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Invisalign

Lumineers or Orthodontics?

My nephew is graduating and I promised to get him orthodontics as a gift. His parents are struggling and I know his teeth bother him. However, his dentist told him that he could get his teeth fixed much faster with Lumineers. I looked into it and they are a LOT more expensive. Would these really be a better option for him than straightening his teeth?

Angie

Dear Angie,

Invisalign aligner

I am glad you wrote before moving forward. If the only thing his teeth need is to be straightened, than orthodontics are the way to go. To do Lumineers simply to straighten teeth would be a bit of an overtreatment, and an expensive one at that as you have noticed.

At his age, instead of traditional metal braces, I would suggest you look into Invisalign. This would allow him to straighten his teeth without anyone even knowing because it uses clear aligners.

If there are other things wrong with his teeth, like their shape or size, and you are willing to invest in a total smile makeover, than porcelain veneers would be the way to go.

That being said, I would not recommend the Lumineers brand. This particular brand is highly marketed to inexperienced cosmetic dentists as being easy to place. Additionally, their lab, which they force dentists to use, is not known to produce beautiful results.

Instead, I would look for a dentist who is accredited by the American Academy of Cosmetic Dentistry. They are the most skilled cosmetic dentists in the country and can give your nephew a stunning smile.

I hope this helps you with your decision.
This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Sedation Dentist

Help! My Five Year Old’s Teeth are Rotting!

I have a five year old daughter. Three of her molars are decayed. I brush her teeth twice a day and floss. I do take her to the dentist but she is remarkably uncooperative. Every appointment is embarassing. First, what is going on with her teeth? Second, how do I get this necessary work done with her being so difficult?

Edith

Dear Edith,

Little girl smiling in a dental chair

I can tell that you are a caring mother and are doing your best to take care of your child. Let’s start with the most urgent issue first. She needs this work done on her molars for two reasons:

  1. If left untreated, this can turn into a dental emergency. When those are left untreated, it can become life threatening.
  2. Molars need to be kept until the child is about twelve years old. Otherwise, the other teeth will drift and it will lead to crowding when her permanent molars come in. That will mean expensive orthodontics. If a molar is so far gone that it cannot be saved, make sure your pediatric dentist places a space maintainer there in order to prevent that issue.
papoose board
Papoose Board

If she is uncooperative, you will either need to have the dentist use a papoose board or dental sedation. The work has to be done for her own good.

As to the second issue of why. Some of it may be genetics, but you didn’t mention this problem with your teeth. My strong suspicion is that she either snacks a lot or has lots of drinks thoughout the day that are not water.

Most people don’t know that one of your biggest allies in the fight against decay is your saliva. It contains bacteria fighting minerals. However, if someone is snacking often or having lots of sugary/citrusy drinks throughout the day then it doesn’t get the time it needs to do its job.

My suggestion is to limit her to one snack a day and make sure she is drinking lots of water instead of juices and sodas. This may be a tough adjustment for her, but if you hold the line, she’ll adjust to the new rules.

I hope this helps.
This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Emergency Dentist

My husband Just Broke Off Two of His Teeth

My husband took quite a fall and broke his two front teeth. It appears the roots are still intact. We went to see an emergency dentist and he told us just to have the teeth extracted. Is there any way to save his teeth?

Brenda

Dear Brenda,

A hockey player smiling with a knocked out tooth

I am sorry about your husband’s accident. While it is possible to save these teeth with root canal treatments and dental crowns, there is not a guarantee. It is a bit tricky. A lot will depend on how much of the tooth is broken off, what condition the roots are in, and the comfort level of the dentist.

You may have some difficulty finding a dentist willing to do the procedure. Now that dental implants have grown in popularity and reliability, even fewer dentist will be willing than might have been twenty years ago. It’s easier just to replace them.

Here are some things to be aware of if you do find a dentist willing to try that will increase the chances of a succesful outcome. Whatever dentist you end up going to for this will need to bear in mind that the rotational forces are working against him or her.

Front teeth are rounded and the posts are as well. This does not bring much resistance to the rotational forces. You can increase your chances of the post working loose by putting two posts into the root, which minimizes the complication.

A second issue is that the post can crack at the root. Some dentists think using a rigid post will help this. However, with a front tooth, there are tipping forces to consider. Because of that, they would need to use a flexible post on the front teeth. Two I’d recommend are carbon fiber or fiberglass.

If it turns out that these teeth cannot be saved, don’t despair. He doesn’t have to look like the hockey player pictured above. Dental implants really are the closest thing to having healthy, natural teeth in his mouth again. I highly recommend them. Just make sure he goes to a dentist with post-doctoral training in dental implants.

Try to save these teeth first and then go from there.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Invisalign

Retainer After Invisalign Treatment

I am on my last pair of aligners for Invisalign. An opportunity I cannot pass up has been offered to me, but it will require me moving in the next week to another state. As you can imagine, I have a LOT to take care of between now and then. Fortunately, my new company is paying for my move and a temporary home until I find something. However, I still have to figure out what to do about my Invisalign. I don’t know if I will need to find another Invisalign dentist when I move or not. My dentist mentioned that I will need to wear a retainer after my treatment is done. I don’t know if that is like a regular retainer or if Invisalign does something different. Can you give me some guidance here?

Belinda

Dear Belinda,

Invisalign aligner

 

Congratulations on the new job! It sounds like you have exciting things ahead of you. If you were in the middle of your Invisalign treatment, I would say that you would need to find another Invisalign certified dentist to continue your treatment.

You are on your last pair of aligners, so unless there have been some complicating factors  that you have not mentioned, then I see no need for you to have to find another Invisalign dentist.

Retainers are something just about any dentist can do. Plus, your current dentist is ethically obligated to send them all of your diagnostics and treatment records, including his notes.

Using Your Invisalign Aligner as a Retainer

You may not even need to do that, though. It sounds like you are going to be very busy so I want you to focus on getting your new life and home set up and not have to squeeze getting fit for a retainer in for that. You can actually use your final aligners as your retainer. Here is how:

  1. Start by wearing them all the time for a month.
  2. Then wear them only at night for one to two months.
  3. Try every other night, testing for movement.

Here is how you test for movement:

If you find it a bit more challenging to put the aligner in after you went to the next stage, that means that the teeth shifted some. Go back to the previous stage for another month or two and then test it again.

4. If every other night works, do that for a couple of months.
5. Try every 3 nights. After each new stage, test for movement.
6. Go to once per week.
7. Try not wearing them at all.

Keep your aligners around even after this for two reasons. First, you can periodically check for shifting of your teeth and use them as needed. Second, the aligners can double as teeth whitening trays. If your dentist offers teeth whitening, they can provide you with the whitening gel and you can wear them without having to have custom trays made, which will save you money.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Botox

I Need Another Option for My Gummy Smile

I’d heard there are treatments for gummy smiles these days. I’ve always hated mine and wanted to do something about it but the two options my dentist gave me were either scary invasive or crazy expensive. The first option he gave me was porcelain veneers, which he said would fix my gummy smile along with “all the other flaws” in my smile. Not only was that a tad insulting, but the price was astronomical. The second option he gave me was gum contouring, which he said he does with lasers. That idea gives me hives. Is there another option that is not as invasive?

Penelope

Dear Penelope,

Botox gummy smile repair

Generally, the best treatment for you will depend on the cause of your gummy smile. There are more than people realize.

Causes of Gummy Smiles

  • Big Gums. This one is obvious. You have normal-sized teeth, but longer gums.
  • A puny upper lip. Some people just have tiny upper lips, so when they smile you see more gum than you would with a longer lip.
  • Medical Gingival Hyperplasia. This is when either a medication, poor dental care, or a medical condition causes the overgrowth of your gums.
  • Hyperactive muscles. This is when your lip tightens up more than normal giving you a gummy appearance.

Comparing Some Options

While porcelain veneers are a great option for a smile makeover and can also repair a gummy smile, if you are otherwise happy with your smile then it is not a good investment for you. This is a better option for someone who was looking for a complete smile makeover. If I am reading you right, that is not what you are after. You want to fix this one issue. So, in that case, don’t invest the money in porcelain veneers.

The laser procedure is not as scary as it sounds, but is not your only other option. A very simple thing you can do, depending on the cause of your gummy smile, believe it or not is Botox. Botox has been successfully used in treating gummy smiles. This is for someone whose lip comes up too tightly when they smile. Using the Botox relaxes the upper lip thereby giving them a more natural looking smile.

There are other options as well such as, orthodontics, root planing, crown lengthening, and even orthognatic surgery. Which of these is useful to you depends on the cause. You asked for the least invasive and that would be Botox.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Pediatric Dentist

Why Do My Children Keep Getting Decay?

I am at my wit’s end. I do everything for my children possible, including taking care of their teeth. We brush twice, sometimes three times a day. We floss. I take them to the dentist every year. I also limit their sugar and still they are getting cavities. I want them to grow up with healthy teeth and do not know what I am doing wrong. At our last appointment, my four year old had four new cavities and my seven year old had two new cavities. What can I do differently?

Libby

Dear Libby,

young mother, holding and giggling with two children

It sounds like you are a loving and conscientious mother. That is fantastic and will only benefit your children. You have checked off some important items in caring for your childrens teeth. These include regularly brushing and flossing. You mentioned that you take them to the dentist every year. If at all possible, I would increase that to twice a year. Dental plans generally give you two full cleanings a year.

One thing you did not mention was the duration of their eating. Do they snack a lot or drink lots of juices? Believe it or not duration of eating, not what you eat, is one of the leading factors of tooth decay.

Our saliva contains bacteria fighting minerals, but it can’t properly do its job if they are frequent snackers. While limiting sugars can be helpful, it would be better to have a sugary snack once in a while than to have pasta or snacks a few times throughout the day. Most people are not aware that pasta and other carbohydrates break down into sugar. Many foods do, in fact.

Brushing constantly won’t even help. However, they only prevent decay on smooth surfaces. All those pits and fissures in your children’s back teeth are at a much greater risk of decay. If you have a good pediatric dentist, then they should have recommended you get sealing done on your children’s back teeth. This is a liquid that is “painted” over your children’s back teeth, the ones with all those pits. This dries then seals them up so that food and other debris cannot get trapped there. This should be done after a thorough cleaning by the dentist so that the teeth are healthy and clean when they are sealed.

They should also be getting regular fluoride treatements, which will help strengthen their teeth. We are fortunate to live in a country that fluorinates the water. However, that extra bit at the dentist makes a difference.

You are doing a great job, mamma. Check their snacking frequency and give yourself some grace.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Invisalign

Will Invisalign Stop My Headaches

I have been dealing with headaches for years. At times, they can be rather intense and make it difficult to function. I had one the other day while at lunch with a friend of mine. She told me that she used to have headaches all the time until she had her teeth straightened with Invisalign. She didn’t get them for that reason. She just wanted to straighten her teeth, but noticed that her headaches stopped when the treatment was done. Is it possible that if I get Invisalign that it could solve my headache problem?

Marina

Dear Marina,

Invisalign aligner

If your headaches are due to the misalignment of your teeth then, yes, getting your teeth into alignment could get rid of your headaches. Invisalign is a great way to do that.

When your bite is out of alignment it can cause headaches, jaw pain, and even lead to TMJ disorder if it doesn’t get repaired.

However, headaches can also be from medical conditions, so I would see your doctor even if your teeth are in need of realignment. They should run some tests just to eliminate some important possibilities.

If you do decide the problem is your bite, then you’ll find Invisalign to be a much better option than traditional metal braces. They are  much more comfortable, invisible even at a conversational distance, and can straighten your teeth in half the time.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

 

Invisalign

Am I Too Old for Invisalign?

I have never had a straight smile. When I was little, my parents could not afford dental care, let alone braces. In adulthood, I had one tragedy after another, which also kept me from getting braces. Now, I am 57. I know it sounds vain, but I am in a situation where I can finally do something about this. I know the teenagers are mostly using Invisalign to straighten their teeth. Am I too old for that way of straightening my teeth? I was hoping to do it without a mouth full of metal.

Althea

Dear Althea,

Invisalign aligner

First, let me say there is absolutely no vanity in wanting straight teeth no matter what your age. Not only is it just taking the best care of your teeth that you can, but when your teeth are not straight, it can contribute to jaw pain and even migraine headaches.  That means that straightening your teeth is also taking care of your health.

Second, you are definitely not too old to have Invisalign. While you may know about it from teenagers, it was actually made first and foremost for adults. Invisalign Teen didn’t come into play until several years later.

I personally know of an 80 something year old woman who used Invisalign and was quite pleased with it! You’ve got quite a few years to catch up with her. In fact, you’re practically a pup!

I’ll let you in on a little secret too. If you were also interested in whitening your teeth, you could do it simultaneously with your Invisalign treatment. The aligners you would use for your orthodontic treatment can double as teeth whitening trays. Then, your dentist would only need to provide you with the whitening gel.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Dental Implants

Can a Maryland Bridge Attach to a Dental Implant

I have two dental implants that had a natural tooth between them. Now that natural tooth needs to be removed and my dentist is recommending a Maryland Bridge. Is it possible to attach a Maryland bridge to the dental implants? I was concerned about attaching the metal to the porcelain. Have you seen this successful?

Charlie

Dear Charlie,

Illustration of a Maryland Bridge

The short answer is yes, it is possible to bond a Maryland Bridge to a dental crown. That being said, it is tricky. The ideal bond is metal against enamel, not metal against porcelain.

It would have been better if your dentist had anticipated that when you have two dental implants on either side of a natural tooth it is very likely that the tooth will eventually need to be replaced. With that foresight, he could have placed the abutments parallel to one another so that you could have changed two screw-retained crowns to a dental bridge with little trouble.

As it is unlikely that your dentist planned ahead, I would suggest your best option will be to place a third dental implant in between the two others, if there is room.

If not, then you can try the Maryland Bridge, but it will take some preparation of the crowns to make it work.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Sedation Dentist

Dentist Cannot Get Me Numb

My dentist tried a paste and seven injections and still could not get me numb. I am in desperate need of a root canal treatment, but the procedure was too excruciating. He ended the appointment and refunded my money. He told me he’d do some research, but I may need to get this extracted surgically with anesthesia if we can’t do the root canal treatment. I really want to save the tooth if possible. He prescribed me some more antibiotics and said he’d be in touch before the prescription runs out. Do you have any way that I can avoid losing this tooth?

Angela

Dear Angela,

Woman resting in dental chair from dental sedation

I am sorry for the horrible experience you went through. The fact that you still want to try and save your tooth says a lot about your character and perseverance.

The good news is I have a solution for you. It sounds like your dentist may not yet be aware of the connection between dental anxiety and the ability to get numb.

When you have a high level of dental anxiety, which many do, your metabolism can burn off the numbing medication before it can be of any use to you.

While you cannot just will your anxiety away, there is a medication that sedation dentists can provide for you that will do it for you. Not only will the medication completely relax you, but if you wanted to you would be able to completely sleep through your entire appointment.  Because of this, some people have dubbed it sleep dentistry.

My suggestion is you see a dentist who offers oral conscious sedation. This is administered by a pill that you will take before your appointment. Be aware that it is strong. In fact, it is so strong you will need someone to drive you to and from your appointment as well as stay with you for a few hours after your appointment. This will be important because you will still be a bit woozy and unsteady on your feet. I would plan on a day of napping or binge-watching your favorite streaming channel.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.