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dentistry

Can I Get a Beautiful Smile with Dental Implants?

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I’ve had dentures for about ten years. I’ve hated them from the very beginning. They’re unattractive and uncomfortable. Their comfort has been going downhill from the beginning. I’m wondering if dental implants will be better. Will they be more attractive than the dentures? And possibly even fit better?

Kitty

Dear Kitty,

Implant overdentures

A beautiful smile isn’t dependent on whether or not you have dental implants or dentures. What creates the beauty is the skill of the dentist. The other issues you mentioned, however, are specifically a denture issue. Those can be fixed with dental implants. Let’s go over that first, then we’ll talk about how you can be sure they’re beautiful.

When your teeth were removed, your body recognized there were no longer any teeth roots in your mouth. As a result, it began to resorb the minerals in your jawbone in an effort to be as efficient with your body’s resources as possible. This has the unfortunate result of shrinking your jawbone. This is known as facial collapse and why it feels like your dentures no longer fit properly. Eventually, you won’t have enough jawbone left to even retain your dentures.

The dental implants serve as prosthetic tooth roots, thereby letting your body know the minerals in your jawbone are still necessary. This preserves your jawbone.

When you’re talking about full removable dentures, such as you have, you wouldn’t do a one-to-one ratio dental implants to teeth. While you could, it is the “Cadillac” of tooth replacements and would cost a pretty penny. Instead, it’s usually recommended you get implant overdentures, which you see pictured above. This uses dental implants spaced around your arch and anchors your dentures to them. They’ll fit perfectly and be completely secure. You won’t feel uncomfortable with your dentures any more.

Dental Implants after Years of Dentures

You will have to deal with the loss of jawbone you’ve likely experienced after ten years with dentures. In order for the implants to be secure, there needs to be enough bone there to retain them. It’s possible you won’t have enough, but that can be solved with an outpatient bone grafting procedure. This builds up the bone enabling you to get the secure treatment you want.

Getting Beautiful Dental Implants

As I mentioned earlier, the best way to get a beautiful result is with an excellent cosmetic dentist. The best of the best cosmetic dentists are AACD accredited. That’s what I’d look for in your case. In a way, this is a blessing in disguise. It gives you a chance to get a stunning smile, like you see celebrities get.

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

Smile Makeover During Pregnancy

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I was planning on getting a smile makeover but just found out I’m pregnant. Can I go through with it or do I need to wait?

Avery

Dear Avery,

A woman smiling with a beauttiful smile

Congratulations on your upcoming blessing. Babies are the best. Whether or not you can go forward with treatment depends on a couple of things. The first is what procedures you were planning. The second is whether or not you’re in a high-risk category in your pregnancy.

Let’s start with the procedures.

Teeth Whitening

Getting your teeth whitened hasn’t been officially cleared for pregnant women. It’s not because there is evidence of it doing harm to the baby, it is because we’ve had no tests to say it doesn’t do harm. As you can imagine, there aren’t a lot of women lining up to have their unborn child be a test subject.

I’m sure you can find a dentist to do it for you. Just make sure you understand the risks. By that I mean we don’t yet know the risks.

Invisalign

These are clear aligners you wear over your teeth to straighten them. It’s perfectly safe to use during pregnancy. However, if you are prone to morning sickness and vomiting, you may find this an inconvenient time to straighten your teeth. The aligners have to be worn almost full-time, with the obvious time exceptions being during meals.

Vomiting will mean thoroughly cleaning out the aligners so you don’t get stuck with anything acidic in them. This will lead to massive decay.

Porcelain Veneers

Porcelain veneers are a safe procedure, even during pregnancy. The only chemical used would be the Lidocaine which is used for numbing during tooth preparation. Lidocaine is one of the medicines which has been FDA approved as safe to use during pregnancy. It’s even sometimes used during the delivery process.

The only cautionary tale I’d offer here is to make sure you see an expert cosmetic dentist or you will be disappointed with your smile makeover results.

All that being said, if you are in a high-risk pregnancy group, you’ll need to scrap everything I just said and talk to your obstetrician and get clearance on everything first. There will likely be special considerations.

Best of luck to you and your baby.

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

Pain After Dental Bonding

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I had dental bonding done a few weeks ago. One was for a cavity, but the rest was for chipped teeth and a gap. I’ve had increasing pain ever since, especially when I bite down. I called the office and they said it is just a matter of me adjusting to the feel over time. Why is it getting worse?

Fred

Dear Fred,

before and after dental bonding

As you can see from the picture above, dental bonding can be a great solution for cosmetic procedures. In the hands of a skilled cosmetic dentist, they can restore a beautiful smile.

I’m uncomfortable with your dentist telling you that you’ll just get used to it. First, when done right, it should feel just like your natural healthy teeth. The procedure is designed to help restore the missing tooth structure. If the bonding was done properly it wouldn’t be causing any pain.

Even if there was initial pain and irritation from the procedure, the pain would be getting better not worse, which is what you are currently experiencing.

The likely problem is your filling is seated too high. This would explain the pain when you bite. Your teeth are hitting together too soon. Your dentist should have called you in to do adjustments. It likely means he has to file them down just a bit.

Never Ignore Pain

Pain should never be ignored. There are quite a few reasons why there could be pain. In addition to the filling being seated too high, there still could be decay under the filling. It could also mean there is a crack in the tooth or any other number of things.

My point is, your dentist is wrong for ignoring it. You need to go back and insist he finds out what the underlying problem is and once he does, he needs to fix it.

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

Porcelain Veneers During Pregnancy

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I’ve been saving up for a smile makeover for years. Now, when I finally have the full amount I needed I find out I’m pregnant. Is it safe for me to go forward with this or do I need to wait until after delivery?

Madison

Dear Madison,

A single porcelain veneer being placed

While there are some procedures which are not recommended in the first trimester, such as teeth whitening, porcelain veneers should be quite safe. The concern is about introducing chemicals to the baby. With porcelain veneers, the only thing you have to worry about is the anesthetic used. Fortunately, lidocaine has been tested and proved safe for use during pregnancy and even delivery. You and your baby should be fine.

Who Should Do Your Porcelain Veneers?

There is another important consideration— who should do your smile makeover. This isn’t a skill taught in dental school, nor is there a recognized specialty where dentists become graduates in the field. Instead, dentists with an interest in cosmetic dentistry have to take the initiative to get the proper training post-doctorally.

This makes it a little challenging for patients. How can they separate the sheep from the goats, so to speak? The easiest way to handle this is to find an AACD accredited dentist in a reasonable distance to you. These dentists have been tested vigorously for both their technical knowledge and their artistic ability and are among the top 1% of cosmetic dentists in the country.

They will give you a stunning smile.

If you can’t find an accredited dentist without a significant amount of travel, which you’re probably not keen on while pregnant, you still have options.

The mynewsmile.com website also recommends excellent cosmetic dentists. Not all of them have reached accreditation, but they’ve all been carefully screened for their ability to do beautiful smile makeovers. Most are on their way to accreditation.

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

Do I Have to See an Accredited Cosmetic Dentist?

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I’m thinking of getting a smile makeover and research says it is important to go to an accredited cosmetic dentist. There doesn’t seem to be any in my area. To get a beautiful smile, do I have to see an accredited dentist?

Mercy

Dear Mercy,

Brunette with a beautiful smile

AACD accredited dentists are in the top 1% in the country.

For a dentist to reach accreditation with the American Academy of Cosmetic Dentistry, they have to pass both technical and clinical exams. The technical exam is to ensure they have the requisite knowledge to do the job skillfully. The clinical exams show they also have the artistry to create stunning smiles.

AACD accredited dentists are in the top 1% of cosmetic dentists in the country. However, there is no regulation to compel a dentist to seek accreditation in order to provide cosmetic work. In fact, there are no regulations necessary for a dentist to call him (or her)self a cosmetic dentist.

Getting a Beautiful Smile Makeover

While you don’t have to see an AACD accredited dentist to get a beautiful smile makeover, you do have to make sure the dentist has the expertise to do the work properly and with artistry. If you don’t have an accredited dentist in your area, you still have an additional resource where you can trust the dentists to know what they’re doing.

The mynewsmile.com website also screens cosmetic dentists. They won’t list them unless they have done post-doctoral studies in smile makeovers at a reputable institution and provided visual evidence of their artistic abilities. Some of these dentists are accredited. Some are on their way to accreditation. Some aren’t interested in going through the process. All of them can give you a stunning smile.

You may already know that the top of the line procedure for a smile makeover is to get porcelain veneers. It is not recommended to place them over dental crowns, so if you have those on any teeth, you will still have to have a crown. A good cosmetic dentist is skilled enough to match your crowns to your veneers. If they’re on visible teeth, they will give you an all-porcelain crown. Those are more natural-looking.

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

Jaw Pain from Dental Appointment

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I had my teeth prepared for both crowns and porcelain veneers on my upper arch. I’m almost a week out and my jaw is still in massive pain. I ache constantly. My dentist suggested taking Ibuprofen, which I have been, but I feel like I’m living on the pills. Could my dentist have caused a TMJ problem? He’s going to be gone for a week. Do I need to see another dentist or can I wait until he gets back?

Missy

Dear Missy,

woman holding her her jaw in pain

This sounds pretty normal for what you’ve been through. Your mouth had to be propped open for quite a while. Soreness in your jaw is to be expected. It may even go on for another week or so. In addition to the pain medicine, you can do hot and cold compresses to help give you some relief.

If your dentist is gone for a week, he should have made arrangements with another dentist to care for his patients in the case of a dental emergency. I don’t think this is one, but if things get worse you can call your office and there should be a number on their answering machine for the dentist he’s made arrangements with.

Symptoms of TMJ Disorder

While jaw pain is a symptom of TMJ, that in isolation isn’t usually a sign. There are generally other things which accompany jaw pain. Some examples would be:

  • Popping or clicking of your jaw
  • Migraines, especially in the morning
  • A change in your bite
  • Neck pain

If any of these symptoms develop, that would be when you should talk to a dentist about TMJ disorder. There are tests a dentist can run to help determine if this is an issue for you.

Don’t go to any dentist about this, though. You want a dentist who has invested time in TMJ training after dental school. You’ve had what sounds like a full-mouth reconstruction. When this is done properly, it can actually treat TMJ disorder. But, if it is done improperly it can make things worse. That’s why you should keep an eye on those other symptoms.

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

Replacing a Front Tooth While on Fosamax

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I had to replace a tooth adjacent to my right front tooth. Right now I have a dental flipper and absolutely hate it. I wanted a dental implant but my dentist said that’s not possible because I take Fosamax. I suggested a dental bridge and he doesn’t want to do that either because it will crown the adjacent teeth which he says are fine. That’s true, but I want to get rid of this flipper. Would an Encore Bridge be an option?

Bruce

Dear Bruce,

Three stages of a dental implant

Can you get a dental implant while on Fosamax?

It is possible to get a dental implant while on Fosamax. Your dentist’s concern has to do with the increased risk of local bone problems when having oral surgery. While the risk is small, the complications are serious. Don’t minimize the risk. One possibility is to temporarily suspend taking Fosamax, under the cooperation of your physician who should oversee this.

If you decide against getting a dental implant, a dental bridge is fine, and a better permanent option for you than a dental flipper. That being said, let your dentist pick the type of bridge. You definitely don’t want to be the first patient he or she has done an Encore Bridge on. Some dentists are your basic bread and butter dentists who can only do the “standard” work. That brings up an important point about your dental implant.

Who Should Place Your Dental Implant?

The concern your dentist mentioned is legitimate, however you should be aware that sometimes a dentist will steer you away from a procedure because they aren’t comfortable or qualified to do it. They don’t want a patient to lose confidence in them so instead they come up with reasons to discourage that particular procedure.

You don’t want to push a dentist into a procedure they are not comfortable doing. This usually ends in disaster.

Dental implants are an advanced procedure. You’re in a high-risk group, so it makes it even more important you have an experienced, qualified dentist to do it for you. Look at Dr. Weiss’ qualifications to get an idea of what type of dentist you are looking for.

Another consideration is cosmetic. You’re talking about matching a single crown to your front teeth. You want someone with the cosmetic skill to make it blend both beautifully and naturally. The best cosmetic dentists are accredited by the American Academy of Cosmetic Dentistry.

In your place, I’d look for an AACD accredited dentist who has a high success rate in dental implants.

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

Cosmetic Dentistry Malpractice

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Can you advise me? I spent a small fortune to get my smile updated. I’d had some cosmetic bonding on my front teeth which was showing its age along with a dental bridge. I went to a dentist who advertises as specializing in cosmetic work. He replaced the metal bridge and then planned crowns on the remainder of the visible front teeth. When they put in the temporaries, they told me they wanted to be certain I’d like them. I’d brought them a very specific smile design I wanted so I was glad to hear them say that. Unfortunately, it proved not to be true. When the permanent ones came in they weren’t the same color. I mentioned that and they said they’ll look different in my mouth. They didn’t. I told them, they still looked dull. Then they said it was because I see them differently in this light. Which, by the way, was the same light I saw the temporaries. When we got in a different light I noticed, they didn’t match the metal bridge. Their response, was, “Of course they don’t. The bridge is metal.” Then they bonded them in even though I wasn’t happy with them and said I’d get used to them and love them. I don’t. I don’t know what to do. My teeth are not what I wanted and don’t match.

Patricia

Dear Patricia,

A woman smiling with a beauttiful smile

When you get a smile makeover, you should be thrilled to share your new smile.

You have a great case to have this re-done by a dentist who actually knows what they’re doing, but you are going to have to be tough. This dentist behaved quite unethically based on what you’ve said and I don’t think he cares whether you like your smile or not.

Aside from shoddy cosmetic work, they violated a very important principle of dental practice, which is informed consent. You did not consent to them bonding in your new smile. In fact, they badgered you into it by trying to make you feel unreasonable. This was after they promised you that you’d get to approve the smile and love it first.

Dealing with Shoddy Smile Makeovers

Because they didn’t have your consent, you have the right to have this done again. However, I wouldn’t trust this dentist to do it. Instead, have them pay for an excellent cosmetic dentist to re-do your work properly. You may have to involve a lawyer, but you’re on solid ground.

It’s unfortunate he ground all those teeth down for dental crowns. Porcelain veneers would have been a better option for you and is much more conservative on your tooth structure. Seeing as you had crowns done (through no fault of your own) you will have to have crowns done again.

This time, get them done by someone who’s invested time and training in cosmetic dentistry (which by the way isn’t a recognized specialty). In your place, I’d go to mynewsmile.com and see which dentists they recommend in your area. Anyone on their list will give you a stunning smile makeover you’ll be proud to show off.

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

Crowns for Chipped Tooth

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I’m not sure what to do and need some advice. I tripped and ended up chipping one of my front teeth. It’s not a huge chip, but it bothers me. My sister told me that dentists can fix chipped teeth even if you don’t have the broken piece. I went in to see my dentist. While he did say he could fix it, he said the solution would be for him to crown my two front teeth. I’m not too keen on that, especially because the other tooth is fine. When I asked him why both teeth, he said so that they could match. While I get that they need to match, it feels stupid to grind down two healthy teeth. I’m worried I’m letting my vanity get in the way of sensibility. What do you think? Crown the teeth or live with a small chip?

Elaine

Dear Elaine,

While I am sure your dentist is trying to do his best for you, I’m going to recommend you see someone else to repair this chipped tooth. Many dentists need to do two crowns on front teeth to match them, however, there are great cosmetic dentists who can match a single crown. If a crown were the right course of action, then another dentist could do the treatment just on one tooth.

The easiest way to find a highly skilled cosmetic dentist is to look on the website of the American Academy of Cosmetic Dentistry (aacd.com). They have a link to help patients find a cosmetic dentist. However, you want one who has reached the accreditation level. AACD accredited dentists are the top cosmetic dentists in the country. Any one of them can match a single porcelain crown to a front tooth.

All that being said, you really don’t even need a crown on the one tooth let alone two. Yes, a crown will cover the chip, but there are much less aggressive ways to repair it.

Dental Bonding for Chipped Teeth

before and after dental bonding

Dental bonding is the standard treatment for a chipped tooth.

The standard treatment for this is to have dental bonding placed on the tooth. This uses a composite resin which a cosmetic dentist will sculpt freehand onto the tooth. I wouldn’t push your family dentist to do this. It is obviously not a procedure he is familiar with and it would take some technical skill along with artistry to do it right.

Instead, I would find an excellent cosmetic dentist and have them do the procedure. You won’t have to completely switch dentists. You can still go to your family dentist for everything else,

There is a cosmetic consideration here (aside from the chipped tooth). Whatever color your dentist makes your bonding is permanent. If you are even considering having teeth whitening done on your teeth, it will save you money to do that before you have your bonding done.

Otherwise, your natural tooth structure will whiten but not your bonding. Then you’ll have to have the bonding re-done to match the newer color.

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

Advice on Picking Dental Implant and Crown Materials

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I’m about to get my smile completely made over with dental implants and crowns. I want it done right so I have some questions.
1. Is Staumann or Nobel Biocare better for implants?
2. Is zirconium or porcelain better for the dental crowns?
3. My dentist said a white porcelain fused to metal crown will not show a black line at the gumline. Is this true?

I am spending a lot of money so want this to end up beautiful.

Laurie

Dear Laurie,

A woman smiling with a beauttiful smile

Getting a beautiful smile makeover requires an artist

I want to refocus your question using an analogy. If you were to commission someone to do a painting to be the centerpiece of your living room, would you spend time investigating paints or the artist? It’s the artist who makes the difference. They have the knowledge and skill to know which paints are good for which situation. Maybe a particular scene look does better with one brand, but for something else another is preferred for its pigment. The artist who works with the materials every day will know their strengths and weaknesses.

So, instead of researching which dental implant or crowns to use, research the dentist. You have a two-fold requirement. They have to be skilled in placing dental implants, including implant overdentures. But, they also have to be skilled cosmetic dentists.

Finding a Dentist Who Can Give You a Beautiful Smile Makeover

Doing smile makeovers aren’t taught in dental school. Instead, dentists who are interested in the art of cosmetic dentistry have to invest time in training for it post-doctorally. Even with that, there is no recognized specialty in cosmetic work. Because of that, patients often find it hard to know who is skilled and who isn’t.

Fortunately, the American Academy of Cosmetic Dentistry offers an accreditation program which gives patients a way to know who they can trust to give them a stunning smile makeover. In order for a dentist to reach accreditation, they have to pass stringent oral and written exams, as well as provide visual evidence of a large number of cosmetic cases they’ve done to show they are not just technically skilled, but artistic as well.

Any AACD accredited cosmetic dentist can give you a celebrity smile you’ll be proud to share. In fact, most of them have a beautiful smile guarantee.

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