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Fixing Tetracycline stains

I’m feeling a bit desperate here. I’ve had tetracycline stains for as long as I can remember. They’ve always embarrassed me, but for some reason now that I’m older, they seem to embarrass me even more. Like maybe I should have fixed this years ago but haven’t bothered. I finally dragged myself to my dentist about it and he wants to crown every tooth. These tooth are all healthy. I’ve never had a cavity in my entire life. I don’t like the idea of grinding them all down. Is there an alternative?

Beth

Dear Beth,

A tetracycline case done by Dr. Mike Malone

Tetracycline stains are among the most challenging cases a dentist can face. Here’s the crux of the problem. These stains are so dark your dentist has to manage to get the coverage opaque enough to cover them, but translucent enough to look natural and beautiful.

Some dentists try to make up for this challenge by doing dental crowns instead. There are two major problems with this. One is that you’re grinding down healthy tooth structure. The second is that crowns don’t guarantee the darkness will be covered. Then you’re stuck with crowns the rest of your life.

Instead, you want the dentist who’s invested the time in training to develop the skills needed to do this the right way with porcelain veneers.

Finding the Right Porcelain Veneers Dentist

It takes a combination of expertise in color theory and manipulation along with detailed knowledge of the properties in a large variety of porcelains. Only about the top 1-2% of dentists in the country are able to do this with good results.

If you want to get the best results possible, you’ll want an accredited dentist with the American Academy of Cosmetic Dentistry. AACD accredited dentists have been extensively screened for both technical skill and artistry.

They’ve passed stringent oral and written exams as well as provided visual evidence of the artistry they’ve accomplished on a large number of required cases.

Anyone of them can give you the stunning smile you want, even with tetracycline stains. Though, it may require driving to another city for the procedure depending on where you live.

This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone.

“Reputable Dentist” Destroyed My Smile

I had an accident which caused me to need a crown on a front tooth. I was nervous about this because it’s my front tooth. Everyone will see it. I looked up many dentists in my community to see who was highly reputable. I found one which everyone seemed to love. The first crown he did wasn’t even close to matching the other front tooth. Even he said he needed to do it again. The second one was closer, but I wasn’t thrilled with it. He was and was going to place it anyway. Fortunately for me it didn’t fit. He went back for a third run and when that one didn’t fit he told me I’d need orthodontics. I gave up at this point even though I have a horrible temporary crown which doesn’t fit right. I need help but I don’t know what to do. Help me please.

Tanya

Dear Tanya,

close up of teeth

These stories make me both sad and frustrated with the dental industry sometimes. First, you should know that a reputable dentist and an excellent cosmetic dentist can be two very different things. There are two different mindsets at play here. In dental school, we’re taught that the dentist knows best. Cosmetic dentists have a different mindset. They feel unless the patient is satisfied (in fact, more than satisfied), they haven’t properly done their job.

Dentists who haven’t done extensive training in cosmetic work see this as pandering to the patient.

All that being said, matching a dental crown to a single front tooth is a very challenging thing even for the best cosmetic dentists. In fact, if your smile is important to you (and it sounds like it is) you will want a dentist with both technical expertise and artistry.

Believe it or not, one of the teeth in the picture above is a dental crown. I bet you can’t tell which one. That’s the type of results a true cosmetic dentist gets.

Finding an Expert Cosmetic Dentist

The easiest way to find a top of the line cosmetic dentist is to go to aacd.com. This is the website for the American Academy of Cosmetic Dentistry. They have a find a dentist link. However, you don’t just want someone who is a member. Any dentist can become a member. You want to find a dentist who is accredited.

In their search options, there is a box to check that you’re looking for an accredited dentist. These dentists have passed stringent oral and written exams as well as demonstrated their artistry in a large number of cases they’ve done.

Anyone of them are more than capable of matching your front tooth with a perfect physical and aesthetic fit.

This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone.

Invisalign Myths Debunked

Ever since Invisalign made its debut in the 1990s, they’ve been in high demand. As with most new or popular things, there are always some myths which pop up about them. Before we debunk the myths, let me tell you what Invisalign can do for you.

Invisalign aligner

What’s True About Invisalign

  • Invisalign can straighten your teeth without anyone knowing, in half the time of traditional glasses.
  • Their aligners can double as teeth whitening trays allowing you to do two procedures simultaneously.
  • They have a very high patient satisfaction rate.

Myth #1: Invisalign is Only for Teenagers

While teenagers certainly do enjoy using Invisalign, the procedure was actually developed for adults. They have professional lives and can’t necessarily work with a mouth full of metal. Having an invisible orthodontic option is a huge help.

It’s only after it became so popular that more and more parents requested it for their teenagers and Invisalign Teen was developed.

Myth #2: Braces are More Effective than Invisalign

While it used to be that Invisalign could only handle certain candidates, that has changed. Now it can handle even difficult orthodontic cases.

Myth #3: You Can’t Eat What You Want with Invisalign

Similar to the first myth, this one is completely backward. With traditional braces, you’re limited in what you can eat. Many things get caught in the metal wires and brackets in traditional braces.

Fortunately, Invisalign is different. Because the aligners are removable, you can actually eat absolutely anything you want. The important thing is you brush your teeth after you are done and place the aligners back on immediately after cleaning your teeth.

Myth #4: You Get More Cavities with Invisalign

It’s possible you can get more cavities with Invisalign, but that’s up to you. If you take care of your teeth, you’ll be fine. That means to observe the following:

  • Brush after each meal before putting your aligners back on.
  • Don’t drink sugary or alcoholic drinks with your aligners in. You can still drink them, just make sure you do it when your aligners are off.

This blog is brought to you by Lafayette Dentist Dr. Mike Malone.

Peroxide on Porcelain Veneers

If I used a DIY mouthwash which included peroxide, would it damage my porcelain veneers? It’s important to me they’re well cared for (as well as the rest of my mouth). If I can’t use that, what can I use?

Tamara

Dear Tamara,

A single porcelain veneer being placed on a tooth

It’s great that you want to take care of your oral health as well as your porcelain veneers. With great care, they can last a lifetime. To answer your question, a mouthwash which contains peroxide won’t harm your porcelain veneers. However, depending on the frequency of use, it could harm you.

The occasional use of hydrogen peroxide will be beneficial. Regular use, say for a week or two, will lead to an imbalance of the microorganisms in your mouth. When that happens, you’ll develop a painful oral yeast infection. So, if you do want to do it, don’t do it too many times close together. Spread it out quite a bit.

Taking Care of Porcelain Veneers

If using a mouthwash is important to you, there is one particular ingredient in a mouthwash you’ll want to avoid. Don’t use anything that contains alcohol. The reason for that is it will eat away at the bonding on your porcelain veneers. This will lead to them falling off.

There are plenty of mouthwashes on the market which will be safe to use. Just check their ingredients list for alcohol and you’re good to go.

The most important thing you can do is have regular oral hygiene at home and keep up with your dental checkups to keep your teeth and gums healthy.

I usually recommend cosmetic patients use Supersmile Toothpaste. It’s specifically formulated to clean cosmetic dental work.

One other thing to be careful of has nothing to do with you. When you go in for your regular appointments, make sure your hygienist doesn’t use anything like a prophy jet during your cleanings. This will take the glazing off your porcelain veneers.

When this happens, you lose the protection for your veneers and they will start picking up stains very quickly. Bleaching them will be completely ineffective because teeth whitening only works on natural tooth structure.

This blog is brought to you by Louisiana Cosmetic Dentist Dr. Mike Malone.

Does Cosmetic Work “Grow on You”?

I’m trying to make a big decision. I paid a fortune to get porcelain veneers. These were supposed to be my dream smile. My dentist and I went over exactly what I wanted and he seemed to think it would be wonderful. When they came in, they looked fake. He wanted to bond them on but I could tell by how they looked when he showed them to me I wasn’t going to like them. I asked for a try-in. I’d read about those. He allowed me to do that and it confirmed my fears. They looked fake, bulky and chalky white. I told him I didn’t like them. He said that’s a common reaction because patients aren’t used to how they look with the new “teeth”. He said they’ll grow on me and I’ll come to love them. I told him I need to think about it. I’m just not sure I want a smile that has to grow on me. I was expecting one I’d love. Be honest with me. Am I overreacting? Will it grow on me?

Maggie

Dear Maggie,

Woman covering her mouth with hand.
A smile makeover from a great cosmetic dentist will make you want to share your smile—not hide it.

You are certainly NOT overreacting. In fact, you’re being pretty understanding given the circumstances. You were also wise to have asked for a temporary try-in of your porcelain veneers. If he’d have bonded them on, it would have been permanent.

My first thought is your dentist isn’t a true cosmetic dentist. There are a few things which draw me to this conclusion. First, when he said, “that’s a common reaction”, I was glad I wasn’t drinking anything because I would have spit it out. Maybe with his patients that is a common reaction, but it’s certainly not so for artistic cosmetic dentists. Most of the time their patients are absolutely thrilled with the results.

That leads me to the second reason. When a skilled cosmetic dentist does have a patient that isn’t thrilled, they certainly wouldn’t tell them they would “get used to it”. They go back to the drawing board. They wouldn’t stop until the patient was absolutely in love with their new smile.

The third reason is he didn’t suggest trying them in first. YOU had to suggest that. I would give him a couple of choices. First, he could give you a refund and let you have your smile makeover done by a more skilled cosmetic dentist or he can re-do the case until you are satisfied with the results.

Finding an Expert Cosmetic Dentist

Let’s say you decide you want to go to a different cosmetic dentist. How do you go about finding the right dentist who can actually design the smile of your dreams?

The easiest way is to do that is to use the search link on the American Academy of Cosmetic Dentistry’s website (aacd.com). When you use their search tool, make sure you check that you’re looking for an accredited dentist.

These are the ones who proven both their technical knowledge and artistic ability.

I hope this helps.
This blog is brought to you by Louisiana Dentist Dr. Mike Malone.

Dentist Said No to CEREC Crowns

My dentist has a CEREC machine. We’ve used it for a crown before, but on a tooth on my bottom arch. Now I need one on my top front tooth and he’s saying “No”. He said they don’t look good on front teeth. I truly liked the convenience. Plus, he wants to crown both front teeth to make them match. Is this legitimate?

Anna

Dear Anna,

Block of porcelain for CEREC crowns

You should be aware that only the top cosmetic dentists in the world can match a single crown to a front tooth. That is even more challenging when it comes to using CEREC. If convenience is what you’re after, go with the two crowns and traditional crowns. I’ll explain why in a moment. If you want gorgeous front teeth with just one crown, you’ll need to find an expert cosmetic dentist.

Matching a Single Crown to a Front Tooth

Your front teeth are right next to each other and much more exposed to the light. Even the slightest deviations will be very noticeable. It will be quite obvious your teeth won’t match.

With even the best dentists, it will take a few try-ins before it matches perfectly. That could go faster with CEREC crowns because it’s milled right there and not sent to a lab. It will still likely take more than one try. This method will take even more skill.

With a CEREC crown, that’s even harder because they are milled from a single block of porcelain. Traditional porcelain crowns use several blocks with variations in opacity. Your dentist would have to be very versed in color theory skills which are not taught in dental school. It’s obvious your dentist doesn’t have that training.

It’s actually showing his integrity that he’s being honest with you. He could have bluffed his way through and given sad looking results.

Finding the Cosmetic Dentist Who Can Do Gorgeous CEREC Crowns

Truthfully, because of the difficulty of this type of case, to get a beautiful, natural looking result which will match your other front tooth, you’ll need to go to a dentist accredited with the American Academy of Cosmetic Dentistry.

AACD accredited dentists have gone through stringent oral and written exams as well as proven their artistry with a large number of cases they’ve done and provided evidence for. All of them have gone through extensive training in advanced cosmetic procedures after graduating dental school.

What it boils down to in this particular case is what’s more important to you— a convenient, fast result, or a natural looking attractive result.

It is definitely your smile and your choice. Don’t feel pressured to go a way you don’t want.

This blog is brought to you by Lafayette Dentist Dr. Mike Malone.

Dentist Broke Tooth “Fixing a Porcelain Veneer”

I had several porcelain veneers done and they ended up looking awful. I never got to see them before he bonded them on so had no idea how bad they were until I got home. He agreed he’d redo them after I called him and told him how miserable I was about how they looked. Unfortunately, when he tried to remove the first one, he broke the tooth. It broke so completely he ended up having to extract it and now I’m having to get a dental implant. I have a flipper for now because I told him not to remove the others until I have a chance to get a second opinion on what’s going on. I know he’s the professional, but I feel like he can’t be trusted. What’s going on?

Jennifer

Dear Jennifer,

A single porcelain veneer being placed on a tooth

I have to tell you this is gross incompetence on the part of your dentist. If I am truly understanding what you’re saying here, it sounds like your dentist tried to “pop” or pry off the veneers from your teeth. That is absolutely NOT how this is done.

Instead, porcelain veneers will be gently ground off, sort of how the dentist prepared your teeth the receive the veneers to begin with. If he broke your tooth so badly it couldn’t be saved, I wouldn’t let him anywhere near the rest of your teeth. He doesn’t have a clue about cosmetic dentistry.

1. He didn’t let you see them with a try-in paste before permanently bonding them on.
2. He didn’t make them to your standards.
3, He didn’t know how to remove them.

You’re going to need an expert cosmetic dentist. I’ll tell you how to find one of those in a moment, but first I want to make sure you don’t get stuck with this bill. You’re going to have to be pretty tough and tell your dentist you won’t sue him if he pays for the repairs with the cosmetic and implant dentist of your choice. If he’s wise, he’ll do it.

Finding an Expert Cosmetic Dentist

The problem many patients run into is the skills necessary to go stunning cosmetic dentistry requires significantly more training than they received in general dental school. It takes significant post-doctoral training to know what you’re doing.

You want a dentist who’s invested that time in the additional studies as well having an artistic eye. To find that type of dentist you can look at two resournces, The first of those is the American Academy of Cosmetic Dentistry website. Once there, you can list a location were you’d like to be treated. The key here, though, is checking you want an accredited cosmetic dentist. These are among the best dentists in the world.

They can give you a stunning smile. However, because it takes many years to reach accreditation, there aren’t many of them around the country.

There is another list. This one is called nynewsmile.com. Like the aacd.com website, they have a link to find a cosmetic dentist. You’ll input your zip code along with how far you’re willing to travel and they’ll give you a list of incredible cosmetic dentists. Many of them are close to being accredited if they’re not accredited already.

Have one of these dentists re-do your smile makeover as well as plan your dental implant. You shouldn’t have anything to worry about with one of them. In fact, most of them have a beautiful smile guarantee.

This blog is brought to you by Lafayette Dentist Dr. Mike Malone.

Help! Which Crown Should I Get?

I need to get a dental crown on a tooth. My dentist threw all these options at me. While he did explain everything, it was all so fast I can’t remember. I told him I’d let him know this week. I tried to do some research but everything is so confusing. Help!

Lacey

Dear Lacey,

CEREC Crown being placed on a tooth

Sometimes dentists think you can understand everything in 5 minutes that they studied all the way through dental school. Sounds easy, right?

It’s good that you’re doing some research. It’s important to go into these type of decisions informed. One thing to be aware of is that you should always feel free to tell your dentist to slow down and to repeat himself if necessary. You should never feel rushed.

To help, I’ll go over the three most common types of dental crowns.

Three Most Common Dental Crowns

The first has been in place for many years and it’s been a staple in the dental diet. These are conventional crowns, also known as porcelain-fused-to-metal crowns. As their name implies, these have porcelain on top and a metal base underneath. These are best used for back teeth because of the amount of biting force we use with our back teeth. If you have a metal allergy, there are metal-free options.

The second type is all-porcelain crowns. These have porcelain all the way through, even as it’s underside. These are especially useful for front teeth because they look more natural than their metal-based counterparts. With front teeth, there is a completely different biting force and these can withstand the pressure.

Thirdly, there are CEREC crowns. These are also all-porcelain. The biggest differences are they are milled by machine using a single block of porcelain. As a result, they’re able to be done in just one appointment. Be aware, unless you have a highly skilled cosmetic dentist, these won’t have the same subtleties that the non-machine milled crowns will have which are made from several different blocks that have different shades.

There’s really not a horrible choice, though I never recommend metal-based crowns on front teeth. You won’t like the results. I hope this helps.

This blog is brought to you by Lafayette Dentist, Dr. Mike Malone.

Invisalign and Bad Breath

I need some help for my mom. She has always had teeth which embarrassed her. She was so excited to get Invisalign. She is very diligent to keep them in and I know she’s going to have a beautiful smile when it’s done. The only thing is, her breath smells really bad now. I don’t want to tell her and make her feel weird about something she’s wanted for so many years. But, I also don’t want her going around with bad breath. Is there a gentle way to help her or is this just part of Invisalign?

Carrie

Dear Carrie,

Image top: A woman putting on her Invisalign aligners. Image bottom: a woman smiling with Invisalign on her teeth

You are such a sweet daughter. You made me as happy for your mother as you are. You’re right, she’ll love her smile at the end. Invisalign doesn’t automatically mean bad breath. However, there are a few common things which we see in patients that can lead to it.

Keeping Your Breath Fresh with Invisalign

  • Don’t eat or drink with them in

Patients are allowed two hours a day when they can take the aligners out. That’s intended to give them plenty of time to eat their meals without the aligners in. It’s possible your mom is so excited about the procedure she’s not taking a break. If you see her eating with them in, remind her she’s supposed to remove them.

  • Brush and floss your teeth after each meal

Food always gets stuck between our teeth when we eat. Unless you remove that, it will make your aligners pretty pungent. It will also lead to decay pretty quickly. I know you don’t want to talk to her about her breath, but if there’s a way you could gently tell her. Or, if you’re uncomfortable with that, you could just say you’re on your way to brush your teeth after meals together as a reminder to her that she’s supposed to be.

  • Hydrate regularly with water

Not drinking enough water can cause not just dehydration, but some pungent breath as well. The added benefit is she can drink that while her aligners are in. It’s the one thing she can drink while she’s wearing them.

  • Use the cleaning kit that comes with the aligners

Cleaning your teeth isn’t enough. Occasionally, your aligners need a good clean as well. If she can’t find her kit. She can give them a quick clean with a soft-bristled toothbrush and a baking soda and water mixture.

I hope this helps.
This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone.

Matching a Crown on a Front Tooth

I needed to get a crown on a front tooth. The first one came back way too white. He sent it back and tried again, but the second one he looked at it and said, “That’s better.” then proceeded to bond it one without me seeing it. When I got home, I realized it didn’t match the other tooth. What do I do?

Lacey

Dear Lacey,

A tooth receiving a dental crown
To match a crown to a single front tooth takes an expert cosmetic dentist.

The procedure you need, matching a single crown to your other front tooth, is an extremely advanced procedure. Only the top cosmetic dentists can do it. Even the best will usually charge up to 40% more for a crown on a front tooth. That’s because it regularly takes four or sometimes more try-ins before it is matched completely to the adjacent front tooth.

There are two things your dentist did which make me think he’s not a skilled cosmetic dentist. First, he thought two tries was enough. A truly skilled cosmetic dentist will not be satisfied with anything less than perfection. He would do it over and over again until they matched.

Second, he permanently bonded on your dental crown before letting you get a look at it. He didn’t want to risk you saying it didn’t look right so he tried to take away your ability to say so. You have two choices in getting this fixed.

Finding the Right Cosmetic Dentist to Fix This

You really do need an expert cosmetic dentist if your dentist isn’t willing to put forth the effort for excellence. I’d look at the American Academy for Cosmetic Dentistry’s website (aacd.com). They have a section which allows you to look for a cosmetic dentist.

You need an accredited cosmetic dentist. These are the cream of the crop. Not only are they capable of matching a single crown, but they won’t be satisfied until you are.

If money is a factor, you may want to see if your dentist is willing to get it right at no additional cost. But, if it’s not a huge factor, you’re better served to find a better cosmetic dentist.

This blog is brought to you by Louisiana Cosmetic Dentist Dr. Mike Malone.