Archives for August 2024

Dentist Can’t Match My Implant Crown

Posted on August 22, 2024 by writeradmin.

I am a bit frustrated and need some advice. I got a dental implant for the tooth next to my front one. The dental implant itself seems to be fine. However, the implant crown just doesn’t look right. I’ve asked him to send it back twice but he says I’m being too picky and that the problem is my teeth are “between shades.” I’m having a hard time agreeing with that because the dental flipper I had before the crown matched better than this. Is there any way to get it at least like the flipper or am I being too picky?

Stacey

Dear Stacey,

Diagram of a dental implant

I am glad you wrote. I can assure you that you are not being picky. This is especially true if you were satisfied with the dental flipper. It’s not that your teeth are between shades. It’s that the color of your teeth is between two colors on the standard shade guide. That doesn’t mean that you can’t get a crown for your dental implant that will actually match the adjacent teeth. However, it does not sound like this dentist has the skills to do it.

A color map for a tooth Matching a tooth that is very exposed when you smile is not just as easy as grabbing a shade from the shade guide. This works when you’re just talking about a back tooth that doesn’t have to match completely. For front teeth, which are exposed to much more light, the shade guides are only the starting point. You need some tints to mimic the variations that you get with a natural tooth. To get that, your dentist will create a color map like the one pictured here.

There is a significantly good chance that your dentist does not have the knowledge or skills to make one of these for you. I think if he is unwilling to keep trying that you should ask for a refund on the porcelain crown portion. Your dental implant is likely fine so you will not need a refund for that portion.

Don’t be surprised if it takes even an expert cosmetic dentist a few try ins, though. They’ll want to get it right. If they know what they’re doing, they will use a temporary try in paste to make sure it matches perfectly. Only when it does will they use a permanent bonding.

This blog is brought to you by Kalamazoo Cosmetic Dentist Dr. Susan Dennis.

Did I Harm My Baby By Getting Porcelain Veneers?

Posted on August 17, 2024 by writeradmin.

I did not know I was pregnant when I got porcelain veneers. It was in the first trimester of my pregnancy and I’ve heard that is the most dangerous time. Did I cause harm to my baby?

Selena

Dear Selena,

First, congratulations! How exciting that you are having a baby. I’m glad you wrote. The porcelain veneers procedure you had will not have harmed your baby. It is true that we do not recommend dental work in the first trimester. This is because during that time period, the baby is the most vulnerable to foreign substances. But, here is the good news.

The only foreign substance generally used in the porcelain veneers procedure is a local anesthetic. The most commonly used of these is Lidocaine. This is one of the few medications that has been proven safe to use in pregnancy. In fact, it is even used during labor and delivery.

One thing you don’t want to do when you are pregnant is to avoid the dentist. Keeping your oral health up is the best thing you can do for your baby. I’d plan ahead and schedule your regular cleaning. The best time for that is the second trimester. You don’t have the worries of the first trimester and you will be much more comfortable in the dental chair than you will be in the second trimester. This way you can avoid any dental emergencies.

Though, if you do end up with a tooth infection or something similar, please do get it dealt with no matter what trimester you are in. You don’t want to pass any bad bacteria on to your baby from an untreated tooth infection.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Sedation and a Smile Makeover Disaster

Posted on August 16, 2024 by writeradmin.

I am at my wits end. About three years ago I went in to get porcelain veneers. Since then it has been nothing but a disaster. It seems like every few days they keep falling off. When I went in the dentist assured me that they wouldn’t take much tooth structure off. but when they fall off what is left of my teeth looks like tiny little nubs. The dentist always puts them back on but I live in a constant state of fear that another one will fall off. Plus, every time she has to put them back on she gives me an Ativan which knocks me out for the whole day. I never get to see what anything looks like until I wake up. Is it normal for the porcelain veneers to be popping off so much?

Annette

Dear Annette,

I am sorry that this happened to you. You, indeed, have what I would consider a cosmetic dentistry horror story. It sounds to me that what your dentist provided for you was not porcelain veneers, but porcelain crowns. I’ve posted an image above that compares the tooth preparation of a dental crown with a porcelain veneer. As you can see, the veneers only remove a few millimeters of tooth surface from the front of the tooth. However, for porcelain crowns, a great deal of structure is removed around the entire tooth.

Often, dentists who do not have a great deal of cosmetic dentistry experience, will point their patients toward crowns instead of veneers in order to save themselves the embarrassment of admitting that they do not know how to do the procedure. While not in the best interest of the patient, that is a bit better than what your dentist has done. Your dentist gave you crowns and told you they were veneers.

What confounds me is how your dentist is not able to even keep those in. Dental crowns are one of the first big procedures dentists are taught in dental school and no one should have graduated without being able to successfully place one. It sounds possible that he over prepared the contour of the area and that is causing them to fall off.

A third thing that bothers me here is the dental sedation. It is not typically used for cosmetic work because we want the patient to be able to look at and approve the work before it is permanently bonded on. Even if you were to have dental anxiety and need some sedation, I would lean toward a nitrous oxide, which gets you back to normal quickly. Then, even if you needed something stronger, like oral conscious sedation, Ativan is a bad choice. It has a serum half-life of 24 hours. I think you’d find most sedation dentists use something that has a half-life of three hours, so you are not useless for a full day afterward.

I think, because you were misled about what you were getting for your smile makeover AND the work is so poorly done it won’t even stay in your mouth, that your dentist should pay to have this fixed by a dentist of your choosing. Just make certain you choose an expert cosmetic dentist this time.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Brown Spots On Teeth

Posted on August 6, 2024 by writeradmin.

I have had some brown discoloration on my teeth ever since my adult teeth came in. They’ve been an embarrassment my entire life. I’ve recently graduated from college and need to improve my smile if I am going to get a good job. My dentist and I have experimented with a ton of those over-the-counter boxes and kits for whitening. The problem we have run into is they don’t whiten the brown spots, just the already white part. She’s now considering two options. First, I could go to another dentist who does teeth whitening and see if professional strength teeth whitening will have more effect on my spots. Second, she could try grinding down the brown parts to get rid of them. She isn’t sure how much she’d have to ground down, so this has me a bit worried. What is the better option for me? I feel stuck with choosing.

Alana

Dear Alana,

Tooth bleaching trays

Though there is a solution for your teeth, I am going to tell you upfront that neither of the options your dentist has suggested will work. I can tell your dentist cares about you and is honest because one of the first options she suggested is that you can get a treatment that she didn’t even offer. This tells me she would rather someone else make the money if it gets you the help you need. That being said, she is in over her head.

Like you experienced with the over-the-counter teeth whitening, professional teeth whitening will not take care of the brown spots. While it will whiten your teeth more efficiently and safely than the stuff you purchase at a store, it whitens your teeth evenly. This means that the brown spots will end up looking more noticeable.

As for her second suggestion, please do not allow her to grind down your teeth. Your issue requires an understanding of advanced cosmetic dental issues. She doesn’t understand teeth whitening, which is the most basic of all the procedures.

The Solution for Browns Spots

There are two good options for you. The first is to have dental bonding done on the tooth. This is where a cosmetic dentist covers the brown spots with a white composite, similar to a dental filling. These will need to be replaced every few years and are not as stain resistant as the second option.

Another procedure is porcelain veneers. With this procedure, cosmetic dentists will use tiny wafers of porcelain that will cover the entire front of your teeth. When well taken care of, they can last a lifetime. Plus, porcelain is very stain resistant; even more stain resistant than your natural teeth.

The caveat is that both of these procedures are very advanced cosmetic procedures, which would require a dentist who has invested in post-doctoral training and knows how to do them well.

This blog is brought to you by Kalamazoo Cosmetic Dentist Dr. Susan Dennis.