Archives for October 2020

I Need Options for My Tooth

Posted on October 31, 2020 by writeradmin.

I had an accident on my tooth when I was a child. Over the years it has turned more and more brown. It’s causing me to not want to smile. I went to see my dentist about it and he said there isn’t a root there anymore and I should just remove the tooth and put a fake one there. Is there a way to have a pretty tooth if it is fake?

Rebecca

Dear Rebecca,

What you are suffering from is root resorption. It is a shame your childhood dentist didn’t give you a root canal treatment when you had the injury. That could have prevented the resorption. It isn’t a guarantee, but not doing anything definitely leads to resorption. He is right that at this point the tooth cannot be saved. It doesn’t sound like he spoke to you about any of your options.

The top of the line option is to get a dental implant. This places a prosthetic root in your jaw and once the bone has integrated with the implant a dental crown will be placed. It has the benefit of being the most secure option and the closest thing to having a natural tooth. However, it is the most expensive option.

If that isn’t for you, the next step would be to get a dental bridge. This suspends a false tooth between two dental crowns. This makes sense if either of those teeth already need crowns. If they don’t, you may not want to grind down healthy tooth structure unnecessarily.

There are less expensive options as well such as a removable partial denture or a dental flipper. Neither of those will be secured to your teeth, so just be aware they come out.

Is Your Dentist Serving You Well?

I’m a tad concerned that your dentist isn’t taking adequate care of you. This is especially true if this is the same dentist that didn’t deal with your tooth injury to begin with that is especially concerning.

It also sounds like he’s leaving you to figure out what to do about replacing your tooth. In reality, he is ethically bound to give you all your options. It may be time to ask why he isn’t doing that.

Will a False Tooth Look Attractive?

As to your concern with how the false tooth will look, that depends completely on the cosmetic dentistry skill of the dentist doing the work. Creating beautiful smiles is an art form. The best cosmetic dentists are AACD accredited, which is completely different from membership, which any dentist can do.

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

Dental Bonding Turning Yellow in a Week

Posted on October 28, 2020 by writeradmin.

I don’t know what is happening. I had dental bonding done on six of my front teeth. It’s been only a week and they’re turning yellow. I really loved them when I first got them and expected them to last a few years. What do I do? Can I whiten them?

Pauline

Dear Pauline,

I am sorry this has happened to you. There are a couple of possibilities here. One is that your dentist used subpar materials. The second is that you did something to damage the polish on them. Either way, the fault will likely lie with your dentist because it is his responsibility to instruct you on your post-operative care.

Is it possible you brushed your dental bonding with something abrasive such as an over the counter whitening toothpaste or some baking soda? This will scratch the polish on the bonding allowing them to pick up stains much more quickly than they would otherwise. Many people aren’t aware that whitening toothpastes that you purchase at the store “whiten” your teeth by using abrasives. This creates a wicked cycle of making your teeth look whiter by scraping off stains, but it also creates micro-scratches on the surface of your teeth that causes them to pick up stains more quickly.

The only type of whitening toothpaste I would ever recommend is Supersmile Toothpaste, which uses a natural enzyme to whiten your teeth without any damage.

Unfortunately, teeth whitening won’t get them any brighter or whiter. It will only work on natural tooth structure. Because it has been such a short time since they provided your dental bonding for you, I am going to suggest you call and ask them to repolish them for you.

Caring For Your Dental Bonding

The best toothpaste for any type of cosmetic work is Supersmile Toothpaste. It’s specifically designed to remove stains without doing anything that will damage the work.
Like with anything related to your teeth, brushing and flossing is an important part of keeping the bonding healthy and shiny.
Make certain your dental hygienist knows how to care for your dental bonding. For instance, during your cleanings it is important she doesn’t use anything like a power prophy jet or acidulated fluoride, which will damage the polish on them.
If you use a mouthwash, make sure it is alcohol-free. Alcohol can loosen the bonding.

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

Smile Makeover on a Fractured Tooth

Posted on October 12, 2020 by writeradmin.

Years ago, I had an accident which fractured some teeth. They received both root canals and dental crowns. As years past, my smile started to show it’s age. I decided to get a smile makeover after my last promotion. I went to see a highly recommended cosmetic dentist in my area. She did a combination of dental crowns and porcelain veneers. I love how it looks and am much more confident. My problem now is with tooth #9. It’s been sensitive ever since and there is a pimple on the tooth next to it. My cosmetic dentist thinks that the tooth needs to be extracted and to have a dental implant placed. I’m also getting a root canal treatment on the adjacent tooth. I’m attaching the x-ray to see if you think the tooth really needs to be extracted. I just had the restoration done and it seems like a waste of money to remove the tooth. I’ll also send a picture of the new smile in case you need it.

Aaron

Dear Aaron,

I am in agreement with your cosmetic dentist. Looking at the circled tooth, in the middle of the root there is a horizontal radiolucent line. This is an old fracture that was either missed by your old dentist who worked on your teeth after the accident or he thought he could get out all the necrotic tissue and save the tooth.

Below the fracture looks healthy. However, above it the tooth looks moth-eaten. That tells me there is probably an infection there. Removing the tooth, will be the safest thing to do. A dental implant is a fantastic replacement so your dentist was right about that too.

Looking at the images you shared of your smile makeover, the dentist you choose was skilled. I’d stick with her for the dental implant as well. However, she should have caught the fracture and infection.

Because she didn’t, it isn’t unreasonable to expect some flexibility in how this is paid for. Originally, had it been properly diagnosed at the beginning, you would have paid for an implant and a crown. I’m going to suggest you ask to pay for the implant, but not the new dental crown to go on top of it because you just paid to have one placed. I don’t think she’ll have a problem with that.

From your x-ray, I have noticed one other issue. It looks like another tooth that had a root canal treatment, didn’t get done properly. You see the tooth on the left has filling material that stops a few millimeters short of the end of the root. I wouldn’t do anything about it unless it flares up. For now, the tooth itself looks healthy.

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

Dentist Said there is no Color to Match my Teeth

Posted on October 5, 2020 by writeradmin.

I don’t know what to do. I’ve never had a dental crown before and this one is on my very front tooth after a nasty fall. My dentist said that my teeth are so white that there is not a color to match a crown to it. He’s done the whitest shade available and it is still several shades darker than my teeth. He’s a new dentist for me because we just relocated. I just had to go to a dentist who saw new patients quickly for emergencies, so I don’t know much about him. I’m having my doubts about what he is saying, though. Is there no way to match white teeth?

Brianna

Dear Brianna,

I think what you are facing here is a dentist who may be a decent bread and butter type dentist but has no clue when it comes to dental aesthetics or cosmetic work. You are not going to have a beautiful, or even natural looking, dental crown done by him.

Here is where part of his confusion lies. Based on what you’ve said, he is still using the standard shade guide (pictured left). Before teeth whitening became both popular and affordable, this was the shade guide dentists turned to when they needed to match a dental crown to existing teeth.

A patient’s teeth would always fall somewhere close to one of these shades. Then, in the 1990s, teeth whitening skyrocketed. Dentists started seeing patients come in with teeth whiter than anything on their shade guides. This is because bleaching your teeth, doesn’t just whiten the stains. It can whiten your natural tooth structure as well. That means your teeth can actually become whiter than their natural white.

Eventually, a new shade guide addition came out that added some whiter shades to meet the demand for whiter teeth (pictured below).

Your dentist is facing an additional problem that he won’t know what to do with as well. Front teeth are harder to match. This is because the light hits them more directly revealing all the subtleties and variations in the shades and translucency. He will need to understand color theory and tinting in order to get a perfect match. That would have required extensive post-doctoral training in cosmetic dentistry, which I sincerely doubt he’s done.

In your place, I would either look for a dentist who has reached accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top 1% of cosmetic dentists in the world. If there isn’t one in a reasonable distance to you, then another good resource for finding excellent cosmetic dentists is the mynewsmile.com “Find a cosmetic dentist” link. They prescreen all dentists who want to be listed there for their technical knowledge and training, as well as the artistry of their results.

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