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How to tackle rotated 8 and 9 upper incisors

S

Skippydoo

Junior member
Joined
Feb 15, 2021
Messages
7
Location
Uk
Since I was young I had to have gas and sedative tablets to deal with my fear. Several times I woke during extractions and remember trying to bite the dentists fingers.
Due to this I felt I didn't have the ability to deal with the treatment options as a teen to sort out the crowding and rotation. It was suggested nothing could be done without extractions which would cause gaps and need bridges I think was suggested. This was too scary.
Anyway now 50 and bereft so trying to improve my confidence and appearance.
I'm in the UK.
My normal dentist is ultra conservative and doesn't really do cosmetic dentistry.
I thought about maybe veneers or Invisalign. I'm getting some trays made to whiten and reduce yellow coffee teeth already so have just taken impression s at home.IMG_20210212_231834__01.jpgIMG_20210212_231942__01.jpgIMG_20210215_145219.jpg
 
Dr. Daniel

Dr. Daniel

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Nov 2, 2010
Messages
1,946
Location
The Hague , Holland
Hi,

esthetics is subjective (though some dentist might argue differently) and you are the one to judge whether treatment is needed. However, from your photos your teeth look great. There is a small overlap between the centrals but very acceptable (judging from the photos).
I strongly suggest you ask other people who will be frank with you whether you need to interfere with your smile. And please don’t ask them while revealing your teeth with retractors, using strong light and looking close up. Let them judge your natural smile from a close conversation distance (if the COVID laws permit that).
by the way, I encourage all dentists to be conservative.
 
S

Skippydoo

Junior member
Joined
Feb 15, 2021
Messages
7
Location
Uk
Hi,

esthetics is subjective (though some dentist might argue differently) and you are the one to judge whether treatment is needed. However, from your photos your teeth look great. There is a small overlap between the centrals but very acceptable (judging from the photos).
I strongly suggest you ask other people who will be frank with you whether you need to interfere with your smile. And please don’t ask them while revealing your teeth with retractors, using strong light and looking close up. Let them judge your natural smile from a close conversation distance (if the COVID laws permit that).
by the way, I encourage all dentists to be conservative.
I realise to some people my smile is reasonable. I have friends with dentures of a similar age. I've been self conscious of my smile from bring a teenager. I think because of my facial structure and excess weight a big smile feels tight and somewhat uncomfortable.
I would dearly love a full toothy smile at some point soon.
I honestly feel myself taming my smile which is unnatural when happy.
 

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Judythecat

Judythecat

Well-known member
Joined
Mar 7, 2018
Messages
642
I’m not a dentist, but I think you have a very nice smile! I asked my own dentist about whitening and veneers a couple of years ago, and she was like NO WAY! She said we are so used to seeing “Love Island” smiles that we have forgotten what normal healthy teeth look like.
 
S

Skippydoo

Junior member
Joined
Feb 15, 2021
Messages
7
Location
Uk
I’m not a dentist, but I think you have a very nice smile! I asked my own dentist about whitening and veneers a couple of years ago, and she was like NO WAY! She said we are so used to seeing “Love Island” smiles that we have forgotten what normal healthy teeth look like.
Your very kind. I'm feline better about it meow 😺
 
Gordon

Gordon

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Straightening out those 2 teeth is not a trivial or risk free matter.
Orthodontics will help but unless a permanent retainer is bonded on to the back of them then they will almost certainly relapse. A bonded retainer brings its own issue with plaque build up and general nuisance.

Veneers or crowns risks the gingival margin shooting up exposing some root surface and the margin of the veneer/crown which is unsightly too. it happened to a patient of mine when I was a young and stupid new dentist, lovely looking girl who talked me into crowning her 2 incisors to straighten them up. 6 months later we were looking at gum grafting to sort out the recession at the neck of the teeth. Never, ever again will I do that!

A bit of gentle bleaching would be the most I'd be prepared to do if you were my patient :)
 
S

Skippydoo

Junior member
Joined
Feb 15, 2021
Messages
7
Location
Uk
Thanks very much for that advice.
I realise the conservative approach is sensible.
I've got some EU CP35 enroute so that should brighten things up.
Second line is either Smile Direct or a trip to Hungary as I've a friend in Budapest and a few hundred litres of nitrous to calm me down. Would the very thin veneers I think they're Lumineers be able to make things look better?
Straightening out those 2 teeth is not a trivial or risk free matter.
Orthodontics will help but unless a permanent retainer is bonded on to the back of them then they will almost certainly relapse. A bonded retainer brings its own issue with plaque build up and general nuisance.

Veneers or crowns risks the gingival margin shooting up exposing some root surface and the margin of the veneer/crown which is unsightly too. it happened to a patient of mine when I was a young and stupid new dentist, lovely looking girl who talked me into crowning her 2 incisors to straighten them up. 6 months later we were looking at gum grafting to sort out the recession at the neck of the teeth. Never, ever again will I do that!

A bit of gentle bleaching would be the most I'd be prepared to do if you were my patient :)
 
Gordon

Gordon

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The problem is that the bone over the roots of those 2 teeth will be very thin. Anything that disturbs the margin where the gum meets the teeth carries a risk that the bone will break down in that area, which will look very unsightly. It's not a risk I would take but I'm not your dentist.
 
S

Skippydoo

Junior member
Joined
Feb 15, 2021
Messages
7
Location
Uk
The problem is that the bone over the roots of those 2 teeth will be very thin. Anything that disturbs the margin where the gum meets the teeth carries a risk that the bone will break down in that area, which will look very unsightly. It's not a risk I would take but I'm not your dentist.
Thanks for your input. Would an Invisalign type system be able to straighten them out with less risk? When I was younger my dentist thought braces would need tooth removal. But now I'm told things have evolved.
 
drhirst

drhirst

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Dec 7, 2008
Messages
724
Location
Welwyn Garden City, UK
Hi Skippydoo,
I would echo the excellent advice drdaniel and Gordon have already given. I too think your smile is just fine, and at normal conversation distance no one will be noticing the slight irregularities.

If you are really set on trying to improve it, I would offer the following advice.

1) Do not go to a cosmetic dentistry centre abroad, many of them are totally unscrupulous and will sell you inappropriate solutions that will be badly constructed and fitted and cause you a world of ongoing dental problems for the rest of your life. You will have no redress if it all goes wrong.

2) Do some whitening, this is so conservative and safe, I'm sure your dentist will oblige.

3) Do not go to a cosmetic dentistry centre abroad, many of them are totally unscrupulous and will sell you inappropriate solutions that will be badly constructed and fitted and cause you a world of ongoing dental problems for the rest of your life. You will have no redress if it all goes wrong.

4) See a qualified orthodontist to straighten your front teeth. A proper qualified orthodontist who can use invisalign or any other combination for braces to quickly and safely straighten your teeth. DO NOT use smile direct, when you are apprehensive you want it all to go right and to have the proper support and backup which you cannot get with smile direct- just google "smile direct class action" to see the problems patients have with them. Remember you will need to wear retainers for life, please refer back to Gordon's comments.

5) Do not go to a cosmetic dentistry centre abroad, many of them are totally unscrupulous and will sell you inappropriate solutions that will be badly constructed and fitted and cause you a world of ongoing dental problems for the rest of your life. You will have no redress if it all goes wrong.

6) Once the orthodontist has straightened them, an artistic dentist will be able to refine things by doing some minor reshaping, such as reducing the prominent back corners of your two upper front teeth and maybe bonding some white filling material here and there to further refine the shape. This will look amazing and will not put your teeth at risk. If you have the white filling bonded on it will need repolishing after a couple of years and maybe replacing after about 6 or 7 but as you will have had your teeth straightened first, there will only be small bits of white filling to maintain.

7) Do not go to a cosmetic dentistry centre abroad, many of them are totally unscrupulous and will sell you inappropriate solutions that will be badly constructed and fitted and cause you a world of ongoing dental problems for the rest of your life. You will have no redress if it all goes wrong.

And finally....
Do not go to a cosmetic dentistry centre abroad, many of them are totally unscrupulous and will sell you inappropriate solutions that will be badly constructed and fitted and cause you a world of ongoing dental problems for the rest of your life. You will have no redress if it all goes wrong.

I hope this information will help you choose the right path for you.

Best wishes

Lincoln
 
S

Skippydoo

Junior member
Joined
Feb 15, 2021
Messages
7
Location
Uk
Hi Skippydoo,
I would echo the excellent advice drdaniel and Gordon have already given. I too think your smile is just fine, and at normal conversation distance no one will be noticing the slight irregularities.

If you are really set on trying to improve it, I would offer the following advice.

1) Do not go to a cosmetic dentistry centre abroad, many of them are totally unscrupulous and will sell you inappropriate solutions that will be badly constructed and fitted and cause you a world of ongoing dental problems for the rest of your life. You will have no redress if it all goes wrong.

2) Do some whitening, this is so conservative and safe, I'm sure your dentist will oblige.

3) Do not go to a cosmetic dentistry centre abroad, many of them are totally unscrupulous and will sell you inappropriate solutions that will be badly constructed and fitted and cause you a world of ongoing dental problems for the rest of your life. You will have no redress if it all goes wrong.

4) See a qualified orthodontist to straighten your front teeth. A proper qualified orthodontist who can use invisalign or any other combination for braces to quickly and safely straighten your teeth. DO NOT use smile direct, when you are apprehensive you want it all to go right and to have the proper support and backup which you cannot get with smile direct- just google "smile direct class action" to see the problems patients have with them. Remember you will need to wear retainers for life, please refer back to Gordon's comments.

5) Do not go to a cosmetic dentistry centre abroad, many of them are totally unscrupulous and will sell you inappropriate solutions that will be badly constructed and fitted and cause you a world of ongoing dental problems for the rest of your life. You will have no redress if it all goes wrong.

6) Once the orthodontist has straightened them, an artistic dentist will be able to refine things by doing some minor reshaping, such as reducing the prominent back corners of your two upper front teeth and maybe bonding some white filling material here and there to further refine the shape. This will look amazing and will not put your teeth at risk. If you have the white filling bonded on it will need repolishing after a couple of years and maybe replacing after about 6 or 7 but as you will have had your teeth straightened first, there will only be small bits of white filling to maintain.

7) Do not go to a cosmetic dentistry centre abroad, many of them are totally unscrupulous and will sell you inappropriate solutions that will be badly constructed and fitted and cause you a world of ongoing dental problems for the rest of your life. You will have no redress if it all goes wrong.

And finally....
Do not go to a cosmetic dentistry centre abroad, many of them are totally unscrupulous and will sell you inappropriate solutions that will be badly constructed and fitted and cause you a world of ongoing dental problems for the rest of your life. You will have no redress if it all goes wrong.

I hope this information will help you choose the right path for you.

Best wishes

Lincoln
Thanks for the detailed advice Lincoln. Can you judge from the pictures if they are suitable for Invisalign? I would like to start planning things but due to covid and my clinically vulnerable status I can't really visit an orthodontist in person at the moment.
 
drhirst

drhirst

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Verified dentist
Joined
Dec 7, 2008
Messages
724
Location
Welwyn Garden City, UK
I am not an orthodontist and refer out all my orthodontic work, so I am not an expert. Having said that, I am sure Invisalign could be used as your teeth require only minor tweaks. Just remember that invsalign is just one brand of clear aligner, which is just one type of brace. Just the same as if you wanted to drive to town to do your shopping you could go in a Ford Mondeo, but could just as effectively use a Range Rover, Mini or Corsa. What is important is not the type of brace but the skill and knowledge of the orthodontist. An expert may use a combinations of systems to get the best solution for you.
Sit tight until covid eases. No one is going to see your teeth with a mask on at present. I've just check with my wife and she has said I've only got marginally uglier over the last 10 months so, if you are like me, we can afford to wait a bit longer ;)😜
 
Last edited:
drhirst

drhirst

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Joined
Dec 7, 2008
Messages
724
Location
Welwyn Garden City, UK
By the way Skippydoo, from the great photos you posted, it is clear that you either clench or grind your teeth at night, you may well not even be aware of this but I can see the wear patterns on your teeth. This is another reason not to have a load of delicate veneers placed as they would be at risk of chipping unless you commit to wearing a nightguard every night forever.
 
S

Skippydoo

Junior member
Joined
Feb 15, 2021
Messages
7
Location
Uk
Thanks for that insight. Sleep is a big problem for me I have a CPAP, fibromyalgia, a neurological disorder, oxycodone pain medication causing dry mouth etc etc. My jaw sometimes vibrates like shivering even in the day so nothing surprises me. I will certainly raise it next visit.
By the way Skippydoo, from the great photos you posted, it is clear that you either clench or grind your teeth at night, you may well not even be aware of this but I can see the wear patterns on your teeth. This is another reason not to have a load of delicate veneers placed as they would be at risk of chipping unless you commit to wearing a nightguard every night forever.
 
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