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I Need Options for My Tooth

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I had an accident on my tooth when I was a child. Over the years it has turned more and more brown. It’s causing me to not want to smile. I went to see my dentist about it and he said there isn’t a root there anymore and I should just remove the tooth and put a fake one there.  Is there a way to have a pretty tooth if it is fake?

Rebecca

Dear Rebecca,

What you are suffering from is root resorption. It is a shame your childhood dentist didn’t give you a root canal treatment when you had the injury. That could have prevented the resorption. It isn’t a guarantee, but not doing anything definitely leads to resorption. He is right that at this point the tooth cannot be saved. It doesn’t sound like he spoke to you about any of your options.

The top of the line option is to get a dental implant. This places a prosthetic root in your jaw and once the bone has integrated with the implant a dental crown will be placed. It has the benefit of being the most secure option and the closest thing to having a natural tooth. However, it is the most expensive option.

If that isn’t for you, the next step would be to get a dental bridge. This suspends a false tooth between two dental crowns. This makes sense if either of those teeth already need crowns. If they don’t, you may not want to grind down healthy tooth structure unnecessarily.

There are less expensive options as well such as a removable partial denture or a dental flipper. Neither of those will be secured to your teeth, so just be aware they come out.

Is Your Dentist Serving You Well?

I’m a tad concerned that your dentist isn’t taking adequate care of you. This is especially true if this is the same dentist that didn’t deal with your tooth injury to begin with that is especially concerning.

It also sounds like he’s leaving you to figure out what to do about replacing your tooth. In reality, he is ethically bound to give you all your options. It may be time to ask why he isn’t doing that.

Will a False Tooth Look Attractive?

As to your concern with how the false tooth will look, that depends completely on the cosmetic dentistry skill of the dentist doing the work. Creating beautiful smiles is an art form. The best cosmetic dentists are AACD accredited, which is completely different from membership, which any dentist can do.

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

Cosmetic Solution for Fluorosis Stains

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I have fluorosis stains on my teeth and wondered if teeth whitening is a good cosmetic fix for someone in my position? I want to have a smile I am proud of.

Diego

Dear Diego,

I will say right off that teeth whitening will not be the solution. It whitens teeth evenly and is only more likely to make your fluorosis stains more obvious. For the benefit of those who are unfamiliar with what fluorosis stains are, it happens when someone ingests too much fluoride while the teeth are still forming. The fluoride in the water in the United States is optimized for the right consumption so we don’t see much of it here.

There is good news, though. Your teeth can be attractive again. Which solution depends on the amount of fluorosis you are dealing with. For either repair, you will need an expert cosmetic dentist. My suggestion would be to find an AACD accredited dentist.

If You Have Mild Fluorosis

 

mild fluorosis stains

The picture above is an example of mild fluorosis. If this is what you are facing, then dental bonding can be a sufficient repair. Your dentist will gently shave about 0.5 millimeters of your tooth enamel. Then, he or she will replace it with direct composite bonding. It doesn’t last as long as the next repair I will talk about, but it does cost less.

If You Have Darker Fluorosis

heavier fluorosis stains

In some cases, as in the picture directly above, the stains are more prominent. In this case, simple dental bonding will not be enough. Instead, I suggest you have porcelain veneers placed. This is actually the go-to procedure for a smile makeover. It is what gives people that “Hollywood Smile.”

This procedure can last for a lifetime. However, don’t try to cut corners by going to an inexperienced cosmetic dentist for this. It’s not an easy procedure to do under the best of circumstances. With severe stains like these, it will take someone highly skilled. This is why I recommended an AACD accredited dentist earlier, these are the best cosmetic dentists.

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.