Tag Archives: COVID-19

Porcelain Veneers

Smile Makeover Disaster

I need some advise. I had porcelain veneers done. The first time they came back they were way too thick. Even my dentist knew that by looking. I asked him to send them back, which he did. When they came back again, they didn’t really let me see them. They did tell me they could make any adjustments necessary after they were bonded on. That turned out not to be true. They ended up very bulky looking and, though I did ask for a white smile, they ended up chalky and fake looking . I absolutely hate them, but my dentist isn’t returning my calls. Do you have a recomendation of how I can get this fixed?

Carla

Dear Carla,

A single porcelain veneer being placed on a tooth

I think you’re suffering from having a decent family who is trying to do cosmetic dentistry he’s not qualified to do. Believe it or not, smile makeovers aren’t taught in dental school. A dentist has to invest in a significant amount of post-doctoral training in order to develop the skills necessary to create beautiful smile makeovers. My guess is your dentist didn’t invest in that.

True cosmetic dentists also know that it is the patient’s perception of their smile that matters most. Because of that, they will use a temporary try-in paste so you can get a good look at your porcelain veneers in a variety of lightings before they are bonded on. You have a legal advantage. He misled you regarding the ability to make changes to your porcelain veneers after they were placed, bonding them on without your official permission.

Getting Your Porcelain Veneers Done Right!

Normally, I would say insist on a refund, however, you mentioned he’s not returning your calls. That may be because he is avoiding you or, if we want to be generous, maybe he’s not checking messages as much if his office is closed during the COVID-19 quarantine. Though, they should be open for emergency procedures.

Leave him another message letting him know if you don’t hear back from him this time, you’ll be contacting a lawyer. That will kick him into gear. If you do end up having to get a lawyer involved, you have a pretty solid case. I’m sure his insurance holders will advice him to settle quickly.

When you go to have these re-done, I want you to be certain you use a dentist with both training and artistry.. Ideally, you’d see an AACD accredited dentist (which is different from just being a member). Accredited dentists are in the top 1% of dentists in the country. If you can’t find one of them within a reasonable distance to you, contact me again and we’ll help you find someone.

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

Invisalign

Smile direct Club Safety

I’ve been wanting to straighten my teeth for years, but wasn’t able to invest the amount of money into it required. I’d run across Smile Direct Club on Facebook. They are significantly cheaper than Invisalign.I did wonder in the back of my mind whether they were too good to be true. Is it okay to use this? I was especially interested because we can’t go in to see a dentist at the moment for routine care because of COVID-19. This seems like a quick, easy way to get my teeth straightened while still social distancing.

Mercy

Dear Mercy,

Invisalign aligner
Invisalign aligner

Smile Direct Club advertises as a more affordable way to invisibly straightening people’s teeth by comparing themselves to Invisalign. While there are some similarities, the differences are the most striking. First, how they’re similar:

  • They use clear aligners
  • You switch your aligners out as your treatment progresses.

That’s about it.

The Shortcomings of Smile Direct Club

It’s the ways in which Invisalign is different that create my biggest concerns.

The Pre-Exam

With orthodontics under the care of a dentist, you get a thorough pre-exam. This is important. You need a dentist to look for things like decay, failing fillings, gum disease, and signs of TMJ Disorder. Ignoring these can have serious consequences. For instance, if you do orthotdontics with untreated gum diease, you could end up with you teeth coming loose.

With Smile Direct, there is no real exam, putting you and your teeth at risk.

The Impression

An accurate impression of your bite is essential for a proper treatment plan. It’s so imperative it’s done right that many dentists won’t even let their hygienists do it.

What you’ll get with Smile Direct is a do it yourself kit. If that impression isn’t free of imperfections, it will throw off your treatment.

The Treatment

Though many cases go as planned, not all of them do. Sometimes teeth don’t turn the way they should or you need more space opened up than originally planned. In that case, a dentist will need to carefully shave some of the sides to your teeth.

I honestly think you are safer waiting for COVID-19 to calm down. This will be the safest way to straighten your teeth.

An Added Benefit with Invisalign

In addition to being able to safely straighten your teeth, the Invisalign aligners can double as teeth whitening trays enabling you to straighten and whiten your teeth simultaneously. It’s like getting a mini smile makeover.

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

Emergency Dentist

what is essential treatment?

I know during this time of quarantine that we all have to do our part. I’ve been doing very well and not going anywhere. Unfortunately, I took a spill down our stairs and ended up chipping a tooth. Would this be considered an essential treatment? I feel silly. I know it is just a chip but it is bugging me.

Camille

Dear Camille,

a before and after picture of dental bonding for a chipped tooth.

The CDC hasn’t listed what procedures and treatments are considered essential and what isn’t. For the most part, they expect us to avoid routine procedures. If it were just a cosmetic issue alone, I would say you would need to wait until the quarantine is over.

However, based on what you said, there is more to this than just cosmetics. You took a fall which caused the damage. There could be underlying trauma to the tooth which needs immediate treatment. Sometimes the ligament can be stretched and if you don’t splint the tooth you can end up with a tooth that comes loose. Other times, the trauma is so severe, the pulp of the tooth dies and you need a root canal treatment.

Under normal circumstances, I’d suggest you call your dentist and ask him to squeeze you in for an emergency dental appointment. In this case, the only appointments are for situations like yours.

If you’re going to need an emergency appointment. This is the perfect time!

Getting the Chipped Fixed

If it turns out there is not damage from the trauma that requires immediate treatment, then your dentist can likely go ahead and fix the chipped tooth. I mean…you’re already there.

The ideal solution for this is to have dental bonding done. You can see an example of that in the image above. I will warn you. It does take an expert cosmetic dentist. If your dentist isn’t one, my suggestion is you see him for the trauma. Then, once the virus calms down, see an AACD accredited dentist to do the bonding to repair the chip to your tooth.

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

Porcelain Veneers

Caring for My Porcelain Veneers

I recently had porcelain veneers placed, before all this quarantine craziness. I do love the veneers but want to make sure I take good care of them. Is there a particular toothpaste or mouthwash I should be using. Normally, I make my own mouthwash, but don’t want to use it if the ingredients are bad for my veneers. Our governor closed all dental offices so I don’t think I can even reach my dentist.

Here’s my recipe:

  • 8 oz. of filtered water
  • 8 oz. of 3% hydrogen peroxide
  • 2 T. of sea salt

Karli

Dear Karli,

A single porcelain veneer being placed on a tooth

I’m glad to hear you love your porcelain veneers. Too many patients end up with a disappointing smile because they don’t go to a skilled and experienced cosmetic dentist.

Caring For Your Porcelain Veneers

Let’s start with the toothpaste. Generally, for any type of cosmetic dental work, I recommend Supersmile toothpaste. It was specifically designed to work with all types of porcelain as well as normal tooth structure. Unique in its ability to keep your teeth stain-free without damaging the glaze on your porcelain veneers or the enamel on your teeth.

Other whitening brands of toothpaste contain abrasives. While they can make your teeth look whiter and cleaner for a while, they are also putting micro etches into the tooth, which will cause it to pick up stains more quickly.

As for mouthwash, when you brush and floss regularly, you really would only need mouthwash occasionally, if at all. If you do want to use a mouthwash, the one thing you want to avoid is any mouthwash which contains alcohol. The alcohol will eat away at the bonding that keeps your veneers attached to your teeth.

The recipe you listed, while safe for your porcelain veneers, has one ingredient which requires caution. Hydrogen peroxide is great at killing bacteria. Unfortunately, it will also kill the helpful microbes allowing candida yeast to thrive.

If you use this recipe sparingly, like once a week, you should be fine. Much more than that and you’ll end up with thrush, which is an oral yeast infection.

I hope this was helpful. Enjoy the extra time with your family during this COVID-19 quarantine.

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

CEREC

Is a CEREC Crown falling Off an Essential treatment?

I had a CEREC crown placed right before the lockdown for COVID-19.. Today, it just fell out. Our governor said you can only go to the dentist for essential treatment. How do I know if this is essential? Do I go in or wait until the quarantine is over?

Mark

Dear Mark,

porcelain block for CEREC crown
Block of porcelain for a CEREC crown

In most cases, because of COVID-19 and how easily it transmits, the CDC and Governors of many states are asking us to forego routine treatments until we have a handle on the virus. That would mostly include things like cleanings, checkups, and elective cosmetic procedures such as teeth whitening and smile makeovers.

Essential appointments are things like emergency dental care, such as you’d have with a tooth infection or other types of repairs. Your case is one of those. If a dental crown falls off, which by itself should be unusal, it is important it gets re-bonded.

If you wait until the quarantine is over, the adjacent teeth will begin to shift into the space left open. This will mean by the time you are able to contact the dentist for the re-bonding, your CEREC crown will no longer fit and you’ll have to get an entirely new one.

Don’t wait. Call your dentist.

One other thing, as I said earlier, it is highly unusual for a dental crown to fall out, especially a CEREC crown. They are milled by a computer so they are usually a tighter, more accurate fit. If your dentist rebonds this and it falls out again, I’d recommend you see a different dentist.

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