Arthur Kezian, DDS

 

The space between front teeth can be closed with bonding, this is the most economical and conservative approach.

 

However, over time the bonding can discolor and will need to be replaced. Need to keep in mind also that the teeth will become wider and a mock-up prior to placing the bonding permanently can give the patient a better idea how things will look. The gap can also be closed with veneers, but it is more costly,  requires two appointments and will be more drilling on the teeth. Can not stress the importance of mock-up for more accurate evaluation of the size and shape of the teeth for a more successful outcome.

 

 

 

 

Recurrent decay can occur under fillings as well as crowns if the margins of the restoration are not sealed well and proper oral hygiene and home care is not being practiced by the patient. If recurrent decay has already occurred under a crown, it is best to remove the crown, clean out the decay and make a new crown that seals the tooth perfectly to prevent further tooth decay. An accurate final impression and a crown that seals the margins after having examined under a microscope by the laboratory technician can assure a more successful outcome and longer lasting restoration.

 

 

 

 

Temporary crown that came off should be re-cemented by the dentist if it’s going to be more then two days.

 

If the patient is not sensitive and can wait for couple of days till they see their dentist its OK, but anything longer then that can cause the adjacent teeth to shift and the bite to alter. For patients who can’t tolerate the pain if the temporary falls out, placing the temporary back carefully with a drug store cement can buy them time till they see the dentist, however, they need to bite down to make sure the temporary crown is in proper position so as to not cause bite discomfort or fracture under pressure.

 

 

Dark gums are usually due to Porcelain fused to metal crowns, where the metal margin of the crown shows through the gums. An all porcelain crown will not cause the gums to darken, especially if the margin of the crown is tucked slightly under the gums. However, if the tooth under the crown is dark or stained due to a root canal treatment, then it needs to be bleached internally before the crown is fabricated and cemented. All porcelain crowns with proper shade selection and proper stain blockers should look very natural without a dark line under the gums.

 

 

 

 

Veneers are very technique sensitive and require a great deal of skill on the part of the dental professional and the lab technician. However, proper color selection, proper tooth contour, veneer thickness, porcelain quality and translucency can yield to very natural looking teeth. Making beautiful porcelain veneers and having them look natural is truly an art form that requires planning, diagnostic workup, before and after photos and careful understanding of the patient’s desires and expectations. Properly done veneers can look amazingly beautiful and natural and tremendously improve the esthetic appearance of teeth.