First, let me say you do have beautiful natural teeth with a nice shape and no apparent irregularities. However, it does appear that your right front tooth has moved down and yes, most likely due to not wearing the orthodontic retainer after the braces were removed. It is also possible that the left front tooth could have moved up. It depends on in which direction your orthodontist was moving your front teeth in order to align them when you were in braces. Nevertheless, from your photo, the discrepancy between your right and left front tooth appears quite significant to make even simply by "filing down" the enamel layer of the longer tooth without exposing the 2nd layer of the tooth called the dentin. If a veneer is going to be placed over your right tooth, then yes, your dentist will have to "file down" to make it even and then file it down slightly more to make room for the porcelain veneer, in addition to filing down the front surface of your right tooth. However, if your dentist is intending the veneer to be placed over your left tooth, then mostly the front surface of your left tooth will need to be "filed down". In either case, treatment with veneers can "mask" the tooth length discrepancy but at the expense of filing down your tooth. This is a very significant long term consideration, since most dental materials will not last a lifetime, and therefore, retreatment in the future should be anticipated. Keep in mind that it is very challenging to have a porcelain veneer look like tooth enamel. An exceptional ceramist will be needed to make any porcelain veneer blend with a natural tooth.A more conservative approach, especially since your natural tooth shape & size is aesthetic, would be to visit your orthodontist again and ask him your options for moving that tooth back up into the proper position. This can often be done with clear braces such as Invisalign or the conventional metal braces, which tend to move teeth faster. With this orthodontic approach, you will be correcting the etiology and not just the treating the symptom of your tooth/teeth moving. Whichever treatment you choose (if any), teeth will move as you age and so, you will still need a retainer from your orthodontist to hold their position and keep your beautiful smile. So when you see your orthodontist for a retainer, ask about your other options.
The appearance of a gummy smile can be the result of the upper lip movement when smiling, talking, laughing, etc... OR various forms of altered eruption patterns (e.g.passive, active, compensatory, delayed). If the gummy smile is a result of lip mobility, treatments such as Botox have been effective in reducing the amount of vertical lip movement. If it is a result of altered eruption, a gum specialist (aka periodontist) will be able to evaluate and recommend appropriate treatment before the treatment with veneers begins. Typically, the excessive gum tissue is removed to expose more of the tooth by a periodontist or trained dentist. There are a variety of method to this. So before you begin, it's best to ask your dentist to confirm the etiology of your gummy smile with a periodontist in ordered to plan how to achieve the best aesthetic result with your new smile!
