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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.

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.

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.

Will Dental Implants Look Fake?

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My mother had dentures and, to me, they always looked fake. I now need to get my teeth replaced. I want to get implant-supported dentures and am hoping they look more natural these days. I’m rather young for dentures at 40 so I don’t want to look old before my time.

Pamela

Dear Pamela,

Implant overdentures

Implant overdentures are a combination of dental implants and dentures

First, I’m going to say you were wise to choose implant overdentures, especially at your young age. Once your teeth are removed, your body will recognize that and begin to resorb the minerals in your jawbone to use elsewhere in your body where it perceives it will be more useful. Eventually, you won’t have enough jawbone left to retain your dentures. This is known as facial collapse.

Getting implant-supported dentures, puts prosthetic roots into your jaw. This tells your body there are still “teeth” that need to be retained, therefore preventing facial collapse. You’ll also find it will improve your chewing capacity.

The Secret to Beautiful Dental Implants

Both dentures and dental implants can be made to look both natural and beautiful. That was true when your mother received her dentures. The beauty of dental implants is correlated to the artistic skill of the dentist. If you want a gorgeous smile, you need to find a dentist who creates beautiful smiles.

In your place, I’d look for a dentist who has reached accreditation with the American Academy of Cosmetic Dentistry (AACD) dentists have done extensive training and are the top cosmetic dentists in the country. They will give you a stunning smile. You’ll actually be thrilled to share your smile with the world.

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

She’s Going to Need a Better Dentist

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I need to replace six crowns. They were done by another dentist but I’ve since moved. I really loved them, but they’re old and need to be replaced. I want to replace them all at the same time. I don’t like the temps my new dentist has provided. They’re much more yellow than my old crowns and are shaped differently. I liked my other smile. When I told him I didn’t like the temporaries, he raised his voice and said he’s the dentist and they’re perfect. What do I do?

Kelly

Dear Kelly,

woman giving a thumbs up from the dental chair

Your bumping up against the difference in philosophy between a standard dentist and a dentist who really invests in cosmetic dentistry. In dental school, we’re taught the dentist knows what is best. But, cosmetic work is different. You are creating a smile which the patient wants. The best cosmetic dentists are more interested in how the patients feel about their smile.

Your current dentist doesn’t understand this. He’s not going to work with you. If I were in your place, I’d go to a different dentist to get this finished. Your current dentist is ethically obligated to pass on all your diagnostics, etc. to the new dentist.

Finding the Best Cosmetic Dentist

Cosmetic dentistry isn’t a recognized specialty. It is up to the dentist how much training they get after they graduate dental school. When you are talking about a smile makeover, you want the best cosmetic dentist possible. These are the dentists who take their craft seriously.

They’ve done significant post-graduate training and have an artistic eye. In your place, I’d look for an AACD accredited dentist. These are the top cosmetic dentists in the country. Through the American Academy of Cosmetic Dentistry, they’ve passed stringent exams which test their technical knowledge. They also have to provide visual evidence of a large number of cases they’ve done in order to gauge their artistry.

I hope this helps you. 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.

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.