Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

May 16, 2016

She says she’s too young for partial dentures

Filed under: Extractions — Tags: , , , , — mesasmiles @ 2:52 pm

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Hi Dr. Hall,
I’ve had teeth problems my whole life. I have chipped missing and discolored teeth. It seems like no one wants to help me fix them. The only thing the dentist wants to do is partial dentures. I guess I could do that but I would really like something more permanent in the front. I’ve tried to talk to him about it and he doesn’t say anything. Finally he said the way your teeth are we can’t do anything else but take out the bad teeth and do partials. I thought with all the stuff dentists had they could fix anything. My question is if you have really bad teeth can they still get fixed? Plus why do dentists suggest partials instead of fixing your teeth? By the way I’m 35 feel like I’m to young for full partials.
– Theresa from New York

Theresa,
Dentists vary a lot in their interest in saving teeth. In my practice, I was passionate about that and rescued a number of teeth that other dentists said were hopeless teeth. Almost every tooth that has tooth decay or is broken can be fixed, but there are many dentists who don’t want to go to the trouble of saving them. And for missing teeth, if you’re willing to pay for dental implants, that is by far a better way to treat missing teeth than removable partials.

Also, when you have a mixture of missing teeth, chipped teeth, and discolored teeth, as you have explained, there are usually a number of different ways to fix them. But some of those ways require newer technologies such as dental implants or dental bonding and some dentists aren’t comfortable doing those.

You can be grateful, at least, that your dentist isn’t willing to go out of his comfort zone. Some dentists will do that, to please the patient or to avoid losing the patient, sometimes with disastrous results.

Just get a second opinion. Look for a dentist with a similar philosophy to yours. Again, don’t try to push any dentist out of his or her comfort zone. Listen to what they recommend, gently prod to see if they are giving you all the options, ask what they recommend, and then decide if that’s what you want to do. If you do want to save the teeth, you want a dentist who enjoys doing that, because they will have a passion and practice in doing that successfully. And for a dentist who is good at placing dental implants, that is the thing they will certainly prefer doing for you and will likely be the first thing they recommend.

Good luck,
Dr. Hall

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About David A. Hall

Dr. David 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 complete Internet marketing for dentists.

June 7, 2012

Why do these dentists just want to pull teeth?

Filed under: Fractured teeth — Tags: , , , — mesasmiles @ 5:38 pm

Dr. Hall,
I’ve been to two different dentists lately because one of my front teeth, that had previously been bonded, broke almost completely off. Both dentists wanted to pull most of my front teeth and get a PARTIAL! I am a single 35 year old woman and the thought of having removable teeth horrifies me! Please help! Money is not a concern. What can I say to get it through a dentists head that I DO NOT want my teeth pulled?? My teeth do not hurt in anyway, even the one that chipped off doesn’t hurt.
– Donna from Kentucky

Donna,
Don’t try to convince either of these dentists to save your teeth. That would be a mistake, even if you could convince them to try. Dentists vary greatly in their commitment to saving teeth. If a dentist doesn’t believe in saving teeth, there is a reason for it. Often it’s that he or she just doesn’t want to bother. It’s riskier to try to save teeth – you might not be successful. And pulling teeth and replacing them with a partial denture is much easier. Or it could be that the dentist doesn’t have very good skills for saving teeth, so I wouldn’t try to push them at all in this.

I wonder, when I get a question like yours, if the situation isn’t that the teeth are truly hopeless. But I’m inclined to believe, in your case, that is not the case, for two reasons. First, you seem very committed to saving your teeth, so I can’t believe that you’ve been neglectful. And you mention that money is not a concern. And then both dentists are recommending removable partial dentures, which is a really low-class way to fix your mouth, even if the teeth were hopeless. So that suggests to me that these dentists are both looking for easy solutions. Why no mention of dental implants, which is a far superior way to replace missing teeth?

Have you checked with Dr. —? [the mynewsmile.com recommended dentist closest to where Donna lives] That’s where I would recommend going. [He] believes in first class solutions. From what I know of [him], I think that [he] would try to do whatever [he] could to save them. To save yourself some money and some time, I would call the office and be very up front about what you want – you want a dentist who believes in saving teeth. And if they tell you over the phone that [this dentist] is strongly committed to saving teeth, tell them that Dr. David Hall recommended [him] and said he thought [he] would agree to a quick complimentary meeting where you could ask [him] about that, face-to-face. If you like what you hear, you could then schedule the exam.

Your case doesn’t sound simple. This front tooth, if it had been bonded, must have broken before. And now if it has broken almost completely off, that may mean that you have a very strong bite, which would require extra expertise to get your teeth fixed so that they will withstand those biting pressures. You really need to get away from dentists with this small-town-dentistry mentality and into a higher level of care. And by small-town-dentistry mentality, I don’t mean to imply that dentists from small towns aren’t good dentists. I have a great affection for small towns and some small-town dentists are among the best in the country. I refer to a mentality of doing patchwork dentistry, or low-tech dentistry, or avoiding difficult things.

– Dr. Hall

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About David A. Hall

Dr. David 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 complete Internet marketing for dentists.

February 20, 2012

Does this tooth really have to be extracted?

Filed under: Extractions — Tags: , , , , — mesasmiles @ 4:49 pm

I had a crown when I was younger that fell off and left half of my tooth there, my dentist tells me I now have a tooth infection under it. There is a little white bubble under my tooth – he didn’t say what the name of the infection is but I’m kinda worried about it. My dentist says he just has to take out my tooth but from what it says on your website he’d have to do a root canal right?
– Maggie from Rhode Island

Maggy,
I think it would be worth it to seek a second opinion about this extraction and see if the tooth can’t be saved. Some dentists, unfortunately, are all too eager to extract teeth when it isn’t necessary.

It could be that your dentist is right, that the tooth has to be extracted. But your dentist should have explained why the tooth can’t be saved and why a root canal treatment and a crown wouldn’t work. If he didn’t, ask another dentist.

It could be that the tooth has decayed so much and there is so little left that there is no way to restore it. It could also be that with the crown of the tooth being missing for so long, the teeth on either side have drifted together so that there isn’t space enough to restore the tooth. But if your dentist didn’t explain this to you, I would get a second opinion to ask another dentist if he or she thinks the tooth can be restored.

Your question reminds me of a man who was president of the American Dental Association in the 1980s who was kind of a crusader for saving teeth, Dr. Burt Press. He often said that too many dentists are too eager to take teeth out. He had a funny way of putting it. When we were in dental school, we were given statistics about how many teeth are lost because of gum disease versus how many are lost because of tooth decay. He said he questioned those numbers. “You know why so many teeth are lost?” he asked. “Because dentists take them out.” But rescuing teeth is hard work, and sometimes you fail. Some dentists like to try to save them, because it’s a noble feeling to save a tooth. But some dentists don’t have that attitude and just take them out.

So my advice is to get a second opinion.

Dr. Hall

We thank our advertisers who help fund this site.

About David A. Hall

Dr. David 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 complete Internet marketing for dentists.

August 11, 2011

I brush and floss every day but still need root canals. What can I do?

Filed under: Root canals — Tags: , , , , , , — mesasmiles @ 7:40 pm

Dear Dr. Hall,
I am 27 years old in the middle of two root canals. The first one was a tooth whose white filling had begun to fail. The second was a crown placed a year and half ago that started to become sensitive to temperature and could not be used to chew with. I have become very worried about the health of my teeth. I have quite a few old (ten years or more) silver filings in the back of my mouth. These two root canals had fillings that were very close to the root of the tooth. I am also a stress grinder which has led to the cracking of at least two teeth. It seems like all my teeth hurt at this moment. Especially the canine on the side of my first root canal treatment. What can I do about the future of my teeth? I don’t want a bridge or implant so young. I brush and floss everyday, sometimes three times a day.
– Janie from New Hampshire

Janie,
I can relate to your experiences. In my late forties, I got my first toothache. It surprised me, because as a dentist, I have taken very good care of my teeth and have sought out the best care I could get from the best dentists. While I had a fair amount of decay in my young adult years, I hadn’t had dental problems for quite some time. The toothache came because I got little cracks in my teeth from the old fillings. Over the next ten years I ended up needing root canal treatments in most of my molars, and all of my molars now have crowns on them.

Still, I don’t have any serious worries about losing my teeth or needing bridgework or implants. Root canal treatments, once they are successful, last for a lifetime. And if crowns are done well and are well cared for, they will last 20, 30, maybe 40 years.

Your problems are not the usual but are not uncommon either. After a tooth has been worked on several times, it is easy for it to develop sensitivity. And grinding your teeth puts a lot of stress on them.

My advice is to be sure you get good dental care. Don’t look for cheap care. Cheap care ends up being very expensive in the long run. Look for a quality dentist who is trustworthy and stays abreast of the latest techniques. Then, if you trust this dentist, stay regular with your checkups and do what the dentist recommends. Follow through with your home care. And to keep tooth decay down, avoid frequent snacking. Most people, and even some dentists, don’t realize how much damage frequent snacking during the day does to your teeth.

For your grinding (dentists call it bruxism), a nightguard can do wonders to provide considerable protection to your teeth.

Dr. Hall

We thank our advertisers who help fund this site.

About David A. Hall

Dr. David 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 complete Internet marketing for dentists.

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