The Cosmetic Dentistry Blog

April 30, 2008

Where can I buy Supersmile?

Filed under: Toothpaste — iowasmiles @ 4:20 pm

Dr. Hall
Where can I buy Supersmile products other than online? I have tried our local Bed, Bath and Beyond in San Jose…no luck!
- Marjorie

Dear Marjorie,
No, you can’t get Supersmile toothpaste or any of their companion products in any store. As far as I know, there are only two ways to get it: some cosmetic dentists will carry it, and then you can get it online, like from our web site. It’s that the company that makes Supersmile has elected not to offer it retail.
- Dr. Hall

Other links:
Find an expert cosmetic dentist.

April 25, 2008

Can I catch an oral yeast infection?

Filed under: Oral Diseases — iowasmiles @ 9:14 pm

Dr. Hall,
My girlfriend has an oral yeast infection. Can I catch that by kissing her?

 Answer:
Oral yeast infection isn’t catching. People have it because their resistance is down for some reason or another–the yeast that causes the infection is present in everyone’s mouth, but when the mouth bacteria get out of balance, the yeast grows more than it is supposed to and causes inflammation.
- Dr. Hall

Other links:
Click here to ask Dr. Hall a question.

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April 22, 2008

Root canal tooth is sore

Filed under: Root canals — iowasmiles @ 8:40 pm

Dr. Hall,
My root canal was done over 10 years ago or so. It becomes very sore at times and sometimes the pain is unbearable. There is a little sore on the outside of the gum, with yellowish pus coming out only when it becomes sore. What do you think the issue is? I dont want a missing tooth. Do I have any other options?
- Shelley in Colorado

Shelley,
You have what is called a root canal failure. Either the root canal treatment, from the start, wasn’t fully sealed, or it’s possible there has been some mishap since then like a cracked root. But probably it wasn’t completely sealed at the beginning, and the root has become infected. It’s not that uncommon for this to happen. It happens to every dentist, and anywhere from 5% to 15% of root canal treatments fail.

I’d recommend going to a root canal specialist and having follow-up treatment. They can either go back into the tooth and try to seal it that way. Or they can do root canal surgery and work at the root end of the tooth with an apicoectomy. The root canal specialist will probably emphasize how he or she can’t guarantee results, and the chances for success may only be 50-50, but they tend to be on the pessimistic side so they don’t raise your expectations too much. I’d still recommend having them try to fix it rather than giving up on the tooth.

I hope this is helpful.
Dr. Hall

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April 18, 2008

Should I get porcelain veneers from a general dentist?

Filed under: Finding a cosmetic dentist, Porcelain veneers — iowasmiles @ 10:02 am

Dr. Hall,
I have large teeth in a small mouth. I chipped one of my front teeth and my dentist recommened porcelain veneers. He is a general dentist but showed me a book of his veneer work. I looked at all the pictures and I can find no one with big teeth. Everyone has small teeth first and the veneers made their teeth a normal size. If I want smaller teeth, am I making a mistake by asking my dentist to file my teeth down to a smaller size? Also he recommended doing veneers on the front two teeth but I thought that it would be better to do the top six teeth. I was hoping by doing this that I could have all six teeth filed down a bit so they are not so big. Also do you think that it is a mistake to have a general dentist do your veneers? By doing this my insurance will cover a lot of the cost and cosmetic dentist in my area won’t take insurance. Thank you in advance for your advice.
- Troy in Texas

Troy,
Yes, it is a big mistake to get porcelain veneers from a general dentist. Cosmetic dentists have an entirely different approach. And even with a “cosmetic dentist” you have to be careful, because any dentist can say he or she is a cosmetic dentist without going through the extensive training that it takes to be good at that. Most dentists pick dentistry because they like to fix things. They’re generally good at fixing, but they have little artistic sense. And artistic sense is absolutely essential in creating a beautiful smile for you.

A couple of points about your experience with your dentist:

  • Just because your dentist can show you a book of photographs doesn’t make him or her an expert cosmetic dentists. I’ve seen many photographs that dentists display proudly but they’re simply not very good, and they don’t seem to see it.
  • If all the photos show patients with smaller teeth and the dentist makes them bigger, that’s a red flag. Good cosmetic dentists address a variety of situations.
  • If your dentist thinks your case can be done with two veneers, but you think it needs six, that’s a red flag.
  • There’s a reason good cosmetic dentists generally don’t subscribe to most of the insurance plans. The fact that your dentist subscribes to your insurance plan is another red flag. Dental insurance companies like dentists that save money and cut corners, which doesn’t work for cosmetic dentistry.So I think you have two choices:
  • If money is your big concern, then do nothing. This is the cheapest alternative, and you won’t be messing up your mouth.
  • If you want a beautiful smile, then go to a cosmetic dentist who is an artist. There are several in your area. Check our Texas cosmetic dentists page.

    • Don’t try to do both: save money AND get a beautiful smile. It doesn’t work.

    - Dr. Hall

    Related information:
    Read more about dental insurance and cosmetic dentistry on our web site.
    Find an expert cosmetic dentist.
    Ask Dr. Hall a question.

    April 15, 2008

    Can my teeth be bleached to match my eyeballs?

    Filed under: Tooth whitening — iowasmiles @ 10:06 pm

    Hello Dr. Hall,
    Can teeth be bleached to match the color of the eyeballs or is this unrealistic?
    - Birte in Michigan

    Dear Birte,
    There seems to be no end to the creativity in these questions that I get. Thanks for a very creative question.

    Whether or not you could get your teeth as white as your eyeballs depends on how white your eyeballs are. It’s possible, but there’s a limit to how white you can get teeth with bleaching.

    But on the general question of matching a color with teeth bleaching–if you want to match some color, porcelain veneers is a better choice, because the results of bleaching are unpredictable. Bleaching will lighten the teeth, but how much depends on factors that are outside our control.

     That’s why when you’re having combination cosmetic dental treatments, it’s best to do the tooth bleaching first, then you match the other dental treatment to the bleached teeth. So if you have dark teeth but you only want to do six porcelain veneers, you bleach the teeth first, let the color stabilize (which takes a couple of weeks), and then veneer the front six so that they blend with the new color of the teeth further back. If you did the veneers first and the bleaching later, you wouldn’t be able to match the colors.
    - Dr. Hall

    Related information and links:
    Read about teeth stains–the types of stains and how to treat them.
    Ask Dr. Hall a question.
    Find an expert cosmetic dentist.

    April 10, 2008

    Should I have my amalgam fillings replaced?

    Filed under: White fillings — iowasmiles @ 2:12 pm

    Dear Dr. Hall,
    Your web site is very helpful and well organized!

    I read the Blog question dated July 31, 2007 “Should I let my dentist replace my fillings?” and in my case the cosmetic dentist I just had a consultation with wants to replace my four amalgam fillings (there is nothing wrong with them).

    He says that they may crack in the future and he wants to perform a T-Scan after the fillings. He also said that if these fillings are not done now, but changed later, the T-Scan would have to be performed again to measure the proper occlusion.

    Should risk replacing these fillings now? What if he cracks a tooth and then I have the added expense of a crown!

    Sincerely,
    Evelyn from California

    Dear Evelyn,
    I am suspicious. But please understand that I have limited information here and can only give you my impressions. Maybe you really need these fillings and all of these things you say. I don’t know. But I’m suspicious. At least your dentist is honest enough to tell you there’s nothing wrong with the teeth.

    You could say, about any tooth that has an amalgam filling, that the tooth MAY crack. In fact, teeth without any fillings at all MAY crack. I’ve seen that happen. MAY is a pretty loose word. I think you need more than that.

    When I did exams, I looked for cracks that were starting to form and already present, and if we saw that, we would do a new bonded white filling to strengthen the tooth, or, if the existing filling was large, we would do a porcelain onlay or a dental crown.

    I am suspicious of any dentist who recommends replacing fillings when he or she can see nothing wrong. To me, this is a patient’s option and the dentist shouldn’t try to sway the patient one way or the other.
    - Dr. Hall

    Click here to find an expert cosmetic dentist.
    Click here to ask Dr. Hall a question.

    April 7, 2008

    Sensitive to novocain

    Filed under: Dental fear, Porcelain veneers — iowasmiles @ 7:36 pm

    Dear Dr. Hall,
    I am going to have porcelain veneers done in a few days. I am very sensitive to novocaine and any other drug that can make my heart race. Is there any drug ingredient in the process (such as a caine or epinephrine) of porcelain veneers that you are aware of? A friend told me that she got very shaky during the beginning process of being fitted. She was not at all nervous, but her hands started to tremble just after a green topical agent was used prior to the impressions. Her heart started to race and her hands continued to tremble for 15 minutes. Is this possible?
    Thank you.
    Alison in Rhode Island

    Dear Alison,
    I have several points to make in answer to your question.

    First, the shaking reaction wouldn’t be to the novocain, but could conceivably be due to the epinephrine that is usually present in the novocain. Epinephrine restricts the blood flow in the area of the novocain injection and thus keeps blood from carrying it away and makes it stronger.

    Second, the shaking reaction, in my opinion, is more likely to be due to dental fear. Even when there is epinephrine in the novocain, that is less significant than the epinephrine your own body will produce if you have any dental fear, which most people have to some degree at least.

    About your friend’s experience, I have some personal experiences as a patient that help me understand that. There were times when I would tell myself that I wasn’t nervous when I began being treated, but what happened during the appointment definitely revealed that I really was nervous. This dental fear can be a strange thing, and part of the way many people try to prepare is to convince themselves that they aren’t nervous. I think that’s what happened to your friend, because there is nothing in the topical ointment that dentists use that would cause shaking or trembling.

    My advice? The best way to reduce the ephinephrine in your system is to use nitrous oxide gas or a pill with relaxant medication. Doing that has done wonders for me and for many patients I have treated that have had this sort of thing happen to them. The dentist could use a form of novocain with no epinephrine, but in my experience in treating people who have had reactions like yours, it’s more important that they are thoroughly numb, which is the purpose of that small amount of epinephrine, and a mild relaxant usually takes care of this reaction completely.
    - Dr. Hall

    Related topics:
    sedation dentistry
    sleep dentistry

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    April 5, 2008

    Can I repair my partial myself?

    Filed under: Partial dentures — iowasmiles @ 3:02 pm

    Dr. Hall,
    I have removable partial dentures and a small piece of the gumline portion of my upper partial broke off. I realize one should not use super glue to repair dentures but this is not a tooth and is above the gum line. Does this require professional work or can I fix it myself?
    Thanks,
    - David from Washington

    David,
    It’s tempting to go ahead and repair it yourself, since the piece is so small. The important thing in a repair like this is to get the pieces exactly in the same position they were in before they broke. Even a fraction of a millimeter deviation will cause sore spots. So that’s what needs to be done.

    But superglue – superglue will deteriorate after a few days in the mouth, so the repair won’t likely hold. And there’s no common household product I’m aware of that will really hold a repair like this.

    And, another problem with superglue is that, once the pieces come apart again, you will make the professional repair more difficult and likely more expensive. Maybe even quite a bit more expensive. The leftover superglue on the pieces makes it so the dental technician can’t fit the pieces back into the exact position they were in, meaning that a new impression could be required, which adds quite a bit to the expense.

    So I’d get a dental office to repair this, even though it seems expensive. And the sooner you do it, the easier it is and likely the cheaper it will be.
    - Dr. Hall

    Related information:
    Denture repair
    Complete dentures
    Cosmetic dentures

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