What is Best Fix for Black Triangles Between Teeth? (photo)

I am 39 years old and a former smoker of 25 years. I quit smoking 8 months ago and would like to fix the black triangles between my front teeth that have formed from receding gums. I cannot afford veneers, but my dentist tells me this may be my only option. Would bonding or gum grafting be viable options? Or are there other procedures that could be done? I am addressing the gum issues with frequent dental cleanings and keeping up with flossing. I also grind my teeth at night.

Doctor Answers 4

Bioclear Method a great option

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The Bioclear Method can fill in the spaces without placing veneers.  While veneers work very well, a conservative solution is Bioclear.

From what I could tell...your best option would be bonding

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Doing a small amount of bonding on both teeth (for symmetry) would likely be the best way to minimize the black triangle appearance.   In this situation, it might lend to the tooth looking a little more 'square'.  Another option to look at is getting Juvaderm to augment and bulk that tissue up.  

Fixing Black Triangles

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A very conservative and cost saving approach would be to have properly contoured and polished bonding added to the teeth in the "black triangle" areas.

Jay Neuhaus, DDS
New York Dentist

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Four ways to fix the "black triangles" that appear between your teeth.

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The unsightly "black triangles" that form between your teeth are usually due to gingival (gum) recession or resorption of the gingival papilla or gum tissue that fills in that space between your teeth. Here are some ways to fix that:

1. Make sure you do not have ongoing (active) gum disease. Periodontal (gum) disease causes this problem by triggering gum recession and, the more serious to treat, bone resorption. The black triangles will only get larger if your periodontal condition is not stable.

2. Have your dentist check your labial frenum attachment. This ligament under your upper lip tends to attach lower against the gum between your upper two front teeth worsening the "black triangle" problem. It can be repositioned higher (by a minor gum surgery) to alleviate this problem and insure a better treatment result to fix it.

3. Gum/Bone grafting is an option, especially if there is a loss of bone between the teeth that has caused the lack of support and corresponding gum recession. A gum graft alone may not be successful if there is not a corresponding augmentation of the supporting bone.

4. If your periodontal condition is stable, some minor composite resin bonding can be done to build out the adjacent teeth to close most if not all of the space. However, this can be problematic if your gum tissue remains inflamed and if the bonding does not allow for a "cleansible embrasure" which is an important part of your periodontal (gum) maintenance. But beware: composite bonding can also alter the shape of your front teeth, making them look "boxier" and less feminine looking. 

The best news is that you stopped smoking which is a major contributor to periodontal disease and the corresponding gum recession which most probably caused the "black triangles" to appear. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.