The Cosmetic Dentistry Blog

May 22, 2009

Will dental insurance help pay for bonding my daughter’s splotched teeth?

Filed under: Braces, Dental insurance, Tooth bonding — iowasmiles @ 4:49 pm

My 13-year-old daughter was born with a lack of tooth enamel. After braces her smile is straight but the two main teeth have two different colors on them – they’re splotchy looking. Will my dental insurance pay for this? It’s Anthem Blue Cross
- Pam in California

Pam,
When teeth are splotchy-looking right after getting braces off and they weren’t that way before, it’s probably because they weren’t really good about brushing their teeth while the braces were on. When you’re wearing braces, it’s a good idea to carry a toothbrush with you, because you need to get all that gunk off after each time you eat, or it will damage your enamel.

And since this is a situation that involves damaged tooth enamel, yes, your dental insurance is probably obligated to pay benefits. But there are a couple of cautions here.

First, your dental insurance is only obligated to pay for repairing the physical damage, and they will probably pay at a very minimal level. Don’t think of them as “covering” the repair, because that implies they will pay for the whole thing. Think of it as that they will “help” pay for the repair. You’ll want this done in a way that looks beautiful and natural. Your insurance is only committed to making the repair be functional.

Second, don’t let your family dentist do this. You want an expert cosmetic dentist. This may cost a little more, but the repair may involve free-hand tooth bonding or even porcelain veneers. You need a dentist-artist, and only 1 or 2 percent of dentists are artistic enough to produce a beautiful result with your front teeth.

- Dr. Hall

Click here to find an expert cosmetic dentist.
Teeth bleaching WILL NOT WORK for these splotches. Read our cosmetic dentistry horror story about how teeth bleaching made splotched teeth worse.

May 12, 2009

Temporary crown fell off

Filed under: Dental crowns — iowasmiles @ 4:29 pm

Dr. Hall,
If a temporary crown falls off will a little toothpaste or vaseline re-activate it?
- Marlene from California

Marlene,
I’m assuming you’re asking how to fasten the temporary crown back on  your teeth. You’re smart to know that you need to have this temporary crown back on. It is possible for your tooth to get damaged if it is exposed for several days without the temporary crown on. Also, your teeth will drift together and make it so your permanent crown won’t fit, meaning that you will have to go back through the entire crown preparation process again and get another crown made, and your dentist may charge extra for that.

Toothpaste or vaseline won’t hold the temporary crown. Actually, my opinion is that your dentist should assume the responsibility for re-cementing your temporary crown for no charge. I think most dentists do that. That’s the best option.

Three other options if you can’t get in to see your dentist:
Superglue. It will hold things on your teeth quite well. But beware – you could complicate the final treatment because of problems in cleaning off the superglue later. So only do this if you call your dentist and she or he says it’s okay.

Denture adhesive. This will hold fairly decently.

Drug stores often have temporary dental cement to help hold on temporary crowns.

I hope this is helpful,
Dr. Hall

Related links:
Read about dental crowns in general and porcelain crowns in particular.
Cerec crowns don’t require a second appointment, so no temporary crown is necessary.

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May 5, 2009

Dentist can’t get porcelain veneers color right

Filed under: Cosmetic dentistry mistakes — iowasmiles @ 1:37 pm

Dr. Hall,
I just got 6 porcelain veneers on my front teeth,this was the second time in about 3 weeks. The dentist made them the first time and they looked awful. The second time he sent them to the dental lab. I was allowed to tell the lab man how I wanted them. I picked a very white shade, when my dentist went to put them on, the teeth were yellowish,especially the 2 front teeth.The lab man said the dentist told him to add a little color. The dentist would not say anything about them. the lab man said they could polish some yellow out, but the dentist would not do it and said the porcelain would come off. Is there any kind of whitener i could use to bring the stain off? it looks like a coffee stain . what about super smile toothpaste or teeth bleaching gel?

Thank-you,
- Jane from Ohio

Jane,
I wish I had a better answer for you. Teeth bleaching or whitening toothpaste won’t work. It sounds like the yellow was put on a superficial stain, which means an expert cosmetic dentist could polish the color out or grind it out, and re-polish the porcelain veneer so that it would look good. (Don’t ask your dentist to do this.) But that has to be done carefully.

Here’s the problem – your dentist may be a great guy, honest, and careful, but he isn’t an artist. And in dental school they teach dentists to be somewhat condescending toward patients on appearance-related issues. The dentist knows best, and the fact that you want these bright white, unnatural-looking teeth is evidence of that. They just don’t get it.

I think you’re well within your rights to ask that this be done a third time. You’re the one who has paid for a new smile, and the dentist going over your head to overrule you on the color of your smile, and then to bond these porcelain veneers on without your getting a good look at them–that could well be considered malpractice. What it violates is the doctrine of informed consent, a fundamental principle of malpractice law. He put yellow porcelain veneers in your mouth without your consent. I think a judge and a jury would stand behind you in that.

Your best option would be to get a refund from this dentist and go to a true artist/dentist to get this smile makeover done–the kind of cosmetic dentist we recommend on our website. That way you would not only get the color you want, but you would get an absolutely gorgeous smile in every respect. But better than nothing would be to get this dentist to do these porcelain veneers a third time.

I would go back to your dentist and tell him that you believe he violated your right of informed consent by putting on these yellow porcelain veneers when you gave explicit instructions about the color you wanted. Explaining it in this way should have a strong effect on him, because it will sound like something important he learned in his dental law class. So tell him you either want a refund, or you want him to take them off, have new ones made, and this time you insist on getting a good, long look at the new veneers on your teeth before they’re bonded on. Bring in a friend or a family member to help you look at them before they’re bonded on. And then, when you’re satisfied with the color, make him promise that he’s going to bond them on with clear bonding resin and not do anything sneaky like add tints to the bonding resin.

Good cosmetic dentists will go to great lengths to make absolutely certain that you love your new smile before they bond it on. So if you have any friends who want porcelain veneers, tell them to go to a mynewsmile.com recommended cosmetic dentist, so that this doesn’t happen to them.
- Dr. Hall

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

May 2, 2009

Teeth hopelessly damaged from bulimia

Filed under: Bulimia — iowasmiles @ 7:44 am

I suffered from bulimia for nearly twenty years. Counseling has finally helped me overcome this illness, and I’m glad for that, but my teeth have been damaged severely. They are about half of normal size, and in the front, they no longer touch and are chipped because they’ve gotten so paper thin. And where my teeth still touch, they don’t fit well.

And now, the left side of my jaw protrudes out almost an inch every time I open my mouth to bite or chew, which causes headaches.

Is there any hope for me, given the severity of my issues? I’d like to see a cosmetic dentist to improve my smile and the functionality of my bite.
- Ruth in Georgia

Ruth,
You’re smart to think of a cosmetic dentist to help you with your teeth. Bulimia is an appearance issue as far as your teeth are concerned, and any expert cosmetic dentist such as the ones we recommend on this website has the training necessary to treat this well. When there is little tooth structure left, you need to have bonding technology used to restore your smile because conventional cementation techniques may not be strong enough to hold crowns on your teeth.

And yes, your headaches are most likely caused by a TMJ disorder, which comes from your bite discrepancy. One other piece of good news is that most expert cosmetic dentists are also fairly well trained in treating TMJ disorders, which requires restoring your bite to it’s normal state. Brace yourself – you are probably facing needing crowns on most if not all of your teeth. But the end result, if you go to the right dentist, will be a beautiful, radiant smile.

Check our list of Georgia cosmetic dentists. They are all carefully screened to be able to do this kind of all-porcelain crown that will bond to your teeth and look lifelike, and they all have the artistic talent necessary to make the work look beautiful.

And congratulations on overcoming your disease. You have made great strides. The worst is behind you, and I anticipate things will just get better for you from this point on.
- Dr. Hall

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