OVERVIEW:
This patient sought a solution for lower teeth crowding and an option to “balance” her various upper tooth sizes and gummy smile. Her objective wasn’t “perfection” but more of a natural (in her words) “if I had been given the smile of my dreams from birth” outcome versus the typical “ultra white” Hollywood smile.
PRIMARY CONCERN:
This patient’s primary concern was her crooked bottom teeth and their appearance, specifically when speaking with clients. She also wanted a more “balanced” look to her upper teeth as her teeth next to her front teeth were significantly smaller than the surrounding teeth. She also commented that she wanted a “brighter” and more “youthful” smile.
TREATMENT PLAN TO “GET READY”:
This patient was up to date on her dental health and had had regular exams and cleaning appointments. After consulting with an orthodontist, she determined that the first step to her “perfect smile” was to undergo orthodontic treatment for a good foundation. Her primary goal was minimal prep and minimal overall dental treatment, so starting with her teeth in alignment would achieve that result.
After completing her orthodontic treatment, she was in a perfect position for a very minimal prep Glass Slipper Veneer™ veneer placement.
OBJECTIVES FOR VENEER PROCEDURE:
The patient repeatedly expressed that she did not want a “blinding white” and obvious smile makeover. She wanted a natural and beautiful smile that looks like it could have been achieved naturally.
She stated that she “didn’t want it to look like she has had work done” when she smiled. And that people would only notice her beautiful smile and not her teeth specifically. A completely natural outcome was her priority.
CONCERNS FOR VENEER PROCEDURE:
The patient’s main concern for the procedure was “pain and nervousness in the dental chair.” In her words:
“If I could just go to sleep and wake up with a new smile, that would absolutely be my preference. Being in the dental chair makes me extremely nervous, specifically the sounds and the sensation of anything touching my teeth.”
“With the holidays coming up I don’t really want there to be any down time between being able to enjoy meals with my family. I am also nervous about looking different with my new teeth to people who know me well like my family.
The last thing which may seem kind of silly because you can’t really see them, was that I really wanted to keep as much integrity of my natural teeth as possible. I’d seen pictures of teeth ground down to small “nubs” with veneers placed on top and I really had a strong desire to keep as much of my tooth structure as possible. I also had done some research and read that keeping as much of my tooth structure as possible is better for the longevity of my teeth and so that was really important to me.”
DR. LEALE’S CONSIDERATIONS FOR VENEER PROCEDURE:
Given the patient’s primary concerns, we crafted the following considerations for her visit.
We planned a “gingivectomy” (a periodontal procedure that removes excess gum tissue to cosmetically reshape a “gummy smile”) that would be performed during her “prep” day that would lift the shape of her gums and create a more balanced gum level across the top of all of her teeth.
Before our “prep day” the patient whitened her bottom teeth to a shade that suited her and that gave us a starting point in creating a shade that was acceptable for her. We opted for 3 shades darker than the “brightest white” available.
For the prep day, which requires the most “dental sounds” and considering the gum procedure she would be undergoing, the patient opted for an IV sedation. This required her to have an anesthetic certified provider present and we were able to bill her insurance for this part of her procedure*.
For “seat day” the patient opted for nitrous gas (or laughing gas) during the procedure.
The patient mentioned that she was a huge Taylor Swift fan, so we had the Eras Tour cue’d up and she was able to relive her concert experience with audio and visual during her seating appointment.
*Individual insurance plans may vary.
OUTCOME IN PATIENTS WORDS:
“I was so incredibly nervous for my first prepping appointment that I was glad that I had the sedation that day. What little I remember of the appointment was smiling faces from the assistant that was there and holding my hand during my glimpses of consciousness and the reassurance of Dr. Leale. In other words, the sedation did its job!
After returning home and having a nice nap, I awoke to a gorgeous new smile. I was a little sore from the injection sites, but felt happy that I don’t even remember getting the actual injections.
After discussing my options with Dr. Leale, we decided that I was going to be foregoing sedation for my next seating appointment. Again, I was very nervous because I don’t enjoy any part of dentistry generally, but I did feel great about Dr Leale and his team because my experience with them throughout the consultation process was excellent. Imagine my surprise when they had the Taylor Swift era’s tour all ready to go for me that morning. I was able to sit back, take a few deep breaths of the nitrous and focus on the Taylor Swift tour show I was watching and really disassociate from any of the “dentistry” that was happening to me. The really nice part of not doing IV sedation that time was that I could see my results immediately at the end of the appointment. I was also able to give Dr. Leale a really good idea of how my bite felt, so he was able to adjust everything. I literally left with perfect teeth. Everything from the color to the balance and size looked great. It honestly just looked like my own natural teeth got leveled up.”
3 MONTH FOLLOW UP:
“I have been so incredibly happy with my veneers. Honestly, the most exciting part for me is the fact that while I have had a ton of comments on my smile, no one has actually ever asked if I got veneers done. I’ve had most people ask if I “finally got my braces off”, but no direct questions about getting my teeth repaired. That tells me that I achieved my goal, which was just to have an amplified version of my own smile.
Specifically, I love the way I look in photos and tend to full-mouth smile way more frequently knowing that it photographs so well. I’ve actually been able to refer quite a few people to Dr. Leale based on the fact that my results have been so natural. I know lots of people probably want the super glamorous, bright white “Hollywood smile” when they’re getting a smile makeover, but for me, I just wanted to feel very confident in my smile with it looking as close to my original smile as possible.
Oh, and a side benefit I didn’t even anticipate is that I’m able to drink coffee and red wine with no fear of staining, something that I didn’t even realize how often I concerned myself with. It’s just one less thing I have to worry about now!”