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Cosmetic and
restorative
dentistry

Tooth Dark After a Root Canal Treatment

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My left front tooth (central incisor) had a root canal treatment several years ago and has since turned a grayish color. My dentist was suggesting a dental crown for it, but I really would rather be more conservative with the tooth structure. He doesn’t think a porcelain veneer is a good idea and so I am wondering about composite bonding. Would that work? One thing I am worried about is that every time it has to be redone that I will lose more structure. I like my dentist but I’m starting to lose confidence in him. He’s just not interested in keeping this tooth as intact as possible. What would your advice be?

Matthew

Dear Matthew,

beautiful smile

I’m glad you wrote. Either a porcelain veneer or some direct dental bonding will be fine, with a catch. You have to be careful who does it. If it is done right you won’t have to worry about losing structure during updates. Let’s start with the direct composite bonding. The benefit to this is the dentist can work with the color right there instead of having to go back and forth with the lab. This will last between three to five years. If well cared for, even longer. My suggestion, if you go with the bonding, is to use Supersmile Toothpaste. It is specifically designed for cosmetic work. The porcelain veneer will last longer, but will cost more.

Now for that catch I mentioned earlier. Matching a single tooth is super advanced. If your dentist is suggesting a dental crown on a healthy tooth, it tells me that he is not comfortable with cosmetic dentistry. I honestly think this is beyond the skills of your family dentist. It doesn’t mean that you have to give him up altogether if you like him. He may be a perfectly respectable general dentist. Many cosmetic patients go to one dentist for their general work and another for their specialized cosmetic work.

To match a front tooth, I would only go to an AACD accredited dentist. They are the top 3% of dentists in the country. These are the only dentists I would trust with such a difficult procedure.

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

Dentist Placed Implant and Now Wants to Remove It

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I paid in full for a dental implant. Before the surgery, my dentist said that I was good and ready to go. When I woke up he told me that after he got in there the situation was different and I didn’t really have enough bone to support the implant. He went ahead and placed it but said he would prefer to remove it and give me a dental bridge. I have a couple of questions. First, should I be entitled to get some of my money back seeing as he is just going to remove it? I feel like he put me through unnecessary surgery and I have nothing to show for it. Second, am I really stuck getting a dental bridge? I would prefer a dental implant if that is even a possibility any more.

Ellie

Dear Ellie,

Illustration of a dental implant next to a natural tooth

You should not only get a partial refund but a full refund. I cannot think of a reason your dentist would think he could get away with this. When you provide a procedure, especially something as invasive as surgery, there is an implied warranty that you have a belief in its success. He placed it knowing there would be failure. That is malpractice.

Additionally, if he would have done adequate diagnostics this would never have happened. He should have done a number of x-rays and, preferably, a CT scan. The reason for the latter is the fact that doing dental implants is a 3-dimensional procedure and really requires a 3-dimensional map. Not to mention the fact that if he’d done these diagnostics, he’d have known right away that you did not have enough bone support, thereby protecting you from the hassle of a surgery bound to fail. Obviously, he did not do his duty with this either.

I would start by demanding a refund. You are certainly entitled to one. From there I would find a great implant dentist. You will not have to settle for a dental bridge. You need a dentist who has significant post-doctoral training. Take a look at the training Dr. Weiss has to give yourself an idea of what type of dentist you will need. In addition, however, you will need a bone grafting procedure in order for your implant to have a chance of succeeding.

If you have any trouble getting that refund, just mention you are going to take a little trip to speak with the dental board. That should sober him up a little.  I am so sorry this happened to you. Most dentists are not this irresponsible.

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

Staining Around 1-Year Old Porcelain Veneers

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I’ve had my porcelain veneers for about a year. I thought they were supposed to be pretty stain resistant. Mine seem to be picking up stains on the top edges though. I’m still paying for thise so I’m kind of worried. Is this normal?

Drew

Dear Drew,

A single porcelain veneer being placed

No, this is not normal. Porcelain veneers are very stain resistant unless there was some damage to your veneer’s glaze. This can happen if your hygienist uses something like a power prophy jet or an acidulated fluoride on them. It takes away the glaze and causes staining.

This, however, will cause staining across the veneer and not just the top as you mentioned.

What you’re describing sounds like you have bulky margins. That’s when the porcelain veneers aren’t bonded flush against the teeth. This essentially creates a tiny shelf on the top of the porcelain veneers.

This will harbor bacteria and cause decay. That means it needs to be repaired. Your dentist should re-do this for you. If he doesn’t want to admit this is the problem, then I’d suggest you get a second opinion from another cosmetic dentist.

If they say it is an issue with bulky margins, then you have a right to get a refund. Your porcelain veneers aren’t considered functional if they put you at risk of decay.

If You Need to Replace Your Porcelain Veneers

IF you end up getting a refund. You’ll want to make sure you go to a more experienced cosmetic dentist. Ideally, look for a dentist who is AACD accredited.

The reason you’ll want this is they have both the technical skill and the artistry to create smiles that are not only perfectly bonded (unlike your current veneers), but stunningly gorgeous.

To get an idea of the kind of beauty they can create, look at Dr. Weiss’ smile gallery. You can find an AACD accredited dentist by going to aacd.com where they have a link to help you find them.

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

TMJ and Dental Crowns

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I have TMJ. It’s been under control for a while, ever since I had a night guard made. However, recently, the pain has returned in force. I think it is because of how tall this crown is, but my dentist says it isn’t. This crown hits the upper teeth before all my other teeth. He’s adjusted it three times and told me that is as good as it gets. He said this happens to many first time crown wearers and I will get used to how it feels. Fine, but what about the TMJ pain? Should I get a second opinion?

Misty

Dear Misty,

Woman in pain with TMJ
Poorly place dental crowns can cause serious damage

On the contrary of needing a second opinion, I think you need a new dentist. This one is not serving you. In fact, he’s either ignorant or deceptive.

The way your teeth meet both adjacently and with their opposing teeth is extremely important. It’s obvious he hasn’t put much time in studying this, which will lead to disaster for his patients.

Normally, your biting force is spread out over all of your teeth. However, when a dental crown is seated to high, it takes on the full force of your bite. Not only does this cause pain on biting, but you also are causing problems to the rest of your bite.

If you have TMJ Disorder, this will exacerbate it. If you don’t have TMJ disorder, it can lead to it.

Finding a TMJ Dentist

As you look for your new dentist, and I strongly suggest you get one, I want you to look for one who specifically has TMJ training. For instance, Dr. Weiss studied at the renowned Dawson Academy known for its TMJ training.

Additionally, he’s been treating TMJ successfully since the 1990s and has a very high success rate. His advanced TMJ training combined with his cosmetic training and expertise in smile makeovers makes him uniquely qualified for the toughest TMJ treatment, reserved for the most advanced cases, a full-mouth reconstruction.

That’s the type of dentist you want to look for in your area so you can make sure you don’t face exacerbated TMJ problem again.

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

Dental Implants are Just Like your Natural Teeth

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If you are reluctant to flash your pearly whites because of a missing tooth, schedule an appointment with your dentist who will be able to determine if you are a good candidate for Dental Implants.

Tooth replacements are certainly not new; in fact, they can be traced back thousands of years with archaeologists discovering skulls with implanted seashells, gemstones, and even animal teeth. Thankfully, because of today’s dental restoration techniques, you do not have to resort to seashells or gemstones to replace missing teeth.

Although modern dentistry has improved, there are still millions of people in the United States who suffer from tooth loss. This occurs because of injury, periodontal disease, and tooth decay. Before Dental Implants, people with missing teeth had to resort to dentures and bridges.

Dental Implants will provide you with a strong and permanent foundation for removable or fixed custom-made teeth matched to your natural teeth literally replacing the roots of your teeth.

There are several advantages including improved speech. If your dentures do not fit correctly, your teeth will slip causing you to slur or mumble when you talk. Because Dental Implants actually fuse to your jawbone, they are permanent and will look and feel just like your natural teeth. Permanent tooth replacements improve your self-esteem making you look and feel better boosting your self-confidence.

Another advantage is the ability to eat and enjoy your food again. Sliding dentures make chewing nearly impossible. Permanent replacements function like your own natural teeth allowing you to eat an apple or tuck into a nice juicy steak without worrying about leaving your teeth behind.

Tooth supported bridges require a reduction of the surrounding teeth. With permanent replacement teeth, there is no need to alter your nearby teeth in order to support your implants. With more of your teeth intact, your long-term oral health is improved.

Dental Implants are extremely durable and can last for years. In fact, the first woman who had hers placed back in 1965 still had them intact when she recently passed away. With good oral hygiene and regular checkups with your dentist, they can last for the rest of your life. 

For more information, schedule an appointment with your Jenkintown dentist who will be able to determine if you are a good candidate for Dental Implants.