, happiest smile, have someone take a photograph, and count how many teeth you can see...that’s the number of teeth Inwould recommend treating.

Regarding “procera” crowns, this is just a brand name of the material used. There are many brands of ceramic restorations that provide beautiful results, and the dentist you choose will use whatever material he or she finds works the best in his or her hands.

Good luck!

It is very difficult to evaluate your situation well from the images you included because they are so dark and blurred. However it appears that the implant are has lost bone on the lip side (from the photograph) which is more concerning to me than the position of the implant. The little string of tissue under your upper lip (called a frenum) appears to be pulling on the implant area tissue which may be a part of the problem here. Both the apparent bone loss and the frenum position should be evaluated as soon as possible. If you have lost bone around the implant, you will likely need to have it removed and a new implant placed.

Regarding the teeth on either side of the implant, I cannot tell for sure from the dark radiograph but certainly that tooth appears to have some challenges. Have the whole area assessed by a dentist experienced in placing dental implants.

Good luck!

Dental bonding or veneers would both work to close the gaps between your teeth and would also correct the sizes to make your smile “flow” better. 

One thing you should also consider, however, is your tongue position. This was only one set of photos, but your tongue is pressed against your front teeth in these photos. Your tongue muscle is strong enough to move teeth, and I would not be surprised to see gaps opening back up even after you close them with bonding or veneers. If you were my patient, I would also recommend an evaluation by someone who does Myofunctional Therapy to retrain your tongue position. This type of work is also done in some dental offices as well as with speech therapists.

Good luck!

This is likely a two part problem. Without further information, I would say the first part is that the tooth has had root canal treatment, which often significantly darkens the tooth. The second part is a thin gum tissue type, which allows that colour to be seen. 

In some cases, the tooth can be adjusted prior to making an impression for the crown so that the dark colour can be blocked out. However, depending on how high your smile line is this may never be fully covered. 

From your photograph, it appears you haven’t chipped your tooth, but the calculus (tartar) that had been growing there. This is plaque which has been allowed to sit on your teeth and harden with time. I would suggest you get yourself an appointment with a dental hygienist to have that removed and your teeth and gums checked. Also, your dental hygienist can show you how to prevent that from continuing to grow, which is important because it contains an astounding amount of bacteria!

Good luck!

Congratulations to you for selecting dental treatment that is state-of-the-art! The swelling, then shrinking, of gum tissue during the healing phase is completely normal. Every patient heals differently from any procedure, and there are many factors involved: number of teeth removed, infections present at that time, space needed for new teeth, etc. Protocols may vary, but usually within 3-6 months your dentist will begin to take records for your final smile. During that time, we usually have our lab technician fill in any gaps between the temporary teeth and your gums to reduce effects like you are having. Unfortunately, removing the temporary teeth to do this too early in your healing can result in slower healing or even damage to the dental implants. Let your dentist know your concerns so she or he can be prepared at your next visit! Good luck!

Your tooth broke due to the underlying cavity. There is also a cavity on the tooth next to it that requires repair. From only looking at the X-ray, it appears you would need fillings on both of those teeth.

The more important question to ask is...why did you get those cavities? These are caused by diet, oral hygiene, and bacteria, and it is important to find the cause and correct that before this becomes a problem everywhere in your mouth. In fact, you should be having a complete examination with a full mouth series of X-rays to evaluate all of your teeth. You may be able to get a handle on this problem soon to avoid further decaying teeth.

Good luck!

That appears to be an abscess related to a non-vital and infected tooth, also may be a cracked root. Perhaps that tooth has a history of being injured in a fall or with sports?

Please go see your dentist to evaluate, you may need root canal treatment to resolve the infection. If the root is fractured, however, you would unfortunately lose that tooth. Good luck!

From the photograph you show, it certainly does not look like a healthy implant. The possible reasons for this are 1) thin tissue type (very thin gums don’t “handle” dental implants as well as thicker gum tissues, 2) cement not completely removed after crown was placed, 3) infection, 4) biting trauma or bite too heavy on the crown. 

I would visit with the dentist who placed the implant for an evaluation. It may be possible to graft some thicker gum tissue in the area, which will help as long as there is enough bone around the implant. If the implant isn’t failing, your dentist will remove it and either place bone and gum grafting and wait, or possibly place a new implant right away with bone and gum grafting. The new implant will likely be placed deeper within the bone, and also a little more away from the cheek and towards the palate for thicker bone and gum on the cheek side of the implant.

Good luck!

As a practitioner who both places and restores dental implants, I would hesitate to restore dental implants I didn’t place and wasn’t involved in the planning of placement. This often leads to complications and compromise in the restoration of the implants. I would be especially concerned with a dentist I don’t know and don’t work with placing the implants, as I do not know of his or her expertise.