On a cold, sunny November afternoon, Helen Harris dashed through the diamond district. She did not have a deadline, per se, and nothing to rush for — scurrying is simply how one maneuvers through this section of Midtown Manhattan, through which so many diamonds that enter the United States eventually pass. Ms. Harris, 40, was doing her rounds, picking up and dropping off pieces of her jewelry to polishers, engravers and diamond setters.

Like the intricate mouthpieces of gold and diamonds she makes for clients — including the rapper Big Sean, the fashion designer Brandon Blackwood, and the models Indira Scott and Solange Van Doorn — Ms. Harris attracts attention.

As she walked, with a black Burberry trench draped over her 6-foot-tall frame, heads turned and eyes followed. When she spoke, the “trillion-cuts” in her gold grills caught the light. Her chains, one with a five-inch Jesus pendant, bounced on her neck to the tempo of her footsteps.

“If she made me and you the same type of grill, we would still have a personal connection to it,” Mr. Blackwood, who also has other pieces of her jewelry, including a Rolex that she outfitted with diamonds, said in a phone interview.

“There’s little subtleties that really separate her work,” he said. “It doesn’t feel like a factory.”

Grills became popular in the 1980s hip-hop scene but have evolved into statement pieces commonly worn by a wide range of artists including Rihanna and Miley Cyrus. Styles are endless and vary regionally. (Florida prefers all gold, shiny tops and bottoms called perms, because they resemble permanent gold teeth.)

In the 1990s, rappers like Flavor Flav, Slick Rick and Big Daddy Kane were wearing grills. In Houston, the rapper Paul Wall, who has made grills for Beyoncé, started making them and they became an emblem of his throughout his rap career. Now, he owns a department store where every part of the grill is made in-house, from casting to polishing.

“We didn’t call them grills back then, we called them gold teeth,” he said, adding that most people did not like grills because they were removable. Usually, people had their gold teeth implanted at the dentist.

Then Wu-Tang and others started wearing grills that didn’t require a trip to the dentist. “That was really a Grade A grill that was removable,” Paul Wall said. “It actually was like a turning of the tide.”

He has made grills for countless customers, including the rappers 2 Chainz and Ludacris, and he thinks the art is in the uniqueness and personalization of each set.

“We’ve done grills with people who have a wide gap and they say, ‘No, don’t close my gap, I want to have two separate grills,’” he said. “To me, that’s artistry.”

For Ms. Harris, grills are her heritage.

“It is genuinely a connection to my culture,” she said. “I won’t quit it because I have so much more to do.”

Some of Ms. Harris’s designs come in solid gold and others in platinum; many are clustered with brilliant diamonds or opals. She often makes references to the Black South and Midwest in her pieces. Some clients prefer the chic two caps of gold on the incisors; others opt for full tops and bottoms, or simply a bottom bridge. Her most requested designs use precious stones, like amethyst, quartz and jade.

Inside Manhattan Polishing on 47th Street, the specialty jewelry lights shone on her face. She could feel the eyes on her but negotiated, undaunted, searching through her purse for tickets. She was picking up a set of grills for a client.

The man at the counter, Joseph Vasquez, 18, offered to clean any other pieces she had. Ms. Harris’s neat French manicure dipped in and out of several pockets until she found the ticket she was looking for. Of the 2,600 businesses in the district, Ms. Harris has found only a handful that she trusts to be as meticulous as she is during their part of the grill-making process. The molding, casting, stone setting, polishing and sometimes laser-perfecting is something that she is interested in doing in-house, eventually.

“I’m bootstrapping everything,” Ms. Harris said in her soft, warm voice. “I have vendors who I have wholesale relationships with and I make stuff with in the diamond district, Florida and Louisiana. I think that those folks are all the best at what they do. The thing that my guys in Florida do, the people in New York don’t do. So, as a business owner and as a designer, I really believe that I’m selling a product with integrity, even if my hands don’t make it.”

Growing up in Milwaukee, Ms. Harris was always certain about her identity and values. She has remained confident even though it has not always been received kindly by others. Dealing with the people in the jewelry business isn’t always easy, she said.

“The diamond district is a tricky place to navigate if you are a diverse person, for sure,” she said as she darted into another building.

“It’s racist, sexist and homophobic,” said Ms. Harris, who is gay, about her experiences in the diamond district. “Sometimes somebody is generous enough to just admit it out loud to me and try to help me find the best path to get what I need to do, done.”

One of those people is Amir Farsijany, 70, who owns Sarah Jewelry and has run a booth in the district for 45 years. Mr. Farsijany advises her on who she can trust and if she is overpaying for any service. He keeps an eye on her. “She is one of the most honest people that I have ever seen,” he said. “If one day I don’t see her, I text her, ‘What happened to you?’”

Jewelry Was Not Always the Plan

After graduating from Antioch College in Yellow Springs, Ohio, in 2005 with a bachelor’s degree in cultural and interdisciplinary studies, Ms. Harris moved to Brooklyn with a friend from school. After a few false starts, which included traveling to Taiwan to teach English, she landed at New York City College of Technology in Brooklyn in 2012.

Ms. Harris was on the search for a livable wage. She took courses in computer science and decided to enroll in a certification program that would allow her to go into the tech industry, thinking it would be a good opportunity to make money. In 2014, having completed several other certification programs, she got a job at a data storage company and moved to Utah.

“That first salary I had wasn’t even a full $50K, but to not be on unemployment anymore and to be working every day, learning more skills that make you worth more money, that meant the world to me,” Ms. Harris said.

In Utah, Ms. Harris, who at the time presented as more masculine, was very private. Her male colleagues would often ask her if she had gotten married when she returned from long weekend visits with her girlfriend in New York. She stayed at the company for five years and resigned in 2019.

“I just sort of felt like there was nothing else I could do,” Ms. Harris said. “I also felt like I had to cut ties for my own wellness. I felt pretty afraid.”

When she resigned, Ms. Harris was already making grills, but only as a hobby. She sold her first set to a woman whom she met at a concert by The-Dream in Williamsburg.

“I had lost a lot of confidence,” Ms. Harris said, her voice timid.

She sold a second pair to a friend of her first customer. That was the encouragement and support Ms. Harris needed. She created an Instagram account using the handle @HelenWithTheGoldTeeth and began taking appointments. She now has 21,500 followers.

Ms. Harris has been featured in Elle magazine, Hypebeast.com, GQ and WWD. Last year, she was a speaker at the Revolt Summit in Atlanta, which featured performances by Lil Yachty and the City Girls, where she discussed how the business of hip-hop is intertwined with the jewelry industry.

When Raisa Flowers, a makeup artist, met Ms. Harris in 2019, she already owned a set of grills. (She discovered the style through Nelly’s 2005 video for “Grillz,” featuring Paul Wall.) Ms. Flowers had an idea for a new grill and thought Ms. Harris could make it: She wanted to combine stones and textures, but she also wanted “perms,” or the high polished gold kind, incorporated in it. She presented the concepts for her idea to Ms. Harris, who fused them together to make her a four-piece grill.

Ms. Flowers’s grills include eight bottom teeth and her right upper fang in white gold perms, an opal on the right side and a red rose across her right front tooth. “She just perfected it and made it really cool,” Ms. Flowers said.

Ms. Harris has recently completed courses in 3-D design at the New York Jewelry Design Institute in the diamond district and will be taking bench jeweler training in Tennessee this winter. She also hopes to do something with her business that she has not been able to do before: start a jewelry collection.

“It makes sense for me to do in jewelry what I wanted to do in tech, which was put my whole self in there and then see what I can get back,” Ms. Harris said. “This is worthy of all of me.”