Cost of Dental Bonding for Black Triangles Because my Top Incisors Are Too Wide?

Question

I have three black triangles in between my top incisors because they are too wide. I can only afford dental bonding at this point. I have read that black triangles are a difficult aesthetic problem. How much can I expect to pay for this dental bonding?

Ronald Konig DDS · Answer

I am in agreement with Lorin Berlands answer below.  The space can easily be closed with contemporary bonding techniques and no anesthesia is necessary.  The fees will be based on the skill and knowledge of the dentist you choose.

	Ask the dentists you consult with to show you up close photos of similar cases.  If you like the result then it is a good start.

	 

	Best

	 

	Ronald W. Konig DDS, FAGD, LVIF

Helen P. Chiu, DMD · Answer

We routinely fix black triangles with composite bonding.  It is very conservative and does not require drilling out the teeth or anesthetics. The important aspect to dental bonding is that one must be a diligent flosser.  Flossing will eliminate bleeding between the teeth.  When the procedure is done, if there is any bleeding in the gum, automatically it will cause staining and debonding.
Porcelain laminates for the black triangle problem will require a lot of tooth reduction, therefore is not my recommended treatment.
If done properly, with proper polishing, the bonding can last a long time.

Wendy S. Spektor, DDS · Answer

Black Triangles can be frustrating. There are many reasons they occur as noted in all of the answers. Usually it is because the bottom of the tooth is wider than the top of the tooth, forming a triangle which appears because the gum has shrunk away. Solutions are as follows-1-Bonding the spaces closed by shaping the top of the tooth into a square instead of a triangle. Easy to numb and pretty easy to do-Usually 450.00 per side of tooth. 2-We are experimenting with filler products like Juviderm infiltrated into the shortened papillae to pump up the gum and close the space. Can be 550 total for all spaces. Long term information has not been determined. 3-If you have alot of space, sometimes you can do porcelain veneers/crowns to close the space as well. Beware-Spaces can open up with time no matter what you choose. Watch tooth picks and habits to keep the space heatlhy and intact.

Chad Colson, DMD · Answer

Black triangles will form when the contact point between the teeth is greater than 5 mm from the height of bone between these teeth.  These black triangles can also form in the presence of periodontal disease.  But judging from the photo, your tissues appear pink and healthy and you look young.  I'm making a big assumption that you do not have periodontal issues.

	The distance between the contact point between these two teeth and the bone height between these teeth can be determined with the help of a radiograph or the area could be anesthetized and the bone can be 'sounded' with a periodontal probe to get a very accurate measurement.  If this distance is greater than 5 mm (which I would assume it is), you will have the black triangle that is present in the photos.  This measurement is the first thing which needs to be assessed.

	If this distance is greater than 5 mm, carefully bonding composite resin between the teeth can decrease the distance between the contact point and bone height.  Again, if this distance can be reduced to 5 mm or less, the tissue should fill in the triangle.  Another option, which is less conservative and carries a higher fee, would be porcelain veneers.  But, again, the distance between the contact and the height of bone is the key regardless of the restorative options.  $200-$250 per tooth for the bonding or $1000-1250 per tooth for the porcelain veneers is a fair price in my area.

Mitchell A. Josephs, DDS · Answer

What type of triangle? Isosceles, scalene or equilateral? (a pedantic attempt of a knowledge of geometry.) My guess is the isosceles, with two equal sides; the base being at the gum line, the apex diving, down between the teeth. We call these gingival embrasures. They can arise due to age, periodontal disease, faulty restorations or after normal orthodontic tooth movement. The small triangular shaped gum between the teeth, called the papilla, becomes blunted, leaving a space. Treatment can consist of composite resin tooth bonding ($200 to $500 per tooth), all-porcelain crowns or veneers ($1400 per tooth). If it is localized to one area, specific periodontal surgery techniques can bulk up the papilla.What type of triangle? Isosceles, scalene or equilateral? (a pedantic attempt of a knowledge of geometry.) My guess is the isosceles, with two equal sides; the base being at the gum line, the apex diving, down between the teeth. We call these gingival embrasures. They can arise due to age, periodontal disease, faulty restorations or after normal orthodontic tooth movement. The small triangular shaped gum between the teeth, called the papilla, becomes blunted, leaving a space. Treatment can consist of composite resin tooth bonding, all-porcelain crowns or veneers. If it is localized to one area, specific periodontal surgery techniques can bulk up the papilla.

Dan Hagi, DDS · Answer

Black triangles between teeth form when the papilla(gum tissue between the teeth) recedes or does not form.  This can be because of tooth shape, trauma or even gum disease.  From the picture it appears that your teeth are only touching at the bottom and as a result there is a lot of gum that can't survive between the teeth.

	Bonding is a great way to conservatively correct the black space.  Bonding material is added to both sides of the triangle.  Expect to pay about $200-500 per tooth (depends on area and clinician experience).  The other conservative option is to slenderize (flatten the teeth) and reshape the contact point and move the teeth closer together.

Lance Timmerman, DMD, MAGD - Account Suspended · Answer

Since access is very limited in the spaces you describe, the service is not easy. However, an experienced Bioclear dentist can do a very nice job. Bioclear will cost less than porcelain veneers, but will still be an investment. A skilled dentist will need to charge enough to cover the time involved and is based on the care, skill and judgement of the dentist. There is a very good chance that if the triangles are large, the result will be very bulky and square looking teeth, which may look worse than the black triangles. Porcelain veneers should be considered as well, but the investment will be considerably more.

Be sure to rule out any active periodontal conditions.

Be sure to rule out any active periodontal conditions.

Lorin F. Berland, DDS (retired) · Answer

Improving the appearance of black triangles in your incisors is difficult. However, with modern dental materials and techniques, resin bonding can be a great and cost-effective way to improve your looks. Depending on where you are located, what qualifications and experience your dentist has, and the number of teeth involved, the cost of this type of procedure can vary considerably in range from a few hundred to a few thousand dollars. Have you considered whitening your teeth for a brighter smile? If so, it would be a good idea to do this prior to the bonding, as the bonding typically will not whiten should you decide to whiten after the bonding. Porcelain veneers offer another viable, but more costly, cosmetic option for the black triangles. Either treatment choice will require excellent home care and regular cleaning appointments with your cosmetic dentist to keep your smile looking great.

Soheyla Marzvaan, DDS (retired) · Answer

I am glad the questioner posted a photo.  We can be very specific in this case.  Simply put , usually open/empty spaces  occurs when one has gum issues. Never the less, if dental white fillings/bonding is all you can afford at this time ( porcelain veneers are best and longest lasting option to cover the space), then a good cosmetic dentist can help close the gap, bill your insurance if you have any and your cost should be  less that 100.00 dollars including your deductible ( usually $50.00 is deductible/year). If you do not have insurance then, you're looking at 3-4 hundred dollars. ( this particular estimate is about the questioner who posted the particular photo)  

	Now here's what you have to know : Bonding discolors, will chip off, and you really need to address the underlying issue of gum problems. if the cause ( gum issues) are not addressed the empty black space will just get bigger. 

	It is the gums and bones that keep your teeth intact , and stable. Do not neglect them, go to your regular check ups. Hope it helped, good luck.

Olga Kharevich, DMD, PhD (in memoriam) · Answer

Black triangles usually appear between the teeth when papilla is gone and there can be multiple reasons for this unaesthetic space. It usually is caused by loss of underlying bone. Bonding material can camouflage the space between the teeth temporary, and the price can be similar to the price of an anterior composite. But your periodontal condition should be evaluated by a specialist to prevent future problems with bone and soft tissue loss and increasing space of black triangles.

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