All posts by iowasmiles

Dr. David Hall is a colleague of Dr. Malone's, an AACD accredited cosmetic dentist, the author of the consumer cosmetic dentistry information website mynewsmile.com, and the president of Infinity Dental Web in Mesa, Arizona.

My friend is a dental student. What about going to him for my smile makeover?

We saw a blog post where the person was asking about getting a smile makeover from a dental student. The dental student is her friend, and I think it appealed to this person because of the prospect of saving a lot of money.

Click here to read the post.

The blogger answered the question well, we thought. A lot of people don’t understand that cosmetic dentistry is art, and the culture in dental school is actually, unfortunately, often anti-creativity. And that’s probably how it should be. The first task of a dentist is to learn the technique and in doing so they need to learn standard procedures. They could get into all kinds of trouble by encouraging creativity.

This blog is sponsored by Lafayette dentist Dr. Michael Malone.

Congratulations to Dr. Chal

We wanted to give recognition to Dr. Arthur Chal in Phoenix who was recognized recently for 16 years of service as an accreditation examiner with the American Academy of Cosmetic Dentistry.

Dr. Chal served also as President of the AACD for 2001-2002, a couple of years before Dr. Malone. Dr. Malone and Dr. Chal have known each other for about twenty years, and we here in Dr. Malone’s office have the highest respect for Dr. Chal, the quality of his dentistry, and his dedication to the profession. For patients who live in the Phoenix area, we consider him the best dentist in Phoenix. He has expertise in cosmetic dentistry, implant dentistry, and TMJ treatment.

Congratulations, Dr. Chal

This blog is sponsored by Lafayette LA cosmetic dentist Dr. Mike Malone.

My Lumineers look terrible

I had Lumineers placed on my teeth a week ago and they look terrible. They have ridges in them and two have already broken off. My dentist is replacing them, with a tray of lumineers, which she says will be stronger because they will be in a tray. Do you have any idea what would cause the ridges? Also if I do not want her to put them on when they come in, would another Dentist possibly put them on for me since I am afraid to have her do them now.
– Pat from Mississippi

Pat,
I’m not sure I follow what you’re saying. I’m not visualizing these ridges, but apparently they make your Lumineers look ugly. Lumineers will have a slight ridge on the edge of the porcelain. Is that what has happened? Or are the ridges in the middle?

And I don’t know what a “tray of Lumineers” is. I’m imagining that she is maybe referring to a different product called Glam Smile that is put on in a tray, and I definitely don’t recommend that.

I would call everything off until you get a second opinion. If you don’t have the confidence in this dentist to have her put them on for you, you need to take a step back from this and examine all your options.

Your best bet is to get a cosmetic dentist who is accredited by the American Academy of Cosmetic Dentistry. That is an assurance that they know how to do beautiful work. But I don’t think there are any accredited cosmetic dentists in Mississippi. In my opinion, there are esthetic risks in going to a dentist who promotes himself or herself as a Lumineers dentist. They are promoted as being so easy that many dentists who don’t understand cosmetic dentistry are tempted to try them.

Other links:
Lumineers are just a particular brand of ultrathin porcelain veneers.

Should I have an implant or dental bridge for a missing molar?

I recently lost one tooth due to decay underneath my crown. The entire tooth broke off at the gum. It had been root canaled so the post is there from the root canal. The tooth is on the top left and is the third molar from the back. My dentist says the tooth can’t be saved. I can’t decide whether to do an implant or a bridge. For a bridge, there is a filling in one tooth next to it and a inlay in the tooth on the other side. I’m worried about bone loss though. Will I get bone loss if it is just one tooth missing? Will I experience bone loss with a bridge? Please let me know what you think. I am 46 and in excellent health and no bone problems right now.
– Deborah from California

Deborah,
It doesn’t sound like there is enough left of your tooth to hold a crown, so it needs to come out.

Yes, even with one tooth missing, there will be bone loss in that space where the tooth used to be. Your body will resorb that bone to use the minerals elsewhere. But, since the space is a small space, the amount of bone loss isn’t very significant. Plus, it’s not in a place that will likely show when you smile.

However, if the adjacent teeth are sound and only have conservative fillings, a dental implant would be a good idea, just to avoid grinding down otherwise healthy teeth for crowns. A dental bridge requires you to have full coverage crowns on each adjacent tooth. A dental implant, on the other hand, just requires placing a root form, allowing it to heal, and then placing a crown on that root form.

Braces or porcelain veneers for my crooked teeth

I am going to get braces in a week to correct a biting problem. My front teeth are inverted slighly. Would veneers correct this problem or should I continue with my plan for braces?
– Sandra in California

Sandra,
I’m not sure what you mean by your front teeth being inverted slightly. Do you mean that they’re tipped inward?

Porcelain veneers will for sure correct any appearance problem with your teeth, other than severe crowding. And if the front teeth are tipped inward, they will make them look straight. But generally they don’t correct functional problems. Sometimes they can. Doing porcelain crowns does more to correct functional problems.

Generally, if braces will correct a problem, I lean toward braces. That way you’re left with your natural teeth and nothing artificial bonded to them. But we most like to use Invisalign invisible braces for adults – it’s faster, more comfortable, more esthetic, and easier to keep your teeth clean with Invisalign than with traditional wire and bracket braces.

If you want to weigh the pros and cons of both approaches and get a professional opinion for your specific situation, I would recommend going to a dentist with expertise in cosmetic dentistry AND Invisalign. That way he or she has the experience and expertise to give you the whole story and doesn’t feel under any pressure to steer you one way or the other.

Related links:
Read about the options for fixing crooked teeth.

Dentist wants to replace porcelain veneers with crowns

When my daughter was 8 the dentist I used said she had a calcium deficiency because her front teeth were discolored. He put porcelain veneers on the front ones. She is 11 now and the veneers are discol ored and decaying. We started using another dentist and he said that we needed to put crowns on the front teeth and she also needs braces. I am concerened of how will they put braces on caps and why cant the veneers be replaced?

Thank You,
Suzanne in Alabama

Suzanne,
I’m not sure how many front teeth you’re talking about, and can’t tell whether your daughter needs crowns or not without an examination. But I can give you two possible reasons that the dentist wants to replace the porcelain veneers with crowns.

First would be that the dentist isn’t comfortable doing porcelain veneers. Many dentists aren’t. It isn’t taught in dental school, and many dentists just aren’t very excited about appearance-related dentistry because it is a very different field and they have to be artistic to enjoy that.

Or it could be that there is so much decay that now the teeth need porcelain crowns. Veneers only cover the fronts of the teeth. I would be surprised if your daughter at age 11 has that much tooth decay on these front teeth that she needs crowns, but maybe she does.

We really try to avoid doing porcelain crowns on young patients because when the teeth are young, they have very large pulp chambers, and the chances of irritating or injuring the tooth so that it needs a root canal treatment are large. And anytime we can do less grinding on the teeth to achieve the same result, the better it is.

As far as the braces go, the crowns wouldn’t be a problem. The orthodontist can work around that.

I think it would be prudent to seek a second opinion to see if she really needs crowns. Find a dentist who does a lot of porcelain veneers and see what he or she says.

I need a small repair to my porcelain veneer

I have porcelain veneers on the front six teeth. A small piece of my front tooth recently cracked and the dentist was able to put some bonding to match. However, after two months, the color is already that dark pasty color and it doesn’t match anymore. Is this normal? I’d rather not replace a whole veneer for a small repair. Should I bond a lighter color so when the color “comes down” a little, it matches the veneer?
– Jim in Michigan

Jim,
There are many different types of composite bonding material for your teeth. Most dentists stock a basic, “all-purpose” composite that really isn’t well suited to doing cosmetic dental bonding on front teeth. While I don’t know for sure without seeing your tooth, it sounds like this is what has happened. These all-purpose materials can tend to stain easily. Other composite bonding materials aren’t very color-stable.

There are bonding materials for your front teeth that take a high polish, are very color-stable, and don’t stain very easily, and that is what you need. I would suggest finding a dentist who is more expert in cosmetic dentistry. A dentist who is accredited by the American Academy of Cosmetic Dentistry should find your porcelain veneer repair to be fairly routine.

These cosmetic dentistry procedures often require more expertise or more specialized materials than most dentists possess. So go to the expert for this, and then go back to your family dentist for your routine maintenance, if you’re pleased with your dentist.

Do I need two front tooth crowns so they can match?

I need a crown on my front tooth. The dentist suggests doing both front teeth so they match perfectly. Is this necessary?
– Laurie in South Dakota

Laurie,
It may be necessary for you, from this dentist, but it isn’t generally necessary. It is possible to match a front tooth crown perfectly to the tooth next to it, but it takes, skill, a strong knowledge of tooth color, translucency, and texture, and a certain amount of trouble. It may require sending the crown back to the dental laboratory more than once to get the color perfected. But it can be done.

Many dentists just aren’t good at that, and some just don’t want to take that trouble. So in your case, yes, it may be necessary to get both crowns if you want the front two teeth to match perfectly. But we don’t do it that way – we just match the single crown.

Read more about Louisiana porcelain crowns or Louisiana Zoom whitening.

How to fix my large gap

I have a not-so-small gap between my front teeth. One of my front teeth is also an older crown. I have been told by two dentists that my gap can be corrected without braces. I was also told by a third dentist that without getting braces that I will have gigantic front teeth. I want to ask if veneers or porcelain crowns would be an option. I really want the gap closed. Please give me your advice.
– Suzy from North Carolina

Suzy,
You need to be careful here. Over 90% of dentists become dentists because they like to fix things, and they don’t have strong artistic inclinations. Often, what looks good to them doesn’t look good to your average patient. I once saw a discussion on a dentistry blog where a number of dentists were talking about putting an extra front tooth between a beautiful woman’s two other front teeth in order to fill the gap.

I could tell better if I actually were to examine your teeth, but it sounds like this gap is a little too large to just be fixed simply. So it’s going to be really important that you see a dentist with a strong artistic side. Your best guarantee of finding someone like that is to find someone who is accredited by the American Academy of Cosmetic Dentistry. You’re in North Carolina, and there are several excellent accredited cosmetic dentists there.

For a small gap, when one of your front teeth has a crown, you could get a new all-porcelain crown on that tooth and then a conservative porcelain veneer on the other. If the gap is large, you may need to put porcelain veneers on two more teeth, so that you could make the two lateral incisors a little larger and then make the two central incisors a more normal size and thus close the gap. But you need a true cosmetic dentist with real artistic inclinations to do something like that and have the result look good.

Another option would be to close the gap with Invisalign invisible braces.

Other links:
You may want to visit our Lafayette, Louisiana Dentist website.
How to fix crooked teeth without braces.
Lafayette Louisiana Invisalign

My porcelain veneers still aren’t right.

I would really appreciate your opinion and advice with regards to the situation I currently find myself in.

I am 23 years old and decided to have porcelain veneers placed last year to improve my smile. My front teeth were aligned well but I wanted to improve the shape and surface, whilst making them whiter.

The veneers were placed and were problematic right away. My bite felt very off and I thought it might settle down in time but it didn’t. The veneers were too large and did not resemble the size of the temporary ones I had worn and approved. I went back to the dentist that placed them and eventually he agreed they were too big for my mouth and to redo them for me without charge.

The veneers have now been redone, the bite is excellent, the size and shape exactly matches the temporories. However I am devastated because these ones are yellow! They are darker than my lower teeth and have a real yellowness to them which I hate. Making the veneers darker was not discussed, I expected them to be quite white like the original set and I was shocked to realise how off the colour is.

I am so worried about this as I now feel very self conscious and I don’t know where I stand with regards to them being corrected, if at all. As my teeth have been done twice already, I am concerned that I need to keep these or risk damaging my teeth even further by attempting to have it corrected.

A different dentist has told me that it would be foolish to consider further treatment, as to treat the teeth for a third time at my age would seriously risk damaging the nerves permanently and I could lose my teeth! Is this likely to be the case?

Just to add that I was told my teeth were prepared conservatively and I did my research beforehand and thought I had chosen a good cosmetic dentist.

I would be very grateful if you could give me any advice on this situation as I am so worried.

Thank you,
Millie in England

Millie,
It’s hard for me to evaluate whether or not your dentist is a good cosmetic dentist, but I will say that it doesn’t sound like it. I could be wrong.

Cosmetic dentistry is a very different field. It requires an artistic sensitivity and ability that the vast majority of dentists don’t have and don’t even appreciate.

If your dentist was willing to re-do the original veneers to meet your satisfaction, that shows honesty and good will. But that doesn’t mean that he’s an artist.

You’re in England. There are some dentists there with credentials from the American Academy of Cosmetic Dentistry. That’s what I’d recommend for you. I believe there is one dentist in England who is accredited with the American Academy of Cosmetic Dentistry. That’s your best bet. Accredited cosmetic dentists have to pass stringent evaluations of their work. Go to www.aacd.com and look for an accredited cosmetic dentist in England. If that’s too far for you to travel, call his office and ask for a recommendation for someone closer to you.

And you don’t have to worry about the teeth being damaged, if the porcelain veneers are done right. A good porcelain veneer preparation is very shallow, and if your teeth were irritated at all by being prepared the first time, they have long since recovered, and they will likely be more resistant to irritation the next time.

Good luck.

this blog sponsored by Louisiana Cosmetic Dentist