This is a follow-up to a question from Jamie from California about Fixing a Black Triangle.
So I went to a cosmetic dentist your site recommends about my black triangle between the 23 and 24. he said it was small and should not bond it because the gum in that area will be hard to keep clean and could become inflamed and not healthy in the long run. If he doesn’t want to do the bonding, should I go to another dentist? I’d really like to reduce the black triangle. He recommended getting veneers in twos for the space, but I’d really rather not ruin perfectly good healthy teeth for veneers at this point.
– Jamie from California
You’re saying that this black triangle is between teeth #s 23 & 24? Those are the lower right central and lateral incisors. I was thinking you were talking about UPPER teeth.
Does this actually show during conversation?
Now I need to be careful here, because maybe this space is really ugly, but I’m skeptical. I don’t have a photograph of your face, so I don’t know, and I’m going to need to make some assumptions in answering your question.
Having black triangles between lower teeth is not really abnormal, and I wouldn’t be inclined to treat them. Some people have them when they are young, and almost everyone has them as they age. I have them, and I have received numerous compliments about my smile. The lower teeth tend to be covered by your lower lip, and even when they aren’t completely covered, people’s attention is naturally focused on your upper teeth.
Have you had other people notice this black triangle? Or is this just something you’re looking at and you have an idea in your mind of how this is supposed to look and how it looks doesn’t measure up to that ideal?
I’d suggest getting a friend or two you can trust, and position them at a normal conversational distance, and have a little conversation with them. And ask them if they notice anything unattractive about your smile. Urge them to be honest with you, and hopefully you can trust them to be honest. And make a judgment from that about whether this black triangle needs treating.
A good cosmetic dentist addresses the cosmetic needs of the patient as the patient perceives them. But there are limits of reasonableness to this approach. I remember hearing Dr. Ronald Goldstein, who is considered by many to be the father of modern-day cosmetic dentistry, discuss the unreasonable obsession some patients have with the details of the appearance of their teeth. Patients, he said, should evaluate the appearance of their teeth at a conversational distance, and when they use a mirror to evaluate their teeth, should hold the mirror at arm’s length, so that they see themselves as others see them. Then he joked that when they would hold the mirror up close, he would adjust the fee to be inversely proportional to the distance between their face and the mirror. That brought a big laugh from the audience of cosmetic dentists, because they all are familiar with patients who have an inordinate obsession with tiny details in the appearance of their teeth that no one else notices.
And the dentist you went to mentioned functional problems with bonding – that you will create an area that will be difficult to clean. Essentially, from what he is saying, he would create a food trap. He is to be commended for his honesty and integrity. But I have a question for you. You said you don’t want to “ruin” perfectly healthy teeth by putting porcelain veneers on them. Why, then, would you want to ruin them by creating gum disease around them? A food trap is far more damaging to the health of your teeth than placing porcelain veneers, and could lead to the eventual loss of those teeth.
Getting good dental care is a matter of being able to accurately judge whether you can trust your dentist. It appears to me that this dentist is trustworthy – as a recommended dentist on our list he has to be esthetically sensitive. And he is pouring cold water on your idea, saying that the damage that would be caused by the treatment you want would outweigh any esthetic benefit. You could just trust him, which is what I think you should do, or you could shop around until you find an untrustworthy dentist who will actually do what you want.
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.