The Cosmetic Dentistry Blog

April 7, 2010

A putrid smell in my mouth, after getting 28 crowns.

Filed under: Dental crowns, Finding a Cosmetic Dentist — iowasmiles @ 5:42 pm

Sir i got all my 28 teeth replaced with crowns for the purpose of teeth lengthening. Upper & lower molars(8) of Porcelain fused to Metal. Premolars of Zirconia(8). Incisors & canine (12)of Empress. And now after 2 months from the procedure done am having very much bad breath that its very much difficult to live with and even to breathe, and it tastes like vomit. Still after using mouthwash and brushing twice a day its not helpful and the smell is as it is. even i got done scaling but still the smell and taste of the teeth remains. Please tell me some solution that can be done now to get rid of this as its too much difficult to live like this. i am really helpless. And also tell me is it was right for the teeth lengthening??
- Ogas in India

Dear Ogas,
There is something very wrong with your dental work. It my days of practice, I had several occasions to replace dental work done in other countries, and I frequently found poor dentistry with overhangs that would catch food or other basic defects.

The materials your dentist used sound first class. But if there are overhangs on all the crowns, that could produce the putrid smell that you’re experiencing. I can’t tell if that’s the case. There are other possibilities.

If this problem is allowed to remain, it will likely lead to gum disease and early loss of your teeth.

There are excellent dentists throughout the world. But I believe the consensus among the world’s dentists is that there is no place that has as high standards for dental care as the United States. So what I would look for would be a dentist in India with some credentials from an international organization based in the United States. A couple examples of that would be accreditation or some other credential from the American Academy of Cosmetic Dentistry (There are two accredited members of the AACD in Mumbai, India, and several accreditation candidates in the country), or fellowship or diplomate status with the International Congress of Oral Implantologists. There may be other credentials. I would track down a dentist with a credential like that and go there for an opinion on your case. Go to the website of the specific organization and they usually have a search tool for finding a credentialed member.
- Dr. Hall

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March 6, 2010

Do cosmetic dentists do other procedures?

Filed under: Finding a Cosmetic Dentist — iowasmiles @ 1:08 am

Hi Dr Hall,
I am looking for a dentist in the Seattle area and am doing some research before I choose one. I came across your site and am thrilled to find all this great comsumer information, thank you! However the dentist that you recommend in Seattle, I can not locate any kind of reviews or testimonials for him, nor can I find him on the list of America’s Top Dentists.

I would like to hear other patient’s opinions about their experience with him but cannot locate any of this through the internet. Any suggestions? Also do these cosmetic dentists that you recommend typically do other general procedeures like root canal etc.?

Thanks for your help.
Brenda

Brenda,
From your question, I think that maybe you don’t understand what our website is. We recommend COSMETIC dentists. That is very different from recommending dentists. Do you need a dentist for general dentistry, or do you need a smile makeover or other anterior work?

When we recruit dentists for our website, I study their credentials as far as cosmetic dentistry training, and we check photographs of their work. That is what is required in order for me to be able to assure visitors to our website that they will get beautiful work done at the hands of these dentists. While we try to get a sense of the office friendliness and chairside manner, and those do factor into our decisions about who to recommend, those aren’t primary considerations. And no, often dentists who are really passionate about appearance-related dentistry do not do root canal treatments, though sometimes they do.  But they always do basic dentistry, such as cleanings, checkups, and fillings. And while they are always highly skilled, and they are often warm and understanding, they are not chosen on the basis of their warmth.

Some might accuse me of poor salesmanship to say this, but to be absolutely honest with you, I would tell you that if all you want is a general dentist – if you don’t have any appearance concerns – then this isn’t the right website for you.

As far as reviews, they are helpful for some situations but aren’t the answer if you’re looking for excellent cosmetic dentistry, and let me explain two reasons why this is true. First of all, I have dentists that I know very well, and I’ve seen their work, and it is magnificent, but I have seen that they occasionally get bad reviews from people on the Internet. Some patients might think the dentist is too expensive or too high class. And every dentist runs into a wack-o patient or two that they can’t please no matter how hard they try, and so they throw up their hands, ask them to go elsewhere, and end up with a very irate patient. While the vast majority of their patients are very pleased, some aren’t, and they can be the source of bad reviews.

And while patient reviews are helpful, patients rarely have the expertise to compare one dentists aesthetic skills with another. I have seen patients who thought their dentist did okay on their smile makeover, only because they didn’t know how beautiful their smile could have been. So that’s why I think our site is indispensible if you are looking for cosmetic dentistry services and why patient reviews simply aren’t your best source of information. But if you are just looking for a dentist, then you don’t need those credentials, and I would just go to the reviews where you will get a good measure of the dentist’s likability, the friendliness of the office, etc., which are all valid considerations for choosing a general dentist.

America’s Top Dentists is not necessarily that reliable. I don’t know how they pick the dentists they list. I know they don’t conduct examinations of the dentists’ work.

I hope this is helpful.
Dr. Hall

Links you may want to check out:
Read about the difference between an artistic cosmetic dentist and an excellent general dentist.
Click here for referral to a cosmetic dentist, screened for artistic ability and cosmetic dentistry training.

December 7, 2009

How does a dentist get listed on mynewsmile.com?

Filed under: Finding a Cosmetic Dentist — iowasmiles @ 11:47 am

Hello,

I was wondering how you determine/identify the Doctors listed in your referral page. Do they apply to be listed or do you have prior knowledge of their reputation and skills? I am in need of a dental implant and am exploring services in the Austin TX area. All of my top teeth are crowned (1994) so I also need someone with the skill to restore my smile by matching the new crown to the rest of my teeth.
Thank you,
Ann from Texas

Ann,
The listings we have sometimes come from dentists whose reputation I know through my association with the American Academy of Cosmetic Dentistry or other cosmetic dentists. Sometimes dentists approach me, and most of those requests are turned down. In the case of Austin, where you are, I didn’t know Dr. Sweeney, but found his name on a list of dentists that I have access to – dentists who had passed the written examinations for accreditation with the American Academy of Cosmetic Dentistry. While this speaks of his knowledge, it doesn’t speak of his ability to apply that knowledge. So I checked out close-up photographs of his work to verify his skill, and examined his other credentials. His work was beautiful. I have since met him at a dental meeting.

There are a number of listing services on the Internet that list dentists. However, I have taken the risk of personally recommending any dentist I list, so I check them out to make sure I am comfortable with the dentistry they do. I am not aware of any other website that actually recommends dentists the way I do, and it’s a matter of personal integrity to me that the dentists listed meet high standards. I am confident that Dr. Sweeney, whom I recommend in Austin, has first class artistic ability and does excellent dentistry. So you are in good hands if you go there.

I do publish a disclaimer that is linked from every page in the referral section, to protect me legally. Ultimately, it is the responsibility of the Boards of Dentistry in each of their respective states, to protect the public from incompetent dentistry. I’m not intending to take their place in that role. And the recommendations are my opinion, not my guarantee. I am not in a position to be able to insure that no dentist I list will ever make a mistake. But in my educated and informed professional opinion, the dentists I list are all excellent.

I hope this helps.
- Dr. Hall

Links:
Click here for referral to a top cosmetic dentist.
Click here to visit our Texas cosmetic dentists page.
Read more about smile makeovers.

November 23, 2009

My cosmetic dentist wants to use Zirconia crowns

Filed under: Crowns for front teeth, Finding a Cosmetic Dentist — iowasmiles @ 8:14 am

Dear Dr. Hall
To find an accredited cosmetic dentist I used your website. The dentist was not aware of using bonded all porcelain crowns for front teeth, the accredited cosmetic dentist relied on the advice of the lab tech. The lab tech refused to use bonded all porcelain on front crowns (upper)and insisted the dentist use Zirconia. Who is more knowledgeable or experienced in accredited cosmetic dentistry, the lab tech or the dentist? Thanking you in advance for your prompt reply.
Gina from Connecticut

Gina,
I’m not sure I understand what you’re saying.

Are you saying that you went to a dentist that we recommended on mynewsmile.com, and that this dentist had not heard of bonded, all–porcelain crowns for front teeth?

If so, I’d like to know, and I’d like to know which dentist that was.
And how was it that the lab tech was asked?

l want to try to figure out what happened with your case and then see if I can help you.

Thanks,
Dr. Hall

Dr. Hall
When I mentioned to Dr. N. Summer Lerch of New Haven,CT that I was looking for an accredited cosmetic dentist that would be skilled in bonded all– porcelain crowns for front teeth. Dr. Lerch did not confirm or acknowledge your findings that bonded all-porcelain crowns for front teeth would have the strength that Zirconia would have. Dr. Lerch relied on the lab tech’s recommendations for the crowns. Actually the lab tech refused to make the crowns in stackable porcelain. Unable to find another dentist at that time because I was charged in full for payment of my crowns on the day the lab tech refused to use stackable porcelain on front crowns.
If all this is confusing I will include my home phone if you have questions.
Thanks
Gina

Gina,
Zirconia crowns ARE stronger than bonded all porcelain. They have no metal, and while they are not all-porcelain, I would call them all-ceramic, and their appearance is excellent. They can be made beautifully translucent. A conventional porcelain is usually baked over the zirconia framework, and the end result can be made to look so natural that you could not tell them from natural teeth.

I don’t believe that your dentist was unaware of bonded all-porcelain, but rather than for your situation she felt that zirconia would work better. I’m not in a position to second guess that recommendation, not being able to examine you.

Which particular crowns should be used in a given situation is a matter that depends on a number of factors. I don’t recommend that patients try to push their dentist into using a particular type of crown, because often part of the decision is based on what works well in the hands of a particular dentist, and this will vary from dentist to dentist. Rather, I recommend that each patient find a dentist whom they trust and has the skills necessary to produce a beautiful result, and then give that dentist free rein to choose the material that works best for them in each particular situation.

Dr. Lerch was carefully considered before I recommended her on this website, and I am absolutely confident that she could produce a beautiful result for you. She has been on the accreditation examining board, which means that her esthetic talent and technical ability are highly regarded among her peers.

As far as relying on information from the lab tech, when a dentist has a trusting relationship with a skilled laboratory technician, yes, we often use them as a source of information on new materials. Zirconia is an up-and-coming material that many top cosmetic dentists are turning to, because it is so strong and can be made highly esthetic. And when it comes to the technical information about the strength of the material and its suitability for various situations, then yes, we will turn to the technician. I have criticized on this blog dentists who use the laboratory technician for a shade-matching appointment, because an excellent cosmetic dentist needs to have a great eye for color and an ability to communicate color. But the dentist and the technician are a team and each brings expertise and talent to every project.

I’m skeptical that the laboratory technician made the final decision in your case. If you were giving me trouble over my choice of material, I might use the lab tech’s opinion to help avoid arguing with you. When we as dentists are faced with a difficult patient who wants to push us into a treatment we know will be sub-standard, it’s easy for us to say things that may seem to that patient to be unreasonable. I’m inclined to believe that Dr. Lerch was showing integrity in your case, but I can see how it wouldn’t appear that way to you.
Dr. Hall

Related information:
Read more about porcelain crowns.
Click here to find an expert cosmetic dentist.

August 29, 2009

My cosmetic dentist wants to restore all my teeth

Filed under: Finding a Cosmetic Dentist — iowasmiles @ 7:26 pm

I have seen a “cosmetic dentist” who is not on your list, and he is suggesting replacing all of my teeth—even the ones that have nothing wrong with them, with all porcelain crowns to correct bite, beautify look of smile. I am concerned about grinding down perfectly good teeth for this. I chose the dentist in question because he has a good reputation in the community, puts a three-year guarantee on his work in writing, does sedation dentistry (I am VERY nervous patient) — and he has spent a good amount of time answering my questions, doing wax-ups that I am supposed to view on Wednesday. However, I am really feeling quite concerned now…and even more anxious.

After reading your website, I am even more ambivalent than I was, and feel that I should RUN to the dentist recommended for the St. Petersburg/Tampa area.

What do you think? Thank you in advance for your reply.
- Pat from Florida

Dear Pat,
Your instincts are good. While I can’t evaluate your case without seeing it and it’s possible that you do need the aggressive treatment being proposed, the way you’re explaining it to me makes me distrustful of this dentist.

Ethical cosmetic dentists will be very careful to avoid unnecessary dentistry. I heard it continually repeated in various cosmetic dentistry lectures, that if the patient is happy with his or her smile, there is no treatment indicated. The majority of excellent cosmetic dentists believe in that ethical standard and would not try to push cosmetic dentistry onto a reluctant patient. For me, personally, I would not trust a dentist who came up with an aggressive treatment plan like you’re explaining without my requesting it.

My general advice is to stay away from dentists who appear to be dental salespeople, and stick with professional dentists who tend to be conservative in their treatment recommendations. There are occasions when the treatment proposed for you would be indicated. You are talking about a full mouth reconstruction. But that should only be required if you have serious bite problems that are causing pain, or if you have a collapsed face, or a large number of broken-down teeth.

You’d be smart to go to one of the dentists on our list for a second opinion.
- Dr. Hall

Related links:
Read more about cosmetic dentistry costs.
Click here for referral to an expert cosmetic dentist.

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