From Fluorosis to Flawless: A Live Veneer Case from CMS Anterior Aesthetic Live Course

Case Background

When treating aesthetic cases, especially in patients who have lived with dental imperfections for most of their lives, it’s essential to approach the plan with empathy, vision, and precision. This patient in their mid-20s presented with a history of dental fluorosis and approximately 10-year-old failing composite bonding. They were unhappy with the patchy appearance of their teeth, mismatched shade, and breakdown at the margins.

Restorative success in these situations hinges on a solid diagnostic process, interdisciplinary planning, and an uncompromising standard for aesthetics. This case was completed during our Anterior Aesthetic Live Course, where we teach participants how to drive optimal outcomes through minimally invasive techniques and thoughtful design.

Clinical Challenges

The patient presented with:

• Moderate fluorosis across the anterior maxillary teeth

• Existing composite bonding with marginal leakage and discoloration

• Interproximal decay influencing preparation design

• Unbalanced smile with visible translucency and color variation

• Mild wear on incisal edges

• High aesthetic expectations

The aesthetic and functional considerations were amplified by the patient’s age—they had lived with these concerns since adolescence and were eager for a confident, natural-looking smile.

Diagnostic and Prep Phase

We began with comprehensive records, photography, and digital smile design to co-plan with the patient and lab. Decay and defective bonding dictated a slightly more aggressive prep in the interproximal zones, while still maintaining a minimally invasive approach elsewhere. Care was taken to preserve enamel where possible to maximize bonding strength for the veneers.

Shade selection: OM3 was chosen to balance brightness with a lifelike, natural value for the patient’s complexion.

Final Restoration

We delivered 10 Emax veneers (#4-13), customized to:

• Correct discoloration and eliminate signs of fluorosis

• Replace deteriorating composite bonding with stronger, longer-lasting porcelain

• Create symmetry and harmony across the smile

• Maintain a conservative prep approach guided by function and decay

Cementation was completed using a heated resin protocol to ensure optimal seating and retention. Functional evaluation confirmed anterior guidance and group function as designed.

Lab partner: Gold Dust Dental Lab provided custom wax-ups and layering techniques that we teach at our live events, enhancing the natural texture and translucency of the restorations.

Outcome

The patient was thrilled with the result—bright, natural, and completely transformed. For a young adult who had spent years feeling self-conscious about their smile, the impact was both cosmetic and deeply emotional.

This case is a reminder that even in seemingly straightforward veneer cases, the why behind every prep, shade, and material choice matters. When decay, previous dentistry, and aesthetic demands intersect, the roadmap to success is education, collaboration, and intentional planning.

Join us at the next Anterior Aesthetic Live Course – September 26–27, 2025 (Click to Register)
Discover how to elevate your veneer outcomes by mastering prep design, lab communication, and restorative workflows that drive patient satisfaction and long-term success.

Case by Anterior Aesthetic Live Instructors

Dr. Kevin Low & Dr. Micah Parkhurst