Every woman wants to look her best on her wedding day. Our patient came to Dr Andrea Shepperson to see how she could enhance her smile for this special time, and also help with tooth wear. Teeth had become very flat and worn and some teeth were sensitive. She wanted a stunning white smile with porcelain veneers, making her teeth longer teeth and whiter.
We started with a detailed assessment and discussion about the transformation we both wanted to achieve. It was apparent that this would involve not just cosmetic improvements with veneers and crowns, but bite correction as well. A closer look at the teeth showed a lot of acid damage from drinking soft drinks. Enamel had dissolved away behind the front teeth, and on the tops of back teeth.
Soft Drinks and Teeth
Most soft drinks have very high levels of 2 acids that are very damaging to teeth:
- Citric Acid
- Phosphoric Acid
The damage that occurred in teenage and university years had left a very worn bite, over-closed and a desire to grind teeth. We needed to rebuild it at the same time we transformed the smile.
No enamel is left on the bottom molars. Yellow dentine is visible.
Acid damaged top teeth.
The Start: Planning The Smile
We did a 2D simulation for our patient to show the possibilities with longer teeth and a whiter smile. She was thrilled with her simulation.
before
afterThe DSD App allows us to preview changes in 2D, before moving on to design in 3D.
The next step was to start planning in 3D.
Instead of conventional molds of teeth, we make very accurate digital scans. These are done with a camera – no gagging, clean up or trays of gooey material.
This video shows the scanning process:
Making A New Bite
Years of chewing on flat worn teeth establishes bad muscle and joint patterns. It is necessary to re-programme muscles and joints to find a new stable place.
We make a small appliance called a deprogrammer that is worn during the day where possible, and at night. After 1-3 weeks we record a consistent bite that is very comfortable. The facial muscles relax and clenching and grinding often disappears when we establish a new, more open bite.
Once we have established a new bite, we scan and start designing with Digital Smile Design.
Creating The New Smile
Lumino City Dental is NZ’s only Digital Smile Design Clinic. We use 3D planning with Digital Smile Design, and work closely with the Digital Smile Design Planning Center in Madrid, Spain. First we analyse the face and decide on the correct midline, smile curve and length of the teeth.
Analysing the smile.
Next we add the correct shapes and proportions.
Top teeth with new shapes.
Analysing from all angles.
Finally we add the bottom teeth, based on our new bite.
Bottom teeth corrected for tooth wear.
The final design….a close match to our 2D simulation.
The completed design and new bite.
The MockUp Appointment
The first time we all get to see the new smile is at the MockUp appointment. This is an exciting time where the new smile is revealed in the mouth.
Restoring Worn Bottom Teeth
We opened the bite using table top restorations in a ceramic-hybrid material, and rebuilt the bottom front teeth with composite veneers. Compare the results in the Before/After photos.
before
afterArtificial enamel replacements to worn back teeth.
Porcelain Veneers and Crowns For Top Teeth
Our finished case brings the final design together, to create a stunning, white smile with natural shapes custom designed in harmony with the face.
before
after
before
after
before
afterDigital Smile Design allows us to precisely replicate the design and MockUp in the final restorations. There are no surprises – our collaboration at the start is reproduced at the end.
If you or anyone you know would like help with your smile, please complete our Patient Enquiry. We would be delighted to discuss how Digital Smile Design can help you.
