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Congratulations to Dr. Chal

We wanted to give recognition to Dr. Arthur Chal in Phoenix who was recognized recently for 16 years of service as an accreditation examiner with the American Academy of Cosmetic Dentistry.

Dr. Chal served also as President of the AACD for 2001-2002, a couple of years before Dr. Malone. Dr. Malone and Dr. Chal have known each other for about twenty years, and we here in Dr. Malone’s office have the highest respect for Dr. Chal, the quality of his dentistry, and his dedication to the profession. For patients who live in the Phoenix area, we consider him the best dentist in Phoenix. He has expertise in cosmetic dentistry, implant dentistry, and TMJ treatment.

Congratulations, Dr. Chal

This blog is sponsored by Lafayette LA cosmetic dentist Dr. Mike Malone.

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Ugly porcelain crowns

I think I made a mistake, but I don’t know what to do about it.  I needed my four front teeth crowned. I told my dentist that I wanted all porcelain crowns. He told me that he hasn’t done many of them, but I told him how important that was for me, so he said he’d go ahead and do it.  When the crowns were completed I was really disappointed. They didn’t look very natural to me. I expressed this to my sweet dentist and he said he’d do them over free of charge. He asked if I wouldn’t mind going to the lab in order to give them some idea of what I am looking for.  I said OK, but now I wonder if that was a mistake. I don’t really know how to instruct a lab. Do you have any advice for me?

Karyn-Texas

Karyn,

You have a fantastic dentist, who obviously cares about you and values you as a patient. He is willing to do this again free of charge, which will actually cost him a significant amount of money in lab fees alone. Because your crowns are functional and the only problem seems to be you not liking the appearance, he is under no obligation to do anything. I hope this gives you some idea of what a generous, kind dentist you have.

You mentioned earlier that you think you’d made a mistake.  To be honest, the mistake wasn’t in agreeing to go to the lab, the mistake is in unintentionally putting your dentist in the position of needing to do a procedure he wasn’t adequately trained in  so that you would be happy.

Doing all-porcelain crowns requires artistry that takes significant post-graduate cosmetic training. You going to the lab won’t really help, because you don’t know any more than your dentist does what instructions to give the lab. Here is what I suggest. You’ll need to go to an expert cosmetic dentist and pay his consulting fee. Tell him the situation and ask him to advise you on what to ask the lab.  He may even suggest you go to a different lab depending on how he  feels about the quality of your dentist’s current one. Then you can tell your original dentist his advice.

The next step is for you to find an expert cosmetic dentist. First, I’d go on the website for the American Academy of Cosmetic Dentistry (AACD) and look for a dentist who is accredited with them in your area. That is different from just being a member.  If you can’t find an accredited dentist in  your area I would go to the mynewsmile.com website and look for who they recommend from your state. This site only lists expert cosmetic dentists, so you’ll be safe with anyone on the list.

From now on I recommend going to your invaluable dentist for all your general dentistry needs, but to another dentist for cosmetic issues.

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

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What is the lightest shade?

Hi, I just got two Lumineers to fix some chips and other problems with those two teeth.  The problem is they are darker than my other natural teeth. My dentist keeps telling me he gave me the lightest shade and if I’d just stop whitening my other teeth (which I don’t anyway) they would match up.  I see people with teeth whiter than even mine, so what exactly does he mean by the whitest shade?

Breanna N. from Wisconsin

Breanna,

The problem is your dentist is a general dentist who does cosmetic dentistry and not an expert in the field. It takes significant post-graduate training to become really skilled with cosmetic dentistry.

Here is what is happening. It dental school we are taught the whitest “natural” shade for most teeth is a B1. I suspect that is what he ordered from the lab. We can get teeth much whiter than that, but the lab has to be instructed properly.  I’m surprised the only thing you didn’t like about your Lumineers was the color. Many people find that brand of porcelain veneers to be a little bulky.

There is no way to change any brand of veneers once they are permanently bonded on. You can, however, get them removed and have another brand of porcelain veneers placed. However, don’t go to your family dentist again. Look for someone in your area who is accredited with the American Academy of Cosmetic Dentistry (AACD).

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

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Smile makeover without spending a fortune

I want to get a smile makeover. My problem is I can’t spend a fortune. My sister just got her smile done, but it cost her $35,000. I don’t have that kind of money. Personally, I think my sister was overcharged. She tends to want to only go to the top of the line for anything. My question is how can I find a highly qualified cosmetic dentist without spending an unreasonable amount of money? Oh, my dentist says I have a problem with grinding. I don’t know if that will affect my makeover. FYI, I don’t trust my dentist for cosmetic work. He’s a good regular dentist though.

Gail B.- New Mexico

Gail,

There are two ways to find a great cosmetic dentist. One is to go on the American Academy of Cosmetic Dentistry (AACD.com) website and look for someone who is accredited with them that practices in your area. There is a difference between accreditation and membership, so make sure you are looking up the right thing. Another avenue is to look on the mynewsmile.com website and see who they recommend in your state.

For a smile makeover you generally do porcelain veneers or porcelain crowns. Sometimes a mix of both.  Because of your grinding issue, I’m guessing the dentist you choose will recommend mostly porcelain crowns.  It is good you are not just going to your family dentist to get your work done, because you would end up out of a lot of money as well as disappointed in the results.  Not all highly qualified cosmetic dentists charge a fortune, but they won’t be cheap either. I would make a list of potential cosmetic dentists from those two sources, then call and ask them how much they charge for porcelain crowns. You’ll probably be able to find one who is both qualified and reasonable in their fees.  I hope this helps.

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

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Dens in dente

My dentist said I have a dens in dente. He wants to do a root canal on it. Is that the best option?

Karrie S.- Albany, NY

Karrie,

You didn’t say if your tooth with the dens in dente (a tooth within a tooth) is infected. If so, then a root canal treatment might be a good option. If not, then there is no point in doing the root canal.  The best treatment for this situation is to clean out the pit of the tooth really well, fill it, then cover it with a white composite material, like you’d get with white fillings. There is no reason to do anything else with this tooth unless there is a cavity or infection.

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

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Broken front tooth

My daughter fell and broke off part of her front tooth. She is really embarrassed and I want to get if fixed right away, but my dentist said he can’t see her for six weeks. He told me the root of the tooth needs time to heal, so it is better to wait. Is there anything I can do to make her feel less conspicuous?

Jeanine- San Francisco

Jeanine,

There really isn’t any reason for you to wait to have her treated.  If you have the piece of the tooth the broke off then the dentist can re-attach it. If you don’t have the piece, they can fix it with dental bonding until she is old enough for a permanent porcelain crown.

Be careful not to price shop these procedures. I cannot stress enough how important it is to see an expert cosmetic dentist. You want your daughter to be comfortable with her appearance. Someone who is accredited by the American Academy of Cosmetic Dentistry (AACD) will be able to create a beautiful bonding for your daughter. Be aware that being a member of the AACD and being accredited by them are two very different things. Any dentist can join the AACD, but to become accredited you have to pass a stringent examination and demonstrate your artistic ability.

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

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Options for straightening teeth

I’ve had crooked teeth my whole life. My parents could not afford to get them fixed. I’m now starting my career and have some discretionary money to fix my teeth. Could you list out some ways to fix my teeth at varying expenses. Don’t tell me what is the cheapest or most expensive. I want to just think about what I feel the best option is.

Thanks,

Cynthia F.- Alabama

Cynthia,

Here are three good options for you:

1. Invisalign: Not everyone is a candidate, but any Invisalign dentist can tell you and many dentists do a complimentary consultation so you don’t waste money figuring out if you’re a candidate.  These are aligners that work like braces, except that they are essentially invisible. No one will know you are wearing them. They’ll take about six months to a year to straighten your teeth.  When you’re done, you’ll have a beautiful, straight smile. You might ask your dentist if he’ll allow you to use the aligners as whitening trays. That will allow you to knock out two birds with one stone.

2. Cosmetic Contouring: This is a reshaping of your teeth that takes about one to three office visits. You’ll need x-rays to make sure your teeth are healthy enough for this procedure.  Sometimes just a couple of millimeters of tooth reduction can make your smile completely different. A sanding drill or laser can reshape them. Abrasive strips can shape the sides of your teeth.

3. Porcelain Veneers: In just two appointments, you can change the shape, size, and color of your teeth.

Here is some important advice though, the last two methods need an expert cosmetic dentist.  Don’t settle for the average family dentist who knows some cosmetic procedures. He needs to have the expertise and artistry that only comes from extensive post-graduate training. Your safest avenue is to find someone who is AACD accredited.

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

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Fluoride in Toothpaste

Does kid’s toothpaste contain more or less fluoride than adult toothpaste?

Thanks, Leslie

Dear Leslie,

Adult toothpaste sold in the United States that contain fluoride have about 1,100 to 1,450 parts per million (ppm) fluorides. Children’s toothpaste contains anywhere from 100 ppm to 1,400 ppm. Almost all toothpaste sold in stores nowadays contains some fluoride. There are some toothpastes that contain no fluoride and these are most likely to be found in health food stores. Since children are more likely to swallow toothpaste it’s recommended not to purchase fluoridated toothpaste for children less than two years of age unless the child is prone to tooth decay and it’s recommended by a dentist. If fluoride is ingested a child can become sick with an upset stomach as well as vomiting. After the age of two parents can start to purchase toothpaste with fluoride however make sure you watch your young child brush their teeth and at the same time make sure they are spit out the excess toothpaste and rinse with water afterwards.

If you are wanting to purchase a fluoridated toothpaste to fight in the prevention of tooth decay research suggest that toothpaste containing less than 1,000 ppm fluoride concentrations has the same effectiveness as toothpaste that contain no fluoride. Therefore in order to prevent cavities purchase toothpaste that has more than 1,000 ppm fluoride concentration levels.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

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Dental Flap Surgery

My dentist is recommending I see a periodontist for dental flap surgery. What is Dental Flap Surgery?

Thanks, Gloria

Dear Gloria,

Flap surgery is recommended when root planing and scaling are not enough to treat moderate to severe periodontal disease in eliminating the pocket. This surgical procedure is done with a local anesthetic and the gums are loosened around the tooth and bone to thoroughly clean the roots of the tooth removing tarter and diseased tissue. Because periodontal disease causes the bone to deteriorate around the tooth, most of the time during flap surgery the bone is reshaped to help the tissue heal properly. If the bone is severely damaged synthetic bone or cadaver bone is placed around the tooth to help bone grow back. Your tissue is then sutured back into place and usually covered with a periodontal pack or gauze to protect the area. After a week your sutures will most likely be removed by the periodontist.

This procedure can take up to three hours to complete, depending on the severity of periodontal disease and the sites being treated. Antibiotics and pain medication are usually prescribed following this procedure to help with infection and ease any discomfort. Twenty four hours after surgery it’s usually recommended to swish with salt water rinses to reduce swelling. If swelling is not reduced over a few days place ice packs on the side of your face where the procedure was completed to help reduce the inflamed site. Make sure you maintain good oral hygiene by brushing and flossing regularly but be gentle. Eat soft foods and as the area heals you can put more solid foods back into your diet.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

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Is There A Way To Prevent Jaw Clenching On Amphetamines?

There is a research chemical that goes by the name of Benzo Fury, its chemical name is 6-APB and theoretically taking it makes your eyes open wide and pupils dilate to the point that it is mostly just your pupil, but it also makes your jaw tense till its rock hard and doesn’t move much when you talk, it tightens around the two sides of your jaw connecting it to your top skull so my main question is that I have been told that magnesium supplements are able to prevent this happening to your jaw, is this true? If there is any other advice it would be much appreciated since it is helping me with my research.

Thanks, Russ

Dear Russ,

One of the main side effects of taking amphetamines is bruxism more commonly known as teeth grinding. Many users of amphetamines become addicted to this drug whether it comes in a legal prescription dose or its illegal use as a recreational drug. There is really no cure for bruxism, however evidence suggests that magnesium supplements, calcium, and pantothenic acid (vitamin B5) may help. It has been noted that a deficiency of magnesium in the diet causes teeth grinding, so even if you increase your intake of magnesium and still take amphetamines which causes one to grind their teeth it most likely will not stop you from grinding. Botox has been used to weaken the muscles surrounding the jaw which has reduced the effects of clenching and grinding of the teeth. Muscle relaxants prescribed from your medical doctor at bedtime has also been effective in reducing teeth grinding.

For the most effective tips on reducing grinding of teeth we recommend the following therapies:

  • Reduce stress – Many of us grind our teeth due to the daily stress we encounter in our lives. Seek counsel or strategies that reduce stress like yoga and meditation.
  • Splints – Ask your dentist to make you an appliance to wear to prevent you from grinding your teeth. This may help you wean your habit of grinding as well as prevent you from wearing down your teeth, having your gums recede, tooth mobility, headaches, pain, and soreness.
  • Misaligned teeth – If your teeth are not aligned properly bruxism can occur. One can benefit from orthodontics or full mouth reconstruction.
  • Behavior therapy – When you notice yourself grinding or clenching start positioning your jaw in the proper position. Close your mouth, don’t allow your teeth to touch, and keep your tongue upward.
  • Exercise your jaw – Before your go to bed open your mouth as wide as you can and hold it open for 10 seconds. Repeat this therapy 10 times, which will help your jaw relax before bedtime.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist