Have your teeth become shorter over the years?
Wear removes length, and shortened teeth account for a great deal of what makes a smile look older than the person wearing it. Restoring the length is what reverses that impression. The bite determines how much length we can add, which is why we test the new proportions in provisional restorations before making anything definitive. Send us a photo of your smile and we will tell you what is involved.
- 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
$502/month
144 payments at 9.99% APR, on approved credit.
Total: $42,000 for the assessment and design, one extraction, one implant, one implant crown, two crowns and nineteen porcelain veneers.
How full-mouth reconstruction works, and what it costs today →
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Treatment Plan by Dr. Mehdizadeh
- Assessment of the wear across both arches, the drifting and the existing mismatched restorations.
- Smile design establishing softer, fuller shapes and the length the bite would accommodate.
- Replacement of a failed root canal in the lower arch with a single implant.
- Provisional restorations on both arches, worn while she tested the new length.
- Revision of the provisionals until she approved the shapes and proportions.
- Nineteen porcelain veneers, two crowns and one implant crown in e.max, twenty-two units.
The Patient's Journey
This patient wanted to look more youthful. She had arrived at that conclusion by noticing two specific changes. Her teeth had become discolored, and they had become visibly shorter. She had also accumulated restorations over the years, placed at different times and by different hands, which no longer matched anything surrounding them.
The photographs show the wear most clearly from the side. The biting edges have flattened and the posterior teeth have darkened. From the front the effect is subtler and harder to attribute, which is the reason patients frequently describe this presentation as looking tired rather than as having worn teeth.
Understanding the Challenge
Wear removes length, and shortened teeth account for a considerable proportion of what makes a smile appear older than the person wearing it. The teeth become squarer, the edges flatten, the smile line loses its curve and progressively less enamel displays when the lips part. Restoring the length is what addresses all four of those consequences simultaneously.
The bite, rather than preference, determines how much length we can restore. Lengthened teeth have to meet the opposing arch somewhere, and length added beyond what the bite will accommodate is length that fractures or interferes with function. The design therefore proposed an amount and the provisional stage established whether it was tolerable.
The second consideration was the character of the shapes rather than their dimensions. Fuller, brighter teeth on a patient in her sixties can appear conspicuously reconstructed, which is the opposite of looking youthful. The brief was softness and femininity in the outlines, at proportions appropriate to her age rather than borrowed from someone thirty years younger.
There was also one failing tooth. A lower posterior tooth carried a root canal that had failed, and it required replacement before we could consider any restorative work above it finished.
Restore the length the wear had removed, within what the bite would accommodate. Replace the failed root canal with an implant. Design softer, fuller outlines appropriate to her age. Replace the mismatched restorations as part of the same set. Test the new length in provisionals before making anything definitive.
How We Approached Treatment
The design established the shapes before any preparation. It corrected the outlines of the worn teeth rather than simply rebuilding them larger. Dr. Mehdizadeh deliberately specified softer edges, a restored curve to the smile line and proportions consistent with her age, because fuller and brighter teeth designed without those constraints look reconstructed rather than younger.
He removed the failing lower tooth and replaced it with a single implant, which is the appropriate treatment for a tooth carrying a root canal that has already failed rather than a further attempt at restoration. That site healed while the restorative design continued, since we could establish the proportions of the remaining twenty-one units from the records without waiting on the bone.
We placed provisional restorations on both arches, and she wore them while we tested the new length in ordinary use. This is the stage that decides how much length the case can carry, because a proposed length either functions in speech and eating or announces itself within days. We revised, adjusted and reassessed the provisionals until we had final approval of the shapes and the proportions.
Our laboratory then made twenty-two units in e.max: nine porcelain veneers and two crowns in the upper arch, and ten veneers and one implant crown in the lower. The two crowns replaced the mismatched restorations she had accumulated previously, so the older work became part of the new set rather than a visible exception within it. Our master ceramist designed and fabricated all of them in our own laboratory.
The Result After Fourteen Weeks
The teeth have their length back. The smile line has recovered its curve and the shade is consistent across both arches. Eight appointments across fourteen weeks covered the assessment, the extraction and the implant, the design, the provisional phase and the cementation of all twenty-two units, which is a longer schedule than a veneer case because the implant had to integrate first. The outlines are softer than the worn teeth she arrived with, and appreciably fuller, rather than merely longer.
There is no outstanding treatment. The restorations are ceramic, and how long they last depends on how the bite loads them, so her routine examinations review the bite alongside the gums. That is the same reason we tested the length in provisionals before making any of it definitive.
Frequently Asked Questions About Worn Teeth, Restoring Length and Age-Appropriate Design
Why do worn teeth make a smile look older?
Because wear removes length. The teeth become squarer, the biting edges flatten, the smile line loses its curve and progressively less enamel displays when the lips part. Restoring the length addresses all four consequences at once.
How much length can be added?
As much as the bite will accommodate, which we assess rather than choose. Lengthened teeth have to meet the opposing arch, and length added beyond what the bite tolerates is length that fractures or interferes with function.
How do you establish what the bite will tolerate?
The design proposes an amount and the provisional restorations establish whether it works. A proposed length either functions in speech and eating or announces itself within days, which is why we made nothing definitive until she had worn the provisionals.
Can restorations look youthful without looking obvious?
That is largely a question of outline rather than shade. Fuller, brighter teeth designed without regard to age can appear conspicuously reconstructed. Here we specified softer outlines and kept the proportions appropriate to her, rather than borrowing them from a much younger patient.
What was wrong with the existing restorations?
They dated from different years and no longer matched the teeth surrounding them. We replaced two as part of this treatment, so the older work became part of the new set rather than a visible exception within it.
Why did one tooth need an implant?
A lower posterior tooth carried a root canal that had failed. We replace a tooth in that condition rather than restoring it again, and Dr. Mehdizadeh placed the implant before we completed the restorative work above it.
Why were both arches treated?
Because the wear was present in both and the two arches meet each other. Restoring length in one arch against worn opposing teeth leaves the new restorations meeting surfaces that are still the wrong shape.
What is the difference between a veneer and a crown here?
A veneer rebuilds the visible surface of a tooth that retains enough sound structure. A crown covers the whole tooth, which is what the two previously restored teeth required. Our laboratory made both in the same material and designed them as part of one set.
Is there anything left to do after treatment?
No further treatment. The restorations are ceramic, and how long they last depends on how the bite loads them, so the routine examinations review the bite as well as the gums.
How much does a full mouth restoration like this cost?
This case was $42,000, covering the assessment and design, one extraction, one implant, one implant crown, two crowns and nineteen porcelain veneers. $502/month: 144 payments at 9.99% APR, on approved credit.
