Archives for August 2020

Should she stop her full-mouth reconstruction at half-mouth?

Posted on August 31, 2020 by AllSmiles.

In June 2019, I had all my lower teeth redone with crowns and veneers as part 1 of my full-mouth reconstruction. My cosmetic dentist recommended a full smile makeover because my teeth are worn from clenching and grinding, my molars were sensitive, and my bite collapsed.

So far, only my lower teeth are completed, and it’s been an emotional battle. I miss some of the imperfections from my old smile. My teeth are a little too white, and I have inflammation in my gums, which is unusual. My dentist suggested that I use baking soda and peroxide rinses for the inflammation.

My dentist is ready to finish the reconstruction, but I think that I want to stop. My bottom teeth are worn and dark, but I’m hesitant. I had Zoom whitening in the past, and my teeth are too worn to bleach them. They would be super sensitive. I’m not in pain anymore, and I am not sure that I want the perfect smile she envisions. – Thanks. Camille from TX

Camille,

Dr. Finley can’t give any definite answers without examining your teeth and dental records.

Your question seems to be if you should complete your full-mouth reconstruction. We aren’t in favor of half-mouth reconstruction.

Your original issue was excessive wear on your teeth. Your upper and lower teeth were likely worn. If that’s the case, your problem is only half solved.

On the other hand, crowns and veneers are an aggressive transformation. If you’re not convinced of the benefits, it might be best to suspend treatment until you’re sure that you want to complete it.

A masterful cosmetic dentist will include some of the imperfections in your smile that you loved. If you have an advanced cosmetic dentist and talk to her about your concerns, it won’t be an issue. Your dentist, along with a ceramist, can give you an imperfect smile and make it look natural.

Teeth Whitening

Your cosmetic dentist can anticipate and minimize sensitivity with Zoom.

You also mentioned discoloration in your teeth. Again, your dentist can determine if Zoom whitening will awaken sensitivity in your teeth. There are other options to whiten your teeth gently. But an advanced cosmetic knows how to minimize sensitivity with any teeth bleaching. If your dentist extensively uses Zoom, she can anticipate sensitivity in your teeth and minimize or avoid it.

Inflammation Around Dental Crowns

Inflammation around your crowns could be due to sensitivity or something else. Your dentist should try to identify the cause before continuing with treatment on your lower teeth. Porcelain onlays don’t meet the gumline, so the chances of inflammation are minimized.

A smile makeover is an emotional event. Many patients are hesitant about it, but it’s a positive life-changing experience when they see the results. Talk with your cosmetic dentist about your concerns and ask questions to calm your worries. If your smile isn’t exactly as you want it, doing a half-mouth reconstruction won’t be satisfying.

David Finley, DDS, an accredited fellow of cosmetic dentistry in Monroe, LA, sponsors this post.

My dentist is pressuring me to get Invisalign before crowns

Posted on August 18, 2020 by AllSmiles.

My dentist is pressuring me to get Invisalign before he places crowns. It almost feels like a threat – do Invisalign treatment or else. I’ve had these crowns for 18 years. They are old, worn, and yellow. I can see that most of my upper teeth are crooked and I have an overbite, but my budget doesn’t allow for braces, Invisalign, or any other orthodontics. But I do need crowns, and with my insurance, I can afford to get new ones. I’m not trying to get a perfect smile. Am I unreasonable? I feel like switching dentists, but that is so inconvenient, and until now, I’ve liked my dentist. Thanks. Jonah from TX

Jonah,

It is inconvenient to switch dentists, but it’s also uncomfortable when a dentist restricts treatment because they think you should have a perfect smile. Although a functional and beautiful smile is healthy and builds your confidence, we understand that patients have a budget. Pressuring you to get a treatment that you can’t afford doesn’t make sense. It creates stress.

Three veritical photos of a woman putting on and wearing Invisalign trays.

Find a cosmetic dentist who doesn’t insist on Invisalign before crowns

You have the right to get your crowns replaced without Invisalign or any orthodontic treatment. And if you have a cosmetic dentist, he or she should be willing to place quality crowns that function well and look great. If your dentist can confirm that your oral health will deteriorate without orthodontic treatment, you might consider braces in the future. And if you choose orthodontics, it doesn’t have to be Invisalign. Low-profile braces are more affordable.

If Your Dentist Refuses Treatment Without Invisalign

You can try to reason with your dentist. If he isn’t understanding and willing to work with your budget, find another dentist.

All-ceramic crowns on front teeth will look natural. In contrast, crowns with a metal foundation will eventually show through at your gumline and create a dark frame around your teeth. And the darkness at your gumline will detract from your smile. Find an advanced cosmetic dentist who is comfortable with all-ceramic crowns. Don’t pressure any dentist to place all-ceramic crowns; just ask what type of crowns the dentist recommends. If he or she recommends porcelain-fused-to-metal crowns, move along.

Advanced cosmetic dentists love doing all-ceramic crowns, so look for a dentist with post-graduate training in aesthetics. And ensure the dentist is willing to give you a natural-looking smile without insisting that you get Invisalign first.

David Finley, DDS, an accredited fellow of the American Academy of Cosmetic Dentistry, in Monroe, LA, sponsors this post.

Can a dentist treat my daughter’s fluorosis stains with veneers?

Posted on August 10, 2020 by AllSmiles.

My 10-year-old daughter has severe fluorosis stains on her teeth. Her upper center and side teeth are blotchy, and one side tooth is jagged. The bottom front and side teeth are her only permanent teeth so far, and they are quite yellow. My daughter sucked her thumb from ages 2 to 7. We want her to feel good about her smile, so she is wearing braces now to correct an open bite instead of waiting until she is a teenager and even more sensitive about her smile. Now I need to think about what we can do, if anything, for the fluorosis stains. I think porcelain veneers might be an option, but I’m not sure if they are good for children. Any recommendations? Thanks. Tisha

Tisha,

Cosmetic dentists conceal severe fluorosis stains with porcelain veneers. Although Dr. Finley would need to examine your daughter’s teeth to recommend a specific treatment, we’ll discuss some possibilities. If a child consumes too much fluoride while teeth are forming, fluorosis stains develop. But this is not the type of work that pediatric dentists do. Neither are family or general dentists qualified. Look for an advanced cosmetic dentist with extensive training and artistic talent. Otherwise, you and your daughter will still be unhappy with her smile.

Although natural drinking water usually has some fluoride, some natural sources don’t have enough fluoride. Lack of fluoride leaves teeth susceptible to decay.

What causes fluorosis stains?

Several factors can cause fluorosis stains, including certain types of water, supplements, and some kinds of toothpaste.

If community water contains too much fluoride, drinking the water for extended periods causes fluorosis stains in teeth.
Untreated well water can also cause fluorosis stains.
Consuming too many fluoride supplements or swallowing too much fluoride toothpaste causes stains.

Types of Fluorosis Stains and Treatment

Depending on how much excess fluoride a child consumes while teeth are developing, teeth can have mild or extensive stains or some discoloration.

Mild

Mild fluorosis creates white or, in severe cases, brown spots on teeth. Often, a dentist can use direct bonding to conceal the spots.

Extensive

If fluorosis stains extensively cover teeth, a cosmetic dentist will use porcelain veneers to conceal the stains. A skilled cosmetic dentist will design veneers that mimic the natural color, shade, and translucency of teeth.

Discoloration

If teeth stains are even and yellow—not blotchy—they might not be fluorosis stains. But a cosmetic dentist can determine the cause of the stains. He or she might try bleaching the teeth before recommending dental bonding or porcelain veneers.

Concealing fluorosis stains is beyond the technical and artistic ability of a family or general dentist. Find a dentist with advanced training in aesthetics.

Orthodontic Treatment and Fluorosis Stains

Can you treat fluorosis while wearing braces? Wait until your daughter completes orthodontic treatment. A cosmetic dentist will want to see how the teeth have erupted. It may be best to use dental bonding or another treatment before porcelain veneers.

Although there is no minimum age for porcelain veneers, teeth bleaching, or dental bonding, an experienced cosmetic dentist must determine which treatment is best depending on tooth eruption and development. A cosmetic dentist who treats children will also consider how your daughter feels about the stains and which treatment will achieve results that make her confident about her smile.

David Finley, DDS, an accredited fellow of cosmetic dentistry in Monroe, LA, sponsors this post.

Does a leaky filling need to be replaced urgently?

Posted on August 4, 2020 by AllSmiles.

Last week I visited a new dentist who said I have a “leaky filling,” and I have some questions about what he recommends. Two of my back molars have composite fillings in them. The dentist says the fillings are leaky and might fail. He recommends removing the fillings and replacing them with newer composite. He can remove a section of one filling and replace it with a new composite, but he says it’s best to replace both fillings to correct the seals. Although I didn’t reschedule the appointment, the dentist said that I should let him complete the work ASAP. Since this is a new dentist, I’m not sure what to do. Is this situation urgent? Thanks. Nichole from Arkansas

Nichole,

Thanks for your question. Leaky fillings require attention, but we’ll provide some background on the fillings and when it’s urgent to replace them.

What Is a Leaky Filling?

A leaky filling is a filling that doesn’t fit snugly against your tooth on all sides. The technical term for it is microleakage. Any gaps between the filling and your tooth allow saliva, bacteria, and food particles to enter. Bacteria can breed beneath the filling and promote decay (recurrent decay) that irritates your tooth, makes it sensitive to heat or cold, and causes pain. A leaky filling can lead to inflammation and infection.

Advantages of Composite Fillings

Composite fillings are tooth colored and make it easier to notice decay around them. Decay beneath amalgam fillings is often unseen until it grows and is advanced. Many dentists who replace amalgam fillings with composite find decay beneath them. But decay beneath composite is usually detected before it advances.

Is Replacing a Leaky Filling Urgent?

Photo of African American woman with dental pain who is holding both hands over her mouth; for informatoin on treatment options from Bayou Dental Group in Monroe, LA.

If your leaky filling hurts or is irritated, don’t delay getting it replaced

Whether or not replacing a leaky filling requires urgent treatment depends on the filling material in the tooth. If the filling is an amalgam, it’s challenging to tell if tooth decay exists and how much of it exists. Decay begins deep within the tooth, so an infection can occur if you delay getting it treated. It’s easier to tell if there is decay beneath composite. Your dentist says that there is a risk of decay beneath your leaky fillings, so your dentist didn’t detect decay.

As your dentist mentioned, if a filling is leaky, he can get a better seal by replacing all of it. If part of an old filling is left, it might eventually start leaking in another area.

David Finley, DDS of Bayou Dental Group in Monroe, LA, sponsors this post.

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