I had Lumineers placed on my teeth a week ago and they look terrible. They have ridges in them and two have already broken off. My dentist is replacing them, with a tray of lumineers, which she says will be stronger because they will be in a tray. Do you have any idea what would cause the ridges? Also if I do not want her to put them on when they come in, would another Dentist possibly put them on for me since I am afraid to have her do them now.
– Pat from Mississippi

Pat,
I’m not sure I follow what you’re saying. I’m not visualizing these ridges, but apparently they make your Lumineers look ugly. Lumineers will have a slight ridge on the edge of the porcelain. Is that what has happened? Or are the ridges in the middle?

And I don’t know what a “tray of Lumineers” is. I’m imagining that she is maybe referring to a different product called Glam Smile that is put on in a tray, and I definitely don’t recommend that.

I would call everything off until you get a second opinion. If you don’t have the confidence in this dentist to have her put them on for you, you need to take a step back from this and examine all your options.

Your best bet is to get a cosmetic dentist who is accredited by the American Academy of Cosmetic Dentistry. That is an assurance that they know how to do beautiful work. But I don’t think there are any accredited cosmetic dentists in Mississippi. In my opinion, there are esthetic risks in going to a dentist who promotes himself or herself as a Lumineers dentist. They are promoted as being so easy that many dentists who don’t understand cosmetic dentistry are tempted to try them.

Other links:
Lumineers are just a particular brand of ultrathin porcelain veneers.

I recently lost one tooth due to decay underneath my crown. The entire tooth broke off at the gum. It had been root canaled so the post is there from the root canal. The tooth is on the top left and is the third molar from the back. My dentist says the tooth can’t be saved. I can’t decide whether to do an implant or a bridge. For a bridge, there is a filling in one tooth next to it and a inlay in the tooth on the other side. I’m worried about bone loss though. Will I get bone loss if it is just one tooth missing? Will I experience bone loss with a bridge? Please let me know what you think. I am 46 and in excellent health and no bone problems right now.
– Deborah from California

Deborah,
It doesn’t sound like there is enough left of your tooth to hold a crown, so it needs to come out.

Yes, even with one tooth missing, there will be bone loss in that space where the tooth used to be. Your body will resorb that bone to use the minerals elsewhere. But, since the space is a small space, the amount of bone loss isn’t very significant. Plus, it’s not in a place that will likely show when you smile.

However, if the adjacent teeth are sound and only have conservative fillings, a dental implant would be a good idea, just to avoid grinding down otherwise healthy teeth for crowns. A dental bridge requires you to have full coverage crowns on each adjacent tooth. A dental implant, on the other hand, just requires placing a root form, allowing it to heal, and then placing a crown on that root form.

I am going to get braces in a week to correct a biting problem. My front teeth are inverted slighly. Would veneers correct this problem or should I continue with my plan for braces?
– Sandra in California

Sandra,
I’m not sure what you mean by your front teeth being inverted slightly. Do you mean that they’re tipped inward?

Porcelain veneers will for sure correct any appearance problem with your teeth, other than severe crowding. And if the front teeth are tipped inward, they will make them look straight. But generally they don’t correct functional problems. Sometimes they can. Doing porcelain crowns does more to correct functional problems.

Generally, if braces will correct a problem, I lean toward braces. That way you’re left with your natural teeth and nothing artificial bonded to them. But we most like to use Invisalign invisible braces for adults – it’s faster, more comfortable, more esthetic, and easier to keep your teeth clean with Invisalign than with traditional wire and bracket braces.

If you want to weigh the pros and cons of both approaches and get a professional opinion for your specific situation, I would recommend going to a dentist with expertise in cosmetic dentistry AND Invisalign. That way he or she has the experience and expertise to give you the whole story and doesn’t feel under any pressure to steer you one way or the other.

Related links:
Read about the options for fixing crooked teeth.

I need a crown on my front tooth. The dentist suggests doing both front teeth so they match perfectly. Is this necessary?
– Laurie in South Dakota

Laurie,
It may be necessary for you, from this dentist, but it isn’t generally necessary. It is possible to match a front tooth crown perfectly to the tooth next to it, but it takes, skill, a strong knowledge of tooth color, translucency, and texture, and a certain amount of trouble. It may require sending the crown back to the dental laboratory more than once to get the color perfected. But it can be done.

Many dentists just aren’t good at that, and some just don’t want to take that trouble. So in your case, yes, it may be necessary to get both crowns if you want the front two teeth to match perfectly. But we don’t do it that way – we just match the single crown.

Read more about Louisiana porcelain crowns or Louisiana Zoom whitening.

I bit into a fork couple of months back. and hurt a lower tooth. I have just lost that one lower tooth(# 24). We are considering doing a bridge from canine to canine because the two on the two sides of the missing tooth are OK but kind of weak the dentist said. Options I have been given are 1) Maryland bridge or 2) fixed conventional bridge. I have tried to compare the two types from literature but I am not sure what would be my best option. I would really appreciate your opinion and advice.
– Avram from New York

Avram,
There may be more than those two options. I haven’t seen your case myself, so I can’t say for sure, but I’d maybe get a second opinion and see if there isn’t something else that can be done.

Neither of the two options sounds very attractive. A Maryland Bridge is conservative, but it is made out of metal, and it will darken the adjacent teeth. You may be interested to see a case of a Maryland Bridge that Dr. Malone removed to replace it with a more esthetic porcelain veneer bridge. The bridge from canine to canine sounds very aggressive for replacing just one missing tooth.

Was a dental implant considered as an option? I’d suggest finding a dentist who does a lot of dental implants and asking if this could be a case for an implant. There are also other conservative esthetic bridge options, such as a porcelain veneer bridge, an Encore bridge, or other choices that an expert cosmetic dentist could provide. You’re in New York. You can find an excellent cosmetic dentist by going to the mynewsmile.com cosmetic dentistry website.

Good luck.

Lafayette, Louisiana dentist

I had the rare opportunity to have a professional Zoom tooth whitening done at cost at a cosmetic dentist. Unfortunately, we didn’t realize until after the first go-around that the color of my teeth seems to be due to natural variation and not stains. That said, the color differences are rather stark after the treatment and I’m unhappy with how noticeably uneven the color of my teeth are. Is there any way to reverse or fix this without having to get expensive bonding or veneers?
– Marcy from DC

Marcy,
I’m hoping your dentist knows more than you seem to be indicating, because from what you’re telling me, there’s a lack of expertise in cosmetic dentistry in your case. One problem with dentistry in the United States is that cosmetic dentistry isn’t a separate specialty recognized by the American Dental Association, and because of this any dentist, with no extra training at all, can call himself or herself a cosmetic dentist.

Zoom whitening will whiten teeth that are naturally dark. It isn’t just for accumulated stains. Most Zoom whitening patients, when they are done, will have teeth that are whiter than any natural color. It removes stains, but it also bleaches out the natural darker colors that are in everyone’s teeth.

However, Zoom whitening and other professional whitening techniques are not appropriate for teeth with uneven coloring. Many general dentists who attempt cosmetic dentistry make this mistake – they try to whiten teeth with spots or stripes, and this only exaggerates the problem. Spots, stripes, and other uneven colorations need to be treated with tooth bonding or porcelain veneers.

Unfortunately, there isn’t a simpler solution for your problem

Related links:
Lafayette dentist
Lumineers – a specific brand of porcelain veneers

My dentist stated I need to have a tooth onlay.

Now I got the estimate and Description say Onlay Porc/Ceram-4+Surface. What does that mean 4+ surface? I thought I was getting one tooth onlay.

My plan covers a Max of $1000 and they are billing me 1300. Plan will only pay 923.50. Why do I need 4 +surface on the onlay?

Any insight would be greatly appreciated.
– Hector in New York

Dear Hector,
You’re running into some very technical jargon here, and I can see where it may be hard to understand.

The 4+Surface refers to the number of surfaces of the tooth that are covered. Insurance plans reimburse more for restorations that cover more surfaces of the tooth. There are five surfaces on any back teeth – the chewing surface and the four sides. So you’re just reading the documentation of the dentist that this onlay covers four or more surfaces and thus entitles you to their maximum benefit for this tooth. Onlays usually cover four or five surfaces.

And $1300 sounds like a very reasonable fee for a porcelain onlay in New York. You are experiencing first-hand how dental insurance has not kept up with the times. Back in the 60s, their common $1000 maximum benefit for a year would cover a reasonable amount of dental work.  Today they have the same yearly limit and it covers very little.

And for those who don’t know what a porcelain onlay is, it is a very nice restoration. It usually covers the entire chewing surface of the tooth, so it reinforces a weakened tooth. But it only goes partway down any of the sides of the teeth. Since it usually doesn’t touch the gum tissue, it is very comfortable, and requires less grinding away of the tooth. If you are interested in having a porcelain onlay, ask Dr. Malone.

Related links:
A related restoration is a porcelain crown
Read about how to fix crooked teeth
Lafayette cosmetic dentist

I recently got Lumineers and, while I like how they look, I am having problems speaking. My lip keeps getting caught on the Lumineers. What can be done to fix this?
– Joy

Joy,
This is one of the problems with the technique that is promoted for doing Lumineers. It sounds wonderful to be able to bond on a new smile with no anesthetic and no shaving of the teeth before the porcelain veneers are put on. But then people get these problems.

When Lumineers are placed on the teeth without first shaving the teeth back about half a millimeter, they will end up thickening the teeth. And even a slight thickening can make them look a little bulky and can cause problems like this with your lip. I think it would be embarrassing to have your lip keep sticking on your teeth when you talk.

You just have to decide if this is bothering you enough to want to have these re-done.

Other links:
Read another blog post about problems with Lumineers
See the home page of Lafayette dentist Dr. Mike Malone

Dr. Malone,
I have a gap in my two front teeth in the top of my mouth. I want to close it but I don’t want braces. Are there any other methods I can use?
– Ashley from Alabama

Ashley,
There are several ways to close a gap between your two upper front teeth, and which way is best may depend on other conditions in your mouth.

If that is the only thing wrong, the easiest and nicest way to close it would be with tooth bonding. With tooth bonding, we add dental composite to the two front teeth and make them each a little wider, so that there is no more gap. I match the color and translucency of your teeth exactly, and shape and polish the composite so that you can’t tell anything was done to the teeth. You should be able to find an excellent cosmetic dentist in Alabama to do this for you. Don’t go to your family dentist for this – doing this right requires considerable artistic ability and special bonding materials and tints that many general dentists don’t stock. Look for a dentist who is accredited by the American Academy of Cosmetic Dentistry.

Another option is to do porcelain veneers. This is more aggressive, because the veneer will cover the entire fronts of the two front teeth, and may even involve other front teeth. But if there are other defects in the teeth, this may be the best.

Another option is to use Invisalign invisible braces. You said you didn’t want braces, but these aren’t conventional braces. There are no metal brackets, and the teeth are moved about twice as fast as they are with conventional braces.

The tooth bonding is by far the least expensive way to go, and the nicest way, too, if the gap is your only problem.

Other links:
Lafayette Louisiana cosmetic dentist