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Invisalign

Will Invisalign Work if I Have Missing Teeth?

I want to get Invisalign but I have a couple of missing teeth. Is Invisalign still possible?

Dan

Dear Dan,

A woman placing in her Invisalign aligners

Invisalign does fine with missing teeth. It used to be that Invisalign could only take certain types of cases but it’s becoming more and more advanced and can take even cases of crowding at times these days.

The key to a successful Invisalign case, when there are missing teeth involved, is communication with your dentist. Are you looking to replace those teeth? Do you want a permanent replacement, such as dental implants? Or, do you just want to close up the spaces? Those will work different ways during treatment so make sure you and your dentist discuss your goals thoroughly.

Invisalign Versus Other Cosmetic Work

What Invisalign will do is straighten your teeth. If that’s all you want to be done, then that’s the perfect treatment solution. If there are other things about your smile you want to tweak, there are several options.

If another issue you have is the whiteness of your teeth, your Invisalign aligners can double as teeth whitening trays. That allows you to simultaneously whiten and straighten your teeth.

If you’re looking for a total smile makeover, porcelain veneers are the way to go. These can change absolutely anything about your teeth— the shape, the size, the color, or any combination of those. One word of caution when it comes to smile makeovers.

While just about any dentist can do Invisalign or teeth whitening, to get a beautiful smile with porcelain veneers takes some additional training and skill. In fact, you’ll want an expert cosmetic dentist. Ideally, you should get an AACD accredited dentist.

These are the top cosmetic dentists in the world. Most, if not all of them will have a beautiful smile guarantee.

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

Porcelain Veneers

What If I Can’t Get Porcelain Veneers?

I’m disappointed with my smile, but my dentist said I can’t get porcelain veneers because I grind my teeth. Is there anything else I can do to improve my smile? I have a gap between my teeth and they are quite discolored.

Mandy

Dear Mandy,

A single porcelain veneer being placed on a tooth

I think your dentist may be a little confused. If the only issue is that you grind your teeth, there is a way for you to get porcelain veneers. It’s possible that he’s not comfortable doing smile makeovers and rather than admit that he’s trying to discourage you from moving forward with that. Don’t pressure him. You will not be happy with the results.

Here’s what I’d recommend. The first thing I want you to do is to get a second opinion. But, make sure you do it with a dentist who’s accredited with the American Academy of Cosmetic Dentistry (AACD). These are the top cosmetic dentists in the country.

In all honesty, in order to get the gorgeous smile you’re hoping for that’s the type of dentist you’d want to do your veneers anyway.

If Porcelain Veneers Aren’t an Option

There are some cases, where other work has to be done before you can get porcelain veneers, such as when you have gum disease. In other cases, they’re good candidates, but this type of makeover is just over their budget. That doesn’t mean you can’t get an upgraded smile. Here are some great, affordable options:

  • Teeth Whitening: This is the most affordable way to brighten your smile dramatically. It will make you look years younger.
  • Invisalign: This is a great option to straighten your teeth without anyone knowing your wearing orthodontics. Plus, it works in half the time of traditional orthodontics.
  • Dental Bonding: This can repair chips and gaps on teeth.

As you can see there are many ways to upgrade a smile. However, no matter what you do, you’ll want to protect your teeth, especially after investing money in improving it. If your dentist hasn’t suggested a night guard to you, knowing that you’re grinding your teeth, then it may be time to get another dentist.

This is a simple orthotic device you’d wear over your teeth and it will take the pressure off of your teeth when you grind them. Without this, your natural teeth will eventually be worn down to nubs, requiring you to get each tooth crowned.

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

Cosmetic Dentist

Cosmetic Dentistry Disaster

My dental bonding for a chipped tooth needed to be replaced. I had a new dentist who suggested I get porcelain veneers instead. He’d do four so they could match. Then, when he saw one of them had a cavity, he said I’d need crowns. So, now I have four crowns on my very front teeth and even though he said he had to do four in order for them to match, the two very front teeth look a weird grayish color. What do I do?

Valerie

Dear Valerie,

Porcelain Veneer being placed on a tooth

There are so many things which went wrong here I hardly know where to start. First, any dentist who says you have to do more than one crown or veneer is not a qualified cosmetic dentist. Yes, it takes skill and artistry to match a single front tooth, but isn’t that what you’re paying them for when it comes to remaking a smile—skill and artistry?

Second, you can still have porcelain veneers bonded to a tooth which has a cavity as long as that cavity isn’t so large that it would require a crown under normal circumstances. That would have prevented you from having to grind down healthy tooth structure.

Sadly, the only way to do this is to have the two front teeth re-done. Hopefully, he’s the type of dentist who cares about the quality of his work and will be willing to replace the crowns free of charge.

However, that’s not enough. You need to make sure he’s willing to get a professional try in the paste. These are clear enough to show the color of the underlying teeth on them, giving you a clearer picture of what the crowns will look like once they’re permanently bonded. Then, he needs to let you try them in and get a good look them in several types of lighting and you’ll approve them before they’re bonded.

If he’s not willing to do that, you aren’t likely to get any better results. In that case, it’s in your best interest to find an expert cosmetic dentist.

Finding an Expert Cosmetic Dentists

Unfortunately, now that you’ve had crowns placed, you have to replace them with that forever. However, a skilled cosmetic dentist can give you gorgeous porcelain crowns. There are two places you can look to find a qualified cosmetic dentist in a reasonable distance from you. The first is at AACD.com. Do a search for an accredited cosmetic dentist. You need to check that you want them to be accredited and not just a member. There’s a difference.

The second is mynewsmile.com. This site only lists artistic and skilled cosmetic dentists who can give you a beautiful smile. You’ll be safe with anyone on their list or anyone who’s been accredited.

Best of luck to you.
This blog is brought to you by Lafayette Cosmetic Dentist Dr. Mike Malone.

Invisalign

If My Teeth Keep Shifting Do I Need to do Invisalign Again?

I had Invisalign years ago and it did a great job. Then I wore a retainer full-time for a year. Even after that was done, I still have to wear one at night. I’ve noticed that my teeth shift quite quickly. Lately, I sometimes can barely get them to fit at night when it’s time to put them in. I almost have to force them on. Do I need to do Invisalign over again? I was really hoping to move on to the next part of my smile makeover—teeth whitening. I feel like I’m taking a step back.

Corinne

Dear Corinne,

A woman placing in her Invisalign aligners

It sounds like your teeth aren’t firming up. Doing Invisalign again won’t make any difference it that case. Some people just have to wear a retainer full-time to keep their teeth in place. That doesn’t mean you’ll need a mouth full of metal for the rest of your life.

There are lingual retainers they can bond to the back of your teeth. No one will even know it’s there. However, if your teeth have shifted out of a position you’re happy with then it would make sense to re-do part of the treatment. In those cases, it doesn’t take long. there’s even an Invisalign express for people who don’t need much movement. From there you could switch to a retainer.

Invisalign and Teeth Whitening

None of this will interfere with your smile makeover goals. Either way, you can move forward. If you need to move things back into place and have to redo part of your Invisalign, you could still get your teeth whitened without waiting. The clear aligners can double as teeth whitening trays. Your cosmetic dentist can provide you with professional whitening gel. You simply place the gel in your aligners and wear them for a minimum of 20 minutes a day.

If you don’t need to wear the aligners and choose to go straight to a lingual retainer, you could just do the teeth whitening as you normally would. That gives you two options.

Traditional Whitening

You could choose traditional whitening where you wear custom-made teeth whitening trays that your dentist designs for you. You wear them at your convenience, though many people choose to sleep in them. The biggest benefits to this method are cost and control. It’s slightly less expensive. It also enables you to determine how much whitening you want. Once you reach the level you’re hoping for you simply stop using the gel.

Zoom Whitening

If you want to get it done quickly, you can use Zoom Whitening. That will allow you to whiten your teeth in just one appointment. It will get them their whitest, so you have less control than if you did the tray whitening. But, if you want your teeth as white as possible as quickly as possible, this is the way to go.

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

Porcelain Veneers

My Sister’s Porcelain Veneers Disaster

My sister and I are in constant competition with one another, even when I don’t want to be. I told her I was planning on getting a smile makeover next year. I’m guessing she felt she needed to beat me to it because three months later she called to tell me she just had Lumineers done and has a gorgeous new smile. At first, I was mad. She’s always “one-upping” me. However, after I saw her new smile, I was relieved. She likes it (or at least says she does). But, I think it looks awful. Her teeth are bulky. To me, they look like horse teeth. They’re also chalky looking. I was hoping for something more natural looking, though I do want them to be very white. How can I avoid a fake looking smile? I’ve seen the pictures of smile makeovers and, in photos, they look gorgeous. What went wrong with my sisters?

Lacey

Dear Lacey,

A single porcelain veneer being held up by a dental tool

Having a copy-cat sister is going to turn out to be a true blessing for you. The most important decision to make when it comes to getting a total smile makeover is the dentist you choose to create your new smile. Cosmetic dentistry is an art. Just like two different sculptors have different levels of artistry and skill, the same is true for dentists.

Choosing the wrong dentist is what went wrong with your sister’s porcelain veneers. My first clue to that is you said he gave her Lumineers. Those are a particular brand of porcelain veneers that are highly marketed to inexperienced cosmetic dentists as being easy to place.

Many expert cosmetic dentists feel the brand is sub-par. The reason for that has more to do with the fact that the DenMat Company, who owns Lumineers, insists dentists use the company’s lab. They’re not known for following the dentist’s directions in a way which creates beautiful results. That’s likely where the chalky look came from.

As for the bulkiness, that’s also a common complaint with that particular brand. They’re advertised as being easy to place because they’re ultra-thin and the teeth don’t have to be prepped as a result. That’s why they’re considered “easy” to place. The problem with that is with some smiles, regardless of how thin the veneers are, without the teeth being prepped you end up with bulky looking teeth.

Finding the Right Dentist to Place Your Porcelain Veneers

If you want a stunning smile, one that will make your sister think twice about rushing into something just to beat you to the punch, then you one a top-of-the-line cosmetic dentist. If possible go to a dentist who has attained accreditation level with the American Academy of Cosmetic Dentistry. These are the best cosmetic dentists in the world. They’re so good

If you can’t find an AACD accredited dentist in a near enough distance for you to reasonably travel, don’t panic. There are many other skilled cosmetic dentists, many of whom are on their way to accreditation which takes many years.

You can look at the mynewsmile.com website to find these dentists. They don’t recommend anyone who cannot create a stunning smile. You’ll be safe with anyone on their list. All you have to do is input your zip code and how far you’re willing to travel for your smile makeover.

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

Cosmetic Dentist

Crowns for Tetracycline Stains

I’ve consulted with two dentists in my desire to improve my smile. I’ve got tetracycline stains which have embarrassed me for years. I’ve spoken to two dentists. One suggested porcelain crowns. The other suggested I get porcelain veneers. Is one a better treatment than the others?

Ariana

Dear Ariana,

Brunette woman with beautiful smile
Beautiful smiles require great dentists!

It’s great that you’re doing your due diligence. To help with this, I want to shift the way you’re approaching this just a bit. While I do have a treatment that I think is better than this and will tell you which it is, the more important decision is what type of dentist do you need.

Tetracycline stains are among the most difficult type of cosmetic issues to treat. Whichever procedure you decide on has to be opaque enough to cover the stains and translucent enough to be beautiful. It takes a truly skilled cosmetic dentist with an artistic eye to create the type of smile you’ll want.

As for the procedure, porcelain crowns can be made to be beautiful. But, it’s quite aggressive. You’re removing healthy tooth structure for no reason. From then on you’ll be stuck with crowns. You can never go back. The only dentist that would recommend crowns for a smile makeover is one who’s not comfortable placing porcelain veneers. That alone tells me he’s not a skilled cosmetic dentist. You should pass.

Now just because the other dentist picked porcelain veneers, doesn’t mean he’s a skilled cosmetic dentist. You’re going to have to check.

Finding a Skilled and Artistic Cosmetic Dentist

It’s almost impossible for a patient to distinguish the skill of one cosmetic dentist from another without doing hours of research. Fortunately, the American Academy of Cosmetic Dentistry (AACD) does that for you. They have an accreditation program that helps patients to know what dentists can offer a beautiful smile guarantee and really provide it.

I’m going to suggest you go to aacd.com and look up accredited dentists in your area. If you don’t have one in your immediate area, it is truly worth it to travel a bit for the smile of your dreams.

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

CEREC

Are CEREC Crowns Better for Anxious Patients?

I have never been crazy about going to the dentist. I had a toothache and decided to go in because it means something is wrong. It turns out I have a large cavity. Now I have to have a dental crown. I’m really nervous about this. What can I expect?

Belinda

Dear Belinda,

A tooth receiving a CEREC crown

It’s good that you went in. The fact that you did despite your dental anxiety means you are courageous. If you’d allowed your fear to get the better of you, you would have ended up with a dental infection. That would have meant an additional procedure of a root canal treatment. Or, possibly your tooth would not be able to be saved and you’d need to have it extracted and replaced. To get a great replacement, like a dental implant, requires surgery. Obviously, you made the right decision.

What to expect depends on the type of dental crown you’re getting. Did your dentist mention whether you’re getting a traditional crown or a CEREC crown?

What to Expect with a Traditional Crown

If you’re getting a traditional crown, it takes two visits. First, your dentist will have to remove any decay as well as grind down enough tooth structure to make room for the dental crown. You can see how small your natural tooth has to be in the image above. After that, your dentist will make an impression of your teeth and fit you with a temporary crown. The impression will be sent to the lab to make your permanent crown.

It takes a couple of weeks for the permanent crown to be made and sent to your dental office. Then your dentist will call you, fit you with the permanent crown and bond it on.

What to Expect with a CEREC Crown

Given your anxiety, this will be a better option for you. First, they can be done in just one appointment. That minimizes how often you have to come in. Second, many patients hate having to do impressions. The goo is messy and bad tasting. With CEREC crowns, you just have a digital image made and a computer designs the crown. Not only is this less nerve-racking, but it’s also faster and more accurate.

While you’re at the office, the computer will mill the crown immediately and your dentist can then bond it on before you leave.

This is a must simpler procedure. Plus, if you’re still nervous, it’s very compatible with a sedation such as nitrous oxide which can relax you.

A Front Tooth Requires an Expert Cosmetic Dentist

You didn’t mention which tooth is being crowned. If it’s a front tooth, there’s an additional consideration. It’s very challenging to match a single crown to a front tooth. You will need to find a dentist with both technical expertise and artistry.

In your place, I’d look for a dentist who has reached accreditation with the American Academy of Cosmetic Dentistry. Simply go to aacd.com and look for an AACD accredited dentist in your area. They can give you a beautiful crown that blends in perfectly with your other front tooth.

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

Invisalign

Invisalign AND Porcelain Veneers?

I had asked my dentist for ten Lumineers. I have one crooked tooth but I heard veneers can make that look straight. What I’m really after is a brighter smile, plus masking that one tooth. My dentist said he’d like me to do Invisalign and then porcelain veneers. He also said he didn’t like Lumineers because they’d make my teeth look bulky but would give me a different brand. I’m not crazy about spending money on both treatments. Do you really think this is necessary?

Catherine C.

Dear Catherine,

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

I’m a little confused here. On the one hand, what your dentist says about Lumineers is true. They tend to make the teeth look bulky. Plus, their lab is sub-par in following the dentist’s directions properly and rarely give gorgeous results. That tells me he has a decent understanding about at least that brand.

However, his other instructions make me think he’s not a skilled cosmetic dentist unless there’s something you’re not telling me about your bite. Generally, a cosmetic dentist would recommend either Invisalign or porcelain veneers. Not both. A skilled cosmetic dentist can make a single crooked tooth look straight.

Porcelain Veneers or Invisalign?

Which procedure you do depends on your needs. It sounds like you’re fairly happy with your smile with the exception of the crooked tooth and the stains. If that’s the case, you’d save a lot of money just getting Invisalign and teeth whitening.

Invisalign works faster than traditional braces and has the added benefit of enabling you to do both procedures at once. The aligners used to straighten your teeth can double as whitening trays.

However, if you feel there are other aspects to your teeth which need changing, such as the size or shape of your teeth, then I’d recommend getting a smile makeover with porcelain veneers.

With the Invisalign option, pretty much any dentist will do. But, if you go with the smile makeover, you will need an expert cosmetic dentist to do your porcelain veneers. I’d make sure you get a dentist who’s reached accreditation level with the American Academy of Cosmetic Dentistry. That way you’d be guaranteed to get a sublime smile.

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

Cosmetic Dentist

Cosmetic Dentist Versus the Lab

Why is it you’re always hearing patients need to find a phenomenal cosmetic dentist to get their smile makeover when in reality 99% of dentists send the work out to a lab to do? The “great cosmetic dentists” are often more costly. Couldn’t I find a great lab and ask a mediocre dentist to send the work to them?

Misty M.

Dear Misty,

Brunette woman with beautiful smile
Beautiful smiles require great dentists and great labs!

This is a very astute question. It seems logical that this would be a great way to get around costly cosmetic dental work. For instance, it’s the sculptor that matters, not where the sculpture is sold. Unfortunately, the analogy doesn’t work completely for dental care. The lab is dependent on the skill of the dentist and vice-versa.

The dentist does all the tooth preparation and planning. First, their need to be quality impressions made which are sent to the lab. The preparation of the tooth also has to be done precisely. These are absolutely essential to a successful case.

Next comes the prescription. A better analogy would be for this situation would be, does the quality of the doctor matter when it’s the pharmacist who provides the medicine. If the doctor diagnoses the problem wrong, there’s no way you’ll get better, even if the pharmacist follows his instructions perfectly.

It’s the dentist who gives detailed instructions about the shade map of the final result. This includes the surface texture, the degree of translucency, a mock-up of the final result, and many other details. Once the porcelain veneers or crowns comes back from the lab, the dentist checks everything over and makes sure it was done properly or whether it needs to be sent back to the technician.

Finding a Great Cosmetic Dentist

Finding a great cosmetic dentist is much easier now thanks to the American Academy of Cosmetic Dentistry. They set up an accreditation program to help patients find the cream of the crop when it comes to cosmetic dentists.

Those seeking accreditation have to pass stringent oral and written exams as well as demonstrate their artistry on a large list of specific cases, showing that it’s their own work. Any dentist who becomes accredited through the AACD is an artistic dentist with skills that can provide you with a gorgeous smile. In fact, most of them have a beautiful smile guarantee.

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

CEREC

Which Dentists Do CEREC Crowns on Front Teeth?

I keep hearing no CEREC crowns on front teeth, but surely there have to be dentists who do it. Is there a way to go about finding those dentists?

May

Dear May,

Machine for CEREC Crowns
Can you get beautiful crowns from a CEREC machine?

Great question! You can certainly find a dentist who will give you a CEREC crown on your front teeth, but what you want is a dentist who can do it well. The first thing you need to look for is a top-notch cosmetic dentist. The best of the best are dentists who’ve reached accreditation level with the American Academy of Cosmetic Dentistry. AACD accredited dentists are among the top 1% of dentists in the country.

If it’s milled by machine, why does the dentist need to be so artistic? Another great question. It’s specifically because they’re milled by machine. Until recently, CEREC machines would only mill from a single block of porcelain. There are new machines which can mill with gradients. But, many dentists just finished investing in the older CEREC machines and aren’t able to scrap it for the new one. They don’t come cheap.

That doesn’t mean they can’t create you a gorgeous crown. With expertise in color theory, they can create the gradient with the way they color the tooth. But again, only the best of the best can do that.

Consideration When Getting Crowns on Front Teeth

When you’re talking about the most visible part of your smile, you want it to be as beautiful as possible. Once the crown is created, the color on it cannot be changed. You not only want the tooth to look natural and beautiful, but to match the surrounding teeth as well.

So, if your teeth are in need of a little brightening, the time to do it is before your crown is created. Teeth whitening is a quick and easy way to give your smile a boost. If you want, you can even do it in just one appointment using in-office Zoom Whitening.

Once you have the color you’re pleased with, your dentist can match the CEREC crown to it exactly.

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