Do you want very white teeth that still look like teeth?
A bright shade is not what makes restorations look artificial. Shape is. The same shade on a correctly proportioned tooth with natural surface texture looks like a healthy tooth. On a flat, uniform one it looks like dentistry. Send us a photo of your smile and we will tell you what is achievable and what it would cost.
- A call within two hours during office hours.
- A written cost from us, before you commit to anything.
- No obligation. Many patients take weeks to decide. That is normal.
What this case cost
$598/month
144 payments at 9.99% APR, on approved credit.
Total: $50,000 for one extraction, one implant, one implant crown and twenty porcelain veneers across both arches.
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Treatment Plan by Dr. Mehdizadeh
- Examination of both arches, which identified one unrestorable tooth she had not come in about.
- Extraction of the decayed tooth and placement of an implant in the upper right posterior region.
- Smile design establishing the proportions, surface texture and light behavior of every restoration.
- Provisional restorations, revised in the mouth to her own specification.
- Shade selected after she approved the shape.
- Twenty porcelain veneers and one implant crown in e.max, ten upper and ten lower.
The Patient's Journey
This patient came in wanting a significantly brighter smile, and that was the whole of her stated complaint. Dr. Mehdizadeh's examination found something she had not come in about: one upper tooth toward the back had decayed beyond the point where a restoration would retain anything, and it needed extraction.
The photographs show the appearance problem. The upper teeth were crowded, darkened and rotated, and the smile was narrow in relation to her face. A brighter shade on its own would not have corrected any of that.
Understanding the Challenge
Very white restorations have a reputation for looking artificial, but the reason is rarely the shade itself. A tooth looks natural because of its proportions, its surface texture and the way light enters it and scatters before leaving. A tooth that is flat, uniform and mechanically even will look manufactured at any shade whatsoever.
The difficult part of this case was designing twenty-one restorations that retained enough individual variation to remain convincing while carrying a shade considerably lighter than the teeth she arrived with.
The extraction introduced a second consideration. An implant crown and a veneer differ in construction and in what supports them. Where both appear in the same arch, the crown has to belong to the same set rather than resemble it approximately.
Remove the unrestorable tooth and replace it with an implant. Establish proportions and surface texture before discussing shade. Design all twenty-one restorations as one set. Deliver the brightness she asked for without the uniformity that makes brightness look artificial. Keep the smile in proportion to her face.
How We Approached Treatment
Dr. Mehdizadeh extracted the decayed tooth and placed an implant in the upper right posterior region. We continued the restorative design while that site healed, because we could establish the proportions of the anterior restorations from the records, independently of the implant's readiness, so none of the design work had to wait on the bone.
The design specified shape before anything else. We settled the proportions, the contours of each surface, the texture across the facial aspect and the way each unit was to handle light before any conversation about shade took place. The shade came afterwards, chosen against approved shapes, which is the reverse of the order most patients expect.
She wore provisional restorations, and we revised them in the mouth to her own specification. Provisionals let patients express their preferences against something they can see and feel, rather than describe them in advance to a laboratory that has never met them.
Our master ceramist reproduced the approved provisionals as twenty porcelain veneers and one implant crown in e.max, ten veneers in the upper arch and ten in the lower, designing and making every unit in our own laboratory. That is how twenty-one restorations carrying deliberate individual variation stay recognizably one set.
The Result After Ten Weeks
The shade is substantially lighter than the teeth she arrived with. The proportions are even, the smile fills the width of her face, and the individual variation in shape and surface texture is what keeps a shade this bright looking like enamel rather than ceramic. Seven appointments across ten weeks covered the extraction, the implant, the design, the provisional phase and the final cementation.
There is no outstanding treatment. The implant does not decay, but the tissue surrounding it requires the same attention as the tissue around a natural tooth, which is what the routine examinations and cleanings provide.
Frequently Asked Questions About Very White Veneers, Shade and Tooth Shape
Do very white veneers always look fake?
No, and the shade is rarely the reason when they do. A tooth looks natural because of its proportions, its surface texture and the way light enters and scatters inside it. A flat, mechanically uniform tooth looks manufactured at any shade.
Why was the shape decided before the shade?
Because shape is what makes a restoration convincing and shade is what makes it bright. Selecting a shade first and fitting shapes to it means the brightness is doing work the shape should be doing. Here we settled the proportions and texture before discussing shade.
What is surface texture and why does it matter?
The fine detail across the front of a tooth, which breaks light up instead of reflecting it evenly. Natural teeth are not smooth. Reproducing that detail is a large part of why a bright restoration still looks like enamel.
How white is too white?
It depends on the shape carrying the shade, which is why a shade guide alone cannot answer the question. A bright shade on well-proportioned, textured teeth remains convincing. The same shade on flat, uniform ones does not.
Why was one tooth extracted?
It had decayed beyond the point where a restoration retains anything. She had not come in about it, and Dr. Mehdizadeh identified it at the examination of both arches rather than later.
Why an implant rather than a bridge for the extracted tooth?
An implant replaces the tooth without involving the teeth on either side of the space. A bridge means preparing both of them for crowns, which means treating two sound teeth in order to replace a third.
Does an implant crown look different from a veneer?
It differs in construction and in what supports it, so we design it into the same set rather than matching it afterwards. Here we specified the crown and the twenty veneers against one plan, which is what keeps them consistent.
What happens during the provisional stage?
You wear provisional restorations, and we revise them in the mouth until you are satisfied with them. This is where you express your preferences against something visible rather than describing them in advance, and the approved result is what our ceramist reproduces in the ceramic.
Is there anything left to do after treatment?
No further treatment. The implant does not decay, but the tissue around it needs the same attention as tissue around a natural tooth, and that is what the routine examinations and cleanings are for.
How much does a case like this cost?
This case was $50,000, covering one extraction, one implant, one implant crown and twenty porcelain veneers across both arches. $598/month: 144 payments at 9.99% APR, on approved credit.
