Joanne Barnes – old cosmetics, gummy and narrow smile

Joanne is a young mum in her 30’s. She had cosmetic treatment done twice before at two other practices in Perth and was very unhappy with the way that her teeth looked. There were four main issues; Joanne has disproportional front teeth due to the old porcelain crowns she had placed previously. She has a very narrow smile where we couldn’t see any teeth beyond her canine teeth, making Joanne look like she had no back teeth at all. Not only did Joanne have a very gummy smile, but she also had a very deep bite. This is when the upper and lower teeth come together tightly. This can be seen in some of her photos where the back molar teeth are at a lower height than her front lower teeth, this premolar drop then creates what is known as a ‘deep bite’.

In Joanne’s cases we had to solve four things at once; the proportion of her teeth, the narrowness of her smile, her gummy smile, and her deep bite. We resolved all issues with porcelain treatment. This was a very complex case and therefore we had to be very meticulous in the analysis and planning of the smile, listening to the concerns of the patient very careful as this is the third she will have undergone treatment.

The first part of treatment was teeth whitening and from there we did the porcelain treatment in accordance with our analysis. Two things to note; we had to make Joanne’s front teeth smaller, pulling the teeth back as they were too far forward. We added porcelain to the sides (premolars) in order to give Joanne a wider smile and added porcelain to those lower back molars in order to eliminate that deep bite. Joanne had two trial smiles, during the first we reanalysed our initial assessment cross-referencing. We followed the same process as the initial consult and from there did a refinement of the trail smile before any porcelain was created.

The differences to Joanne’s smile is that her front teeth are smaller, more proportioned. That they have been pulled back so they don’t appear so bucky. The smile has been widened, the bite has been altered, and a gum lift with injectables eliminated the gummy smile.


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