Off center teeth create a slanted smile that can be a little bit tricky. Many patients want off centered teeth corrected and this patient was one of them. Her first dentist made the front four crowns but did not correct the off centered teeth. She did not like the oversized two front teeth either.
She wanted a little more balance between the size of her teeth and the color. Another problem was that she needed a wider smile because the bicuspid teeth on the sides were too small. The upper teeth needed the bad porcelain crowns replaced but again there was a big problem from the previous cosmetic dentists work because he ground too much tooth structure away under her gums causing inflammation of the gums and gum infections.
When the dentist grinds too much tooth away under the gums the new crowns must fit absolutely perfectly. The gums will recover to complete and total health if the reconstruction dentist can fit and bond the new high tech porcelain crowns to the tooth structure with a perfect fit.
Red, infected and swollen gums resulting from bad porcelain crowns were completely healed with perfect fit high tech solid porcelain crowns from Dr. Muslin. Additionally, the off center teeth and slanted smile were also corrected.
When the midline is off centered, the nose and the teeth are not aligned properly. When the teeth are not aligned with the tip of the nose, the smile looks slanted. Slanted looking smiles lead to facial asymmetry because of the off center teeth. Sometimes, dental labs do not really know where the midline of the patient is really located and the cosmetic dentist failed to let them know. The patient very often are not aware that there is a problem, give the dentist permission to cement the porcelain crowns and later discovers the teeth are not aligned with the tip of the nose.
She needed a cosmetic dentist to develop her smile to its maximum potential. Her existing crowns looked fake and were not properly shaped or proportioned. The centerline of her teeth (also called the midline) did not align with the center of her lip and nose. This patient needed a midline correction and a bite correction too. The upper midline correction was the most important but during the treatment Dr. Sam Muslin corrected the mandibular incisal plane, the lower midline, the upper midline and restored the broken lower teeth at the same time.
This was painless dentistry for this patient because the entire treatment plan was completed in only two visits. Patients fly in from all over the world and the United States to see Dr. Muslin and he can complete a full mouth reconstruction in as little as one week for the VIP patients.
The teeth were clearly too far to the right and this made her entire face appear somewhat off center. Not only were the crowns off center, they were too dark, out of proportion, and almost grey in color. She had black lines at the gum line and infected gums. The tips of her lower teeth were also broken off from grinding and wear. The off-centered teeth can be fixed very easily with painless dentistry in a surprisingly short period of time.
On the first picture you can see the front two teeth are too big and there are black lines around the old upper crown. The chipped lower teeth are the result of a bad bite. In the second picture the six lower teeth look brighter and are restored back to their original shape. The ten upper teeth have new porcelain to balance the shape, improve the color, eliminate the black lines and revitalize her appearance.
When old dental crowns have black around the gum line of the tooth it is very ugly looking. The black gums can go around the gum line and in between the teeth and gums. It is not so much a black gum disease problem as an oxidation of the metal under the porcelain and staining at the margins of the crowns because they did not fit the teeth well enough.
The quality of the fit of the crown is critical to avoid the oxidation and marginal decay at the interface of the crown and the tooth. Patients can also get a black line between porcelain veneers and grey gums that are discolored due to contamination during the dental bonding process.
The dental bonding process must be perfect or else the grey gums, infected gums, black spots near the gums and discolored gums are the results of contamination during the dental bonding.
The skill of the cosmetic dentist is far more important than a cheap dental crown. Cheap veneers usually end up costing the patients far more money than high quality porcelain veneers over time.
To restore her smile, Dr. Muslin removed all of the old work and prepared her natural teeth to accept the new crowns. It was critical that he prepared the teeth in a way that would allow the new crowns to align with the centerline of her nose and lip. To make her look even more natural he designed the new crowns to be free of black lines at the gums. His dental bonding technique has been highly successful in solving the black gum problem and in solving tooth sensitivity problems too.
Sensitive teeth after dental fillings and crowns are generally the result of poor technique and bad dental bonding. Occasionally, the nerve is inflamed causing the tooth to be sensitive but most of the time sensitive teeth after dental restorations are a result of bad technique.
Dr. Muslin was able to center her teeth so that they aligned with her lip and nose, which gave her face a more balanced look. The teeth to the sides of the crowns (the bicuspid teeth) received veneers to widen her smile and make it fuller. Notice that the crowns and veneers are perfectly color matched throughout her mouth even thought they are totally different types of restorations. Porcelain veneers should never have black lines at the gum because veneers do not have metal.
Any black line at the gum associated with veneers is due to contamination and leakage under the porcelain veneers. Finally, in order to perfect the look and to reverse the damage to the lower teeth, porcelain veneers were bonded in place on the bottom teeth with no resulting black gum lines. Once again, notice that Dr. Muslin achieved a perfect color match between the upper and lower teeth and none of her teeth were sensitive after the dental crowns and porcelain veneers were bonded.
Dr. Muslin says, “I used to have the same teeth sensitivity problems after placing crowns or veneers over 30 years ago but have long since solved the problem with better technique and better materials”.
The upper teeth are porcelain crowns and the lower teeth are porcelain veneers with no black lines, no dark margins, no black margin or receding gums. These porcelain restorations were not cheap veneers because there is a wide difference in the material, talent and skill involved in providing this level of high tech dentistry. Cheap veneers usually don’t last and that may be a good thing because they look cheap and actually discourage people from getting porcelain veneers for themselves.
To protect all of the work from grinding teeth at night, the last step was a custom designed super thin night guard. Dr. Muslin completed the treatment over 12 years ago and there have been no problems since. This patient has enjoyed many years of health and cosmetic benefit and still has many more years ahead of her. The long lasting restorative dentistry saves his patients a lot of time and money. Dr. Muslin was awarded LA’s Best Cosmetic Dentistry for 2012.
Dr. Muslin's night guards are so thin and clear that they can barely be seen and are very comfortable. A night guard, when worn every night, can save you thousands of dollars by protecting your natural teeth and your porcelain teeth from grinding, wear, fracture, chipping and breaking. Night guards protect your entire mouth and they are “custom made” to be worn on either your upper teeth or your lower teeth. Ultra thin night guards are more comfortable and the patient’s breath more comfortably when they use them.
The photos of this patient were taken with a film camera and then digitized over 12 years ago. All of the before and after photos displayed on this website are actual patients treated by Dr. Muslin and are untouched and unaltered. Please call for your appointment or click on the “contact us” button to communicate with the dental office.