Minimal intervention to achieve natural-looking results
She also reported that she did not smile as much due to the way that the upper central and lateral incisors protruded outwards. The patient had undergone two unsuccessful courses of orthodontic treatment in the past, so her goal was to have an improved smile with teeth that were aligned and all of a similar colour.
Assessment and diagnosis
A comprehensive dental health examination was completed and the patient’s oral hygiene found to be of a fair standard. The patient’s soft tissues, temporomandibular joints and masticatory muscles were also assessed, but this did not reveal anything abnormal. As there was nothing untoward with the patient’s existing occlusal scheme, it was decided that a conformative approach would be taken, utilising the existing maximum intercuspal position.
The loss of tooth substance was present on the palatal surfaces of the upper central and lateral incisors. The patient advised that she did not consume acidic beverages and had a limited intake of acidic fruits. She did not drink alcohol or smoke, but she did report having a funny, sour-like taste in her mouth upon waking up in the morning and even during the day sometimes. Therefore, it was diagnosed that the loss of tooth substance was due to regurgitated acid from gastro-oesophageal reflux.