Archives for June 2020

Full-Mouth Reconstruction to Whiten Teeth?

Posted on June 27, 2020 by writeradmin.

I need to make some important choices soon. I have a dental crown that is about 20 years old and two porcelain veneers that are a bit older. I’ve been experiencing some dry mouth. I’ve chipped the veneers on the front teeth and now there is a gray line at the gumline by the crown. I went to my dentist to discuss replacing them. Because my smile is no longer very white, he is suggesting I get crowns on both my upper and lower arch to do a smile makeover of sorts. The more I think about it, the more concerned I am, especially with my dry mouth. It may be better for me to just replace the old work and wait to see what happens with the dry mouth first. What do you think?

Carolyn

Dear Carolyn,

The first thing I am going to suggest is that you get a different dentist. If I understand you correctly, your dentist is suggesting crowning all of your teeth because your teeth need to be whitened? Really?

So, here’s the thing. Whitening your teeth will bring him in a few hundred dollars. Crowning all your teeth, known as a full mouth reconstruction, will bring him in $30,000+. Your dentist is being self-serving. The best dentists are doing their best to serve their patients without unnecessary expense for his or her benefit and while preserving as much tooth structure as possible. He’s doing neither.

My suggestion is you have your teeth whitened and then just replace the damaged dental work. However, I don’t think your dentist should be the one to do it and not just because he’s grabbing for the bucks. There is another warning sign that he isn’t what you need. When a dentist suggests dental crowns instead of porcelain veneers for a smile makeover, it is because they are not comfortable doing porcelain veneers. Doing crowns in a case where they are not needed is a waste of healthy tooth structure.

As you likely know from the crown you already have, in order to make room for the restoration, he’d have to grind your teeth down to nubs. This is irreversible. Once you have dental crowns you will always have to have dental crowns. It is much better to do porcelain veneers when it comes to a smile makeover.

Now, you do already have one crown. You mentioned a gray line at the gumline. This tells me the original dentist did a porcelain-fused to metal crown. On a front tooth, what you really want is an all-porcelain crown.

What you need is a skilled cosmetic dentist to take over. In your place, I’d look for an AACD accredited dentist. These dentists are in the top of the cosmetic field and have proven skill and artistry. You’ll have a smile you are proud of.

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

Can My Smile Be Pretty after Dentures?

Posted on June 19, 2020 by writeradmin.

Around 30 years ago, I lost all my teeth. My dentist never mentioned dental implants so I don’t think that was an option. I have a friend who has them and her smile is so much prettier. Plus, she can eat anything she wants. I don’t know which I’m longing for more, but I think it is a pretty smile. If I got dental implants now, could they be as pretty as her smile?

Alice

Dear Alice,

I’m so sorry you have been going through this for so long. It is not the dentures that are the reason your smile doesn’t look pretty to you. Both dentures and dental implants can be beautiful giving you a smile you are proud of. The problem lies in the artistic skills of the dentist. My guess is your dentist thirty years ago had good intentions but not the skill. I truly wish he would have mentioned dental implants to you. They were available then and it would have made the last 30 years significantly more pleasant for you. However, that is water under the bridge and all we can do now is go from here.

There’s one obstacle you will face when it comes to dental implants— the aftermath of facial collapse. When your teeth were first removed, your body decided without the roots of your teeth you no longer needed the minerals in the jawbone that are used to help retain your teeth. After all, they are already gone. Slowly, that leeches your jawbone away. After 30 years, I’m guessing you are having quite the time keeping those dentures in any more.

As you can see from the image above, like your teeth, dental implants need bone to keep them secured in your jaw. There is a solution to this, though. There is a bone grafting procedure that can build that missing bone structure back up for you. Once that is done, you will be right as rain for dental implant again.

How to Get that Beautiful Smile

As I mentioned earlier, it is the dentist who does your procedure that determines how beautiful your smile is. You need a dentist who is both qualified to give you dental implants along with the artistry to make the dentures that anchor to them beautiful. My suggestion is you start by looking for an AACD accredited dentist. These are proven artists when it comes to dental work. You will finally have that smile you have always wanted and you can share it while you eat some steak!

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

Bonding Color is Wrong

Posted on June 14, 2020 by writeradmin.

I have these exposed places at the top of my teeth that are very sensitive. Other than that, my teeth were attractive. They showed me their plan and I knew immediately the color would need to be whiter. I pointed that out and they agreed. Then, they put in the new “whiter” color. It still doesn’t match my teeth. Plus, it looks opaque and is rougher looking than my natural tooth structure. I feel like what was an attractive smile has been made less attractive in order to prevent the sensitivity I was feeling. Is there a fix for this?

Callie

Dear Callie,

$abfraction lesion$ When done well, dental bonding should blend seamlessly with the remainder of the tooth. I’m especially sorry for what you are going through because what your dentist is trying to do is even easier than when you have to repair a chip. If I understand your description correctly, you are dealing with what is known as an abfraction lesion (pictured left).

We used to think these were caused by brushing too hard. We now think it has more to do with clenching and grinding of your teeth. This flexes the tooth right at your gumline, adding stress. That repeated movement wears away the gumline. One thing you will want to do after this is repaired is to have a night guard made. This is a custom fit mouthpiece, similar to a sports mouthguard that you will wear while you are sleeping. Nighttime is when most grinding and clenching takes place. Usually, until their teeth are worn down, the patient has no idea it is taking place. Over time, this can lead to TMJ Disorder as well as wearing your teeth down to numbs.

Repairing Your Dental Bonding

Pictured directly above, you will see a case of dental bonding done well. You can’t tell where the bonding ends and the natural tooth structure begins. Your teeth can look this way too. Unfortunately, the only way to fix this is to have it done over again.

Being blunt, I think this is beyond the scope of your dentist’s abilities. You will need to have a dentist with more cosmetic training step in and repair this. Ask your current dentist for a refund. Then, look for an AACD accredited dentist in your area. They can give you the results you are looking for.

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

Full Mouth Reconstruction Disaster

Posted on June 8, 2020 by writeradmin.

I needed to replace some old veneers and two crowns. When I saw my dentist, he said that he’d need to open my bite a bit so my teeth would show more. I never considered that a problem, but figured there was a reason. The temporaries are very uncomfortable I asked him to redo them twice. Then when the permanents came in, he put them in so fast, I hardly had a chance to check them out before they were permanently bonded on.

I’ve had massive problems since and can’t even shut my mouth all the way. I have been drinking water and sloshing it around my mouth constantly. If I don’t, my lips stick to my teeth. I spoke to my dentist about it and he said he’s hit all the checkpoints and his work is perfect. What do I do? I don’t feel like I can continue like this.

Pam

Dear Pam,

This is unacceptable for you. When your dentist tried to open your bite, which I am not convinced was necessary, it sounds like he was in over his head as well. Additionally, it doesn’t sound like he cares. He ignored every concern you had during the temporaries. This is the stage that is imperative to help ensure the bite is perfect. He should never have moved forward until your bite was completely comfortable. He blew past that and placed the permanent ones in a rush.

Now that they’re on and not doing well, he’s ignoring you again. This time, putting your oral health at risk. What you are experiencing is lip incompetence because he opened your bite too much. He’s really messed up and doesn’t want to admit it.

The only way to fix this at this point is to completely have the case re-done. However, you don’t want to have this dentist do it. To be frank, he doesn’t know what he’s doing. You need another dentist to do this for you. I also think your dentist needs to be the one to pay for it. It is his mistake.

Who Should Re-Do This?

You need a dentist with both cosmetic and restorative training. When you do, make sure the temporaries are exactly the way you want them before the case goes any further. A good dentist will know this, but I don’t want you suffering the same way again, so I just want to make sure you don’t allow anyone to move forward without satisfactory temporaries.

What that means is, your lips will come naturally together, your bite “feels” normal to you, and you love how they look. Unfortunately, smile makeovers and advanced restorative procedures aren’t taught in dental school. A dentist has to study this in a post-doctoral setting, though it isn’t required for them to practice. If at all possible, you should get an AACD accredited dentist to do your case. They will be the most likely to have the training and the skills necessary to do this for you.

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