Here are Suzanne’s teeth before and after the bonding.
The space is significantly closed by simply making the teeth their ideal width. Because of this the orthodontist will have an easier time moving the teeth….less guesswork and less movement. Suzanne is happy about that, too!
The central incisors can then be moved together predictably by the orthodontist because the bonding that has been placed on these teeth has made their width ideal. Once they touch, he’s done! Also, he can then make additional room for the laterals, allowing for a more conservative preparation of these teeth, too. As we talked about before (See text here), one of the BIG advantages of involving the orthodontist is the ultimate outcome. The teeth are ideally positioned, the preparations can be more conservative, and the case will look better and be more stable.
The gum specialist asked about the size/proportion of Suzanne’s teeth. After examining her I thought the best solution was a combination of bonding and orthodontics. Since her front teeth were too small width-wise (from left to right) they appeared skinny and thin. These teeth will ultimately need veneers to correct this discrepancy. But until then, bonding is the solution. We decided to make her central incisors (her middle two front teeth) the CORRECT size with bonding. The orthodontist could then pull them together until the bonding touches. This way we know these teeth will be in the correct position to allow for very conservative veneer preparations.
Now came the fun stuff. We saw Robert one last time to fine-tune his bite and check for any other minor adjustments. Afterwards Robert was kind enough to let me take a few portrait photos. I was really proud of the final results and so was he!
Here’s a ‘before’ portrait:
and ‘after’… what a change!
Looking at Robert’s final result, I have to agree with him. Even smiling as big as he can, no one can see the gum-line area of his crowns. In this case the tissue did not need to be changed to have an excellent final result. If his lip rose above the tissue/crown meeting area at the gum-line, these crowns would not have been as pleasing to look at. Here he is at ‘maximum’ smile:
Since we agreed on ‘natural’ and not ‘Hollywood’ for the shade of his teeth, Robert decided to proceed. We placed 6 beautiful all-ceramic crowns on his upper front teeth. The gaps were closed, the color was brighter (but not TOO bright!), and the teeth were the right size because the orthodontics were a success. Also, the edges and corners were restored to their ideal position allowing Robert’s new teeth to function better. He was ecstatic! Take a look: 
We’ve talked a bit about getting the teeth in the right position before restoring, or fixing them. Now let’s say they’ve been moved correctly, or are already where they need to be. What’s the next step?
Here’s another example of what we discussed. Robert came to me at the end of his orthodontic treatment. His orthodontist had moved his teeth to the right general area for restoring. Robert and I went over the options and decided to fix his top teeth first, followed by the lower front teeth later. He wasn’t happy with the color and shape that he currently had. I think you’ll agree: 
What makes this process even easier is the development of a new way to move teeth. In the past the orthodontist would have to place brackets and wires to change the alignment of teeth. This is the ‘common’ version of orthodontics. But now he has a new, high tech tool that often can be used. It’s called Invisalign. I won’t go into the details, but I will tell you that it’s by far easier and FASTER than conventional braces. And without all the added ‘hardware’ that comes with traditional braces, there’s less trauma and complications for the patient. I can’t tell you how may times I’ve had people tell me what a breeze their Invisalign treatment has been!
So if you need to have teeth realigned in order to make your dental work ideal, you’ve got a great new way to do it! Ask us about Invisalign and we can get you some more information.
So to continue, the instant ortho craze has been fueled by people’s desire for an immediate change. And it can be impressive. Who wouldn’t want to walk in with a mouth full of yellowed, worn, misaligned teeth and leave with a gleaming, straight, gorgeous smile? Few things can change a person’s appearance as dramatically and easily.
But let’s look at it differently. If the same teeth can be moved to a more ideal position first, a few things occur. First, the final ‘look’ many times will be enhanced significantly because the spacing between teeth will be ideal, allowing for the correct size of the new teeth. Second, less teeth may have to be worked on to get this great new look, saving the patient money. Also, less work may have to be done on each individual tooth. What I mean by this is that a more conservative preparation (or less ‘grinding’ of each tooth) will occur if it is in the right spot.
Often the decision comes down to an ‘immediate’ fix versus one that takes a little longer, but frequently is more conservative. Which way would you go?
Had a great discussion with a local specialist about the referral pattern of some orthodontists. It seems their common treatment plan is to automatically extract 4 bicuspids, place brackets, and then pull everything ‘back’. In the end, yes, the teeth are straight. But at what expense? Take a look at the profiles of some of these cases after treatment. Instead of being full, pleasing, naturally contoured profiles it looks like their whole lower face is ‘pulled back’.
This is disturbing enough, but often these same othodontists are too quick to refer to the oral surgeon for jaw surgery to move the upper, lower, or often both jaws into alignment. Does this occur too often? I’m certainly not an orthodontist but in my opinion….yes. We’ll talk more about it later. Watch for more before and after smiles here: before and after
