Maryam Talaie, DDS

To move teeth you need invisalign or something similar. Your overall bite can be affected by the slightest shift. Some dentist can fabricate a special aligner that can shift only the front tooth slightly without going through an entire invisalign case but not every dentist feels comfortable doing this.  Another option is to do enamelplasty which re-shapes the tooth a bit and gives the illusion the tooth is aligned more symetrically. This involves removing  millimeter(s) of tooth structure but is safe when done correctly. You may need to reshape both front teeth, possibly add bonding to achieve optimal look. This should cost about $500 or less.

It is a good thing that you had the scaling done. Your gums are the foundation on your mouth and periodontal disease leads to bone/tooth loss. Keep it in check and go back for cleanings every 3-4 months. Also ask your dentist about bonding the lower front teeth to close the space a bit and smooth out the sharpness. Bonding is applying tooth colored filling material to the teeth. It is used in fillings and fixing chipped teeth. If there is significant gum recession in the area, a gum graft is needed to replace the gum tissue. It is painful and doesnt alway work. Go back to your dentist and discuss the situation with them. 

A combination of Orthodontics and veneers will help. Also subtle lip filler can change the way your lip looks when you smile. You can achieve what you are looking for but it will take time and money. Consult an orthodontist as well as a cosmetic dentist. 

Your dentist recommended Zoom because the new veneer need a shade/color. If you are happy with your current shade on the natural teeth, then tell him or her that. If you feel you want to lighten your natural teeth and match those with new veneers, then do the whitening/zoom. The veneers will not change color but your natural teeth will only get darker...bleach trays for 'touch-ups' are also useful when you have veneers, next to natural teeth. A1 is light but B1 is the lightest shade...probably too white. Have an in-depth conversation with the dentist about this. I would recommend doing the bleaching before the veneers but if you do not see yourself maintaining it with trays at home and you are happy with your current shade, then skip it.

Your situation is not permanent and your gums will heal. Try warm salt water rinses and vitamin E to help it heal faster. The dental assistant was probably inexperienced in doing the whitening for this type of situation to happen. I would go back and have the dentist take a look and explain to him or her how much your soft tissue was not properly blocked/protected. There is a very basic step when performing a in-office teeth bleaching and that is to block / protect the gums from the bleach. Your mouth is also to remain open with a bite block, not allowing for the bleach to touch ANY soft tissue in the mouth. Some dentists will apply a material to protect the gums or a rubber dam. It seems like a very sloppy in-office bleaching job (by someone very inexperienced) to me.

Margins refer to the border between your natural tooth and the veneer. This border should be smooth and and complety sealed. I do not have all the details on your case and just relying on this post of your perspective... margins are typcially near the gum line but usually below the gum line. Gum tissue can recede over time and expose the margins...going deeper under the gum can prevent this. If your teeth were short but your new veneers are longer, a 'raised' margin could be indicated which helps with retention. Your gumline isnt going to be changed unless you specifically have a 'gummy' smile and the dentist cuts the gum tissue.

IPR is sometimes necessary to achieve optimal results and give your teeth room to move into place. IPR only reduces the enamel by millimeters...very small amount of enamel is removed, not enough to be concerned about. There is no stripping of teeth done when it comes to this. 

The black triangle can be reduced or minimized with invisalign. Each invisalign case has steps to reach optimal results and IPR might be indicated. You could also try bonding with resin composite (tooth colored filling material) and enamelplasty (re-contouring) on the teeth. The dentist can re-contour the teeth and add filling material to close the dark triangle spot. Another option is cosmetic veneers or crowns to change the entire look of the teeth and remove the black triangle. That option is more invasive and costly.

The picture is very blurry and hard to tell what it is. It could be a stain. The cavity most likely would have been detected with xrays. Typically dentists treat all cavities BEFORE starting invisalign. There are exceptions to this but chances are the dark spot is a stain. Monitor the spot and then bring it up to them when you go in next. If it is a new cavity, it is still in the enamal and not in danger of causing issue that can't be taken care of in a month or so.

Just because you had braces in the past doesn't mean your teeth/bite are in an ideal position. Teeth will shift unless you're wearing a retainer everynight. 

If your bonding keeps chipping, you should wear a night guard and or retainers that protect your teeth but keep them in place.  The surface area of the bonidng might be too much or too little....I can tell for sure without a photo. You may also need a crown which is more invasive and costly but will not chip. If you crown a front tooth, crown BOTH front teeth for the best result. 

The proper answer to your question does require more information about your situation but heres what I can tell you.

An implant failing a few days after being placed is rare but could be due to infection left behind after taking out the original tooth and or not enough bone graft being placed…or not allowing enough time to let the bone graft integrate before placing the implant/screw.  

If the space for the missing tooth was wide enough to house a dental implant/tooth, then the space may not close completely, leaving open contact/food trap.... but it is not impossible.

Successful treatment with braces involves your entire mouth/bite.  Changing your bite by shifting teeth around (to close such a big space) can affect your neuroskeletal alignment.  I would seek a consultation with Orthodontist (specialist) first before making this decision. Even if your general dentist recommended braces to close the gap, I would still seek the opinion of a specialist in this area of dentistry to make sure braces will be an ideal long term treatment option.

Another route to go is to bone graft the implant site again and allow more time for the bone to regenerate in the space before placing the screw or doing a bridge. The bridge will close the space with a crown that is connected to the adjacent teeth/crowns. There are downsides to a bridge but it will probably be the least invasive and less costly way to achieve the goal.  I would also bone graft the site regardless of bridge or implant. 

Bottomline ....see a orthodontist and periodontist....get second opinions.