The term “veneer” is dental speak for front teeth cosmetics, and a fracture is always a catastrophe. No one wants the front teeth not to look their best. A fracture of a veneer is a cosmetic emergency. I wrote a column a little while ago about how wearing masks helps our anxiety in these situations, but in the privacy of our home, the esthetic downturn magnifies itself. What makes matters worse is that the fracture happened on a Tuesday. What’s wrong with Tuesday? It precedes Wednesday, and her dentist closes his office on that day. She could not walk around for two days with a cracked front tooth.
I reached out to her, and we discussed her situation. The patient is a dental hygienist and knew what type of material was on her front tooth. Her veneer was made in the office using bonding material. When a dentist makes a veneer right at the chairside, eliminating a laboratory, the repair is easy. She would not need an anesthetic, and I told her that I could fix it in 10-15 minutes.
She came to see me the next day, and I examined the tooth. In addition to the veneer breaking, she fractured the edge of the tooth underneath the veneer. Her teeth were gorgeous and reflective of how she took care of herself, making everything more complicated.
The first thing that I addressed was the cause of the fracture. I made a very delicate adjustment to the way her teeth come together. This adjustment would ensure that my repair would last for her. Once I finished the bite modification, I turned my attention to the actual broken tooth and veneer. I felt confident that I could repair both of them.
I chose the proper color for her and did a dry run to match the color. Everything looked good. One point was in the back of my mind during this whole process. The part of the tooth which remained was very dark. Next to her very white teeth, the dark color was even more intense. I didn’t think twice about this until I found out that the intense darkness altered my repair color. I could not attain the level of whiteness that was required.
Wait, it gets better! The shape of this tooth did not mirror the same tooth on the other side. To say that her mouth is a cosmetic challenge would be an understatement. She left my office looking much better than when she first came in. However, we were not where I wanted to be. I was also concerned that her bite would break the tooth again in the back of my mind.
I suggested that we make her a highly esthetic crown using a process that gives her and me a preview of the final crown. I have many patients come to me with stories that their teeth came out differently than expected. I utilize a technique that shows everyone how the ultimate result will appear. My lab and I use a custom provisional crown to give the patient a preview of the permanent crown’s color and shape. The potential for disappointment goes down dramatically.
If you have a cosmetic dilemma, please feel free to call me. You and I can discuss various options and decide on the best course of action for you. My number is 440-892-1810. I look forward to hearing from you.
Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.
The Healthy Smile • 27239 Wolf Road, Bay Village, OH 44140 • 440-892-1810 • www.jeffreygrossdds.com