Your leading source for cosmetic dentistry
information and referrals.

I’m getting dentures. Do I go to a general dentist or oral surgeon first?

Posted on by .

Dr. Hall:
I am a 50 year old man who grew up with a fear of dentist. At an early age I was “freaked out” by a dentist and never really wanted to go to them – unless it was to have a tooth pulled.

Now that I am older most of my teeth are broken or missing. I need to get dentures – my question is how do I know if I need a dentist or an oral surgeon to remove what teeth I have left? This is rather embarassing for me and it keeps me from a lot of activities involving my daughter because of the embarrassment.

Can you tell me which I should look for so I can have my teeth fixed and once again be able to smile in public?

Thanks in advance – I would appreciate the help.
Robert from Ohio

Robert,
I would go to a dentist who can do the tooth extractions – the surgery AND do the dentures. Doing pre-denture surgery isn’t complicated, and there are many general dentists who do it. Just call the dentist’s office and ask what the dentist USUALLY does. Don’t give any hint as to your preference before you ask the question. You just want to find out how the dentist usually handles cases like that. A dentist who usually does the surgery, too, will have plenty of experience at that.

And since you have this dental fear you talk about, you’ll also want a dentist who offers sleep dentistry. In Ohio that shouldn’t be a problem, as there are a number of dentists there who do sleep dentistry.

The reason is that there is a certain amount of coordination that is needed between the surgery and the denture. You may, for example, choose to have the denture placed the same day as the teeth are coming out. This is called an immediate denture. This eliminates the embarrassment of going for six weeks or more without any teeth. Even if you don’t do that, there are certain things the dentist can do during the surgery to help the dentures fit better and be more comfortable, and general dentists are more familiar with those things than oral surgeons.

But even if you did have an oral surgeon take out the teeth, you’d still want to go to the general dentist first, because the general dentist will coordinate the procedures.

Good luck,
Dr. Hall

We thank our advertisers who help fund this site.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

What to do if I can’t have a dental implant.

Posted on by .

Hello, and thanks for letting me ask a question. I was in an auto accident – hit head-on by a drunk driver. This required many surgeries, and one of my teeth sustained a spiral crack that extends up through the root. It is a front top tooth, third from the center. They tried to repair it with an “apicoectomy” but the crack was too extensive – about 10 years ago. While having all of the surgeries, they discovered that I also have had sarcoidosis at some time, which is inactive now and has never been symptomatic. Now this tooth is getting quite painful, and I need to determine what to do – I understand that if you have sarcoidosis, you can’t be a candidate for dental implants. I am an author, and frequently have to travel to conferences to give speeches – so my smile is important. What can be done if I can’t have a dental implant?
Thanks,
Amanda in Tennessee

Dear Amanda,
A dental bridge works very well for replacing front teeth. A crown is done on the tooth on either side, and the false tooth is suspended between them.

And if the appearance of your front teeth is important, then be sure you go to an expert cosmetic dentist such as we recommend. Dental bridges can be done so that they create the illusion that there is no false tooth there, but it takes quite a bit of aesthetic sensitivity for a dentist and a laboratory technician to create this illusion.

Dr. Hall

We thank our advertisers who help fund this site.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

Discolored baby teeth

Posted on by .

Question:
My son (age 4) injured front teeth and have become discolored….is there any way they will regain original color? Anything I can do to help…diet?
Teri in Pennsylvania

Dear Teri,
Your son’s baby teeth are so small, there really isn’t anything practical to get their color back. Diet won’t have any effect. And they are already starting to lose their roots, if they are the very front teeth, and doing too much will make them grow loose prematurely. I’d advise just waiting until they’re ready to fall out. It’s probably only another two or three years before they fall out.
– Dr. Hall

We thank our advertisers who help fund this site.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

Maryland bridge won’t stay in.

Posted on by .

Dr. Hall
Due to a failed root canal, I had tooth #12 removed and a bone graft in preparation for a dental implant. My dentist and the oral surgeon agreed that a Maryland bridge would be a good temporary plan for me cosmetically. My dentist placed it post surgery and it fell out after only 12-13 hours. He again placed it and it fell out in less than 2 days. He has taken another impression for another bridge but I have to wonder if the new Maryland bridge will be any more successful than the original one. I have eaten only soft foods post surgery 5 days ago. I am at my wits end and would like any recommendations you may offer.
– Betty from New Jersey

Betty,
One thing about Maryland bridges is that they are bonded in, not cemented, so they require a knowledge of bonding technology that may be beyond the training of some general dentists. So here I have a list of possibilities why your Maryland Bridge didn’t stay in. I don’t know why it fell out. Things go wrong in every dental office from time to time. But here are some possible reasons:

1. It was placed too soon after the surgery when there was still oozing and bleeding from the surgery that contaminated the bond. And now that a little more time has passed, it will be easier.

2. The bleeding and oozing from the surgery had stopped, but the dentist still wasn’t able to completely control contamination from saliva. He should be able to get that done trying one more time.

3. The dentist didn’t make an adequate preparation for the Maryland Bridge. (There have to be certain grooves and divots placed in the adjacent teeth to hold a Maryland Bridge well.)

4. It was the oral surgeon’s idea, and your general dentist really doesn’t know how to do a Maryland Bridge, but didn’t want to appear to have a lack of knowledge.

As far as the reason why your dentist couldn’t re-insert it and get it to stay, that’s easier. Once a Maryland Bridge falls out, it can’t be re-bonded without a special treatment of the metal. The metal surface of the wings of the Maryland Bridge are etched, and if it falls out, those wings should be re-etched in order for it to stay in. If your dentist has a type of a mini-sand-blaster called a micro-etcher, he can re-etch it himself. Otherwise, he has to send it back to the laboratory and they can do it.

If the Maryland Bridge doesn’t work this third time, maybe you should have him do a dental flipper for you. Read more about dental bridges in the main section of mynewsmile.com.
Dr. Hall

We thank our advertisers who help fund this site. Our cosmetic dentist referral pages list cosmetic dentists we recommend.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

Baby teeth not falling out

Posted on by .

Dr. Hall –
My 6 year old has his second set of teeth that have come up but the baby teeth are still there and have not loosened up. Should I wait till they do loosen up or should he have them removed? I have not taken him to the dentist because I thought they would fall out on their own. Help what should I do???
– Mona from Michigan

Mona:
If you can see the permanent teeth coming in but the baby teeth haven’t fallen out, and you can’t jiggle them out yourself, I’d take your son to a dentist and have the dentist take them out. The baby teeth can deflect the permanent teeth if they’re not coming out the way they should.
– Dr. Hall

We thank our advertisers who help fund this site. Our cosmetic dentist referral pages list cosmetic dentists we recommend.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

Black deposits at the gumline

Posted on by .

Question:
I have black deposits on the side of the teeth at the gumline. When I scrape them with a steel scaler, they break down but brushing doesn’t do anything. It’s like a formation of plaques, but it’s not yellow, it’s black. What is it?
– Mr. Worried in New York City

Dear Mr. Worried,
Your black deposits sound like dental calculus, and you should worry. Over time, dental calculus like this can make your teeth get loose and eventually fall out. You need to get to a dentist, have him or her confirm what they are, and if it is this dental calculus, get into a gum disease treatment program.
Dr. Hall

We thank our advertisers who help fund this site. Our cosmetic dentist referral pages list cosmetic dentists we recommend.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

Infected wisdom tooth

Posted on by .

Dr. Hall:

I am 38 years old. My lower bottom wisdom tooth is part ways out, and the gum surrounding it is very very sore. It did get infected 2 weeks ago, and I was put on anti biotics. I have been off the antibiotics for a week now,and I am feeling alot of discomfort again. Is this pain because it is growing, or should I get it removed. I am deathly afraid of getting it removed. With reading the complications of getting them removed when you are my age, should I be concerned? Please contact me soon. Thank you.

Sandra in Saskatchewan

Dear Sandra:

You need to get this wisdom tooth removed, and the sooner the better.

What you have done by taking antibiotics without getting the tooth out is that you’ve helped create antibiotic-resistant bacteria in your infected wisdom tooth. If you keep doing that, you’ll end up with an infection that is impossible to control, and infections in this facial area are very close to your brain, so they can actually become life-threatening. And it’s impossible to get rid of this kind of infection with antibiotics alone

Yes, it would have been easier to have had them out when you were in your early twenties. But 38 isn’t all that old. They don’t start getting really difficult until you’re up in your forties or fifties. Get a competent oral surgeon, and you should be fine.

But brace yourself for their legal warnings about every little thing that could possibly go wrong. They have to give those in order to protect themselves legally. But the risk of doing nothing is truly your greatest risk at this point.

Meanwhile, I would recommend that you ask the dentist for a blunt irrigation needle and irrigate the pocket under the flap of tissue that surrounds the wisdom tooth with a gentle, warm rinse of a mild salt water solution, maybe with a little hydrogen peroxide mixed in to help bubble out the infected material. Do that after every time you eat, and it will help keep the infection temporarily under control for a couple of weeks until you can get it out, and that way you won’t be breeding antibiotic-resistant bacteria.

And get ALL your wisdom teeth extracted. If you have one infected tooth, the others will eventually get infected also. You’re lucky this is happening now rather than waiting until you’re fifty or something.

-Dr. Hall

We thank our advertisers who help fund this site. Our cosmetic dentist referral pages list cosmetic dentists we recommend.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

Receding gums

Posted on by .

Question:

I was wondering what exactly is the cause of a receding gumline? Even when the gingiva appears healthy..is it malnutrition?? And it’s only really noticably serious on the person’s first premolars…

– Michelle in Texas

Dear Michelle,

There are several possible causes for a receding gumline. I’ll list them here:gum disease. If that’s the case, you need to visit a general dentist or a gum specialist (periodontist) for treatment. Plaque and other irritants build up under the gumline and will eventually cause your teeth to become loose.

2. The bone in the area of the recession could be thin or missing, causing the root to show through to some extent and the gum to gradually recede over your lifetime. The treatment for this is to be very gentle when you brush. It can sometimes be repaired with a gum graft, which is usually done by a periodontist, though some general dentists can do this.

3. You could have what’s called traumatic occlusion. If you clench or grind your teeth at night, it can cause notches to develop in your teeth at the gumline and your gums will recede from this area. Further gum recession can be prevented or slowed by wearing a nightguard.

4. You could be brushing too aggressively with a hard brush. (The best toothbrush is soft)

– Dr. Hall

We thank our advertisers who help fund this site. Our cosmetic dentist referral pages list cosmetic dentists we recommend.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

Categories

Follow this blog

Get every new post delivered right to your inbox.