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dentistry

Will Switching to Dental Implants Give Me a Better Smile?

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I’ve been in dentures for about a year and I hate them. Hate isn’t even a strong enough word. They move. It’s impossible to eat the things I love. What I can eat gets stuck in them. It’s humiliating. I think I might have been able to put up with this if my smile looked attractive. In all honesty, my one consolation to myself about needing dentures was that I could finally have a pretty smile…except I don’t. The dentures look fake. I feel like George Washington and his wooden teeth. I’m hoping if I switch to dental implants that I can at least have a beautiful smile. However, I don’t want to spend that fortune if it won’t make a difference. Any advice?

Kelly

Dear Kelly,

Implant overdentures

I have some great news for you with a “but” attached. Getting dental implants can solve all the problems you mentioned above, plus some, BUT, you will probably need to do it with a different dentist. The reason I say that is because your smile could be beautiful even with dentures, though you would still have those other problems. The reason it isn’t beautiful now has to do with the cosmetic skills of your dentist.

My recommendation is you look for a qualified implant dentist who is also a skilled cosmetic dentist. The top cosmetic dentists in the country are AACD accredited, so I’d look for one of those first.

What Can Dental Implants Do for You?

before and after facial collapse

Because your dentures will be anchored to dental implants they will be completely secure. No moving around. Plus, you’ll be able to eat anything you want again.

However, the most important reason to get dental implants instead of removable dentures is the prevention of facial collapse. Once your teeth were removed, your body immediately began resorbing the minerals in your jawbone. This is to use your body’s resources as efficiently as possible. However, the unpleasant result from that is the shrinking of your jawbone. In about ten years or so, you will not only no longer have enough jawbone left to retain your denture, but will look decades older. Dental implants prevent this by signaling to your body that you still have teeth roots that need to be retained. As a result, your body leaves the minerals alone.

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

Treating Enamel Hypoplasia

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I am frustrated with my smile and tired of always hiding from pictures. We’re thinking about starting a family and I don’t want to avoid photos during my child’s entire life. What are my options for treating this?

Caroline

Dear Caroline,

Congrats on starting a family. I can completely understand why you want to feel comfortable and present for pictures. There are a couple of good options for you in giving you a smile you can feel proud to share with the world. For those who are unaware of what enamel hypoplasia is, it is a defect, which is caused either by genetics or an illness during the formation of the teeth, that causes to the enamel of the teeth to not fully form.

Mild and severe enamel hypoplasia

Treating Enamel Hypoplasia

With mild hypoplasia, you have two good options. The first is dental bonding. With this procedure, your dentist will drill or sand out the white spots and then fill the tooth with composite resin. This is done freehand and will be finished when you leave. It is the least expensive of the two options but does need to be replaced periodically.

Your second option is to have porcelain veneers placed over your teeth. If you are dealing with severe hypoplasia, as pictured above, this would be the only option I would recommend. With porcelain veneers, thin wafers of porcelain are bonded to your teeth. They are the go-to for those Hollywood smile makeovers and can not just cover the hypoplasia, but completely redesign your smile. Porcelain veneers can change the size, color, and even shape of your teeth.

Pick the Dentist Carefully

Both of these are cosmetic procedures. Unfortunately, cosmetic dentistry is not a recognized specialty yet. This means that any dentist can call themselves a cosmetic dentist. To make matters worse, smile makeovers are not adequately taught in dental school. If a dentist wants to develop skills in creating smile makeovers, then they will need to invest in post-doctoral training. Not many dentists do.

So how are you to know the real deal from the pretenders? Well, you could ask them where they got their post-doctoral training in cosmetic work and then ask to see their smile gallery to see what type of artistry they have. Another option is to look for a dentist who has been accredited by the American Academy of Cosmetic Dentistry. AACD accredited dentists have passed stringent exams on the technical procedures as well as demonstrated a high level of artistry in the work they do.

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

Should I Finish My Full Mouth Reconstruction?

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I am in the middle of a full-mouth reconstruction and I am not sure if I want to complete it. The lower teeth were done first. They look beautiful because I hired an AACD-accredited dentist. I know it sounds weird but that is what is bothering me. They look so perfect. I had a quirky smile and this just looks like your typical celebrity smile. I feel stupid but I miss the quirkiness of my smile. The reason for the reconstruction to begin with is that I had been grinding my teeth down. My dentist didn’t mention it until they were ground down and then he told me that I needed a full-mouth reconstruction. I was a little annoyed, which is how I started doing research about what it means and who should do it. That led me to getting an accredited dentist. Will I have to get the uppers done? Can I just whiten the uppers so they don’t look so perfect as the bottoms?

Callie

Dear Callie,

A woman pointing at her smile

First, I want to tell you that your original dentist could and should have told you about the grinding to begin with. That would have saved you this expense and hassle. All you would have needed was a simple mouthguard and your teeth would have been protected even with the grinding. I’m going to suggest you find a different dentist who is more interested in protecting your teeth. Though, that doesn’t help with your present predicament.

If you are worried about the smile looking too perfect, I would say take full advantage of the skill an AACD accredited dentist has. What I mean by that is they are tasked with making Hollywood smiles all day long. I think they would jump with glee at the chance to make a quirky smile. You could literally get whatever you wanted and make a dentist and ceramist’s day with your desire for it not to be perfect.

As for just not completing it and just whitening, I haven’t seen your case, so couldn’t tell you with definitely. While you can definitely whiten, what I can tell you is that if the damage isn’t too bad, you can just get a mouthguard to protect them for further grinding. This will be important because the crowns on your lower teeth will be a bit more abrasive on the uppers than your natural teeth are. If the damage is bad, you will want to complete the case. Having a collapsed bite can lead to pain and serious TMJ Disorder.

Just remember, you can get quirky.

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

Discolored and Crooked Teeth

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I finally have money to do something about my hideous smile and wanted to find out what my options are. My teeth are both stained and crooked. What are some ways I can approach this?

Mindy

Dear Mindy,

You actually have a couple of good options. The first is porcelain veneers and the second is Invisalign combined with teeth whitening.

Option One: Porcelain Veneers

a porcelain veneer being placed on a tooth

 

A skilled cosmetic dentist can use porcelain veneers to do a total smile makeover. This can make your teeth look straight while making them any shape, size, and color you want. The key to this is the dentist who does the procedure. You need someone who has advanced training in cosmetic dentistry. This would need to be post-doctoral training because it is not adequately taught in dental school. Unfortunately, it is not a recognized specialty. This means any dentist can call themselves a cosmetic dentist regardless of the amount of training they have invested in. So, how is a patient supposed to know whether or not a dentist is truly qualified to give them a smile makeover?

The simplest way is to look for a dentist who is AACD accredited. This is different than just being a member of the American Academy of Cosmetic Dentistry. To receive accreditation, they not only have to pass difficult exams on the procedures and technique but also have to demonstrate their artistry in a demanding number of cases with visual evidence of their results. These are among the top 1% of cosmetic dentists in the country.

Option Two: Invisalign and Teeth Whitening

teeth whitening trays being put on teeth

 

Invisalign uses clear aligners to straighten your teeth. They are a huge improvement on braces. No one will even know you are straightening your teeth because they are even invisible at a conversational distance. Additionally, the aligners can double as teeth whitening trays, which means you can do them simultaneously instead of one at a time.

This is something I would recommend if you can’t afford (or don’t want) porcelain veneers. They don’t need someone with special cosmetic training. You simply have to find a dentist that offers Invisalign.

Enjoy your new beautiful smile whichever procedure you decide on.

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

 

Dentist Said I Cannot Have White Crowns

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I had eight dental crowns placed two decades ago. I wanted whiter crowns then they gave me but they insisted they wouldn’t look natural with the white color I wanted. Now, I want to replace them, this time getting the white color I’d always wanted. However, my new dentist said the whitest we should do is B1. The temporaries in that color are hardly whiter than what I have. His reasoning is that there are posts that would show through with a whiter color. I’m so disappointed. Before I have these permanently bonded on I want to see if there is a possibility I could get a BL4 without the posts showing. Just something a little brighter.

Sandy

Dear Sandy,

Woman with a beautiful smile

I don’t know who your dentist is, but I get the impression he isn’t really an expert cosmetic dentist. He is confusing color with translucency. If the posts are not seen through on a B1, they won’t be seen through the BL4 or if you want really white crowns, as it sounds you do, you could even get a BL1. I am not saying you have to switch dentists at this point, but I would insist your dentist give you the color you want for your porcelain crowns.

Additionally, you need to insist he do them with a temporary try-in paste and you get to see and approve them before they are permanently bonded on. If you don’t like them, they should go back to the lab until you do. Sometimes, it is helpful to have a friend with you during the try-in to give you courage and be a second set of eyes for you.

If he cannot or is unwilling to get them the way you want, then it will be time to switch dentists. If you do need to switch, the best cosmetic dentists are accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists have proven expertise and artistry. They will have not only the skill to give you the smile you wanted two decades ago, but the right mindset that it is about what kind of smile the patient wants that matters.

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

Is It Possible to Save Some Money on a Nice Smile Makeover?

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When I was younger I wore braces, but didn’t wear the retainer afterward like I was supposed to. Now my teeth are shifted and not centered. I also have chips and dings and some teeth are worn down from grinding. I know you have to go to an expert cosmetic dentist for this. My neighbor recently had a smile makeover and his dentist did a fantastic job, but the cost was $35,000. I can’t afford that. Is there a way to get an attractive smile makeover without it costing quite so much?

Aaron

Dear Aaron,

a porcelain veneer being placed on a tooth

A smile makeover is generally done with porcelain veneers, though because of your teeth grinding you may need some porcelain crowns as well. The most important aspect of any smile makeover is the skill and artistry of the dentist who does it. Each dentist’s prices vary depending on a great deal of factors including property and salary costs in their area.

There are two resources I can give you where you can safely price shop. Do NOT just call around to random cosmetic dentists looking for a cheap price. You will end up with a cosmetic dentistry horror story. Just use the dentists on these two lists I’m going to provide. The reason I say that is each of these cosmetic dentists have been screened for their training, technical knowledge and skill, as well as their artistry. Any one of them can provide you with a beautiful smile makeover. In these cases, you can go with the most affordable.

The first resource has a list of AACD accredited dentists. You will go to AACD.com and click on “find a cosmetic dentist”. Make certain you check the box for AACD accredited. Accreditation is completely different from membership, so that is vital. These are the top cosmetic dentists in the country.

The second resource is mynewsmile.com. The dentist that runs this website is a retired accredited dentist. He prescreens dentists who want to be listed. They can’t get on there without massive skills. While many are accredited on his list, some are still in the process of accreditation, which takes years, but have the skills necessary now.

I hope this helps!

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

Getting Porcelain Veneers and Crowns to Match

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I have five porcelain veneers and one dental crown. The problem I am having is getting the crown to match the veneers. Right now the crown is actually whiter than the veneers. I think that happened because he is trying to overcome the dark stub. I’ve seen these match before on other people, so I’m wondering what I can do to help my dentist get this right. I like the guy, so I don’t want to just ask for a refund and go somewhere else.

Anthony

Dear Anthony,

a porcelain veneer being placed on a tooth

I hope your dentist appreciates your loyalty and willingness to be patient as he learns. To answer your question, yes, there is a way to get this done to where your dental crown matches your porcelain veneers. One of the problems your dentist faces is that cosmetic dentistry isn’t really taught at dental school. they minimize the expertise required to do it well and tell dentists it is easy to learn. All while not teaching them some very basic color theory that will be essential.

There are two ways around this. One is directly with the porcelain at the lab. However, this would require a high level of skill and I am not confident the lab will have the skills. The other is for the dentist to add an opaquer to the tooth before he sends the case off to the lab. This is the way I am going to recommend. Your dentist will shave a little extra layer from the dark part of the tooth. Then, he can directly apply an opaque layer of composite. He will want enough room to create the translucent look with the porcelain that will bond on top of that, so the deeper the layer of opaquer, the more room he will have to do that.

If your dentist has a real interest in cosmetic dentistry, He should invest in some post-doctoral training and work toward becoming accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists have the skills and training to create stunning smile makeovers and are in the top 3% of cosmetic dentists in the country.

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

 

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 Wants to Crown My Tetracycline Stains

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I mentioned to my dentist how much I hate my smile because of my tetracycline stains. He said the best solution is to put crowns on all my visible teeth. While my teeth are ugly, they are also healthy. I hate the idea of grounding them all down. Will they look natural if I do? Would teeth whitening solve the problem instead?

Miranda

Dear Miranda,

Woman covering her mouth

 

It is difficult having a smile you are embarrassed by, especially when our smile is the first thing people notice about us. I agree with you that dental crowns is not the way to go for this. If you have healthy teeth, it is always best to keep them as intact as possible. While teeth whitening could help IF you were very persistent. Even then, they would never be completely gone. Because of that, it is not the best solution for tetracycline stains.

My recommendation is that you use porcelain veneers. These remove hardly any tooth structure. Unlike dental crowns, which have to fit around the entire tooth, porcelain veneers go on the front of the tooth. One important word of caution. I am going to recommend you do not go to your dentist for this.

Tetracycline stains are one of the most difficult to address. It takes advanced cosmetic dentistry training to do it properly. Training that is not available in dental school. The trick comes in getting the veneers opaque enough to cover the stains, but still translucent enough to look beautiful and natural.  A dentist has to invest in that instruction post-doctorally. The fact that your dentist is suggesting crowns instead of veneers tells me he does not have the right training for this. Many dentists think they can make up for that lack of training by using dental crowns, which are thicker. But that is not enough to make them look beautiful.

When dealing with tetracycline stains, I would only go to a dentist who is AACD accredited. You can find them on aacd.com. Accreditation is different than membership. Any dentist can join the American Academy of Cosmetic Dentistry. To become accredited, however, requires passing extensive examinations as well as proving your artistry to a board of examiners.

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

Daughter’s Dental Bonding Is Yellow

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I took my twelve year old daughter to the dentist in order to deal with some discoloration on her two front teeth. We’d decided on dental bonding. When the dentist put it on, it was yellow. I thought that was like a step one, but she declared it done. I told her we really can’t accept my daughter having two yellow front teeth. The dentist did it again. Still yellow. Now she is talking about a porcelain veneer. I thought she’d be too young for this. What do we do? She can’t go around with two yellow front teeth.

Miranda

Dear Miranda,

before and after dental bonding

 

When done right, dental bonding should seamlessly blend in with the rest of your natural teeth. Your dentist is obviously unqualified to do this procedure. These types of cosmetic procedures are not really adequately covered in dental school In order to do them properly, your dentist would have to take significant post-doctoral training. Dental bonding especially is hard because it has to be done freehand along with understanding color theory.

The first thing I would do is ask your dentist for a refund. Even if your daughter were not too young, I doubt this dentist could do porcelain veneers either. What you will need, is an expert cosmetic dentist. The best are accredited with the American Academy of Cosmetic Dentistry (AACD). This is different than just being a member. AACD accredited dentists had to pass stringent exams as well as demonstrate their artistry in a large number of cases to a board of examiners. Those who pass accreditation are in the top 3% of cosmetic dentists in the world.

Schedule an appointment with one of them and he or she will be able to get your daughter’s smile shining beautifully.

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