“I was mowing the lawn and a rock broke my tooth. What can you do to help me?” This story was quite surprising and the rock did quite a lot of damage. I would never have thought about having to wear a mouth guard to protect my teeth while mowing the lawn before this.
This story was a little unusual, but the treatment was quite routine. The patient had broken about one quarter of his central and lateral incisor on his right side. When restoring front teeth, I almost always use porcelain to restore the teeth because it is the most life like and transmits light similarly to the natural enamel. I told him that we would need to do porcelain crowns. I also pointed out the cosmetic components of his unique situation. He had a gap between his front two teeth and the teeth that were needing treatment were unilaterally on one side.
When we repair teeth in the front, especially if there are any cosmetic concerns at all, it is preferable to do the same number of teeth on both sides of the midline. This means that for best esthetics, if we are going to crown the central and lateral on the right side, we should also crown the central and lateral tooth on the left side. This is to keep consistency in the color of the teeth as well as the dimensions. The eye will catch an odd number of teeth or something unilateral more easily.
He also had a gap between his front two teeth. This was a great opportunity, if we restored all 4 teeth, to close the gap, and to distribute and differences in widths caused when filling the gap among all 4 teeth. The patient was interested in closing the gap, so he accepted the treatment recommendation to crown his 4 incisors.
The teeth were prepared for crowns and temporary crowns were made. We chose a shade the same as the surrounding natural teeth for the crowns. He returned to the office to have the permanent crowns cemented and was delighted by the result. You simply cannot tell that he broke his teeth, or ever had a gap. This unfortunate lawn-mowing accident turned out to be a blessing.
