A full smile for a patient who cares about every detail: dental erosion from acid reflux
A patient who had long struggled with her teeth because of acid erosion from reflux, to the point of losing part of her bite height. We designed the smile and tried it in her mouth before any preparation, then treated the upper and lower arches in stages with full zirconia restorations.
A patient who knows what she wants
She had always struggled with her teeth. The cause was acid reflux, which dissolved her enamel over the years until her teeth became shorter and her bite lost part of its height.
She is very precise, loves details, and it mattered to her that everything came out accurate. As a life coach, she cared about how the smile fit her face and personality as a whole, and at times she guided me on things she had noticed.
The plan
From the start we agreed to be as conservative as possible:
- Smile design first.
- A mock-up in the mouth before any preparation, so she could see and approve the result.
- Then the upper arch, followed by the lower arch, in stages.
The midline shift was corrected digitally during the design, and all restorations were zirconia.
What she taught me
Quality is not only about materials. A large part of it is listening to the patient and taking her details seriously, even the ones that seem small to you.
A smile that brought a new patient
Years later, a new patient came to me without knowing me. She had been sitting in a café, noticed a woman laughing, was struck by her smile, and went over to ask: "Who did your teeth? I want mine like yours." That woman was the patient in this case.
She is also one of the patients who has referred the most friends and acquaintances to me.
Clinical details for dentists
1 Before: smile 
2 Before: worn, shortened teeth and loss of vertical dimension 
3 Before: upper arch, occlusal view 
4 Before: lower arch, occlusal view 
5 Mock-up in the mouth before any preparation 
6 Upper arch after preparation 
7 Intraoral scan of the upper preparations 
8 Intraoral scan: upper arch 
9 Lower arch after preparation 
10 Lower anterior teeth after preparation 
11 Intraoral scan of the lower preparations (Medit) 
12 Bite scan: upper restorations against the lower preparations 
13 Final result: frontal view 
14 Final result: lateral detail 
15 Final result: close-up 16 Final smile
Case summary
Adult female. Generalised intrinsic and extrinsic acid erosion (gastro-oesophageal reflux), with loss of vertical dimension and a midline shift.
Treatment plan
- Smile design and digital planning.
- Intraoral mock-up to approve aesthetics and the new vertical dimension before any tooth preparation.
- Staged treatment: upper arch first, then lower arch.
- Conservative preparations; full-contour zirconia restorations.
Digital workflow
- Intraoral scanning (Medit).
- Midline shift corrected digitally at the design stage.
- Laboratory work: Abdelhalim Faris.
Key points
- In erosion cases, the cause has to be addressed alongside the restorations, and the lost vertical dimension planned and tested before preparing.
- The mock-up turns the plan into something the patient can see and approve, which matters most for a detail-oriented patient.
- Staging the arches keeps each phase controlled and easier for the patient.
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