The Cosmetic Dentistry Blog

December 30, 2008

Tooth Effects bands making her teeth become loose

Filed under: Braces — iowasmiles @ 2:20 pm

Dr. Hall,
I wore braces for most of my teenage life. I had a huge gap between my front teeth since I was a child. However, my orthodontist failed to tell me that I would need a surgical procedure done to remove the mass of tissue between my front teeth (the probable cause of the gap). After my braces were taken off, constant wear of the retainer caused it to break and my teeth shifted VERY quickly (within hours). Now I rely on the Teeth Effects bands (teeth-gap.com) your site wrote negatively about to keep my teeth together. Since my teeth shift very quickly, I wore the bands constantly. Lately, however, I’ve noticed my two front teeth are fairly loose and my gums are receding. However, if I do not wear the bands, my teeth shift so much that it causes discomfort to my other teeth. I wish I had read your article sooner – I really don’t want my teeth to fall out. :( Any advice will do.
Thanks so much!
Katy from Pennsylvania

Dear Katy,
I hope that we are catching you in time, and that your front teeth aren’t so loose that they will fall out! This is a very real possibility, so I would recommend immediately discontinuing the use of the Teeth Effects bands. The damage to the support of your teeth will be much greater than it appears to be on the outside, and if your teeth are loose, you have probably already lost most of their bone support.

You have two options. One is to have another removable retainer made. It really isn’t very expensive, and almost any dentist should be able to do this for you. They just take an impression of your teeth and send it to the lab. It’s quick and easy.

Another option is to have a permanent retainer. Again, almost any dentist should be able to do this, or you could go to an orthodontist. And again, this shouldn’t be very expensive. The dentist would bond a short wire on the backs of your two front teeth to hold them together.

If money is a big issue for you, then tell the dental office that and ask them before you schedule the appointment how much either of these services would cost.

Good luck,
Dr. Hall

Related links:
Read more about braces.
Read about the various options for treating a tooth gap.

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December 27, 2008

My Lumineer broke

Filed under: Lumineers — iowasmiles @ 8:32 pm

I got a Lumineer about two months ago. Yesterday morning I yawned and when I closed my mouth I felt a “pop” and then discovered that my Lumineer broke and I lost at least 1/3 of it.

The Lumineers people said the dentist will replace it for free. But I don’t want another one! If it could break off form me yawning, then this is a problem that I do not need. And I would expect at LEAST a partial refund. But so far they seem to not hear me when I mention a refund – they keep referring to replacing the Lumineer. The Dentist himself has never called me back, just the girl from Lumineers.
- Andrea from Florida

Dear Andrea,
We are seeing that, in spite of Lumineers being so strong, that they do break, just like other brands of porcelain veneers. They get their strength from the bond to the tooth. If they’re bonded properly and the bite is adjusted correctly and you take reasonably good care of them, they won’t break. But if they’re not bonded well, they can break very easily.

I don’t believe that legally you can insist on a refund. And it would be the dentist who would give you the refund, not the Lumineers people. If you can talk the dentist into giving you a refund, then he will, but he doesn’t have to. But I imagine they would rather just re-do it.

Has this dentist done very many of these? Hopefully he has and he can get the Lumineer to stay on this next time. I would go ahead and let them replace it. It shouldn’t happen again. If it does, then I’d just chalk it up to experience.
- Dr. Hall

Click here to find an expert cosmetic dentist.
Click here to read more about smile makeovers.

December 23, 2008

Do they do smile makeovers with crowns?

Filed under: Crowns for front teeth, Porcelain veneers — iowasmiles @ 10:18 pm

Dr. Hall,
I recently had a smile makeover done. I had thought I got porcelain veneers, but it looks like the porcelain goes all the way around my teeth. I assume this is because my teeth as they were previous were not good candidates for veneers? Is it normal to have the entire tooth covered when done only for cosmetic reasons? I’ve gone to other dentists since having them done and they are all impressed, and say that it is normal. What do you think?
- Andrew in Utah

Andrew,
The difference between porcelain veneers and porcelain crowns is only a matter of degree, and there is no hard-and-fast distinction pinning down exactly when a porcelain veneer becomes a crown. And most cosmetic dentists have fees that are either exactly the same or very nearly the same for either procedure, because they take about the same amount of work.

And yes, it is common to have porcelain crowns done across the front teeth for cosmetic reasons. There are several reasons a dentist may include the whole tooth in a smile makeover–if the tooth is weakened for any reason, if there are existing fillings in the teeth, or if it is needed to control the bite.

I would expect the dentist to discuss this with you and if he or she recommends crowns, to explain why. Most cosmetic dentists try to be as conservative as possible, meaning that they try to preserve natural tooth structure as much as possible. Crowns are a more aggressive treatment than porcelain veneers: Veneers require a very light shaving of the front of the tooth; crowns require a substantial reduction of the tooth all the way around. So I would expect to be given a good reason for getting crowns rather than veneers.
- Dr. Hall

Click here to find a cosmetic dentist

December 20, 2008

I have a lisp now with my porcelain veneers

Filed under: Cosmetic dentistry mistakes, Finding a cosmetic dentist, Porcelain veneers — iowasmiles @ 10:22 am

Dr. Hall,
I had porcelain venners on my four front teeth #7,8,9,10. My teeth were very healthy but slightly unattractive. They all started to crumble and break within week. After failed attempts to glue them back together, I saw another dentist, who did six veneers, including my canines, #6 and 11. However this second set fractured the next day. I was told they were baked too long and the cracks did not appear until they were wet in my mouth. 

These were replaced, however this third set is much longer and I now lisp. Also # 7 and #10 are rotated and stick out beyond #8 & 9. I never had misalignment before this. The second Dentist said he would replace the four front if I am not happy. I am not happy having over $6000. on my charge card. I wish I HAD MY TEETH BACK – THEY WEREN’T THAT BAD! I plan to have this done for the fourth time in Jan. Any advice? Also why do I lisp now – I never did before. Will it go away?

Thank You, Marilyn
a dental hygienist in New York

Dear Marilyn,
There has to be a reason that you keep ending up getting porcelain veneers from dentists who don’t know how to do them. Maybe someone has given you the idea that these are easy to do and any dentist can do them. Well, you’ve proven that wrong, haven’t you?

Even if a porcelain veneer cracks, none of the pieces will come off the tooth unless there is a problem in the bonding of them. They are very thin and aren’t strong at all by themselves. You can crush one in your fingers. It is the bond to the tooth that gives them their strength. I’ve seen cracked porcelain veneers stay on the teeth for months.

And you would never end up with porcelain veneers that are too long if you went to an expert cosmetic dentist. Dentists that love doing smile makeovers always have some mechanism for making sure that the appearance of porcelain veneers is pleasing to you before they are ever bonded on. Many of them will make a prototype set of veneers and place them before making the final ones. Others will use computer imaging combined with a try-in, or wax-ups, or other tools to make sure that you have a full chance to evaluate the appearance and feel of the veneers before they are finally bonded.

Yes, porcelain veneers that are too long, besides looking funny, could cause you to lisp. Also if they’re too thick.

And’s what’s this with four porcelain veneers and then six? A smile includes either eight or ten upper teeth. I hope you at least bleached your other teeth.

My advice to you? Bite the bullet and go to a true cosmetic dentist – one who makes his or her living doing smile makeovers and not one who does this as a sideline. Someone who has done this enough to be able to work out all the bugs. Someone who has such a passion for creating a beautiful smile that he or she will fly to courses all around the country to learn the best techniques from the masters in the field. These are the kinds of cosmetic dentists we have listed on our New York cosmetic dentists page.

When you go to such a cosmetic dentist to have these fixed, you will end up ecstatic about how your smile looks, so much so that you may smile continuously for about a week, so amazed at how beautiful your teeth look that you’ll be looking at them in your rear view mirror as you drive. That’s what we see with new smiles that are done right.

Dr. Hall

Related links:
Read about Invisalign invisible braces.
Be wary of Lumineers and GlamSmile.

December 15, 2008

Should I have my porcelain veneers replaced with crowns?

Filed under: Porcelain veneers — iowasmiles @ 4:30 am

Dr. Hall,
I find myself in a dilemma. I currently have 17-year-old porcelain veneers that have recently chipped. One dentist recommends crowns however another recommends Lumineers even though my teeth have already been prepped for veneers. Can Lumineers be made thicker and could a dentist remove my current veneers without compromising the little amount of tooth that is left? How can 2 dentists both certified in Lumineer have such different opinions?
- Josie from New York

Dear Josie,
I think you should get your porcelain veneers replaced with a new set of porcelain veneers, and I don’t think you should go to either of these dentists.

I think the one dentist is recommending crowns because he or she doesn’t know how to do good porcelain veneers.

I think the other dentist is comfortable with Lumineers but isn’t comfortable with traditional porcelain veneers.

I don’t know. This is just what I suspect.

Are you specifically looking for “Lumineers” dentists? If so, this is a bad approach, in my opinion. I’d tend to stay away from dentists who advertise that they do Lumineers. Some excellent cosmetic dentists also do Lumineers, but if you go to a “Lumineers dentist,” you tend to find that the solution to all the problems are Lumineers. Go to a dentist who is fully trained in every cosmetic dentistry procedure.

All you have to do to be certified in Lumineers is to attend the DenMat course. You can sleep through it, and still be certified. It’s no big deal. You want a true cosmetic dentist, which requires a lot of training.

You’re on Long Island – check our list of great cosmetic dentists on Long Island by visiting our New York cosmetic dentists page.

An excellent cosmetic dentist can remove your old porcelain veneers and not damage the underlying teeth, and place a new, beautiful set for you.

Dr. Hall

December 11, 2008

Is chewing gum bad for your teeth?

Filed under: Tooth decay — iowasmiles @ 4:03 am

Does chewing gum hurt your teeth? I mean chewing gum a lot, not just after meals.
Jessica from Pennsylvania

Jessica,
We used to think, in dentistry, that chewing gum was bad for your teeth, especially if it had sugar in it. But it cleans your teeth, and it stimulates the flow of saliva, which is very healthy for your teeth. It helps combat tooth decay, and is a good substitute for toothbrushing if you don’t have a brush with you.

As long as you chew it for long enough that the sugar is gone, it doesn’t reallly hurt your teeth.

However, if you have TMJ problems (temporo-mandibular joint disorder), you could be overworking your jaw muscles and they could become sore or go into spasms. But if your jaw muscles aren’t bothering you, then I wouldn’t worry about that.

Dr. Hall

Other links:
Which is the best toothbrush?
Which is the best toothpaste?

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December 6, 2008

Will the gum drop down on my dental implant?

Filed under: Dental implants — iowasmiles @ 2:43 am

Dr. Hall,
I just had a dental implant done in September on my front tooth and the gumline is now higher than the rest of front teeth. My dentist suggested a temporary crown saying the gumline will drop down to this crown when this is on. Is this normal? The temporary crown stands out as an obviously ‘fake’ tooth? Would this be an example of what the permanent will look like? After spending $6000 on this tooth I would like it to look like the rest of my teeth. Is this possible, or do you think or will it always be obvious that it is a fake tooth?

I now kind of regret even having the implant if it will always look fake. The flipper I had looked better than this.

Could you suggest good cosmetic dentist in (my city) as they ALL say they are cosmetic.

Thank you,
Maria from Ontario

Dear Maria,
Putting the temporary crown on is a good idea, to see if the gum will indeed grow down to the tooth. I doubt that it will. And I would insist that the temporary crown look the way you want the tooth to look before the permanent crown is put on. This is your way to help make sure that you get what you are paying for—a normal-looking smile. And yes, that should be possible.

You do want the gumline across your front teeth to be symmetrical, assuming that your gumline shows when you smile. Many people don’t show their gums at all when they smile. Mine don’t. Look in the mirror and smile your broadest smile. If you can see the unevenness in your gums, then I would want them to be made even. If you can’t, then I wouldn’t worry about it.

After dental implants are surgically placed, if the gums aren’t in the correct position, it could require some additional surgery to make that right. But I would insist that your dentist arrange for that, if it is needed.

Check our list of Ontario cosmetic dentists. I know we have a great cosmetic dentist close to where you live. Yes, legally any dentist can say he or she is a cosmetic dentist, because the dental society doesn’t consider cosmetic dentistry a distinct specialty. I think they should, but they don’t. So that’s why we list the ones who are true cosmetic dentists.
Dr. hall

December 1, 2008

Can I use Supersmile toothpaste with porcelain crowns?

Filed under: Porcelain crowns, Toothpaste — iowasmiles @ 6:01 am

Dr. Hall,
I would like to know if I can use supersmile toothpaste with porcelain crowns? I have porcelain crowns.
Linda in Louisiana

Dear Linda,
Yes, Supersmile toothpaste works great with porcelain crowns. Supersmile was designed for use with extensive cosmetic dental work. It keeps stains away, yet it is non-abrasive.
- Dr. Hall

Related links:
Read all about whitening toothpaste
Read Dr. Hall’s opinion about what is the best toothpaste

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