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Medically Reviewed by Sam Muslin, DDS, MAGD | Last Updated on 08/16/2022
She had ugly black gum lines around her crowns at the gum line. When she smiled the black gum lines and dark gums looked so bad that she would try to smile in a way that they would not show. These black lines can occur around the type of porcelain crowns that have metal underneath the porcelain.
The metal is actually exposed or it is oxidizing so the dark color shows through the thin tissue causing a black gum line around the tooth. In addition, gum tissue tends to recede or pull away from crowns that are not fitted perfectly by the dentist.
The first method is to find a dentist that can construct and bond crowns perfectly so that the gum tissue stays healthy and in place. If the gum tissue is not in good shape before new crowns are constructed, then it is very important that the new crowns are done perfectly so that the gum tissue will grow back around the tooth. This is what happened with this patient.
The second method is to switch materials. Rather than have a crown with porcelain over metal switch to a solid porcelain crown. A solid porcelain crown requires just as much perfection in the construction and bonding by the dentist as well as at home care by the patient otherwise the ugly gum line can return.
She had dark spaces and holes between her upper porcelain crowns because the fit was not perfect. Food was trapping in these dark spaces and holes leaving her upper teeth and gums at risk from a health standpoint. The black lines from the old upper crowns had to go and her gums were infected and receded. Her crooked lower teeth also trapped food and looked unattractive. The dark lines of the upper porcelain crowns and constant food trapping created the look of an aging woman who did not care about her health.
Fortunately nothing could have been further from the truth. She wanted the black gum line eliminated for better health and cosmetics along with a bite correction. She had been tolerating an uneven bite and a deep overbite that was misaligned for years. She came from the Brentwood - Pacific Palisades California and had struggled in the past with dental care. She wanted better health and cosmetics along with a bite correction.
The old crowns were replaced with all porcelain crowns that are completely biologically compatible and safe. These types of porcelain crowns are so natural looking that you would never even know that they are crowns. Dr. Sam Muslin routinely replaces other dentists work to improve all deficient areas. In the end the new crowns are fitted perfectly, the color looks great, and her gums are healthy.
Patients look older because of their older looking dentistry. When you have mismatched teeth, crooked teeth, yellow teeth and dark gum lines you appear old and tired. Additionally, gaps between teeth are bad for your health because decay becomes more prevalent under the old dental crowns. The gaps between the teeth also trap food and when you are eating dinner and talking, the trapped food is unsightly. The goal of high tech modern cosmetic dentistry is to benefit the patient’s health by replacing all of the old crowns with biologically compatible crowns made of solid porcelain.
Porcelain crowns are better looking and are bonded into place with high tech hybrid resin materials that are stronger than anything used in the past. The dentist must be meticulous in his or her technique to produce dental crowns and porcelain veneers that have a perfect fit. When the dentist lacks the precision needed for a perfect fit, the crowns will get the black line effect and decay sooner. Bad dental crowns are not good for your health or your look.
When the tooth is black under the crown there are special problems in hiding the color. Just simply making a solid porcelain crown is not enough. Dr. Sam Muslin has developed a method to hide the black color before the crown is made. The challenge becomes blocking out the black color while still making the porcelain crown look natural. In an effort to hide the black tone of the tooth sometimes crowns are made too opaque.
When this happens the new porcelain crown will look fake or unnatural. Dr. Muslin’s method provides a natural and translucent crown color, while still managing to hide the black tooth color. He uses a similar technique when the teeth are not black but rather a very dark brown color.
The cosmetic dental treatment on this patient was to remove the old porcelain crowns with black gum lines and get the gums to grow back down in between the teeth. In the before photos you will see holes between the teeth at the gum lines and in the after photo you will see that these holes are gone. Dr. Muslin says that ‘”The only way the gums will grow back is to get an absolutely perfect fit between the crown and the tooth”. Not only does the fit have to be perfect but the shape of the crown must also provide the perfect biologic space for the gums to grow back in between the teeth.
This patient is a perfect example of how the gums can grown back as long as the dentistry is perfect. After the new crowns were bonded into place her now healthy gums grew back in and filled the dark spaces between her teeth. With these holes filled food was less likely to trap. Her lower teeth were then straightened using Instant Braces. All of her teeth were lightened and now that food isn't getting trapped there is far less harmful bacteria in her mouth and body.
Her mouth is now all porcelain with no metal at all. Her bite is now comfortable, balanced and functional. She has no TMJ pain, no headaches and no jaw clicking or popping now that her bite is restored. When her husband saw her after treatment he was so surprised that he said, “I have been looking at the food stuck between your teeth for the last 20 years and if I knew that this was possible, I would have had you do this sooner. That dentist is great so I am going to him next.”
Her lower teeth now appear clean and youthful. They are straighter, whiter, and food can no longer collect between the teeth. In addition, the new porcelain crowns are far easier to clean than her natural teeth were because the shapes have been dramatically improved. Food does not stick any longer and the new color is not only better but it is also permanent. Her health and appearance have been revitalized. Treatment was completed in only 2 weeks however it can be completed much sooner for those VIP patients on a tight schedule.
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