Would a good cosmetic dentist still have problems with eliminating black triangles? (photos)

Question

I asked a dentist who is an Accredited Fellow of AACD If he could get rid of my black triangles, and he said "yes" but now after having 12 new crowns put in, I still see black triangles. Is my dentist responsible for these black triangles and have the crowns redone at his expense? Are black triangles still a challenge even for an Accredited Fellow of AACD? Do the crowns look OK? I'm disappointed.

Brad Lockhart, DDS · Answer

The most predictable solution for black triangles in the gums between teeth is to change the shape of the teeth adjacent to the black triangles. When crowns are not involved, teeth must be reshaped and then orthodontically moved closer together. In your case, the solution is much more simple. Unfortunately, the design of your crowns was not adequate to resolve the black triangle issue. The simple solution (not so simple now that the crowns have been permanently cemented) is to reshape the crowns. Your question about who should have to pay to redo the crowns you are not satisfied with is a tricky question. Did your dentist ask your permission before permanently cementing your new crowns? Did you give that permission? Was the elimination of black triangles discussed before crown preparations were done, i.e. was the elimination of all black triangles one of your treatment goals?I will often insist that my patients who are having aesthetic procedures done wear their new crowns cemented with temporary cement so that after a little time if there is anything they don't like about their new crowns it can be easily fixed. No matter how carefully a case is planned, sometimes things don't work out to the doctor's and/or patient's satisfaction. In those circumstances, I am more concerned about making the patient happy (so they come back and refer their friends and family) than I am about spending more time or money to make them happy.By the way, the Pinhole Surgical Technique will not work to eliminate your black triangles.Good luck!

Thomas R. Gonzales, DDS · Answer

Having crowns made to cover the black triangle might not allow for the esthetic results you desire.  If you are happy with the crowns itself, you might want to consider periodontal surgery to correct the black triangle issue.  There is a procedure called the Pinhole Surgery that might be what you are looking for.  You can look for a Dentist familiar with this technique and get a consultation about the procedure.

Robert L. Knudson, DDS · Answer

Accreditation with AACD and being a Fellow is a really tough thing to get as a dentist.  You were with one of the best.  You have very long teeth and your gums appear to have backed up a bit.    In your case, if the dentist tried to close off the entire triangle with porcelain, you would have ended up with teeth looking like Chicklets.  Long and square.  Kind of denture looking.  Not pretty.  Looks like these have a good shape to them.  How long ago did you get them put on?  Usually takes several months for the gums to heal up.  You need to keep things really clean for a while and follow your dental hygienists advice about preventing periodontal disease or even if the gaps were closed, you will get them back if your gums recede.  Do they show with a big smile?  If not, what are you worried about?  If they do, talk to a periodontist (gum dentist) about a little augmentation of the gums.  In fact, they can even us the collagen fillers like they use on all the big lip folks like Marie Osmond to close them up.

Would a good cosmetic dentist still have problems with eliminating black triangles? (photos)

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Would a good cosmetic dentist still have problems with eliminating black triangles? (photos)

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Everything you need to know about Dental Crown

Our mission is to create a world where every investment in modern beauty is Worth It.