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Cosmetic and
restorative
dentistry

Archives for June 2019

Replacing a Front Tooth While on Fosamax

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I had to replace a tooth adjacent to my right front tooth. Right now I have a dental flipper and absolutely hate it. I wanted a dental implant but my dentist said that’s not possible because I take Fosamax. I suggested a dental bridge and he doesn’t want to do that either because it will crown the adjacent teeth which he says are fine. That’s true, but I want to get rid of this flipper. Would an Encore Bridge be an option?

Bruce

Dear Bruce,

Three stages of a dental implant

Can you get a dental implant while on Fosamax?

It is possible to get a dental implant while on Fosamax. Your dentist’s concern has to do with the increased risk of local bone problems when having oral surgery. While the risk is small, the complications are serious. Don’t minimize the risk. One possibility is to temporarily suspend taking Fosamax, under the cooperation of your physician who should oversee this.

If you decide against getting a dental implant, a dental bridge is fine, and a better permanent option for you than a dental flipper. That being said, let your dentist pick the type of bridge. You definitely don’t want to be the first patient he or she has done an Encore Bridge on. Some dentists are your basic bread and butter dentists who can only do the “standard” work. That brings up an important point about your dental implant.

Who Should Place Your Dental Implant?

The concern your dentist mentioned is legitimate, however you should be aware that sometimes a dentist will steer you away from a procedure because they aren’t comfortable or qualified to do it. They don’t want a patient to lose confidence in them so instead they come up with reasons to discourage that particular procedure.

You don’t want to push a dentist into a procedure they are not comfortable doing. This usually ends in disaster.

Dental implants are an advanced procedure. You’re in a high-risk group, so it makes it even more important you have an experienced, qualified dentist to do it for you. Look at Dr. Weiss’ qualifications to get an idea of what type of dentist you are looking for.

Another consideration is cosmetic. You’re talking about matching a single crown to your front teeth. You want someone with the cosmetic skill to make it blend both beautifully and naturally. The best cosmetic dentists are accredited by the American Academy of Cosmetic Dentistry.

In your place, I’d look for an AACD accredited dentist who has a high success rate in dental implants.

This blog is brought to you by Philadelphia Dentist Dr. Michael Weiss.

Cosmetic Dentistry Malpractice

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Can you advise me? I spent a small fortune to get my smile updated. I’d had some cosmetic bonding on my front teeth which was showing its age along with a dental bridge. I went to a dentist who advertises as specializing in cosmetic work. He replaced the metal bridge and then planned crowns on the remainder of the visible front teeth. When they put in the temporaries, they told me they wanted to be certain I’d like them. I’d brought them a very specific smile design I wanted so I was glad to hear them say that. Unfortunately, it proved not to be true. When the permanent ones came in they weren’t the same color. I mentioned that and they said they’ll look different in my mouth. They didn’t. I told them, they still looked dull. Then they said it was because I see them differently in this light. Which, by the way, was the same light I saw the temporaries. When we got in a different light I noticed, they didn’t match the metal bridge. Their response, was, “Of course they don’t. The bridge is metal.” Then they bonded them in even though I wasn’t happy with them and said I’d get used to them and love them. I don’t. I don’t know what to do. My teeth are not what I wanted and don’t match.

Patricia

Dear Patricia,

A woman smiling with a beauttiful smile

When you get a smile makeover, you should be thrilled to share your new smile.

You have a great case to have this re-done by a dentist who actually knows what they’re doing, but you are going to have to be tough. This dentist behaved quite unethically based on what you’ve said and I don’t think he cares whether you like your smile or not.

Aside from shoddy cosmetic work, they violated a very important principle of dental practice, which is informed consent. You did not consent to them bonding in your new smile. In fact, they badgered you into it by trying to make you feel unreasonable. This was after they promised you that you’d get to approve the smile and love it first.

Dealing with Shoddy Smile Makeovers

Because they didn’t have your consent, you have the right to have this done again. However, I wouldn’t trust this dentist to do it. Instead, have them pay for an excellent cosmetic dentist to re-do your work properly. You may have to involve a lawyer, but you’re on solid ground.

It’s unfortunate he ground all those teeth down for dental crowns. Porcelain veneers would have been a better option for you and is much more conservative on your tooth structure. Seeing as you had crowns done (through no fault of your own) you will have to have crowns done again.

This time, get them done by someone who’s invested time and training in cosmetic dentistry (which by the way isn’t a recognized specialty). In your place, I’d go to mynewsmile.com and see which dentists they recommend in your area. Anyone on their list will give you a stunning smile makeover you’ll be proud to show off.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Crowns for Chipped Tooth

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I’m not sure what to do and need some advice. I tripped and ended up chipping one of my front teeth. It’s not a huge chip, but it bothers me. My sister told me that dentists can fix chipped teeth even if you don’t have the broken piece. I went in to see my dentist. While he did say he could fix it, he said the solution would be for him to crown my two front teeth. I’m not too keen on that, especially because the other tooth is fine. When I asked him why both teeth, he said so that they could match. While I get that they need to match, it feels stupid to grind down two healthy teeth. I’m worried I’m letting my vanity get in the way of sensibility. What do you think? Crown the teeth or live with a small chip?

Elaine

Dear Elaine,

While I am sure your dentist is trying to do his best for you, I’m going to recommend you see someone else to repair this chipped tooth. Many dentists need to do two crowns on front teeth to match them, however, there are great cosmetic dentists who can match a single crown. If a crown were the right course of action, then another dentist could do the treatment just on one tooth.

The easiest way to find a highly skilled cosmetic dentist is to look on the website of the American Academy of Cosmetic Dentistry (aacd.com). They have a link to help patients find a cosmetic dentist. However, you want one who has reached the accreditation level. AACD accredited dentists are the top cosmetic dentists in the country. Any one of them can match a single porcelain crown to a front tooth.

All that being said, you really don’t even need a crown on the one tooth let alone two. Yes, a crown will cover the chip, but there are much less aggressive ways to repair it.

Dental Bonding for Chipped Teeth

before and after dental bonding

Dental bonding is the standard treatment for a chipped tooth.

The standard treatment for this is to have dental bonding placed on the tooth. This uses a composite resin which a cosmetic dentist will sculpt freehand onto the tooth. I wouldn’t push your family dentist to do this. It is obviously not a procedure he is familiar with and it would take some technical skill along with artistry to do it right.

Instead, I would find an excellent cosmetic dentist and have them do the procedure. You won’t have to completely switch dentists. You can still go to your family dentist for everything else,

There is a cosmetic consideration here (aside from the chipped tooth). Whatever color your dentist makes your bonding is permanent. If you are even considering having teeth whitening done on your teeth, it will save you money to do that before you have your bonding done.

Otherwise, your natural tooth structure will whiten but not your bonding. Then you’ll have to have the bonding re-done to match the newer color.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Advice on Picking Dental Implant and Crown Materials

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I’m about to get my smile completely made over with dental implants and crowns. I want it done right so I have some questions.
1. Is Staumann or Nobel Biocare better for implants?
2. Is zirconium or porcelain better for the dental crowns?
3. My dentist said a white porcelain fused to metal crown will not show a black line at the gumline. Is this true?

I am spending a lot of money so want this to end up beautiful.

Laurie

Dear Laurie,

A woman smiling with a beauttiful smile

Getting a beautiful smile makeover requires an artist

I want to refocus your question using an analogy. If you were to commission someone to do a painting to be the centerpiece of your living room, would you spend time investigating paints or the artist? It’s the artist who makes the difference. They have the knowledge and skill to know which paints are good for which situation. Maybe a particular scene look does better with one brand, but for something else another is preferred for its pigment. The artist who works with the materials every day will know their strengths and weaknesses.

So, instead of researching which dental implant or crowns to use, research the dentist. You have a two-fold requirement. They have to be skilled in placing dental implants, including implant overdentures. But, they also have to be skilled cosmetic dentists.

Finding a Dentist Who Can Give You a Beautiful Smile Makeover

Doing smile makeovers aren’t taught in dental school. Instead, dentists who are interested in the art of cosmetic dentistry have to invest time in training for it post-doctorally. Even with that, there is no recognized specialty in cosmetic work. Because of that, patients often find it hard to know who is skilled and who isn’t.

Fortunately, the American Academy of Cosmetic Dentistry offers an accreditation program which gives patients a way to know who they can trust to give them a stunning smile makeover. In order for a dentist to reach accreditation, they have to pass stringent oral and written exams, as well as provide visual evidence of a large number of cosmetic cases they’ve done to show they are not just technically skilled, but artistic as well.

Any AACD accredited cosmetic dentist can give you a celebrity smile you’ll be proud to share. In fact, most of them have a beautiful smile guarantee.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.