James had expressed an interest in cosmetic dentistry at his routine checkup with Dr Murphy. His porcelain veneers fitted via the NHS 15 years ago, were provided to mask a malformation in his enamel, which made his teeth chip and wear. It also resulted in them showing much more of the underlying dentine which is yellow in colour.
Other issues were:
1. Comparative size and shape of two front teeth. One was “short and stumpy.”
2. Dark grey shadowing around the neck of old porcelain veneers. This was due to contamination of old cement with bacteria.
3. “I don’t really see the teeth behind my veneers, it’s just the front six.” This is what we call a ‘profile’ issue, where more blending is required, especially in a wider smile.
After a few discussions James opted to go ahead and have his porcelain veneers replaced.
The plan view shows the lack of profile in regards to the first premolars (just behind the ‘eye’ teeth, which were obscuring them slightly). They also show the problems with underlying dentine.
The final image shows how front teeth were balanced in shape and size, following slight re-contouring of the gums.
The patient paid 8 x £350 for replacement porcelain veneers and the feedback from James was great:
“I’m only sorry I didn’t do this 10 years ago. I just accepted that I’d never have a nice smile. Dr Murphy was very deliberate in not promising Hollywood- he could see the issues of bottom tooth colour and underlying condition. Subtle changes and adjustments were what he advised to get a natural smile. Anyone thinking about cosmetic dentistry should talk to the dentists at Appletree first. They don’t just go for bright white teeth which was actually a worry for me. Also, they’re now looking after my regular dental checkups. “