Gummy smile - Unnatural tooth proportions - Square teeth
This north shore Chicago client recently had her entire dentition restored with unattractive and ill-fitting crowns. The treatment was aggressive and very poorly planned not addressing many occlusal, periodontal, and cosmetic issues. The poor fit of the dentistry made it more difficult to clean which made the periodontal disease worse. The patient was not satisfied with the cosmetic results but did not have an understanding of what was wrong. She had told the previous dentist that she did not like her gummy smile and the large boney defect above her upper right teeth. Her recent dentistry did not help with either of her chief complaints.
Cosmetic prosthodontics - Fixing a gummy smile with a "gum-lift" or perio-plastic surgery
This patient really wanted a healthy nice smile and was highly motivated to achieve her goals with a "smile makeover" or "full mouth reconstruction". The gummy smile was corrected by perio-plastic surgery and the bone defect was improved by additional crown lengthening and recontouring. The prior treatment that was only 3 years old had already caused the loss of 4 teeth that needed to be replaced with implants. The short and squatty crowns were replaced with new Empress crowns with the appropriate "length to width ratios".
“Full mouth reconstruction” and “gum lift” to create normal tooth proportions – Length to width ratios
Tooth proportions do vary between young and old and grinders and non-grinders. Studies show that the normal horizontal width of a upper central incisor tooth averages 80% of its length. There is a range of this “length to width ratio” that dentists try to stay within of 75%- 85%. When designing every anterior case, the thoughtful cosmetic dentist will tend to use a lower ratio for female clients yielding a more “feminine look” and a higher ratio for males yielding a more “masculine look”. The former dentist in the case example above violated the range by making short squatty upper central incisors (her front teeth) with ratios of 105% or greater.
High quality prosthodontic care – Becoming a knowledable consumer
When a patient decides to have their smile redone, we invite them to share their dreams, desires and expectations with us. Reality is that there are medical and dental experts that can do just about anything today if the patient is willing to go to the steps to have it done. Due to Dr. Fondriest’s extensive teaching and lecturing history, he has built friendships and relationships with many of the top medical and dental specialists in the world. Our office can offer access to these top practitioners through referrals. Many general dentists offer advice based on their understanding of what is possible. In many cases, the advice limits treatment to the level of education of that practitioner. All patients should consider themselves as dental consumers who will benefit from knowing “ALL” that can be done for each particular circumstance.
Having already gone through treatment once, this patient wanted to address everything that could be done to improve the long term health, bite, and cosmetic appearance of her smile.