I have a space between my two front teeth. And I’m wondering which treatment will work and how long I will be sedated for it. The older I get, the less I like my smile, so I want to do something about this even though I’m anxious about getting major dental work done. I have a crowns on both teeth. Can the gap between my teeth be closed with porcelain veneers, or do I need new crowns?

-Thanks, Eliza from New Hampshire

Eliza,

After reading your question, I am wondering why the dentist who made your crowns left a gap between your teeth. It would have been much easier if the dentist closed the space when placing the crowns.

Closing a Gap When You Have Crowns on Your Front Teeth

• Size of the gap – Depending on the width of the gap between your teeth, your dentist might recommend replacing both crowns. Your dentist will ensure both teeth are the same size and enhance your smile. If the gap is large, there could be some work also required on the lateral incisors to give you properly proportioned teeth.
• Composite bonded to porcelain – A cosmetic dentist can close the gap by bonding composite resin to the porcelain crowns. A micro-etcher is a dental tool that has a small sandblasting piece. Your dentist can complete these steps:
  • Micro-etch the porcelain next to the gap
  • Use hydrofluoric acid gel to etch the tooth and prime the surface with a coupling agent—a synthetic agent that will help the bonding seal to the porcelain
  • Applied bonding resin followed by composite bonding material that matches the shade of your crowns
  • Shape and polish the composite
  • Although this method is less expensive than replacing your crown and dental bridge, it is not uncommon for stains to later appear around the margin where the composite meets the porcelain.
• Porcelain veneers – Although it is possible to bond veneers over porcelain crowns, you have the same risk of staining at the margins. Veneers are expensive, so it will cost the same as redoing your crowns.
• Orthodontics – You would probably be a good candidate for Invisalign invisible braces.

I would recommend seeing a dentist who is accredited by the American Academy of Cosmetic Dentistry. Some of these options are tricky and require advanced training. After an examination and digital x-rays, your dentist will determine which treatment options are best for the health and appearance of your teeth and smile.

Would You Want to Be Sedated?

You mention that you are anxious about major dental work. You may want to consider conscious sedation. You can read about that procedure on this website and if you decide that’s what you want, ask about that when you call to make your appointment.

Beverly Hills cosmetic dentist Dr. Brian LeSage sponsors this post.