Ouch..that's got to hurt...

Unfortunately when you have a practice with a lot of elderly patients you occassionally get the phone call telling you that one of your patient's took a fall and stopped that fall with their face...
In any case this wonderful woman was just in last week for a routine procedure and yesterday she called to say she took a fall yesterday and needed to see me right away...
I told her to come on down and here she is..fresh out of the emergency room...

Clinical exam shows that although none of the teeth are unusually loose there are some chips evident on the two central incisors...take a look...


Now we have a machine to tell us the vitality of the nerves that are in the teeth and the test revealed that all of the teeth except for these two respond normally..
these two teeth show no response to an electrical stimulus...
so stay tuned...she is returning next week and we will re-examine her and see if
she will need to have work done on these teeth....

Did you say white???? Yes Dr. - I said WHITE!

As dental students one of the first things you learn about cosmetic dentistry is that you don't want to give someone really white white teeth...it just looks too fake.
Well in today's world it seems that patients will occasionally want that overly too white to be true look and here is one of those cases.
This gentleman has seen his share of dentists over the years and he wants to have a certain look at all costs...
He had his upper teeth capped with really white porcelain and now he is in my office to have his lower teeth "fixed"....He says he wants them to be whiter, and bolder, and stronger ...and bigger and so on and so on.
So take a look at these two pictures and you can see how the lower front six teeth are looking pretty poor next to what was done on the upper...
As usual for this blog..click on any picture to get a larger version then hit the back button to return to the blog!

Now the upper six teeth, were like I said, done elsewhere....and I made the 2 back teeth that you see on each side on his lower jaw...

And to tell you the truth in this particular case I see his need to have his lower teeth whitened, since they are so off shade from the uppers...so here goes...
I determined that in order to make them a bit taller and stronger I would have to
open his bite slightly...which he was able to easily tolerate with the temporary caps I made for him...
After about three try in visits in which our patient had numerous requests for changes we finally settled on this result....
He loves it and is very happy...and he is especially pleased with the slight overlapping of the teeth to give them a more natural appearance instead of the straight line across look.
Would I do it from the outset...probably not..but he claims he is in show business and he needs it...
so there you go....white as white can be...maybe he should say he is in snow business with this level of white! Here are a few different views.


Of course, now the upper teeth don't look as white as he would like them to look..
I would not be surprised if he wanted his upper teeth redone to look this white...
and by the way these crowns are pressed porcelain and are very easy for the labs to work with and modify!