When Sarah* first came to our Midtown Manhattan office, she'd already consulted with a few dentists about improving her smile—but she still wasn't happy with how her teeth looked.
Her concerns went beyond cosmetics, though. She could see dark spots on her teeth and wanted to know: were they just stains, or something more serious like cavities? As someone who preferred naturopathic approaches whenever possible, she wanted a beautiful, natural-looking result with the least invasive treatment possible.
Understanding What Was Really Happening
After her initial exam, x-rays, and cleaning, I invited Sarah back so we could take detailed photos of her face and smile. This step is crucial—it allows me to study proportions, symmetry, and function before we make any decisions together.
Once I created her digital smile simulation, she could see exactly what I hoped to achieve: a balanced, symmetrical smile that looked natural and would last for years. She loved it.
But here's what the simulation also revealed: those dark spots weren't stains. They were cavities that had compromised the strength of her teeth. She was also a heavy grinder, which meant she'd worn down significant enamel on her back molars. Over time, this created a collapsed bite—making her teeth shorter than they originally were.
Creating a Conservative Personalized Plan
In the spirit of being as conservative as possible, I explained that we'd use porcelain veneers wherever we could. Veneers require less tooth structure removal than crowns, which aligned with her values. However, where the cavities had weakened the teeth too much, we'd need full-coverage crowns to restore their original strength, function, and beauty.
Sarah also had a crooked lower premolar that hadn't responded to clear aligners or traditional braces. Instead of forcing movement that wasn't happening, I recommended correcting the position with a porcelain crown—a solution that gave her the alignment she wanted while maintaining stability.
Her Treatment, Visit by Visit
- Planning. I took an impression of her teeth and pictures to plan her case. (Today I use a digital scanner instead of a physical impression.)
- Her treatment plan and simulation. I reviewed my proposed treatment plan and the simulation with her. She loved her simulation and was in disbelief that anything close could be achieved.
- Preparing her teeth. We removed all of the cavities on her teeth and prepared her teeth for the veneers and crowns. She left with temporaries that looked like her final teeth. We made all the adjustments she requested so that her final veneers and crowns were perfect.
- Her veneers and crowns. We inserted her veneers and crowns and scanned her for her night guard.
- Night guard. We gave her the night guard. She loves her night guard and says she can't sleep without it now.
The Result: A Smile That Lasts
This was an investment in time, effort, and money—but Sarah was thrilled with the result. Four years later, her smile looks just as gorgeous as the day she left our office. It's strong, natural, and effortless.
If you've been to other dentists and still feel uncertain about your smile, let's talk. We'll take the time to understand what's happening, show you what's possible, and create a plan that feels right for you.
*All photos and stories are of actual patients. Patient names changed for confidentiality.
