Archives for June 2021

Dental Bonding Disaster

Posted on June 24, 2021 by writeradmin.

A couple of years ago, I had dental bonding done for a chipped tooth with a dentist from another city. This year, I relocated. A few months into the move, the bonding started to have some discoloration. So, I asked my new dentist to fix it. She said she’d need to bond both teeth for it to look right. I thought that was odd because my last dentist did not have to do that, but decided to give her a chance. I wish I hadn’t. The color doesn’t match my teeth at all, there is now a gap between my teeth that wasn’t there before, and now one tooth is longer than the other! I asked her about the gap and she said that is a common issue with bonding. Then I asked her to file down the long tooth, so it could be the same size as its partner. Finally, when I asked about the color, she said natural teeth aren’t all the same color. Her suggestion is that I wait a week and see if I change my mind about its appearance. Then we are supposed to meet again and determine if there is anything I still want her to change. Should I wait and give her a chance to fix this or just ask for a refund. She is nice, but honestly, my smile is worse than it was before.

Cadance

Dear Cadance,

I think you need to ask for the refund and then find another dentist to do the work. Here’s the problem you are facing with this dentist. Cosmetic dentistry is not taught in dental school. She may have learned how to repair teeth, but learning to make them look beautiful and natural is a skill set they have to invest in during a post-doctoral course of study.

Dental bonding in particular is one of the most challenging of the procedures because it has to be done free hand. Additionally, they have to understand all the materials, such as colors, textures, and translucencies, and which ones go together in order to sculpt a true replica of the tooth. I don’t think this skillset is going to magically appear in a week. In fact, I would not even wait the week. Call the office, tell them you want the refund and start your search for the dentist who can do this right.

Which Dentist Can Do Dental Bonding Well?

My first suggestion is that you look for a dentist who has reached accreditation level with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the country. They have the technical knowledge, skill, and artistry to create a beautiful result for you. It is sometimes hard to find one, depending on where you live, but it will be worth it even if you have to travel to a nearby city or state.

If that proves impossible for you, your second option is to look on the mynewsmile.com website. They recommend excellent cosmetic dentists by zip code and the distance you are willing to travel. The site is run by an AACD accredited dentist and he personally screens each dentist he recommends. A dentist cannot just pay to be listed on his site. Many are on their way to accreditation, which is a process that takes years.

One other thing I will mention. You may not even need this, but if you’ve been considering teeth whitening, I suggest you do it before having the bonding placed. The color of the bonding will mot respond to whitening agents, only your natural tooth structure will. If you try to do that after, you’ll end up with two different colored teeth.

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

Cavity on Tooth with Porcelain Veneer

Posted on June 10, 2021 by writeradmin.

I have porcelain veneers and one of my teeth has a cavity. My dentist wants to remove the porcelain veneer, treat the cavity, and then replace the veneer with a dental crown. I am not too keen on this idea and wondered if it was the standard operating procedure for someone in my situation? It is a front tooth, so it is important to me it looks good.

Malorie

Dear Malorie,

If I were in your place, I would recommend you get a second opinion. A crown is a much more aggressive treatment than I think you need. Your cavity would have to be rather substantial in order to justify it. I would think you would need about 1/3 of the tooth to be overrun with decay in order to make it a valid treatment option. If it is just some small decay, why would he recommend a dental crown instead of a porcelain veneer?

Generally, when a dentist is suggesting a less than ideal treatment, it is because they are not comfortable doing the better option. Unfortunately, this does not directly translate to them being able to provide you with a beautiful dental crown that matches your porcelain veneers. In fact, I would estimate that only 1-2% of dentists are actually able to match a single crown to the adjacent teeth in a way that looks attractive and blends naturally.

Getting a Second Opinion

When you go to get that second opinion, you want make certain of two things. The first is that the dentist you go to for your second opinion is in that 1-2% category of dentists who can provide a beautiful result and have the skills to do things well. In order to find a qualified cosmetic dentist, I would look for someone who is accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the best cosmetic dentists in the world.

The second consideration is that it is a blind second opinion. Many dentists know each other. They are peers. You don’t want the dentist who is giving you the second opinion feel conflicted because telling you the truth would mean saying his friend is wrong.

Because of that complication, I always recommend you ask for their opinion without them knowing who it was that did the work to begin with or what their diagnosis was. Be open with them about wanting an unbiased opinion if they ask who your dentist is. They should not have a problem with that.

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

Zoom Whitening and Uneven Teeth

Posted on June 4, 2021 by writeradmin.

My daughter got her braces off not too long ago and there were a bunch of white spots around her teeth. The orthodontist said this was fairly common in teenagers and that our dentist could take care of it. When we went to see our dentist, she suggested we try Zoom Whitening. She had just gotten the equipment and would even give us a discount as her first patient using it. I liked the idea of getting a discount for the treatment that she would need anyway and agreed. When we were done, the teeth seemed worse, not better. Is it possible because this is a new thing for our dentist she did something wrong?

Sally

Dear Sally,

I am very glad you wrote and believe I can be a great help to you and your daughter. Zoom Whitening is an effective teeth whitening procedure that can produce remarkable results in just one appointment. The problem wasn’t with her not understanding how to do Zoom Whitening. The real problem was her not understanding the principles behind how teeth whitening works.

No matter what method of teeth whitening you do, it will always whiten the teeth evenly. That means the white spots will get whiter along with the remainder of her teeth. The good news is there is a solution.

The white spots your daughter is dealing with are actually decalcification spots. Decalcification is a precursor to decay. My guess is your daughter used traditional wire and bracket braces. Those can be very hard for patients, whether adults or teenagers, to really get in there and brush well around all the metal clutter. This leaves food and other bacteria trapped, which in turn leads to the decalcification which your daughter is dealing with now.

There are two possible ways to fix this. One only works sometimes but is less expensive, so I’ll make sure you know about it in case it works for her.

Repairing White Spots on Teeth

The first thing I would try is a product called Tooth Mousse. This is applied topically and can sometimes remineralize the teeth. You can purchase it over the counter. It doesn’t always work so if you don’t start seeing results, I would move on to the next option before decay sets in.

The second solution is dental bonding. This needs to be done by an expert cosmetic dentist. I’ll tell you how to find one in a moment. With this repair, the dentist will gently remove the decalcified spots and then fill in the area with the composite bonding material. The dentist will use a variety of colors, textures, and translucencies to match her tooth structure and appearance perfectly.

As I mentioned, she will need an expert cosmetic dentist. This has to be done freehand and is one of the most difficult cosmetic procedures. I cannot stress enough that I do not think your current dentist is up to the task. In your place, I would look for an AACD accredited dentist or one who has been recommended on the mynewsmile.com website. Any of those dentists will be able to give your daughter a beautiful result.

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

Dental Implants for Hockey Players

Posted on June 3, 2021 by writeradmin.

My son lost a tooth in a hockey game. Our dentist suggested we get him a dental implant to replace it, but his coach said that is a bad idea because of the chance of re-injury. What is the right choice? I want to do what is best for him, but the mixed messages are confusing.

Kami

Dear Kami,

In a way, they are both right. Dental implants are the absolute best tooth replacement option. However, there is a risk for re-injury if he is continuing to play hockey. A dental implant consists of a prosthetic root form and a dental crown bonded on top of it to serve as the visible part of the tooth. If he is re-injured with both parts completed, there is a good chance he will lose some bone with the injury (and possibly even some of his jaw).

Here is my recommnedation. First, get the implant placed, but just the implant. This will allow him to get the benefits of the dental implant without having to worry about extra damage being done in case the tooth is lost again. You won’t want him going “toothless” in that area, so I suggest an inexpensive temporary restoration, such as you would get with a dental flipper. This gives him the best of both worlds.

Having the root form placed, ensures his jawbone can stay healthy and will not suffer any effects of the structural loss that normally occurs when you lose or remove some teeth. Having a dental flipper means if he is hit in the mouth again, the flipper will come out with ease and he won’t risk additional injury. When he is done playing hockey, that will be the time to have the permanent dental crown placed on his implant.

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