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Treating top and bottom teeth together

February 17, 2018 ,

by Dr. Olitsky

Many patients wonder about the process and how many teeth to treat when getting a smile makeover.  There are multiple reason to treat the top and bottom teeth together at the same time when consider improvements to the smile.  Some patients have crooked, worn or chipping teeth on the bottom and are concerned about the look of those teeth as well as the top teeth, while other do not feel like the bottom teeth show when they smile.  Keep in mind that the bottom teeth do show when we talk, if not when we smile, and while people are paying attention to you speaking they are seeing your bottom teeth.  If your top teeth get improved to look perfect, then a noticeable contrast will occur between the top and bottom teeth making the new top teeth look unnatural.  In cases where the bottom teeth are straight and unworn, then a professional whitening treatment can be a great option.  In cases where the bottom teeth are crooked and unworn, they can be straightened with Invisalign or short term orthodontics.  Many patients are looking for the ideal change for their smiles and would prefer the top and bottom teeth to match.  In these instances, the best option is to finish with top and bottom teeth with porcelain veneers.

Beyond aesthetics, there are other reasons to decide to veneer or crown your lower teeth.  Often times, the damage that occurs to top teeth is also happening to the bottom teeth and results in a break down of the entire mouth as a system.  If all the teeth are affected, then only perfecting the front top teeth may lead to disaster with your new porcelain restorations.  Systems that are breaking down, often need intervention on the top and bottom and even back teeth to get healthy.

Patients frequently want longer front teeth to improve the proportions of the teeth, show more top teeth when they speak or smile and revers the signs of tooth chipping and incisal edge wear.  When dentists make the front teeth longer, it changes the bite on the front teeth.  Not all patients will function properly with more over bite (top teeth that bite over the bottom teeth).  In order to lengthen the front top teeth, often dentists will lengthen the bottom front teeth and be required to put porcelain crowns or occlusal veneers on the back teeth.

It is very important to see a dentist that understands the way the system works and can improve the smile and function of every patient.