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Medical Forum / General / Dentistry / August 2005

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New porcelain, one tooth misshaped

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Rich - 03 Aug 2005 22:37 GMT
Finally got my new veneers/crowns. One or two bottom teeth are a little too
round:

http://tinyurl.com/74x2l

It is difficult to see in this photo but there is a dark area / gap. It
looks like I have a flake of pepper between the two teeth. The picture
doesn't show it very well but its there. Immediately noticeable - to me
anyway.

Is there a way to fix this without making it look more noticeable, like with
re-enamel (is that permanent?) or do I need 2 new crowns?

Rich
Steven Fawks - 03 Aug 2005 22:53 GMT
Why I don't advertise as a cosmetic dentist.

Fawks

> Finally got my new veneers/crowns. One or two bottom teeth are a little too
> round:
[quoted text clipped - 10 lines]
>
> Rich
Rich - 03 Aug 2005 23:16 GMT
> Why I don't advertise as a cosmetic dentist.

Steve, what do you mean by that, exactly?

Richard
(who has been visiting this group for advice for the past 4 years)

> Fawks
>
[quoted text clipped - 12 lines]
> >
> > Rich
Rich - 03 Aug 2005 23:29 GMT
OK. Fawks. Either my teeth look like total sh.t or you think I'm being too
picky. The picture doesn't show it well, the flash blends it in. My question
was can a porcelain veneer be slightly reshaped / added to? If I have to pay
for another one because I am too picky, so be it. I don't plan on taking
advantage of the poor cosmetic dentist who made $20k. That crown was
originally done by my regular dentist who had to do RCT on that tooth. I was
never happy with the crown. The damn thing always looked like a chicklette
tooth. When they took impressions for the new crown, the feature was carried
over to the new crown. It *really* looks worse from a different angle. It
looks horrible.

> > Why I don't advertise as a cosmetic dentist.
>
[quoted text clipped - 21 lines]
> > >
> > > Rich
Mark & Steven Bornfeld - 04 Aug 2005 00:01 GMT
> OK. Fawks. Either my teeth look like total sh.t or you think I'm being too
> picky. The picture doesn't show it well, the flash blends it in. My question
[quoted text clipped - 6 lines]
> over to the new crown. It *really* looks worse from a different angle. It
> looks horrible.

    Let me try to give you an answer.  It is difficult to see just what is
going on because of the poor focus of the photo.  There seems to be a
small space (black triangle) which is not filled totally by the gingival
papilla.  This may well be trivial, as most of my patients will show a
space of this size and location little if at all.  But in a patient with
a space such as this between upper teeth and with a naturally high "lip
line" it could well be unacceptable.
    Sometimes these papillae can be re-shaped to fill the space by
judicious countouring of the surfaces of the two adjacent teeth.  This
usually requires ADDITIONAL, rather than less contour.
    In your case (again, I'm a bit unsure based on the photo) the crowns
already look somewhat bulky to me.  So increasing the contour to
compress of fill the space may give you bulky, un-natural looking
crowns.  Some patients may find this preferable to the space.  Most
dentists however, familiar with some of the problems secondary to
over-contoured crowns, would rather leave you with a bit of a space.
    Your concerns should be discussed with your dentist.  It may be that a
small plastic procedure by a periodontist would give you a better result
without needing to resort to overcontoured crowns.

Steve

>>>Why I don't advertise as a cosmetic dentist.
>>
[quoted text clipped - 35 lines]
>>>>
>>>>Rich

Signature

Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

Rich - 04 Aug 2005 00:29 GMT
> > OK. Fawks. Either my teeth look like total sh.t or you think I'm being too
> > picky. The picture doesn't show it well, the flash blends it in. My question
[quoted text clipped - 28 lines]
>
> Steve

Thanks for the info. I didn't want to say anything to my dentist yet.. . I'm
going to wait a few days. The more I look at it, its kind of like my gumline
is all bloody and whatnot, maybe it will look better in a few days, maybe
not. Thanks again.

Rich

> >>>Why I don't advertise as a cosmetic dentist.
> >>
[quoted text clipped - 35 lines]
> >>>>
> >>>>Rich
Steven Fawks - 04 Aug 2005 13:35 GMT
Then again.....for $20K per patient, I might be willing
to listen to a little whining and complaining.

Sometimes you get what you pay for, sometimes you get less.

;-)
Fawks

 I don't plan on taking
> advantage of the poor cosmetic dentist who made $20k.
Steven Fawks - 04 Aug 2005 13:31 GMT
While the picture was a little out of focus and there
was no "before" picture, what I could see didn't look
too bad.

This is all hand craftmanship with an eye for a
pleasing esthetic result.  The dentist and lab
can work their butts off and have the end result
nit-picked to death by the patient studying each
tooth for hours with their lips pulled back looking
in a mirror from 6".

The only person studying the teeth that closely should
be the dentist.  The patient should look at their
face and see how their smile looks from 2-3 feet.

JMO,
Fawks

>>Why I don't advertise as a cosmetic dentist.
>
[quoted text clipped - 4 lines]
>
>>Fawks
Rich - 04 Aug 2005 21:49 GMT
In my defense... I was approximately 3 (maybe 4) feet away from the mirror
:)
You can see it from perhaps 6 or 7 feet away.

Looks different today but still a little weird.

Richard

> While the picture was a little out of focus and there
> was no "before" picture, what I could see didn't look
[quoted text clipped - 22 lines]
> >
> >>Fawks
CWatters - 10 Aug 2005 22:01 GMT
> In my defense... I was approximately 3 (maybe 4) feet away from the mirror
> :)
> You can see it from perhaps 6 or 7 feet away.
> Looks different today but still a little weird.

I had a quick look at that photo and all I can says is...

They look too perfect :-) Haven't you got anything better to spend your
money on?
Richard - 11 Aug 2005 02:29 GMT
> > In my defense... I was approximately 3 (maybe 4) feet away from the mirror
> > :)
[quoted text clipped - 5 lines]
> They look too perfect :-) Haven't you got anything better to spend your
> money on?

This is what I'm worried about. They are too perfect now and its making me
self conscious. I need to hire a new dentist to screw them up. Honestly, I
hope they don't look like dentures. The dentist kept asking how I wanted
them shaped. I said "like normal teeth". Oh well, I'm going to have dentures
before too long the way I'm going. Dentists make too much money - from me at
least. I'm going to have to take up cosmetic dentistry to recoup some of my
money. Maybe not. This game's payoff matrix really sucks.
StovePipe - 11 Aug 2005 06:07 GMT
> This is what I'm worried about. They are too perfect now and its making me
> self conscious.

How about giving yourself and your new smile three months to grow into
each other and then re-evaluate the situation?

SP
Signature

Finally: take out the TRASHH

 
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