1. #1

    Join Date
    Aug 2009

    Default Cosmetic dentistry after periodontitis

    During the past two years, I have had quite extensive treatment at the Eastman Dental Hospital in London to treat Periodontitis.

    I had a few bouts of surgery, including a bone graft to arrest the problem. The treatment as successful, and I now have a rigorous interdental hygiene routine but as my gums calmed down they recessed (I was warned this would happen) and now I have some very recessed areas and large gaps pretty much everywhere. Add to this my yellow-ish teeth and unattractive crown and equally unattractive veneer on my two upper front teeth, I could do with a makeover.

    My question is, though: Can anything be done about the advanced gum recession? Veneers are, quite literally, a 'surface only' treatment. On some of my, now quite extended, teeth, the veneers would have to be quite large.

    Or, would laser reshaping be a viable option to get my gums back to where they were?

    Lastly, and I guess the most fundamental question, is there any point doing extensive cosmetic work at all. will I end up with a sufficiently different smile?

  2. #2
    Dr Pav Khaira's Avatar
    Join Date
    Dec 2007


    There are a number of options available. I would not recommend veneers alone if you've had gum disease and recession as a result. The veneers would end up looking too long and disproportionate.

    Options include gum grafts, which I would recommend be done by a gum specialist, or prosthetic ("fake") gums which are removable but can give excellent results

    I hope this helps

    Special interest in TMJ treatments, tension headaches and migraine therapy

  3. #3
    davidbloom's Avatar
    Join Date
    Sep 2009


    Firstly I am glad to hear that your gum disease has been successfully
    treated. As I am sure you are aware the most important thing now with
    regards to your gums is maintenance.

    With regards to the appearance of your teeth there are a few options:

    1/just whiten your teeth and replace the unsightly crown and veneers and
    accept the black triangles

    2/no 1 with a removable silicone gum slip to hide the black triangles

    3/just a removable gum slip and accept the colour, old crown and veneer

    4/Full smile makeover. Veneers are just a facing but can be used to
    cover the black triangles. This can result in long contacts but with
    carefull planning and with correct techniques good results can be

    Unfortunately laser recontouring or grafting would not deal with your

    Dr David Bloom BDS

  4. #4
    prosman's Avatar
    Join Date
    Aug 2009
    Pangbourne & London


    Good advice from David, I agree with everything he says especially the gum grafting/ re-contouring.
    If you can run to the expense then a full mouth reconstruction will be the ticket.
    Dr Nick Fahey BDS (NZ), MCLIN DENT PROS (London), FRACDS, MRD RCS (Edin) Pros, MFDS RCS (Eng)

  5. #5
    davidbloom's Avatar
    Join Date
    Sep 2009


    Firstly I am glad your gum disease has been treated and I would
    encourage you about your home care as this is now the most important
    factor in keeping this disease under control.

    It is entirely possible to help hide the 'black triangles' you have been
    left with after your gum disease has been treated. The first and
    simplest way is by constructing a plastic ' gum slip' that is removable
    and will hide these spaces by covering them. Unfortunately it is
    removable and will not address the colour or previous crowns or veneers.

    An alternative is replacing the existing crowns and veneers and
    considering more veneers that have 'long contact points' that will
    effectively cover the black triangles . Not only will this not involve
    anything removable but it will also address the whole smile and can
    achieve any significant changes you wish to make. Care has to be taken
    to not make the teeth appear too big but this, in the right hands, can
    be achieved and certainly can be assessed and confirmed in advance of
    any treatment. It should be remembered that veneers can and should be a
    minimally invasive treatment and correct planning is essential to
    achieve this. Whilst veneers are only facings they can be used to help
    hide this type of problem, whilst still allowing you to keep these areas

    Unfortunately Gum grafting or laser reshaping are unlikely to help your
    type of aesthetic problem


    David Bloom
    Past President BACD
    Accredited member BACD

    cid:[email protected]

    Senova Dental Studios
    10 Beechen grove,Watford,
    Herts. WD17 2AD
    United Kingdom T: 01923 233600
    F: 01923 440041
    E: [email protected]
    W: cosmetic dentists in London dentists Watford provides tooth whitening, porcelain veneers and dental implants Watford
    Dr David Bloom BDS

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