The Cosmetic Dentistry Blog

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.

August 26, 2009

The tooth next to my recently extracted tooth hurts.

Filed under: Extractions — iowasmiles @ 6:13 pm

I just had a lower 2nd molar removed last week. Not as straightforward as I would have hoped – it took about 2 hours and came out in pieces. As the swelling and general pain subsides, I’ve noticed pain is much more localized on the neighboring 1st molar. It hurts to tap on it and responds to heat and cold. This was perfectly fine before. Is this normal?

Thanks,
- Eric from Ontario

Eric,
Many dentists have difficulty from time to time with extractions they thought were going to be routine. Unfortunately, you’re the one that suffers the trauma when this occurs.

Experiencing pain on the neighboring tooth after a tooth extraction isn’t unusual, especially when there was difficulty with the extraction. Apparently, in the course of the extraction, the dentist needed to leverage against this other tooth. This would cause the symptoms you’re experiencing – tenderness to touch and sensitivity to cold. This pain should gradually subside over the next week or so.
- Dr. Hall

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August 21, 2009

How much would porcelain veneers cost for me?

Filed under: Cosmetic dentistry costs — iowasmiles @ 7:04 pm

I would like to get porcelain venners on the top maybe 4 teeth. I have very small teeth. Could you give me a close estimate what it would cost me.
- Teresa in Hibbing, Minnesota

Teresa,
I would not recommend that you get porcelain veneers in Hibbing. You will be very disappointed in the results. 98% of dentists are not artistic at all, and especially in a smaller city like Hibbing, you will find only general dentists and no one who has taken extra time and effort to be expert in cosmetic dentistry.

There is an excellent cosmetic dentist in Duluth, however – Dr. Greg Kaake. I know him very well, and he does excellent work and his fees are very reasonable. People come to him from all over the state.

I’m guessing that four veneers would cost about $4000.
- Dr. Hall

Other links: Read about porcelain veneer costs.

August 17, 2009

Salty taste from porcelain veneers

Filed under: Porcelain veneers — iowasmiles @ 8:00 pm

I am quietly going insane about a problem I perceive due to porcelain veneers.After paying a lot of money for veneers I have noticed a very salty taste in my mouth. Is this possible?
- Lee from Florida

Lee,
There is nothing used in the normal porcelain veneer placement process that would taste salty or that would leave a salty taste behind. Did your dentist use something really weird on you? I’d ask him or her about the taste.

- Dr. Hall

Click here for referral to a cosmetic dentist

August 15, 2009

Treatment for a single dark tooth

Filed under: Porcelain veneers, Tooth bonding — iowasmiles @ 8:00 pm

My smile is good except my right front tooth is turning brown. It may have gotten bumped when I was a child but I do not recall. It is not painful. It is solid and fine…just slowly dying. What would be the best procedure to take care of this problem do you think? I don’t smile as much due to the fact it has gotten darker. Dentists here want to do a root canal and cap but that seems a bit extreme. It’s not infected and does not hurt.

Thank you for your time,
- Vicki from California

Vicki,
If your tooth is fine and not infected, then there is no reason to have a root canal treatment. When a tooth is bumped hard enough, it can sever its blood supply, and it will die, develop an abscess, and turn dark. It will need a root canal. But if it’s bumped lightly, often it will later develop thicker dentin and will look dark but will be perfectly healthy.

If the tooth is healthy, it just needs some type of veneer to change the color. But the degree of color manipulation required for a single tooth is difficult for about 98% of dentists. If the dentist is artistic enough, often he or she will prefer to use direct dental bonding, because that way you can see the color as you go. Or, a single porcelain veneer works excellently for this situation also, with the porcelain veneer made by a dental laboratory.

But don’t go to the dentist on the corner for this – the color matching required is too difficult. I’d recommend one of the cosmetic dentists on our list, because they are screened for artistic ability.

I’d expect to pay $1300 to $2000 to get this done right.
- Dr. Hall

August 11, 2009

Hello world!

Filed under: Uncategorized — iowasmiles @ 8:32 pm

Welcome to WordPress. This is your first post. Edit or delete it, then start blogging!

August 10, 2009

Can I use bleaching trays for a retainer?

Filed under: Braces — iowasmiles @ 2:13 pm

Dr. Hall,
I had braces on my teeth and I have had the old type retainer for years (pink w/wire) and have worn it out. Can I use my plastic bleaching trays for retainers? I do not use my trays anymore and my teeth have not shifted in any way. I just hate to spend $300+ if these would work just as well.
- Janice from Tennessee

Dear Janice,
Bleaching trays can be used as retainers in some cases, depending on how well they fit and the forces that are tending to get your teeth to move. But I give that advice cautiously. I think you’d be best off with an orthodontic retainer made for that purpose. I am surprised that they are asking $300 for the orthodontic retainer. Those aren’t hard to make. A dentist just has to get a good impression of your teeth, pour up a model, and send that to a dental laboratory. I would think you could find a dentist who would do it for a lot less and you wouldn’t notice any difference in the quality.

Here’s what I would suggest, and I’m assuming that you are wearing these teeth bleaching trays faithfully every night – use the bleaching trays. But, over time, if you can sense any difference developing in how your bleaching trays fit, then go get the retainer made.
- Dr. Hall

Other links:
Click here for referral to an expert cosmetic dentist.

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August 7, 2009

How best to replace a front tooth – taking Fosamax

Filed under: Dental bridges, Dental implants — iowasmiles @ 9:45 am

I had a next to the front tooth extracted. My surgeon cautioned about an implant as I have been on fosamax for about 10 years. I am now wearing a flipper which annoys me and has a sour taste in my mouth. I read about the Encore Bridge or Maryland Bridge. The tooth next to the one pulled has a cap on it. Am I eligible for an Encore Bridge? My dentist hesitates to give a regular bridge as he would have to file down a front large tooth. Any advice?
- Susan in Massachusetts

Susan,
I have a couple of points that may be helpful.

First, taking Fosamax doesn’t mean you can’t have a dental implant. There is a slightly increased risk of serious local bone problems when you are taking Fosamax and you have oral surgery that involves the bone, which placing dental implants does. The risk is small, but the potential consequences are serious, so I wouldn’t ignore the risk. However, you can temporarily suspend taking the Fosamax and work around it, if your oral surgeon coordinates this with your physician.

If you don’t want to deal with that, then some type of dental bridge would be best. But I would leave it up to your dentist to choose the type of bridge. An Encore Bridge is a nice service and is esthetic and conservative. But I wouldn’t want you to be the first patient your dentist had ever done an Encore Bridge on. The procedure is very tricky and has some strength limitations. Stick to the types of bridges your dentist suggests, because then you can be fairly certain your dentist is comfortable doing that type of bridge.

If your dentist is a typical general dentist, I would recommend doing the conventional, tried-and-true regular bridge, filing down the front teeth like has been done millions of times before for other patients, and it works.

There is no perfect solution for you. Given the assumptions I have made in this answer, I think the conventional bridge has the smallest downside and the least risk for you.
- Dr. Hall

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August 3, 2009

Porcelain veneers not smooth

Filed under: Porcelain veneers — iowasmiles @ 2:49 pm

I have porcelain veneers on my upper front 5 teeth. They are pasty-looking and not smooth (don’t feel slick like my regular teeth). I got them in  April 2007, and the dentist has polished them “twice” now to date.

Thanks,
Inge from California

Dear Inge,
You’re telling me that your dentist doesn’t seem to know how to polish your porcelain veneers, and that the dental laboratory he used to make them doesn’t seem to know how to make lifelike porcelain veneers.

I’m not surprised. Most dentists don’t know how to do these things well. That’s why I run this website – to help people find good cosmetic dentists. I’m very familiar with the pasty look you talk about, and we examine closely the work of every cosmetic dentist we list on this website to make sure they know how to create lifelike porcelain veneers.

Porcelain veneers shouldn’t need to be polished. When they are fired in the porcelain oven they are given a shiny glaze that is extremely durable and stain resistant. But, if the occasion arises, usually through improper maintenance, where they need to be polished, expert cosmetic dentists such as we list on this website know how to do that. Check our list of northern California cosmetic dentists to find someone who could do this for you.
- Dr. Hall

Other links:
Click here to find a cosmetic dentist
Click here for information about dental implants

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