Several Accidents as a Child and Have Very Small Teeth. Thinking about Getting 4 Veneers; is Gum Lift Necessary? (photo)

No question: it's necessary. I've had several accidents as a child & small teeth. Now, I want cosmetic dentistry. I live in the Baltimore and was thinking about getting four veneers for the top (my dentist says four or six is how it's normally done; front two and the two lateral) and possibly a bridge for the front bottom? Do you think a gum lift is also necessary (can that be done POST veneers? Just in case the veneers make them w/o the lift) & what's a rough estimate for everything in my area?

Doctor Answers 3

Cosmetic "Gum Lift" should be done prior to placing Porcelain Veneers

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When you smile broadly, it appears that you show an excess of gum tissue (also known a high lip line). If this bother's you, the "gum lift" procedure which is a cosmetic surgical gum procedure should be done prior to fabrication and placement of the porcelain veneers. The divergent diastema (space) between your central incisors (front teeth) and boxy short shape of your lateral incisors (side of the front teeth) make these teeth excellent candidates for porcelain veneers. While you upper left canine (eye tooth) looks a little yellow, you should be fine with the 4 porcelain veneers on the incisors. The lower central incisors are another story and appear to be primary (baby) teeth which should be addressed first.

Hard to tell from pics if gum lift is needed prior to veneers

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This case needs a full work-up with photos and study models to determine if a gum lift is needed and to derermine how many veneers you would need. Im my experiece 6 veneers do not look good. It gives a "toothy" look on the front and the sides/back look dark.

A diagnostic wax-up/ mock-up is critical to plan this, and would help to determine the number. The tooth size, ratio, and relation of the edges to the lower lip at rest and full smile are critical to determine if a gum lift is needed and if it would make the case look better. 

In the event that a gum lift is recommended, it must be done at least 2 months prior to veneer preparation.

Good luck

Dr. T

Mauricio C. Tijerino, DMD
Miami Beach Dentist

4 Veneers and a Gum-Lift

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I definitely think you would benefit from a gumlift BEFORE you do the veneers, not after. Especially if you are only doing 4 Veneers. Ideally you should do 8 or 10 in order to get your entire smile in the correct proportion. If you are only doing 4, you definitely want to make them taller on the "gum end", otherwise they will appear to be too wide and square looking. I can't help you on the price, since I'm from the NY area. As far as the lowers, they appear to be "baby-teeth". It all depends on what the X-ray shows going on below.

Jay Neuhaus, DDS
New York Dentist

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