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dentistry

Gross Dental Implant Incompetence

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I am not sure where to go from here and need some advice. I had a dental implant placed. It felt like the crown was loose so I went to see my dentist. He said the crown was loose and needed to be re-cemented. When he tried to take the crown off he had a bit of trouble. His next step was to use a special tool, but when he got the crown off the dental implant came with it. What do I do now?

Phylicia

Dear Phylicia,

Three stages of a dental implant

Can you get a dental implant while on Fosamax?

I hate to be the one to tell you this, but your dentist is completely incompetent. First, if a dental crown is loose, it is incredibly easy to remove them. Most often, they fall off of their own accord. What was actually loose was your dental implant. If your dentist wasn’t incompetent then he was incredibly dishonest. Neither scenario bodes well for you as his patient.

Some Reasons for Loose Dental Implants

If the implant came loose right after the dental crown was placed, then it means the crown was placed prematurely. Before you can place an implant crown there has to be sufficient osseointegration. Without that, the crown will pull the implant loose. Another option is there wasn’t enough bone support to begin with. Doing implants requires substantial diagnostics. A dentist should determine how healthy the bone structure is. Then, if there isn’t enough, suggest bone grafting to make sure you have the best chance of a successful outcome.

Some implants fail because of an infection. You didn’t mention either pain or a fever. In most cases of infection, one or both of those would be present.

Fixing a Failed Dental Implant

The first thing you need to do is demand the dentist who botched this so badly pay to get it fixed by a dentist you choose. That is important. Fixing this involves more than your original procedure, so just getting a refund will not be enough. You also want it to be a dentist you choose, so you can make sure they have the expertise to do this right.

It will require significant post-doctoral training. For instance, Dr. Weiss trained at the esteemed Dawson Academy. He’s also an instructor at the Academy of Osseointegration. This is what you want to look for. Not only that, he’san AACD accredited dentist which means he can create a beautiful crown.

I’m sorry this happened to you. Hopefully, this can be rectified soon.

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

Dentist Gave Me a “Wallace & Grommit” Smile

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I have a disastrous smile makeover. The closest way I can describe it is he’s given me a Wallace & Grommit smile. My front teeth are way too big and make it hard to even close my mouth all the way! He also provided a few mini implants for missing teeth in the back of my mouth. What do I do? It is so bad that my friends ask me if they made my dentures too big. I don’t have dentures! That’s how ridiculous I look. My dentist thinks it is fine. What do you recommend?

Monica

Dear Monica,

Image of Wallace & Grommit

I’m sorry this has happened to you. I’ve put a photo of Wallace & Grommit here for the sake of those who may be unfamiliar with the reference. I’m afraid we hear about these smile makeover disasters way too often. Most of the problem stems from dentists who are inexperienced in cosmetic work. While cosmetic dentistry isn’t a recognized specialty, it does require specialized training. Smile makeovers aren’t taught in dental school, so they have to invest the time and training to study the skills in a post-doctoral setting. Not all dentists have invested in the necessary training or could just be he’s just started out. We have all had our first few cases.

Generally, if the problem with your case is simply it doesn’t look good, you don’t have much recourse. You could appeal to the dentist’s sense of integrity in his work or get another cosmetic dentist on your side to appeal to the dentist’s sense of peer respect. Another option is to threaten to write a bad review.

That being said, you are in a better position. Your mouth doesn’t close. This causes serious problems to your dental health and would not be considered a clinically sound case. When your mouth doesn’t close, it leads to dry mouth. This means you are not producing enough saliva. Our saliva is a key factor in preventing cavities. It contains minerals and other properties that help fight the bacteria in our mouths. People with dry mouth suffer from decay and gum disease and a much higher rate than normal.

Getting Your Smile Makeover Fixed

Frankly, your case needs to be redone. This is actually good news for you. I don’t want your current dentist doing the work. I’m concerned about what I”m hearing from you. You need a better cosmetic dentist. So, before you ask for your refund, I want you to see a better cosmetic dentist, preferably an AACD accredited dentist. While you are there, ask them to look at your implants too. I don’t like hearing he put mini implants in. While they are fine to help with securing a denture, they are not a good option for a single dental crown. For that, you would need a full-sized dental implant.

If your second opinion dentist thinks they are fine, then you can simply get a refund on the other work. If he thinks you’ve had the wrong tooth replacement then you will want to get a refund on both. Plus, have him pay the additional cost of the bone grafting which would be necessary to do the replacement.

You then have your second opinion dentist do the work or get another dentist.

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

Victim of Dental Tourism for a Smile Makeover

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I went to Croatia and was able to receive $60,000 worth of cosmetic work for just over $10,000, including airfare. I thought I was getting the deal of the century. When I asked them how they could afford to do that, they told me health care was more affordable in their country because they don’t have as many laws and restrictions. I fell for it hook line and sinker. I’ve been home two weeks and have followed all their instructions including not to eat with my front teeth for a few months. But, since then four of them have already fallen out including one of the front teeth. I promise I haven’t been eating with it. What do you recommend?

Stacey

Dear Stacey,

A woman smiling with a beauttiful smile

The most important factor in a smile makeover is the skill of the cosmetic dentist.

Dental tourism is a booming industry, especially for advanced cases like smile makeovers. Unfortunately, as you are discovering, it rarely works out the way the tourist hopes. While it is true we have more regulations in our health care system, most of that is to protect the patient from unhealthy or incompetent practices.

If they truly gave you porcelain veneers, telling you to avoid eating with your front teeth sends off huge warning bells to me. With correctly bonded porcelain veneers, you should be able to eat anything you want. It sounds to me like these “dentists” may not truly understand how to bond them. Though, there is always the possibility they didn’t provide you with true porcelain veneers.

Getting this Smile Makeover Repaired

You are going to need the expertise of a top of the line cosmetic dentist. Look for one who is AACD accredited. They are in the top 1% of cosmetic dentists in the country.

The first thing you’ll want to find out is if they are truly porcelain veneers. That is your best-case scenario. If they are, an expert cosmetic dentist can bond them back on properly. This isn’t something any dentist can do. It requires techniques and skills most dentists don’t have. I’d recommend having the rest of them re-bonded as well if that is the case.

If they are not porcelain veneers, you can try to get your money back, but most of that will depend on the laws available to the consumer in Croatia. It’s not likely to be anywhere near as useful as what you have here.

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

Trouble with Porcelain Veneers

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I have this set of porcelain veneers and I’ve had nothing but trouble with them. First, they kept coming off. Then, once they started staying on permanently, I noticed one of them has a horizontal divot which I hadn’t noticed before. I called my dentist and graciously agreed to buff it out, but now that tooth looks more matte than the surrounding teeth. What’s going on? I thought porcelain veneers were the top of the line for smile makeovers.

Pamela

Dear Pamela,

A single porcelain veneer being placed on a tooth.

You say that your porcelain veneers are the problem. On the contrary, I’m pretty sure it’s your dentist who is the issue here. First, you said they wouldn’t stay bonded. This shows a lack of basic technique. Then, you came to him with a divot in your veneer. While he may have buffed out the divot, he simultaneously took off the glazing on the veneer as well. This has ruined your porcelain veneer and it will begin to pick up stains rather soon.

You have three choices here.

  1. Have the veneer polished.
  2. Have your dentist replace your veneer.
  3. Have another dentist do the work.

First, you can have your dentist polish the damaged veneer. It’s not complicated, but it does require knowledge and equipment your dentist likely doesn’t have. You start by using diamond polishing instruments and polishing paste, then end with an ultra-fine diamond polishing paste. I recommend Brasseler’s Dialite Porcelain Polishing System.

If you aren’t confident your dentist can pull this off or he’s not interested in investing in the right equipment, then you can require him to replace the porcelain veneer. This would require he has improved his bonding technique.

Finally, if you don’t have confidence in him to be able to do either of the above correctly, then you simply ask him to pay for the repair from a more qualified dentist, whom YOU pick.

Who Should Do Your Porcelain Veneers?

You were correct in thinking that porcelain veneers are the top of the line smile makeover procedure. However, to get that gorgeous celebrity smile, it also requires having a top of the line cosmetic dentist. I always recommend you look for an AACD accredited dentist in your area.

These are the dentists who, not only invested in advanced cosmetic training, but also have an artistic eye with the ability to craft stunning smiles.

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

Three Different Colored Teeth After Getting Porcelain Veneers

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Help me! I had four porcelain veneers placed on my teeth. As a result, I have three different colored teeth. My natural teeth are yellowish. The four porcelain veneers I received were all the same color, but now have a grayish tint in a splotchy way all the way down. I’m so frustrated because I paid a lot for these. What do I do?

Dania

Dear Dania,

A single porcelain veneer being placed on a tooth.

I’m sorry this has happened to you after investing in a beautiful smile. When you pay for a smile makeover, you expect it to be something you can be proud of. This isn’t what you received. My guess is your dentist is just your bread and butter general dentist, who hasn’t invested a lot of training in cosmetic work.

Unfortunately, this has its most negative impact on you. Most patients don’t realize that cosmetic dentistry isn’t a recognized specialty in the dental field. Any dentist can do it and it is up to them how much time they invest in training Think of it as an art form. If one person had a year of violin lessons and dabbled in practice and another person studied for years and practiced diligently, which one would you want to play at your wedding?

Getting Your Porcelain Veneers Done Right

There are some solutions to your situation. Let’s start with the visibility of your yellowed natural teeth. You received four porcelain veneers. Most smiles, including yours, are wider than four teeth. To keep that smile as uniform in appearance as possible, you have two options. One is to get enough porcelain veneers to cover all teeth which are visible when you smile. The second, if you can’t afford that many veneers, is to whiten your teeth. This is typically done before getting your veneers, so they can be made to match the color of your new white natural teeth as closely as possible. However, you can still get your teeth whitened now. The procedure will not damage your veneers.

As for your graying veneers. It sounds like the bonding isn’t well done on those teeth. Because it is splotchy, I believe there is food and bacteria getting caught between your teeth and the veneers. The only solution to this is to have them re-done. In fact, you need them to be replaced. Otherwise, your teeth will begin to decay under the porcelain veneers.

In some way, this is actually good news for you. It gives you a case for getting a refund from this dentist. Then, you can invest that money in a dentist who has done more training and has an artistic eye as well as the technical skill. My suggestion is you find an AACD accredited dentist. They’re the top cosmetic dentists in the country. They’ll give you a stunning smile.

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

Form and Function with TMJ Disorder

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I am a mess. I had been grinding my teeth for years. Apparently, my dentist knew this and never mentioned it until my teeth were down to nubs. He crowned the worn teeth, but now I am in constant pain. Plus, I’ve worn those down as well. I don’t know how to stop doing that because I didn’t realize I was doing it to begin with. I went to get specialist help but learned there isn’t a specialist in this. It has been suggested I see a prosthodontist, but I’m worried the teeth won’t look good. Do I have to choose between functioning pain-free teeth and a pretty smile?

Amelia

Dear Amelia,

woman holding her her jaw in pain

I’m sorry you’ve been put through this. Plus, I hope you don’t mind saying I think you need to find a better dentist. This one doesn’t seem to have your best interests at heart. He knew you were grinding your teeth and never provided you with the simple tool to protect your teeth to keep from wearing them down.

Then he let you do it again with your dental crowns. I’m sorry, but that is like standing there watching a blind person walk off a cliff, charge them for the hospital bill and repairs, then watching them do it again. How were you supposed to know you were grinding your teeth, let alone what would help? He’s the professional.

Yes, a prosthodontist will typically have more training in treating TMJ Disorders than your average dentist, but as you mentioned not many of them are artistic. They are passionate about the technical aspects and don’t really care about appearance-related issues.

What you need is a dentist who is passionate about form and function; one who has invested in both TMJ training as well as cosmetic training. I promise they exist. They’re not as much of a unicorn as it might seem at the moment.

Finding a Great TMJ Dentist Who Can Create Beautiful Smiles

You’ll need to begin with the TMJ training. It will not matter how beautiful your smile is if you are in too much pain to share it. Here are some institutions which have great TMJ training. You’ll want to find a dentist who has trained with one of them.

  • The Dawson Academy
  • The Kois Center
  • The Pankey Institute
  • The Las Vegas Institute of Advanced Dental Studies

From there, you’ll look to see if any of them have great cosmetic skills. The best are AACD accredited. These are hard to find. Dr. Weiss is one of six accredited dentists in the whole of Pennsylvania. If you can’t find one, that doesn’t mean it’s hopeless. Many great cosmetic dentists are on their way toward accreditation. I would look at their smile galleries to see what type of results they get. Just makes sure it is images of their actual work and not just stock photos.

One other thing. You need to get a nightguard. This is like a sport’s mouthguard, but is custom-fitted to your bite. It will protect your teeth from the grinding you are doing while you sleep.

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

Cracked Porcelain Veneer

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I received a huge bonus and decided to invest it on my smile. I had porcelain veneers done about three months ago. My teeth were quite small the excellent cosmetic dentist I went to made them longer. My smile is gorgeous. I can’t tell you how often I smile these days. This morning I noticed a horizontal crack about a 1/3 of the way down the tooth. Will it fall off? I spent all my bonus to get these veneers. I don’t think I can afford to get it replaced. I honestly don’t think I did anything to it. I’ve taken great care of the teeth. What do you recommend I do?

Portia

Dear Portia,

A single porcelain veneer being placed on a tooth.

I truly don’t think your dentist will blame you for what happened to your porcelain veneer. If a patient abused their porcelain veneers, it would show up as chips, not a horizontal crack. Plus, as you’ve said, patients generally love their new smile makeover so much they take great care of their porcelain veneers.

While often a cracked porcelain veneer is in no danger of falling off due to the bonding procedure, based on the fact that they needed to make your teeth longer, I’d be a little concerned it doesn’t have much to hold on to, especially given where you said the crack was located. I think this veneer will need to be replaced.

I know you’re worried about money, however, given the short amount of time you’ve had the veneer, I think it is very likely they will not charge you to replace it, especially if you explain the financial situation and what allowed you to get your smile makeover to begin with, he’ll be compassionate about the replacement.

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

Dental Insurance for Dental Implants

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I want to replace all of my teeth with dental implants. They are in pretty bad shape and I want a smile I can be proud of. Is there a dental insurance that will cover these?

Kevin C.

Dear Kevin,

When you say your teeth are in pretty bad shape, you didn’t specify whether you meant in appearance or in health. If it is just an appearance issue, getting dental implants would be an overtreatment. This is designed for patients who need to replace their teeth because they have to be removed as a result of decay and infections. If that’s not you, a great cosmetic dentist can create a stunning smile for you, while enabling you to keep your natural teeth using porcelain veneers.

If, however, the teeth are unhealthy and have to be removed, then dental implants will be the right way to go. If you already have dental insurance, they will cover part of the cost but probably not as much as you would hope. Dental insurance tends to only want to cover the least expensive option. For tooth replacements, that is dentures. Though I only recommend dentures as an absolute last resort for reasons I’ll go over in a moment.

If you don’t already have dental insurance, be aware that most policies have a waiting period for anything other than cleanings and checkups. That may defeat the purpose if your teeth need to come out right away.

Why Not Dentures?

Two profile photos of a woman who experienced jawbone shrinkage and facial collapse, which can be prevented with implant overdentures, available from Philadelphia cosmetic dentist Dr. Michael Weiss.

Jawbone shrinkage results in facial collapse

When your teeth are removed, your body begins to resorb the minerals in your jawbone to use elsewhere. This is in an effort to be efficient with its resources. Unfortunately, this also has the result of slowly shrinking your jawbone. Eventually, you won’t have enough jawbone left to retain your dentures. This is known as facial collapse.

Getting dental implants signals to your body your jawbone is still necessary and will leave the minerals in place, thereby protecting you from facial collapse.

Implant Overdentures

Implant overdentures

Implant overdentures are a combination of dental implants and dentures

You don’t have to get a dental implant for every tooth. Instead, you can get implant overdentures. This will use between four and six dental implants and will anchor a set of dentures to them. This has the benefit of being more affordable while still providing you with all the benefits of dental implants.

If You Want a Stunning Smile

Whether you get dental implants or porcelain veneers, you still need a dentist who is skilled in cosmetic dentistry to give you that gorgeous smile you want. The top cosmetic dentists are AACD accredited. When you’re looking for natural results that look great, then you need to see an accredited dentist.

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

Dental Bonding Color Doesn’t Match

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I need advice on how to help my sweet grandaughter. She’s not confrontational but paid over $1,000 to have teeth whitening and dental bonding done to improve the look of her smile. Her lateral incisors ended up gray, which is much darker than her natural teeth and even more so after the teeth whitening was done. She asked the dentist about it and he told her the lateral incisors are supposed to be darker. I just don’t buy that. She’s too nice to argue with her dentist but I know she is embarrassed by this and doesn’t smile as much. After paying that much money, she should be happy to smile. What can she do?

Andy

Dear Andy,

before and after dental bonding case

Your gut feeling is right. The lateral incisors should NOT be darker than her central incisors, as you can see from this case done by Dr. Weiss above. In fact, in many cases, they are actually slightly lighter. The dentist who did your grandaughter’s dental bonding either doesn’t know that, which means he doesn’t understand his own craft, or he isn’t honest and is making stuff up to shut her up. Neither of those options are good.

You have two choices in helping your granddaughter. The first is to ask the dentist to re-do the teeth which are too dark. Truthfully, I’m not sure you will get any better results the second time around. A true cosmetic dentist would not be satisfied with a case if their patient wasn’t thrilled. They certainly wouldn’t make up some excuse as to why his bad results are “good”.

Your second option is probably the best. That is where you ask him to cover the expense of having this done right with a different cosmetic dentist. She paid for a beautiful smile and didn’t get it. Additionally, he wasn’t honest. You can feel free to show him this post if it will help with her case.

Where to go to Get Her Dental Bonding Done Correctly

You need an expert cosmetic dentist to re-do her case. Smile makeovers aren’t taught in dental school and cosmetic dentistry isn’t a recognized specialty. If a dentist wants to excel at it, they have to invest in post-doctoral training themselves. Most just dabble. She needs an artist, especially with dental bonding which is done freehand.

I suggest, if at all possible to take your granddaughter to see a dentist who is accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top in the country. They not only have to pass stringent exams to show they understand the technical process of their craft, but they also have to provide visual evidence of their artistry.

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

Can Dental Bonding by Safely Removed?

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I have dental bonding I’m not too thrilled with. I’m moving and want to find a better cosmetic dentist. However, before I do anything I wanted to ask if it is possible to remove dental bonding without damaging the tooth. Have you had experience with that?

Mazie

Dear Mazie,

before and after dental bonding case

Yes, it is possible to safely remove dental bonding on two conditions: First, you must go to a dentist who understands the procedure and has the equipment. Second, the dental bonding has to be attached to the enamel of your tooth and not the soft dentist which is beneath the enamel.

Here are three ways to safely remove dental bonding:

Sandpaper disks

Dentists use these to polish composites. These are probably the easiest for a dentist to use for this particular job. They are flexible enough to form to the shape of the tooth and leave a nice smooth, polished tooth surface.

Carbide Drills

These have a high-speed. If the dentist is able to use them with light pressure, they will do the job faster than the sandpaper disks. Their big disadvantage is they tend to leave streaks of material on the tooth. If a dentist uses this, they’ll want to finish up with the sandpaper disks to get that nice smooth finish.

Air Abrasion

It will be hard to find dentists who have this equipment. It’s not as commonly used as the other options.

Getting Your Beautiful Smile

Whether you just have a dentist re-do your dental bonding or you get a full smile makeover with porcelain veneers, you want to make sure you have an expert cosmetic dentist do the work. In your place, I’d look for a dentist who is AACD Accredited. These are the top cosmetic dentists in the country.

Some, less experienced dentists, will try to tell you if you get Lumineers they will be reversible. This is absolutely not true. They say this because they are marketed as a no-prep veneer. However, the material in porcelain veneers, including the Lumineers brand is much harder than the composite material and the tooth will almost positively end up damaged in the removal process.

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