DENTAL CARE

Jeffrey Gross, DDS, FAGD

Q: A:I Want Veneers

With those words, I met a new patient yesterday. I asked how she found out about our office. “Your office is close to my new home,” she responded. She knew nothing about me except that I was close. An online search revealed that I perform veneer procedures for patients, and she decided to make an appointment.

I asked her why she wanted veneers on her teeth, and she told me that she had two concerns. She pointed to the little tooth next to her upper front tooth. That particular tooth was twisted or rotated partially to the side. When she smiled, there was a space visible between that rotated tooth and her large front tooth. Her second concern involved a “gummy smile.” She used this term and then smiled at me. Typically, when we smile, we like to see teeth. The degree of teeth that show will depend on the position of the tooth and the upper lip. The amount of tooth that we display may also change with age. As time goes on, front teeth can get shorter, and less tooth structure is visible. This shortening is especially true if we don’t have back teeth and we use our front teeth to grind our food

If the teeth extend way down below the lip, then we see the other extreme. Ideal cosmetics show about a third to two-thirds of the front teeth. If the teeth are very long or very low in the mouth, we start to see pink gum. Excessive visible gum creates the gummy smile that my patient referenced at the start of her appointment.

Let us take a moment to discuss the veneers’ appropriateness to solve her problems and address her concerns. Her rotated front tooth would benefit from a veneer procedure. Veneers are covers that are bonded to a tooth to correct a cosmetic problem. The problem could be one of color, shape, or position. Just like an older kitchen would benefit from cabinet veneers, so too can teeth benefit from a tooth veneer.

Veneers are a great way to make a short tooth longer. Since our patient wants more teeth and less gum visible on her smile, the longer tooth should accomplish this. She expressed this thought process to me. I pointed out to her that her concern was at the base of the tooth. Too much gum was visible. A veneer extends the tip of the tooth. Veneers could create a longer tooth, but the gum problem would not go away.

Typically, veneers do not involve trimming or cutting of the teeth. As such, a veneer is a relatively noninvasive procedure. However, there is still maintenance as the veneers are glued or bonded to the teeth. I suggested a procedure that was less than minimally invasive and required almost no maintenance. I recommended moving the teeth upwards with a clear aligner. When the teeth move upwards, the gum follows along, and voila, the gummy smile goes away. The aligner will also correct the rotated tooth, so we do not have to do any veneers for her.

One procedure to solve both problems is a win-win for everyone. At the same time, I am moving the front teeth. I offer whitening as a complimentary bonus. There are many ways to deal with cosmetic dental problems. A patient should review all of them thoroughly before embarking down a path. If you have a cosmetic issue, please call us at 440.951.7856. Nicole or Cat will guide you in a direction to help you rectify it.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

The Healthy Smile

34586 Lakeshore Boulevard (¼ mile west of Route 91 on Lakeshore Blvd) Eastlake, Ohio 44095 440-951-7856 Severance Medical Arts, Suite 603 5 Severance Center Cleveland Heights, Ohio 44118 216-371-2333 www.jeffreygrossdds.com