this sweet lady came to me with the desire to close the space between her front teeth.  she had this condition for years, and had decided it was time to make a change.  i have to be careful with situations like this because the change can be drastic.  so anytime we change the smile, we have a long discussion about the patients expectations.  as with other cases, i decided to use composite resin because it is fast, relatively inexpensive and most importantly, reversible.

on the surface, closing a space may seem relatively simple.  in this case, the space was wide enough, that closing it could have a negative impact on the size of the tooth's appearance.  in other words, they may look too large.  this could be masked by contouring certain elements of the tooth's anatomy, which i decided to do here.  it all starts with measuring the space, and splitting the difference.

i made the measurement, added composite to one side to close half the space, and repeated on the other side.  i also added composite to the patient's right canine and made some minor aesthetic adjustments through recontouring.  as you can see, the result appears very natural and the patient was very happy with the outcome.

this patient came to me in tears about her smile.  she had been unable to smile for years because she was self-conscious.  her main concerns were that her teeth were too yellow and worn down.  she was also concerned about the cost of treating these issues.  after a thorough exam, we discussed some different options including porcelain veneers, crowns, and resin veneers.  based on our discussions, we decided that resin veneers would be the best option.  this treatment, also known as bonding, is an economical option that can be performed in less than an hour.  it is important to note, that with this patient, due to the severe wear, this may not be a long-term solution to her problem.  she was however, extremely pleased with the outcome.  

Our 30 minute mission, to close a gap that has made this patient self-conscious for years.  

This patient was a very sweet lady, her main concern was the space between her two front teeth. I could see some other opportunities for improving the appearance here as well. First, the space is a "V" shape because her teeth are also angled away from one another. The other issue is that the edges are very jagged. Correcting these problems with composite resin bonding was the immediate choice for me.

This is a relatively inexpensive, quick and painless procedure that can have a huge impact. What struck me about this patient is that she had trouble smiling in the pre-operative picture because she never does it! She habituated a non-smiling posture after years of being self-conscious about the "space" issue. 

After 20 minutes you can see a drastic improvement in her smile. The three problems: the space, the incorrect position and the jagged incisal edges are corrected. This patient was ecstatic by the change and had a great big smile on her face when she left the office."

some patients hesitate to get treatments for many years because they believe it will be a major undertaking.  this is not always the case.  in today's smile file, we meet patient 'ashley.'  in high school, she suffered a severe injury to her front teeth, which left several cosmetic issues.  having these corrected was something she always wanted to do, and i was the first dentist to recommend these conservative procedures.

cosmetic bonding and esthetic recontouring, while very conservative and relatively inexpensive, can have a tremendous impact on a patient's smile.  take a look at what can be done in less than thirty minutes in our office.  

patient concerns:
teeth were stained from age and two prior root canals
teeth were uneven across the front
canine was rotated on one side, leaving a space in her bite

my approach:
after bleaching, i lengthened both lateral incisors with composite bonding.  i felt that the central incisors were too long, so i removed a small amount of enamel at the edge.  the spaces that were of concern at the canine teeth were bonded to reduce the space.  the patient was extremely happy with her results, as evidenced in her glowing 'after' pictures.