Archives for August 2020

Root Canals Needed after Her Smile Makeover

August 29, 2020 by writeradmin

I had a complete smile makeover with veneer crowns. When I went in for my consultation I specifically asked about any risks involved. He told me there weren’t really any. I went forward with the procedure confident and excited. Since then, four of the teeth have needed root canal treatments. He suggested I see an endodontist. I did and was informed even more teeth are likely to need root canals soon enough. I thought there wasn’t much risk with these. What happened? Have you seen this before?

Ruth

Dear Ruth,

I think there is some confusion here. There are porcelain veneers and there are porcelain crowns, but there aren’t veneer crowns. So, I’m not sure which you received. However, based on the number of root canal treatments you received, my guess is it was porcelain crowns. I’m going to show you two photos below. The first image is what a tooth would look like with porcelain veneer preparation. The second with dental crown preparation.

Porcelain Veneer Preparation

Porcelain veneer preparation will take off maybe a 1/2 millimeter of tooth structure. It is rare for this procedure to end up needing even one root canal treatment, let alone the amount you are ending up needing.

Porcelain Crown Preparation

On the other hand, a porcelain crown preparation goes much deeper into the tooth structure, which puts you at a greater risk of exposing the pulp of your teeth. That in turn leads to a tooth infection.

What is a Smile Makeover

You said you were getting a smile makeover. Unless there are other issues such as extensive decay or TMJ Disorder, you would use porcelain veneers for this. Giving you the number of dental crowns he gave you is more of what would happen with a full-mouth reconstruction.

If you really only needed porcelain veneers than your dentist was much more aggressive than he should have been and should be liable for the damage he caused to your teeth. That means paying for the root canal treatments you need. This is especially true because he told you there weren’t really any risks. If he prepped for crowns, there are always risks.

Hopefully, you at least like how these teeth look.

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

Cosmetic Solution for Fluorosis Stains

August 16, 2020 by writeradmin

I have fluorosis stains on my teeth and wondered if teeth whitening is a good cosmetic fix for someone in my position? I want to have a smile I am proud of.

Diego

Dear Diego,

I will say right off that teeth whitening will not be the solution. It whitens teeth evenly and is only more likely to make your fluorosis stains more obvious. For the benefit of those who are unfamiliar with what fluorosis stains are, it happens when someone ingests too much fluoride while the teeth are still forming. The fluoride in the water in the United States is optimized for the right consumption so we don’t see much of it here.

There is good news, though. Your teeth can be attractive again. Which solution depends on the amount of fluorosis you are dealing with. For either repair, you will need an expert cosmetic dentist. My suggestion would be to find an AACD accredited dentist.

If You Have Mild Fluorosis

The picture above is an example of mild fluorosis. If this is what you are facing, then dental bonding can be a sufficient repair. Your dentist will gently shave about 0.5 millimeters of your tooth enamel. Then, he or she will replace it with direct composite bonding. It doesn’t last as long as the next repair I will talk about, but it does cost less.

If You Have Darker Fluorosis

In some cases, as in the picture directly above, the stains are more prominent. In this case, simple dental bonding will not be enough. Instead, I suggest you have porcelain veneers placed. This is actually the go-to procedure for a smile makeover. It is what gives people that “Hollywood Smile.”

This procedure can last for a lifetime. However, don’t try to cut corners by going to an inexperienced cosmetic dentist for this. It’s not an easy procedure to do under the best of circumstances. With severe stains like these, it will take someone highly skilled. This is why I recommended an AACD accredited dentist earlier, these are the best cosmetic dentists.

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

Can You Get Porcelain Veneers if You Have an Overbite?

August 3, 2020 by writeradmin

I have tetracycline stains that I have always wanted to be covered. I asked my dentist about porcelain veneers and he said I can’t get them because I have an overbite which makes my upper teeth cover my bottom teeth. Instead, he wants to do six porcelain crowns on the upper teeth. Because my lower teeth can’t really be seen, what do I do with those, whiten them?

Elisabeth

Dear Elisabeth,

Please don’t let this dentist do your smile makeover. He’s making quite a few errors and he hasn’t even started. Him telling you that porcelain veneers don’t work for an overbite isn’t true. Instead, it is likely just an excuse because he doesn’t know how to do porcelain veneers. In fact, veneers make more sense in a case where there is an overbite involved because dental crowns must surround the whole tooth. This will cause it to hit up against your lower teeth. Instead, porcelain veneers are thin wafers of porcelain that only cover the front and hug the sides a smidge. This is a much better fit for someone with an overbite.

A second concern I have is that dentists who recommend dental crowns for a smile makeover when it isn’t necessary are generally not experienced cosmetic dentists. They think they have done dental crowns for treatments before with decayed teeth. How hard could it be just to add a few more? Actually…quite hard. In your case, this is especially true. You are dealing with tetracycline stains which are among the most difficult and advanced cosmetic procedures there are to do well.

He’s also recommending just six dental crowns. Most smiles are at least 8 – 10 teeth wide. What does he intend to do to make those adjacent, visible teeth do to match? Teeth whitening, which could be an acceptable option on many cases, will not work in yours because of how deep and dark the stains are with tetracycline. This will make the six teeth that are crowned, look obviously fake and silly, like children playing dress-up in their parent’s shoes. They obviously don’t fit, but at least they’re trying.

Teeth whitening could help with your bottom arch. This arch won’t be so obvious when the color doesn’t match exactly. However, I’d recommend a strong whitening system such as KoR whitening. Plus, you will have to be persistent and stick with it much longer than the average patient.

Your Smile Makeover Requires an Expert Cosmetic Dentist

Especially because of the difficulty with your type of smile, you need a top of the line cosmetic dentist. My suggestion would be to find an AACD accredited dentist. This is different from being a member of the American Academy of Cosmetic Dentistry. To reach accreditation, the dentist has to pass stringent exams as well as provide visual evidence on a large number of specific cases they’ve done that are assessed by a panel of judges on their technical quality along with their artistry.

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

Will Dental Implants Help if I Still Have Baby Canine Teeth

August 2, 2020 by writeradmin

Both my upper and lower canine teeth are still baby teeth. I recently removed the bottom ones, but now there is a space because the adult teeth came up behind them. I know I need to take the upper baby teeth out too, but I’m worried about there being a space there too. I’m a senior this year and will be taking my senior pictures. I don’t want to look ridiculous in my pictures. Could I just take them out and replace them with dental implants so I have teeth?

Penny

Dear Penny,

I am very surprised your dentist hasn’t taken care of this. We are taught in dental school exactly what to do in these situations. I’m concerned that you may need a new dentist.

Your canine teeth are very important both to the form and function of your smile. It is important this is fixed. How it is handled will depend on whether you have adult canine teeth and, if so, the position they are in.

The first thing you need are x-rays to determine what is going on with the canine teeth. Often when they haven’t erupted, it means they are impacted. In this case, you will need some brackets and braces to help the tooth come up in the right position. Because your baby teeth are smaller, there may not be enough room for the adult teeth. Your canine teeth are very important as I mentioned earlier, so you will need to open up room for them. It is often advisable in this case to remove a first premolar to make room for them, but this is best addressed by an orthodontist.

A dental implant will only work if there are no adult teeth at all. When this happens, it is called congenitally missing teeth. If you have any adult teeth there, it is best to get those into proper position.

I’m sorry you are going through this. It would have been much easier for you if your dentist would have addressed this early on.

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