Coral Posert, DDS

Hello and thank you for your question. I think you would like the permanent crowns to correct the overjet a little bit more (not completely) and appear "back" a little further. You would like to have the provisional crowns altered to reflect this.

This may be possible, however, usually a certain amount is removed from each tooth in anticipation of the thickness and appearance of the future crowns. If we are restoring a tooth in its current position, we remove 1.5 - 2 mm of the outer layer of the tooth. If we are restoring (placing crowns) on a tooth to make it appear further back from its current position, we need to remove more than  2 mm from the outer layer. At this point, causing the teeth to appear even further back will probably require removing even more of the teeth. This may mean a root canal will be necessary to create the desired appearance since removal of addtional amounts of the teeth might cause nerve damage.

In my cosmetic practice, I have done root canals on teeth when the new shape of the tooth required crowns placed too close to the nerve. This is actually fairly common.

Unfortunately, it is impossible to tell how close to the nerve your dentist has already placed these provisionals without an x-ray.

All my best to you,

Coral E Posert, DDS

Hello and thank you for your question. I think the previous answer from the oral surgeon, Dr. Jamali, was a good option. I have a few additional thoughts.

Here is what I see from the photos you posted (I can't see how much of your lower teeth show when you are biting completely together):

1) "Gummy smile" showing the top gums above your top front teeth.
2) Too much vertical overbite (top front teeth covering lower front teeth)
3) Overall a nice smile, but your concerns are valid

I would first consider "intruding" your top front teeth using Invisalign. This would raise them up into the gums allowing more display of the lower teeth and less "gummy" smile. You might also consider gingival recontouring with a laser. This raises the level of the top jaw gums.

I enjoy cosmetic dentistry and often do this same procedure with success in my practice. Having said that, I would require more information - x-rays, models of all your teeth, photos, etc. to make a complete and accurate treatment plan.

All my best to you,

Coral E Posert, DDS

Congratulations on your wedding! Yes, tooth whitening is an excellent idea.  There are two types of whitening:  take home and in-office whitening. The take home process involves bleaching trays which you wear for a few hours daily for about 2 weeks. The in office process is a one time appointment in the dental office which takes about 90 minutes. We do a lot of in office whitening in my office using the Phillips Zoom system . A bleaching light with lower temperature LED bulbs accelerates the bleaching process without causing much tooth sensitivity. Patients are very pleased with the results. Most whitening products are peroxide based so you should make sure you do not have allergies to peroxide.  I hope this helps.

Hello,
Thank you for your excellent question. There are 3 ways to fill in your midline gap:

1) Move teeth orthodontically. This can be done with Invisalign - the clear plastic trays which move teeth without wearing traditional braces. Depending how much additional tooth movement is needed the cost would range from $2000-$5000 for this.

2) Add tooth colored bonding material to the side of both teeth to fill the gap. This would be both teeth wider. This is the least expensive option, but the least desirable because it does not last as long. You may not like the result of widening only the 2 front teeth.  The cost of this is $400 - 800

3) Porcelain veneers. To get a good result, it would be necessary to put veneers on your 4 front teeth so they would all be similiar in size. This is a permanent solution and costs $4000 - $6000 for all 4 teeth.

Good luck and I hope this helps.

This is an excellent question. In general, whitening products are all peroxide based and differ mostly in the concentration or dosage of the whitening agent. Crest white strips have a lower dosage of the active ingredient since they are not dispensed by a licensed professional.

The process will not damage your teeth. Translucent enamel is usually thinner, but whitens at the same rate as the rest of your teeth. I suggest you try it over the course of one to two weeks while monitoring the changes to make sure the whitening is homogeneous.

We use the in-office Phillips Zoom whitening process in our office with excellent results. The entire treatment takes about 90 minutes. You might also consider this option for whitening.