Archives for March 2022

Fixing a Gap Between a Crown and a Dental Bridge

Posted on March 14, 2022 by writeradmin.

I have a gap between my front teeth I would really like to fix. Unfortunately, the tooth on the right is a dental crown and the left is a crown attached to a dental bridge. Is there a way for me to close this gap without having the fixtures replaced? Maybe by putting something like Lumineers on top of them?

Peggy

Dear Peggy,

Years ago, Lumineers would advertise something like you mentioned. They told patients that old crowns can be restored by placing Lumineers on them, but it ended up not working out as well as they hoped. First, porcelain does not bond to porcelain as well as it does to the natural tooth structure. Second, it takes as much work to place them over crowns as it would to just make a new crown. Finally, you have double the risk of failure because now there are two things bonded.

I am curious why your dentist didn’t place the crown and the bridge in a way where there was not a gap to begin with. That makes me wonder about his skills. In reality, because of that you will likely have to have these two procedures re-done. You don’t want to re-do just one of them because the porcelain would be “lopsided”.

There is a possibility you could have someone do a repair by bonding composite to porcelain, but they would need to have some experience with dental bonding and some special equipment. Your dentist would need to use a micro-etcher on the areas of porcelain near the gap. After that, they’d need to etch the area with a hydrofluoric acid gel. Then it would need to be primed with a silane coupling agent. Finally, a bonding resin and then a composite bonding applied to match the color of your crown and bridge. As you can see this would take some specialty skill. I’m not sure your dentist has it if he or she was not able to apply your procedures without a gap to begin with. If you want to try this repair method before resorting to replacing everything, I suggest you see an AACD accredited dentist.

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

Dental Work in Costa Rica

Posted on March 5, 2022 by writeradmin.

I need twelve dental crowns done. After doing some calling around, I learned I can get this done for just $6000 in Costa Rica. I would have to stay two weeks, but that’s like a vacation and it is still cheaper than what I can do in the states. My sister is freaking out saying this is a huge mistake. She asked me to at least call my dentist and get his opinion on this plan, but of course he’s going to say don’t do it because then he gets my money. I came across your website. You are across the country from me and have no chance of getting my money, so what do you think of my plan?

Mason

Dear Mason,

Should you get dental work done in Costa Rica?

I’m glad you wrote. I think I can save you a lot of grief. The dental industry is a real risk in Costa Rica. Because of the way their legal system is set up you have no recourse if something goes wrong. And let me tell you, a LOT can go wrong. Here are just a handful that come to mind:

A tooth can be broken off or lost
Overdrilling could take place causing nerve or root damage
You could end up needing a root canal treatment
Your bite can get thrown off leading to painful TMJ Disorder
Once you return home, the crowns can fall off
The crowns could look terrible, pasty, fake, and the wrong color
Poor placement of the crowns can impact your speech

Believe me, I am not exaggerating here. I recently read a case that you can read about in total here, but I will sum it up. A woman went to Costa Rica to save money on her dental care. The job was so badly done that she was in terrible pain. A dentist in the states called it criminal negligence and it would cost her around $35,000 to get the needed repairs done. Of course, she didn’t have that kind of money. She tried to get her money back from the Costa Rican dentist, even hiring a lawyer from the area, who was on her side. However, the law in that area is very corrupt and she ended up getting in trouble for complaining about a Costa Rican dentist publicly who had not been convicted of any crime and they put a warrant out for her arrest. She ended up having to flee the country.

You are at particular risk because of the number of dental crowns you need. There is a lot that could go wrong with that type of bite placement. My advice is to find a dentist here in the states with good qualifications and let him or her do the work. You may even be able to work out payment arrangements. Leave the Costa Rica trip for a true vacation, where you are not putting yourself at risk.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss, an AACD accredited dentist.

Should I Switch Implant Dentists?

Posted on March 1, 2022 by writeradmin.

I am getting two dental implants. I’m paying a LOT of money for this and am concerned that my dentist may be in over his head for reasons I am about to explain. I have had the teeth extracted and some bone grafting done. Then, my dentist provided me with two different Maryland Bridges as temporary replacements. They’ve fallen off several times each. This has made me wonder if he understands esthetic dentistry. Should I switch dentists in the middle of my procedure to a dentist who has more experience?

Misty

Dear Misty,

For those who do not know, a Maryland Bridge is a false tooth that is attached to the adjacent teeth with either metal or ceramic wings. I would not consider this a temporary tooth replacement because the adjacent teeth have to be etched and bonded on. If your dentist does not understand how to adequately place this, then I have concerns about two aspects of this. First, I have the same concern you do. If he doesn’t understand how a Maryland Bridge works you are not likely to get an attractive aesthetic result. A second concern is just the dental implant procedure itself. This is quite an advanced procedure. If he cannot do the Maryland Bridge, then I would have concerns about the implants.

You can switch dentists in the middle of a procedure. Your current dentist is ethically obligated to cooperate with your new dentist, including providing him with all the necessary diagnostics and notes that he has on your procedure. You will want to make certain that whichever dentist you go to has post-doctoral implant training. Some training to look for is someone who has been to the Dawson Academy, the Kois Center, or the Las Vegas Institute for Advanced Dental Studies. He will want to examine your implants and make sure they’re placed properly before moving forward. Don’t be surprised if the dentist suggests a different temporary tooth replacement. A dental bridge is the most common recommendation. The good news is that it is much less expensive than the Maryland Bridge.

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