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Can I get dental implants after wearing dentures for 10 years?

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Dr. Hall,
Is it possible to get dental implants after 10+ years of full dentures?
– Kathy from Lancaster, PA
 


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Kathy,
The short answer is yes, you can get dental implants placed after wearing dentures for years, no matter how long it has been.

The longer answer is that it gets more complicated the longer you wear your completely removable denture. Ten years is long enough for facial collapse to set in. What happens is that once all your teeth are gone, your body takes the minerals in your jaw bone and uses them elsewhere in your body, causing your jawbone to resorb and shrink. This has undoubtedly happened with you, and the longer the period of time, the more difficult it is to have a denture that feels comfortable and works well.

The problem this causes with dental implants is that there isn’t enough bone left to support the implants. There are two ways to address this problem.

The first way is with bone grafting procedures. In some cases, bone is harvested from some other part of your body, like your hip. Or there are sterilized or artificial bone products that can be used to build up the bone. You have to check with the surgeon placing your implants for the sources they use.

A way to get around the bone grafting can be with what is called either an all-on-4 dental implants procedure or the all-on-6 procedure. Often there is more thickness of bone left in the front of your mouth, enough to support some shorter implants. They are placed at angles, which increases their resistance to displacement, and engineering the placement of the implants in this way can eliminate the need for bone grafting.

Start with a visit to a general dentist experienced in working with dental implants, and ask them for referral to the surgeon they work with to find out what needs to be done in your case. Don’t go to the surgeon first, or you run the risk of having the dental implants placed and then going to the restorative dentist who finds that the implants are placed in locations he or she can’t work with.

I hope this is helpful.
– Dr. Hall

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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.

My new crown feels funny

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Hello Dr. Hall,
I moved, & went to a new dentist for a recommended crown. The dentist allowed the hygienist to attach the permanent crown, & did not check it, much to my surprise. It feels like there is “play” in it, & it is not fitted properly. Can this be corrected, & what should I do?

Kathy from Missouri
 


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Kathy,
I checked the dental regulations for Missouri and was able to verify that this is legal for a dentist to allow a dental assistant to cement a crown. And I’m suspecting that this auxiliary who cemented the crown was an expanded function dental assistant and not a dental hygienist. Dental hygienists specialize in cleaning teeth and screening examinations, and usually don’t perform other functions in a dental office. In Missouri, a dental assistant who has completed education in expanded functions can be certified to be able to place fillings once the tooth has been prepared by the dentist. They can perform adjustments on permanent crowns as long as they do it outside the mouth, and they can perform the final cementation of that crown.
It would seem to me, though, that the dentist would need to check the crown to make sure it fits properly. I can’t tell, by reading the regulations if that is specifically addressed by the dental board, but I suspect that some type of direct supervision of the dental assistant is required meaning that the dentist at some point needs to check the crown and make sure it meets certain clinical standards. And even if that isn’t spelled out clearly in the regulations, in my opinion a good dentist dedicated to providing quality work would want to check the crown before it is cemented. If I were the dentist in that situation, I can’t imagine doing anything less than that.
About your feeling that there is “play” in the crown—I don’t know how to evaluate that. If the crown is loose on the tooth in any way, it will fall off, so I’m sure that isn’t the case. But a new crown should not be noticeable to you. There shouldn’t be any type of strange feeling with a crown, a feeling that it isn’t quite right. It should feel so perfectly natural that you don’t notice it.
What to do at this point? I would start by making an appointment with the dentist to check the crown. There should be no charge for that. Then, if you don’t get a satisfactory answer, I would ask for a second opinion from another dentist. If you are interested, let me know and I could find you a quality dentist for that second opinion.
– Dr. Hall

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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.

My dentist wants to wait till the nerves settle down before replacing my crowns

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Dr. Hall,
My dentist convinced me to replace all my old amalgam fillings even though many were still stable. She was going to replace them with either composite or crowns depending on the size of the filling and how much tooth structure would be left. Anyway, we started on the project, and about six weeks ago she did three zirconia crowns for me. These crowns are so uncomfortable for me. They feel bulky to me, they press on my gums to the point that sometimes it hurts, and my bite feels off, making these teeth sore. It’s causing me a lot of stress, which especially concerns me because I have a new baby that I am nursing, and it’s like the stress is affecting her. She hasn’t been able to sleep lately and has been waking up crying all the time.
So I canceled the rest of her treatment plan. But of course she refuses to refund the money for the 3 crowns because she’s convinced they are fine and says if there is any problem, she will fix it. I don’t trust her to fix it though.
But now I have gone to a new dentist, and I want her to re-do these crowns. I realize that I will have to pay for this out-of-pocket, but I really want to get this done. But this new dentist says she does not want to touch my crowns until I give the nerves time to heal and lower the risk of needing root canals. But that can be months. I don’t know if I can wait that long.
 
– Gail from New Jersey
 


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Gail
I’m confused by the reluctance of your new dentist to replace these crowns, saying that the nerves need to heal. The problems you have with the crowns—pressing on the gums, bite is off, they feel bulky—have nothing to do with the nerves of the teeth. If those nerves were irritated, there would be heightened sensitivity to cold in those teeth. While it doesn’t sound like your first dentist has a strong level of expertise when it comes to crowns, it doesn’t sound like your new dentist has a firm understanding of dentistry either.
Yes, a crown preparation, where the dentist is cutting deeply into the tooth, can be irritating to the nerve of the tooth—in some cases highly irritating. But removing an existing crown is only mildly irritating, if any at all. If, indeed, the nerves had been highly irritated by the first crown preparations, which it doesn’t seem like has happened, six weeks would be enough time for them to settle down.
I wish you well and hope you get this problem solved. I see no reason for a delay in replacing these crowns, and I am very wary of the level of expertise of this new dentist of yours. She is displaying timidity in tackling this problem—not a good sign at all. I warn patients in several of my blog posts about how easy it is to push some dentists outside of their comfort zone, and she is giving you a red flag here that she isn’t comfortable re-doing these crowns. Maybe what is making her timid is the difficulty in grinding off zirconia crowns. They are very tough and very hard to grind off, especially if they are bonded on. The worst thing you could do would be to urge her to go against her instincts here.
If you’d like help finding a dentist who could do a good job on this for you, let me know and let me know exactly where in New Jersey you are. I know a number of excellent cosmetic dentists there.
Good luck,
Dr. Hall

 

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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.

My crown on my front tooth isn’t staying on

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Dr. Hall,
I read your last answer about the crown not staying on. I have a root canal in tooth # 10 (upper left lateral incisor). The crown stayed on for about ten years. Then, about 1 1/2 years ago, my dentist replaced it. During the time since the new crown was placed, it has come off several times and been recemented. It never has felt really secure. Do you think there is hope for the crown to stay on if re-cemented? There isn’t really much to cement it to.
Thanks, Evelyn from California
 


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Evelyn,

There should be a way to get this crown to stay on better. The problem is probably in the design of the crown preparation, and not in the strength of the cement or bonding material. If that’s true, it would mean you need a new crown for this to stay on. That’s just a guess. But let me give you an explanation of what can be done when a tooth has had a root canal treatment and there isn’t much tooth left to hold on to.

I wrote in an earlier post that the main reason crowns come off is that they aren’t prepared with proper retention form. Now, if there isn’t much tooth structure left, it isn’t possible to properly prepare the tooth. So what I would do to improve the retention would be to cement a fiberglass post deep into the canal. It needs to be a post with some flexibility to it, or under the stress of oral function the post could fracture the tooth root. I would then bond to the tooth and the post some core material.

Here are photographs of a case of a crown on a front tooth in a situation like this, courtesy of the dental journal Dentistry Today.
close-up photo of a broken down lateral incisor tooth with a fiberglass post fitted into the root canal spaceIn this first photograph, some of the root canal filling material has been removed and a fiberglass post is fitted into the canal. The post needs to go deeply into the tooth, but not so far as to require removal of all of the root canal filling material. About 2/3 of the length of the tooth would be good.

A close-up photograph of the same lateral incisor, with core material added and the core trimmed into a crown preparation.Then the post is bonded into the canal and a core material is built up. Composite is usually used for both the bonding of the post into the canal and the core. That composite is then shaped into a conventional crown preparation as shown here.

Built up like this, the tooth should be able to retain a crown easily. I will note that there has to be some tooth structure remaining. The amount of tooth remaining in this case is about the minimum amount needed. If a front tooth, say, is broken off level with the gums, and the retention has to come completely from the post, it won’t work. Normal oral function will create twisting stresses on the post and will eventually dislodge it.

I hope this is helpful.
Dr. Hall

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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.

My CEREC Crown Is Too Bulky

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Dr. Hall,
I recently had a crown replaced on an upper molar (second molar from the back) due to the first crown breaking after several years. I needed it done quickly, so I went to a new dentist who used CEREC to make a same-day crown.

The crown feels like a wad of bubble gum stuck to my tooth. There was a large “bubble” that stuck out into my mouth and was rubbing my tongue. When I went back, she could see that it was misshapen, and she filed it down some. It STILL feels too big. It rubs my tongue when I talk, and I think I’m biting my tongue in my sleep. Should I go back and have more filed away? I have had upwards of 10 crowns, so I’m not just unused to the feeling of a crown in my mouth. I also thought that with CEREC, the computer would make the crown fit really well. I’m not sure how to proceed. Thank you.
– Renee from Utah


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Renee,
How is it you keep ending up with these dentists who don’t seem they know what they’re doing? My first question would be about the crown that broke. Crowns aren’t supposed to break, even after several years. They are supposed to be super-strong and are put on the tooth to keep IT from breaking.

But anyway, about this replacement crown. I would insist that this crown feel right to you. Besides feeling bulky or misshapen, it needs to be shaped so that you don’t bite your tongue in your sleep. Persistent tongue biting, lip biting, or cheek biting is a serious problem that in some cases can lead to the growth of a tumor. Proper overlap between the upper and lower teeth should prevent this. A properly shaped crown should not feel noticeable in the slightest.

With CEREC crowns, the dentist can scan the tooth before it is prepared for a crown and use the shape of the existing tooth as a guide in directing the CEREC machine in how to shape the tooth. Since the old crown had broken, she didn’t have that to go by. But then the CEREC software is fairly easy to direct so that the tooth is shaped properly. I’m just guessing based on what you’re telling me, and my guess is that your dentist didn’t know how to work the software to shape the crown without the original tooth or old crown to guide her.

If I were you, I would ask the dentist to take this crown off and start over again. Shaping a crown freehand after it is cemented is an arduous job and is next to impossible to do. That’s the reason crowns are made outside of the mouth, either in a laboratory or in a CEREC machine and then placed on the tooth after its shaping is finished. For example, one serious limitation is that she isn’t going to be able to shape it between the teeth at all. Another is that it is going to be quite difficult to shape it right at the gumline. Trying to shape it there, unless you have a dentist with uncommon skill, would result in either overcontouring or gouging the tooth. Overcountouring in these two locations will lead to food trapping and gum disease.

Based on your experience so far, I would have a hard time trusting your dentist with shaping the crown with the CEREC software, so I would ask your dentist to have the crown made by a dental laboratory. I hate sounding so tough on her, but you’re going to end up with problems with this tooth unless this crown can be made right.

To illustrate the problem with having an overcontoured crown, here is a photograph courtesy of the dentalcaseoftheday.com website submitted by Dr. Arthur Volker, a dentist in Queens, NY. This patient had this overcontoured crown for 7 years and presented to Dr. Volker complaining of constant bleeding of the gums around this crown. You can see from the purple color of the gums around the crown that there is gum disease here. Renee, I’m visualizing the crown you’re describing to me is worse than this one.
a photo of the front upper and lower teeth, showing a large crown on the right central incisor with inflamed gums around the crown

Good luck.
Dr. Hall
 
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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.

Is it too late to treat my sinus perforation?

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Hi, Dr. Hall,
I had a tooth removed about 6 weeks ago. My dentist told me that he could see right into my sinuses. Rt upper sinus perforation. He put me on a week’s worth of antibiotics. That was all. Nothing more than general post-extraction protocol. I also had 2 other teeth pulled. They have healed fine. But this one with the sinus perforation has not even closed yet. It feels like there is still a deep hole there. I have had several rounds of antibiotics from my GP for sinus infection. It didn’t help that I have a horrible headache everyday and a fever, not too high around 99.2 to 99.8. My question is … is it too late for him to follow the preferred sinus perforation protocol to fix this or am I headed to an oral surgeon or the ENT? Thanks so much,
Cheryl
 


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Cheryl
It sounds like you have had a persistent sinus infection ever since this extraction with the sinus perforation. With this extraction being six weeks ago, the perforation should have healed. The fact that it hasn’t makes me worried that there is a root tip of the tooth or a bone fragment or some other foreign object pushed up into your sinus. Have you had an x-ray of your sinus to see what is going on there? If I were in your shoes, I would seek a referral to an otorhinolaryngologist (ear, nose, and throat physician) to check for that possibility and to provide proper care for this perforation. Had your dentist known how to take care of this incident, you wouldn’t be in your current situation. The sinus should be checked for any foreign objects. If present, they should be removed. That’s the tricky part of this. Then the hole should be closed. That’s the simpler part. After that, a course of antibiotics of about ten days should clear this up for you.
If there is indeed a tooth or bone fragment in your sinus, you are probably better off that your dentist didn’t close the hole.

Dr. Hall

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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.

How can I hide the metal clasps from my partial denture?

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Dr. Hall,
I have an upper and lower dental partial that have metal clamps which connect to my teeth. Is it possible to have the metal pieces colored pink to match my gums? I am very self-conscious when I smile and the metal is showing “gleaming.” Is this procedure possible and what will my price be? Thanking you in advance for your assistance with my current situation.
– Patricia from New York


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Patricia,
Unfortunately, I don’t believe there is any way to make the metal clasps on your removable partial pink. These metal clasps need to be flexible, and anything your dentist would bond to it would break off under the bending stress.

However, the gleaming that you get from light reflecting from the clasps can be toned down dramatically with a little sand blasting—something very simple to do. If your dentist doesn’t have a little “micro-etcher” device to do this job, his dental laboratory certainly would, and this is such a simple procedure that, if they didn’t offer to do it for free, the charge should be minimal. You could maybe even stop off at the dental lab yourself and have them do this. It will change the metal from being shiny and gleaming to a matte finish that doesn’t reflect much light.

photograph of a removable partial denture replacing three back teeth on each side of the mouth, made entirely of plastic

A Valplast Partial

For others who are in the market for new removable partial dentures, the new plastic clasps that can be either pink or transparent are much less obvious to people, and while these partials may not be as sturdy, I believe they are sturdy enough and are way more aesthetic. There are various brands of these. The photograph here is of a Valplast partial. DuraFlex is another brand.
– Dr. Hall

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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.

Are Nesbit partials illegal in Pennsylvania?

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Dr. Hall,
I had a partial Nesbit on my #2 upper molar (upper right) & threw it out in error at a restaurant.
I live in Pittsburgh, PA, & my dentist & the Pitt dental school tell me Nesbit partials are now illegal in PA.
Could you please tell me what states that are close to me permit Nesbit partials?
– Kathleen from Pennsylvania


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Kathleen,
I am not aware of any dental procedure or dental prosthesis being outlawed in any state. Hearing you tell me what your dentist and the dental school said about the Nesbit partial, I thought I would check the most recent version of Pennsylvania’s dental practice act. Not only did I see no mention of Nesbit partials, but I saw no section of the law where any particular dental procedure or device was outlawed. Several years ago I received a report from a patient in Oregon who said her dentist told her that Nesbits were illegal in Oregon, and I remain skeptical about that also.

Now maybe the Pennsylvania Dental Board has passed some rule on this, but I am highly skeptical. What could be the case, giving your dentist and the dental school the benefit of the doubt, is that there was some lawsuit in Pennsylvania where the dentist gave a patient a Nesbit partial and was successfully sued, but I think there would have to be some negligence on the part of the dentist for that suit to be successful—a failure to warn the patient of the risks of such a partial. Or maybe what is going on is that the dental school and your dentist are so adamant about the risks of this small partial that they are exaggerating the situation.

So if you’re really determined to get another Nesbit partial, I would start by asking around to other dentists in Pittsburgh. If other dentists confirm that it is illegal, then I’m pretty confident that you could go across the border into Ohio or West Virginia with no problem and find a dentist to do this.

Having said that, I think you would be better off listening to their strong discouragement on this and getting some other type of tooth replacement—a flipper partial for example. A Nesbit partial is extremely easy to swallow if it comes loose and could easily puncture your esophagus or intestine causing serious medical issues. I had an experience in my practice when I was just out of dental school where I made one of these partials for a patient. He came in later saying that he had lost it. On quizzing I learned that it disappeared overnight, and I warned him that he could have swallowed it in his sleep and urged him to get x-rayed. He wasn’t interested in doing that. And then, when it was time for his next 6-month checkup, I learned that he had died. That story from then afterward spooked me about these Nesbit partials and I didn’t do any more of them. Instead, I would make larger flipper partials that were just as inexpensive.
– Dr. Hall

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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.

My front tooth is slowly turning dark

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Dr. Hall,
I’m 35 years old, and my tooth number 7 (right lateral incisor) is turning dark and has been for at least 5 years. My endodontist said the tooth is still viable (I was able to feel ice and an electric current, although my response was delayed). There was a possible, very faint horizontal fracture observed on the x-ray, and a root canal was deemed optional at this time.
I’m debating between getting the root canal done or pursuing a cosmetic procedure.
I’m under the impression that a root canal can weaken the tooth, but I was also advised by the endo that bonding would have to be applied to several teeth in order to achieve a cohesive look.
What are the cosmetic options for this kind of issue? Should I go ahead and get the root canal done now since I’ll likely need it in the future, or is it better to hold off and keep the tooth strong for as long as possible.
Which option is the least invasive and best for my oral health?
– Amanda


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Dear Amanda,

To me, “optional root canal” is the same as saying “not necessary to do a root canal.” So why would you want to do a root canal if it isn’t necessary? Either your tooth is infected or it isn’t. If it is infected, a root canal treatment is necessary. Since it’s not, I would leave it alone.

And I am skeptical that you have an actual horizontal fracture in the root of the tooth. A crack would be possible. A fracture seems highly unlikely. If you had a fracture, the tooth would be dead. Furthermore, if there were really a fracture, a root canal treatment would be problematic because it would traverse the fracture and thus be susceptible to leaking and failure.

Your tooth gradually turning dark could be because of some trauma you had some time ago, at least the five years during which it has been turning dark. Trauma can cause a tooth to build up defenses in the form of what is called secondary dentin. This will cause the tooth to darken somewhat and will also cause the living pulp tissue to shrink which would make your tooth less sensitive to cold or other stimuli.

The bottom line is that, from what you’re telling me, the only problem that has been diagnosed for your tooth is that it is turning dark. The solution to that would be a porcelain veneer or direct composite bonding, either one at the hands of a true dental artist. In the unlikely event that you later need a root canal treatment on this tooth, it would be a simple matter to do that after the veneer or bonding, since root canal access is gained from the back of a front tooth. You need to be very careful who you ask to do this cosmetic work because the color manipulation would be quite tricky and you do need to have this tooth match the surrounding teeth. I believe that only 1-2% of dentists have the passion for appearance-related dentistry plus the training to make this tooth look perfectly natural. I would not bond several teeth because it isn’t necessary, provided you have a properly skilled cosmetic dentist. The reason your endodontist is suggesting bonding several teeth is because your basic family dentist would not be able to get this tooth to match any other way. Furthermore, the problem with getting a dentist to bond several teeth is that if he or she doesn’t know how to color match teeth in this situation, they probably aren’t very good at bonding either and would want to crown several front teeth instead. But if you gave me your city, I could find you a dentist who could get the tooth to match – perfectly – with a very conservative restoration.

Good luck with moving forward.

Dr. Hall

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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.

Using restraints in treating difficult children

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In my practice, I very much enjoyed seeing children—even children who were difficult to treat. Part of the reason for that was that the pediatric dentist on my side of town was someone I felt was mean and who would put ugly stainless steel crowns on front teeth, so I didn’t want to refer to him. But a big part of it was because I enjoyed the challenge of trying to understand each child and how to get them through the care that they needed.

One issue in providing dental treatment to children is the use of physical restraints. Sometimes it is needed, and I want to address two aspects of that restraint.

The first aspect is the use of a mouth prop to keep their mouth open anytime I was drilling on their teeth. When I was in dental school doing my rotation in the pediatric dentistry clinic, before I took my turn as the operator I did a turn as an assistant. My fellow dental student was doing a small, routine filling on a baby tooth when our patient bit down unexpectedly, poking the drill through to the pulp of his tooth. We had to call the instructor over and upgrade the treatment to a pulpotomy (the baby-tooth equivalent of a root canal treatment) and stainless steel crown. My partner got a lecture about using a mouth prop and I vowed in that moment that this would never happen to one of my patients—I would always use some type of mouth restraint.

I ended up routinely using a Molt mouth gag on all my child patients when I was using a drill on a back tooth. I never, during dental school or my 20+ years of private practice, had an accident like my dental school partner.

a scissors-like device with rubber prongs on one end to hold the mouth open and a ratchet to hold the position

The Molt mouth gag

But there was a very small minority of child patients that we would run into maybe once every couple of years that would need even more restraint to treat them safely. In spite of all the psychology we could use on them, they would thrash around with their head, arms, and legs, making safe treatment impossible. When this would occur, I would excuse myself to the reception room and ask the parent for permission to physically restrain their child. They always gave permission, and we would proceed to wrap them in a papoose and complete the treatment.

a 6-year-old child wrapped tightly in a blanket and papoose board, restraining his arms, legs, and head

The Papoose Board

This technique has been criticized by some as being mean and traumatic to the child. That isn’t my experience at all. These were strong-willed children who refused to cooperate and were determined to make it impossible to fix their teeth; and without general anesthesia it would have been completely impossible to treat them. Once they fully realized that the treatment was going to go forward whether or not they chose to cooperate, they would completely calm down. I cannot remember an instance when that didn’t happen. Sometimes, having become physically worn out from their earlier resistance, they would actually fall asleep as the treatment proceeded.

Once treatment was done, we would unwrap them, congratulate them on finally settling down, give them their choice of toys from the prize box, and part friends.

– Dr. David Hall

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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.

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