Tuesday, May 8, 2012

Before and After Dental Photos

A smile tells a lot about an individual person. Before babies can speak and communicate verbally, they have the ability to relate to the human smiles, especially those of their mothers. Smiles have a complex language structure, depending on how wide we smile and how much teeth we show, combined with other cues. We use smiles to express our emotion non-verbally when we meet someone, eventhough we might not speak the same language. A smile is an essential part of human communication with each other and everyone deserves to have a beautiful and healthy one. Below is an example of how modern dentistry can improve a person's smile. Please ask us how we can improve yours!




This nice gentleman has worn his same dentures for over 20 years! They were worn out, loose, uncomfortable, painful, stained and chipped. His biggest complaint was that he could no longer chew food properly as he used to. You can see how his face was collapsed because of the worn out teeth. He could not hold his teeth together for them to touch. Dr. Vuong made a new set of dentures, keeping in mind the proper esthetics, fit, and phonetic aspects for the ideal function. This patient didn't want extremely white teeth. He didn't want the fake look. We took a step further and customized the teeth position to make them look more natural. He now could even eat steak since the dentures fit better with better bite and are no longer loose. The best part is that he now smiles all the time! He didn't realize he could look so much younger too!



This young lady hasn't been to the dentist in over 10 years due to many factors. As you can see there were obvious issues she presented to Dr. Vuong for help. We addressed many of her concerns and executed them in stages to make them possible on a tight budget. We treated her bleeding and sensitive gums from early periodontal disease, and removed a badly broken down and hurting tooth. After her gums healed, Dr. Vuong spent about 2 hours rebuilding many of the damaged front teeth from deep cavities with direct tooth-colored composite bonding, also known as white fillings. Ideally, these teeth should have received all porcelain crowns or porcelain veneers. Meticulous care was taken to assure proper shade/color match, contacts, contour, and that there were no ledges or open margins. We avoided root canals on these teeth. She couldn't believe in seeing her new smile! While this patient's treatment is no where completed, she can go on and keep smiling and regaining her new self-confidence!



This young gentleman came to Dr. Vuong wanting to look better, and becoming dentally healthy and not having to deal with pain all the time. He has lived with this condition for many years. While many of these teeth can be saved, they would require extensive work as decay is too advanced. They would need root canal therapy, crowns and bridges to build missing tooth back up and replace many other missing teeth. He also had a few failed root canal treated teeth, cross bite, and crowding. We devised a treatment plan that was affordable to him, while maintaining good overall dental health for the remaining teeth. We also wanted to achieve the best cosmetic and long term result. The second adjacent picture was taken one day after oral surgery when we removed the badly decay and broken teeth, and delivered the immediate upper denture and lower partial dentures. When time and proper steps are taken, Dr. Vuong often achieves excellent result with the fit, comfort, bite, and esthetics for immediate dentures. We needed only minor adjustments for this case! And of course, the patient was very happy! He smiles all the time now and has regained much self-confidence!









Amanda wanted to have straight teeth fast for her upcoming wedding. She explored options with porcelain veneers, Invisalign clear braces, and traditional metal brackets and wires braces. Porcelain veneers can be aggressive in cutting down good tooth structures, while Invisalign and traditional braces take too long for her immediate needs. 6 Month Braces is a great solution! We focused on the front teeth that show when she smiles, and used tooth colored brackets and wires. Teeth were straightened out in 6 months, perfect timing for her beautiful wedding photos!










This lady presented to Dr. Vuong with some challenges. Her old partial denture didn't fit anymore because one of her lower back teeth broke off from decay, among others that would need extensive work. She had a complete denture that was old and also worn out from a bad bite. We discussed the options, and came up with the best solution for her budget. We took out some bad teeth, made a brand new partial denture, and a complete economy upper denture. Dr. Vuong addressed many of her concerns, phased the treatment according to her budget, and paid special attention to esthetics, comfort, and function. We also chose esthetic clasps for the partial to hide the metal when she smiles. Not only was she able to chew and eat again, she was thrilled with the result!





This beautiful lady has had many esthetic concerns about her teeth. The case took us almost a year to complete due to many factors. Her main complaint was her shortened upper front teeth because many "white fillings" have turned black from recurrent decay. In order to make these restorations successful and take the load off the front, we needed to make a lower partial for her since she had lost those teeth in the back. She decided not to have implants placed at this time, we planned it so that she could choose that option in the future. A few other teeth have had root canal treatment incompleted and had temporary fillings. Dr. Vuong did a complete workup and treatment plan, keeping in mind the esthetic results as well as the ideal bite for comfort and function. We chose to have porcelain fused to metal (PFM) substructure crowns on the back teeth for strength. As for the above case, we elected to have the esthetic clasp partial so that no metal shows. For the six upper front teeth, we chose 3M ESPE Lava zirconia all porcelain crowns for strength and the most esthetic results, and avoided the risk of black gums caused by PFM crowns. She could not stop smiling and looking in the mirror as she discovered her new self! She's become a good flosser and her gum has become very healthy too!









This lady has had problems with her existing removable partial dentures for her missing 4 front teeth and many back teeth. They were not pleasant looking, or fitting properly, and were very loose. She couldn't eat regular food. Also, she couldn't wear her lower partial denture. Dr. Vuong made a new set of cosmetic partial dentures after treating her gum condition and any existing cavities. At the same time, he improved the patient's bite. We had a few limitations and couldn't hide the metal clasps on the back, but made the esthetic clasps for the front teeth so that they wouldn't show too much when the patient smiles. Metal frameworks were needed for rigidity and support of many missing teeth. Due to limited budget, could we make crowns on the back teeth, she would have a wider and more attractive smile!






Teeth Whitening is one of the safest and least expensive way to enhance an already beautiful smile. The above photos were taken Before and After customized take home teeth whitening treatment with professional guidance to give the result that the patient wanted. We used the same shade/color guide for comparison and to show that these photos were not manipulated or processed. This patient was very pleased with the result after a short period of treatment! We wish he would allow us to show his full face, but you can imagine that every time he smiles, his beautiful teeth light up his face! :)











This lady has not been to the dentist in over 10 years due to fears. She was aware of loose teeth and was looking for a solution to her unpleasant smile. Dr. Vuong spent time on her first visit to discuss her concerns and goals. We determined that all of her teeth were not save-able due to advanced periodontal or gum disease. Dr. Vuong worked out a plan to make treatment possible based on her schedule and budget. We made the upper and lower immediate healing dentures and removed all her remaining teeth. The patient was able to carry on her usual activities as a public speaker during the healing period. We noted the esthetic issues for improvement, since these were temporary dentures. We plan on placing implants in the next few months and make a new set of final and definitive implant supported over-dentures. The implants will help keeping the dentures tightly secured in place. Look at the dramatic changes in her smile! Imagine the significant change in her overall appearance! The patient was very pleased with the result!







A Saturday morning emergency patient! This man had an accident and broke his front tooth. A large piece came off. Fortunately, there was no nerve exposure or root fracture, and he had no pain. The challenge was to cosmetically rebuild the missing tooth fragment freehand without any template or mould. Dr. Vuong prepared the area and used composite tooth colored bonding material to rebuild the tooth to its original shape, size, color, contour, and contacts. This gentleman is also bruxer, as you can see in his worn out teeth and other chipped edges. A nightguard such as the NTI-tss Plus is recommended to protect these teeth from further damage.


This young man had a concern about his lower front tooth sticking out, and that he may end up losing it. He was not too concerned about crookedness or uneven look. Dr. Vuong noticed that there were cavities between those two front teeth, as the patient had difficulty keeping them clean. The solution: 6 Month Braces! After 6 month of orthodontic movement, the teeth were straightened out. Dr. Vuong now could fix the cavities where they were not possible to reach in between! The patient could also floss to keep his gums healthier. The added bonus is that he now has a much more handsome smile to show off!


This patient didn't like the way her old fillings look due to the stain. She has also noticed inflammed and tender gingival tissues due to plaque trapped in the rough margins and overhangs. These 3 fillings actually had leaky margins and recurrent decay underneath them. Dr. Vuong replaced them with newer ones. He also paid special attention to the contour, contact, shape, color match, gingival health, and margin integrity. The dark halo of the pre-molar tooth comes from the exisiting amalgam filling. Dr. Vuong can replace that when the patient requests it, since it is relatively intact and doesn't need replacement at this time.





This case involved a correction of a filling that caused food trap, sensitivity to cold, and tender bleeding gums because of open contact and open margin (void). Note also the decay or cavity lesion on the molar, and other jagged margins that make flossing difficult. These large fillings will need correction in the future. Without correction, this open margin may result in the need for a root canal when the cavity gets deeper. As you can see, that the new filling got bigger and closer to the nerve canal. You can see another similar tooth that needed root canal treatment because it was painful to the patient. Dr. Vuong replaced the filling and also treated the cavity in the molar, established tight contact, respected the embrasures and contour of the two teeth, and ascertained that there was no overhang to make flossing easy. These are important criteria to keep gingival tissues healthy from chronic inflammation and recurrent problems.



This case illustrates what cosmetic dentistry can achieve and what your white fillings should look like. These are treatments for cavities in between contacts of each tooth, as well as for those on the top chewing surface. Cavities between contacts can be caused by lack of flossing or inadequate hygiene, and can only be detected by x-rays, similar to the case above. When you see a hole in your tooth, the cavities are too big already. Note the existing white filling which has a ledge that causes plaque trap and serious recurrent decay (or cavity, do you see the dark halo?) on the tooth next to it. Dr. Vuong took proper steps to ensure that the contacts are tight and embrasures of these teeth have no overhangs or ledges, so that flossing can be achieved easily. Floss should slide through without any shredding, and food should not be trapped in between to maintain a healthy condition for your gums and long lasting restorations. The fillings should be comfortable without any severe post-operative sensitivity. Now it is critical that the patient flosses regularly to prevent future problems.