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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.

Invisalign

Switching from Braces to Invisalign

If I’m absolutely miserable with braces can I switch to Invisalign? I love that I’m getting my teeth straightened, but the metal cuts my mouth, I can’t eat anything I like, and I feel ugly.

Angela B.

Dear Angela,

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

If your case is a good candidate for Invisalign, then yes, you can switch. Though most cases work with Invisalign, there are a few more tricky cases that require braces. It’s just a matter of talking to your dentist or orthodontist and they can let you know.

Why Invisalign is So Popular

You named many reasons that people actually love Invisalign. There is no metal to deal with. That will mean no cuts for you. Until you switch, your dentist should be able to provide you with some wax to put on the braces which should help with the pain.

Invisalign has absolutely no restrictions as to what you can eat during meal time. You simply remove the aligners, eat as you wish, then brush your teeth and place the aligners back on your teeth. However, there are some restrictions when they’re on.

You don’t want to drink things like coffee or soda when the aligners are in. The reason for that is they’ll pool in your aligners, soaking your teeth with their ingredients. This will eat away at your decay, putting you at a tremendous risk for decay. You can still drink those beverages, just make sure you do it at meal times instead of between meals. While your aligners are in, drink water. Drink as much water as you want.

Oral hygiene is so much easier with Invisalign. You don’t have to worry about getting around the wires and brackets. That lessens your chance of the decalcification many people with braces experience.

You mentioned appearance. The beauty of Invisalign is that you can’t see it. It’s invisible even at a conversational distance. When you smile, they’ll just see your smile.

Whiten Your Teeth with Invisalign

Your Invisalign aligners can also double as teeth whitening trays. It’s an easy way to take an additional step toward beautifying your smile without having to also pay for custom fit whitening trays. You’ll only need the tooth whitening gel your dentist can provide.

Once you have a straight, white smile you’ll be astounded at the boost it gives to your confidence. You’ll find yourself smiling more and lighting up a room.

This blog is brought to you by AACD accredited dentist Dr. Mike Malone.

Lafayette LA Dentist

Planning For a Child’s Dental Care

I spent 10 years trying to get pregnant unsuccessfully. So, we applied for adoption. I just found out we’ve been approved and we’re flying to pick up our new son next week. So, now I’m in a mad dash of preparation for my new son. I can’t believe I can say my son. I want to do everything right. He’ll be 5 soon. What age should he start seeing a dentist? At what age should I switch him to a regular dentist?
What else should I know?

Laura A.

Dear Laura,

Boy smiling and holding a toothbrush
Dental Care for Children Should be All Smiles

The first thing I want you to do is to take a deep breath. This is a tremendous moment for you and I know you must feel thrilled and terrified simultaneously. I also don’t want you to get disappointed by unrealistic expectations.

I know you want to do everything perfectly, but like everyone else, you’re human. You’re going to make mistakes. You’ll make incredible sacrifices for your son, but you’ll also have selfish moments you’ll feel bad about the moment it’s done. Don’t beat yourself up about it too much. Just learn from it and move on.

As for what age he should see a pediatric dentist, I’d start him immediately, especially if he hasn’t been much in the past. Too many parents wait until there’s a dental problem and they need an emergency appointment. Then, the child’s first experience with the dentist is a negative one.

You can take him to a pediatric dentist or a general dentist who enjoys working with children. Both are qualified. Both have their pros and cons.

Pediatric Dentist or General Dentist?

A true pediatric dentist has done extra schooling and can handle certain more unusual issues that come up with children but not on adults very often. Additionally, their office is designed for children with little chairs and lots of colorful walls and toys. They usually go into the field because they love children and are great working with them.

A general dentist is still qualified to treat children, but have not had the additional schooling. That means there could be a tricky issue come up where they’d have to give you a referral to a specialist. However, that happens no matter what field someone is in. Many parents find it convenient for the entire family to go to the same practice. Though their office isn’t always designed with children in mind, if they enjoy treating children they will have things on hand for them.

When your son is with a general dentist, there won’t be any worries about having to switch dentists when he reaches a certain age. He’ll already be with a “grown-up” dentist.

I hope this helps and congratulations on being a mom.

CEREC

Pain with CEREC Crown

I had three crowns put on back teeth. I’ve had one other crown in the past without issue. This is the first time I’ve gotten CEREC crowns. Every time I bite down it’s a nightmare. I feel as if a knife is going through my jaw. Is it because it’s CEREC crowns or something else?

Olivia

Dear Olivia,

A tooth receiving a CEREC crown

I don’t think it’s the fact you received CEREC crowns this time which is causing the problem. When there is a pain on biting with dental crowns, whether traditional or CEREC, there is usually one of two causes.

Do You Have a Lingering Infection?

People often get dental crowns because of a tooth infection and root canal treatment. There are many canals in our teeth and some of them do a pretty good job of hiding from the dentist, even when they do everything right in the procedure. If he or she missed a canal it would explain the pain. You can have an x-ray done to see if there is still some ick left.

Your CEREC Crown Could be Seated too High

Because the pain is when you’re biting down, it leads me to believe the crown may be seated too high. Generally, when we bite down the force is absorbed by all of our teeth. But, if your crown is seated higher than your other teeth, it’s taking on the full force of your bite, which would cause quite a “zing” of pain. If that’s the case, a simple adjustment by your dentist should do the trick.

When NOT to get a CEREC Crown

CEREC crowns are wonderful. They generally have a better chance of fitting perfectly because they’re milled by computer. They’re also incredibly convenient because you get it the same day and don’t need to bother with a temporary crown and second appointment. All that being said, there is one time I do not recommend a CEREC crown. Instead, you’d need the traditional all-porcelain crowns.

CEREC crowns are milled out of a single block of porcelain. That limits the variation and subtle color changes you’d normally be able to achieve when getting a traditional all-porcelain crown. On back teeth, that’s no big deal, but when you’re talking about your front teeth that’s a totally different story.

Your front teeth are exposed when you smile and the light hits them which reveals their secrets even more. You’ll want a skilled cosmetic dentist to make sure you get a crown crafted with all the color and translucency changes you’d get with your natural teeth so they blend in beautifully.

This blog is brought to you by AACD accredited dentist Dr. Mike Malone.

Invisalign

Is Orthly Equal to Invisalign?

I told a friend the other day that I wish I could afford Invisalign. I’ve spent a lifetime embarrassed about my teeth. She sent me this link to a company called Orthly. It looks like Invisalign, but it’s 70% cheaper. I just want to make sure it’s safe to do it and it’s similar to Invisalign.

Ellen

Dear Ellen,

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

It sounds like you have a friend who cares about you. It’s lovely to have friends like that. If you won’t hate me, I’m going to help you understand the differences taking you back to High School. Do you remember geometry class where you had similar triangles versus congruent triangles? As you recall, congruent triangles were completely equal to one another in both sides and angles. But, similar triangles were only that, similar but not equal. They had the same angles but not the same lengths.

That’s how I would describe Orthly to Invisalign. Similar but not equal. It will save you money. Unfortunately, it could also cost you some teeth.

The first thing you should know is it wasn’t founded by dentists or anyone with dental knowledge. The idea came to two students who wanted to get Invisalign but couldn’t afford it. Their company is very straightforward about that. They say, “Orthly does not practice dentistry nor do any employees in the company.” That alone wouldn’t make it dangerous. I’m sure they consulted with dentists and orthodontists as they followed through on their idea.

Where Does Orthly Fall Short of Invisalign?

The way Orthly saves money is by avoiding orthodontic appointments. You see a dentist a total of two times. They can request photos through the app, but that’s the extent of the “looking after” you get. You may think that’s no big deal, but here’s what worries me about that.

The reason dentists keep an eye on you throughout the treatment is to measure things like mobility, root absorption, periodontal disease, and oral hygiene. None of these can be tracked through a photo. If they don’t catch any one of these problems in time, it could lead to the patient losing their teeth.

Then you’re talking about a much greater expense then they’d have had if they’d done the best treatment to begin with. They’ll need to replace their teeth.

So, in your place, I’d weigh the benefits with the risks before you decide.

You could always talk to your dentist about your desire and ask if there’s a way he’d let you pay out “the real deal” in installments you can afford.

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

Porcelain Veneers

Will Press-on Veneers Be a Good Option for Me?

I have stained teeth and a chip on a very front tooth. My smile has always embarrassed me. A friend recently got porcelain veneers and her smile is stunning. I was going to do that myself until she told me the price tag. I just can’t afford that. I saw an advertisement for Press-on Veneers. They’re about $1000, which I could afford. However, I don’t want to spend that much money if it won’t give me a comparatively beautiful smile. What do you think? Is it a good option?

Karen S.

Dear Karen,

Porcelain Veneer being placed on a tooth

I’m about to save you a lot of money AND give you an improved and pretty smile. First, don’t get the Press-on Veneers. It’s not what you’re after. They’re not permanently placed and more just fit over your teeth.

Additionally, they’re not made of the same material and will look fake to people you’re having a conversation with. They’ll also be bulky. To the credit of the site who sells them, they’re very open about these issues so customers know what they’re getting into. So what good are they?

They’re a quick cheap solution if you’re having a photo shoot and want a prettier smile. Other than that, I’d look for better cosmetic options.

Porcelain Veneers and Cosmetic Alternatives

Porcelain veneers are the top of the line treatment for a smile makeover. They can change everything about your smile— the shape, size, color, and character. As you noted, they’re also the most expensive of your options.

However, I think you can get a smile you’re proud of for less than half the cost of the Press-on Veneers with the additional benefit of being permanent instead of removable.

You mentioned your teeth are stained and chipped. First, get your teeth whitened. This is a very affordable procedure that can be done either at the comfort of your own home or in one appointment in-office. After the whitening, a dental bonding can be done to repair your chipped tooth.

While any dentist can do the teeth whitening. Dental bonding is done free-hand and requires a skilled and artistic cosmetic dentist. I’d look on the mynewsmile.com website to see who they recommend. The site is very reliable. They will only recommend skilled cosmetic dentists.

I hope this helps.
This blog is brought to you by Dr. Mike Malone, an AACD accredited Dentist.

Cosmetic Dentist

Does Teeth Whitening Require a Specialist?

I think I’m ready to get my teeth whitened. I keep hearing you have to go to a certain expert dentist for cosmetic work. Is that right? What type of dentist do I need?

Caryn

Dear Caryn,

Teeth Whitening trays
Teeth Whitening Trays

While it’s true in some cases you have to choose your cosmetic dentist carefully, teeth whitening isn’t one of those procedures. It’s fairly simple. The dentist is their mostly to design custom-fitted trays along with keeping an eye on the health of your teeth and gums throughout the procedure so no complications pop up.

As we get older, we accumulate stains. That gives our smile an aged appearance. Teeth whitening is a fantastic way to brighten up your smile and give you a much more youthful appearance.

When is an Expert Cosmetic Dentist Necessary?

There are procedures which sincerely need to be done by a dentist with significant post-graduate training. But, beyond that, they need to be artistic. The procedure that is the most important is porcelain veneers. These require some significant training both in technique and artistry.

It’s hard for patients to know which dentists are artistic and which aren’t. You can have two dentists do the very same smile makeover and achieve vastly different results. There are many horror stories about cosmetic dentists ruining a patient’s smile.

How Can a Patient Find an Expert Cosmetic Dentist?

The easiest way to find an expert cosmetic dentist is to go to the American Academy of Cosmetic Dentistry (aacd.com) and look for an accredited dentist in your area. Accreditation is completely different from membership.

To reach accreditation, dentists have to pass stringent oral and written exams. In addition to that, they have to demonstrate a large number of cases they’ve personally done to demonstrate their artistry. They’re among the best cosmetic dentists in the country. You’d be pretty much guaranteed a gorgeous smile.

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

Porcelain Veneers

Scratched Porcelain Veneer

If I have a scratch on a porcelain veneer, does that mean I have to have it completely re-done? I asked my dentist about replacing just the one and he said for them to match I’d have to re-do the whole thing. I can’t afford that so I didn’t know if there were any other options.

Lisa

Dear Lisa,

Porcelain Veneer being placed on a tooth

It may be that your dentist can’t match a single porcelain veneer to the rest of them, but an expert cosmetic could. Some dentists, fairly new to cosmetic dentistry, are still developing their color skills and techniques. Because of that, the only way they can assure a uniform look to your porcelain veneers is by doing the whole set together.

You have a few choices here. You can allow your dentist to re-do your entire set, which will be quite pricey. I wouldn’t recommend that even if you had the money though. It just seems a waste of good resources.

Another option, however, is to have just the single veneer replaced with a dentist who’s qualified to do so. What you’ll want to do is find a dentist who’s AACD accredited. They’ll have the skills necessary to match a single veneer.

Polishing A Porcelain Veneer

Something your dentist may not even be aware of is there’s a way to polish the veneer to remove the scratch, without having to replace it at all. I can write out the procedure for you to take to your dentist or you can go to a dentist who already knows the diamond polishing technique.

If you want your dentist to do it, that’s fine. Just make sure you give him these instructions. Otherwise, he might just buff it which will take off the glaze, leaving you with a matte finish. Not only is that unattractive and won’t match your other teeth, but removing the glaze makes it susceptible to staining.

My suggestion would be for him to get Brasseler’s Dialite porcelain polishing system. It will include diamond polishing instruments and polishing pastes. He’ll need to end with the ultra-fine diamond polishing paste. that will give you back the glossy finish you need to protect your veneer.

This blog is brought to you by Dr. Mike Malone. Check out his smile gallery.