I would like to share a particularly challenging case I had to deal with a few years ago, and how keeping an open mind along with some great teamwork and planning allowed us to triumph over the dark side.

The dark side I'm referring to is the dark root of my hygienist's left maxillary central incisor. Her root was so dark it actually showed through the gingiva making it appear bluish gray. Needless to say, she was less than happy with the color of her gingiva. This was totally understandable as it clearly highlighted her smile, just not in a way she liked.

Upon examination it was clear simply placing a new crown would not solve her concern, since placing the crown margin deep enough would have invaded the biologic width and left us with a whole new problem. Although we certainly could have decided to remove the tooth to take the dark root completely out of play, but she was not ready to loose her tooth just yet.

We made the decision to team up with my periodontist, Dr. Brien Harvey, to thicken the tissue over the root in an attempt to hide the dark root. Although we knew doing this might not work and the tissue would be thicker over this tooth than the adjacent teeth, we decided it was worth a try.

As you can see in the photos in the digest, “Six Tips to Improve Your Occlusal Photographs”, it actually worked beautifully. While the tissue is slightly thicker, as we knew it would be, to hide the root it is not noticeable in normal conversation and most importantly, she is thrilled with the results we achieved. Sure we could have treated this in other ways; however, keeping an open mind allowed us to achieve her goals and keep her tooth.

John R. Carson, DDS, PC, Spear Visiting Faculty. [ www.johnrcarsondds.com ]