A Complete Smile Makeover with Porcelain Crowns for Teeth Damaged by Bulimia

There are many reasons patients come to see me for cosmetic dentistry.  One of the most common reasons is because their teeth are badly worn down from grinding, often in combination with acid erosion that has eaten away at the enamel.  Treating these cases can be complex, because if we don’t properly diagnose and solve the problem that caused the worn, eroded teeth in the first place, then any cosmetic dentistry is sure to fail very fast.

When Jenni (not her real name, as she prefers to stay anonymous) first came to see me through a referral back in 2005 for a Smile Makeover consultation, she admitted that she had suffered from bulimia as a teen, about 20 years prior.  She had recovered from this debilitating disease and had been leading a healthy, normal life for many years, but her teeth had been so eroded that she was extremely self-conscious and embarrassed by her smile.

Since Jenni’s original issue had been addressed medically, we were safe moving forward with a greatly decreased risk of acid erosion causing problems again, although bulimics are at a much higher risk of GERD/acid reflux, so she is monitored regularly by her physician, and she uses a prescription strength fluoride rinse daily to help protect the teeth under the porcelain.

Due to complicating factors, Jenni’s case was just completed this year; however, I think you’ll see why Jenni is now happy with her smile again, although she doesn’t want everyone to know what she had done,  so she has asked me to not use her portrait.

Cosmetic dentist Dr. Charles Payet, of Charlotte NC, performed a Smile Makeover with Porcelain Crowns to Restore these Teeth Damaged by Acid Erosion/Bulimia

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Not all dental crowns are metal-free, even for cosmetic dentists doing Smile Makeovers

While many cosmetic dentists claim to be “metal-free” dentists, too, I do not make any such claim.  Why not?  For a few simple reasons…..

1. Gold onlays and gold crowns are still the strongest and longest-lasting ways to fix broken teeth or teeth with cavities currently available, and if that’s what you want, then you want gold.
2. Teeth stained by the antibiotic tetracycline can be so dark that is extremely difficult to  bleach (whiten) them, except with Deep Bleaching (TM), and even porcelain veneers may have difficulty covering such dark tooth stains,  so Porcelain-to-Metal (also known as Porcelain-to-Gold) crowns are sometimes the best choice.
3. Bonding (tooth-colored fillings) usually does not hold up very well if you grind or clench your teeth intensely, as they aren’t hard enough to take that much force, so silver (amalgam) fillings are often a better choice.

Here’s a case from a few years ago where the patient was really unhappy with his old, yellowed, kind of ugly old Porcelain-to-Metal crowns, partially because of the dark grey line at the end of the crowns where the black metal underneath the porcelain was showing as his gums receded.  He only had crowns on the top 6 front teeth (a bad idea), and he wanted all of his teeth bright white, and he’d gotten the crowns initially because of severe Tetracycline staining of his teeth.  They were the darkest teeth I’ve EVER had to treat.  I’ll post something soon about how to create a beautiful smile despite tetracycline-stained teeth, but for this I simply want to show that dental crowns that are used to create a Smile Makeover can be just as beautiful and natural-looking as all-porcelain crowns.

Replacing ugly old porcelain-and-metal crowns with a dark grey line at the gums with porcelain-to-gold crowns that look beautiful, natural, and white - to cover tetracycline-stained teeth.

Terrie Reeves, Founder of the Wellness Coalition of America

One of my very favorite people is a simply AMAZING woman named Terrie Reeves.  We first met at the Charlotte Yoga studio near Park Rd.  & Woodlawn Rd. about 5 years ago, when she was an instructor and I was a student.  Shortly after that, we got to talking about her smile and that, while she liked it ok, she would like it brighter and to fix the chips in the front teeth, and she’d noticed that it seemed her front teeth were getting thinner and more see-through.  So after a thorough dental exam and long consultations, we decided on a Total Smile Makeover for Terrie that would be completed with 16 porcelain veneers.  The top veneers were completed first, then the lower ones made to match, and ever since then, Terrie has absolutely loved her smile! And if you’ve ever met Terrie (which I highly recommend), you will understand when I say that her smile truly matches HER.  She is filled with more energy than any 10 people have a right to, and she has to be one of the happiest people I’ve ever met.

If you’ve seen the portrait of her below before……don’t be surprised!  After Terrie saw her post-Smile Makeover Portrait Shoot (on the side, I am a professional photographer as well), she asked if she could use some in her Wellness Coalition of America promotional materials; how could I refuse? 🙂

Before and After Pictures of 16 Porcelain Veneers, Portrait of Terrie Reeves