Steve's Veneers: Worn, Crooked Teeth — Restored on Both Arches
Clinically Reviewed by Brennan Bonati, DDS — Cosmetic & Restorative Dentistry
Before
After
| Patient | Steve, 50s |
| Chief Complaint | Worn, crooked teeth — could not see his teeth when he smiled; concerned about continued wear |
| Treatment | 14 E.max veneers — 8 upper arch, 6 lower arch |
| Material | E.max (lithium disilicate porcelain) |
| Shade | B1 |
| Pre-Treatment | None |
| Investment | $25,000 |
| Appointments | 5 visits |
| Location | Lakewood, Colorado |
| Clinical Reviewer | Dr. Brennan Bonati, DDS |
Steve's Story
Steve was in his 50s and had watched his teeth get shorter and more crooked over the years. By the time he came in for his consultation, the wear had progressed to the point where he could not see his teeth when he smiled — his lips would part but the teeth were so short they barely showed. He was also concerned about the trajectory: he could see the wear getting worse, and he did not want to wait until the damage was irreversible.
His concern was both cosmetic and preventive. He wanted his teeth back — the length, the visibility, the smile he used to have — and he wanted to stop the wear before it reached the point where veneers were no longer an option and crowns became necessary.
Click to enlarge
Click to enlarge
The Treatment Plan
Fourteen E.max veneers across both arches — 8 on the upper and 6 on the lower — in shade B1. Treating both arches was necessary for two reasons. First, the wear had affected both upper and lower teeth, and restoring only the upper arch would have left a visible mismatch in color and length. Second, the bite design required that both arches be addressed together to ensure the new veneer length on the upper teeth contacted the lower teeth in a way that distributed forces evenly and protected both sets of restorations.
Shade B1 was selected: bright enough to be clearly whiter than Steve's worn and yellowed natural teeth, but with the translucency and warmth of natural enamel rather than an artificial appearance. The case was completed in 5 appointments over approximately 4 to 5 weeks.
Clinical Insight
Steve's case illustrates an important clinical decision point: the difference between a case that can be treated with veneers and one that has progressed to requiring crowns. Veneers are appropriate when there is sufficient enamel remaining to bond to and support the restoration. When wear has progressed to the point where the enamel is largely gone and the dentin is exposed across most of the tooth surface, crowns become necessary. Steve's case was at the boundary — the wear was significant, but there was still adequate enamel for a strong veneer bond. Acting at this stage, rather than waiting, preserved the option of a less invasive restoration.
The lower arch veneers in Steve's case deserve specific mention. Lower arch veneers are technically more challenging than upper arch veneers because the lower teeth are smaller, the access is more limited, and the bite forces on the lower anterior teeth are significant. E.max is the material of choice for lower arch veneers because its high flexural strength — approximately 400 MPa — allows it to withstand the forces that would fracture a weaker material.
The Result
Steve's transformation is one of the most striking in the gallery — not because of dramatic color change, but because of the difference in what his smile communicates. In the before photo, the teeth are barely visible, and the smile looks guarded and aged. In the after photos, the teeth are full-length, bright, and well-proportioned, and the smile looks open and confident. The change in apparent age is remarkable.
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At a Glance
Worn, crooked teeth so short they were barely visible when smiling. Continued wear was a concern.
Wear affected both upper and lower teeth. Treating both arches together ensured color and length match and a balanced bite.
14 E.max veneers (8 upper, 6 lower), shade B1. 5 appointments. $25,000.
Full-length, bright, confident smile on both arches. Wear stopped. Steve was very happy.
Steve's treatment of worn and crooked teeth with 14 E.max veneers demonstrates how veneers can address both aesthetic and functional concerns in patients with moderate wear. This case is a practical example of veneers for worn teeth improving smile appearance and tooth alignment. It also illustrates the importance of assessing veneer candidacy when correcting multiple issues simultaneously. The choice of porcelain veneers balances durability and natural aesthetics, with cost considerations detailed in the porcelain veneers cost guide. For patients curious about longevity, this case also relates to how long veneers last when restoring worn teeth.
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Frequently Asked Questions
Can veneers fix worn-down teeth?
Yes, in many cases veneers can restore the length and appearance of teeth that have been worn down by grinding or acid erosion. Veneers add material to the front surface and incisal edge of the tooth, rebuilding the length and shape that has been lost. The key consideration is whether the wear is severe enough to require full-coverage crowns instead of veneers. For moderate wear where adequate tooth structure remains, veneers are an excellent solution.
Why do both upper and lower veneers sometimes need to be done together?
When teeth have been worn down by grinding, both arches are typically affected. Restoring only the upper arch while leaving the lower arch worn creates a mismatch in color, length, and proportion. More importantly, restoring only one arch without addressing the other can create bite problems, as the new veneer length on the upper teeth will contact the worn lower teeth in ways that can stress the restorations. Treating both arches together allows the dentist to design a harmonious bite that distributes forces evenly.
Will veneers stop my teeth from wearing down further?
Veneers restore the teeth to their correct length and shape, but they do not stop the grinding habit that caused the wear. To protect the veneers, a custom night guard is typically provided after treatment. The night guard protects the veneers during sleep, when most grinding occurs. With a properly fitted night guard and regular dental monitoring, E.max veneers can last 15 to 20 years even in patients who grind.
Related Reading
- Porcelain Veneers: What They Are and How They Work
- How Much Do Veneers Cost? The Complete Guide
- Joan — Full-Mouth Rehabilitation for Collapsed Bite
- Am I a Candidate for Veneers?
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