Tag Archives: Louisiana Cosmetic Dentist

CEREC

Do CEREC Crowns Break Easily?

I’ve had crowns before and have never had any problems. My previous crowns were with a different dentist and were always the result of an infection gone mad which required a root canal treatment. This time, I decided to try to get treatment before an infection developed. Unfortunately, the new dentist said the cavity is too large for a traditional filling and will still need a crown (well, at least I don’t also need a root canal). It’s a step up. He told me he could give me a CEREC crown in just one day. I liked the idea of not missing more work and agreed, but after just two weeks it broke. I called the office and he offered to replace it for free. I’m hesitant to do so if it will just break again. Are CERECs weaker than other crowns?

Olivia

Dear Olivia,

Machine for CEREC Crowns
CEREC Crowns are Milled by Computer

CEREC crowns are just as strong as traditional crowns. What happened in your situation is incredibly unusual. As you’ve had several crowns before, did you notice anything which felt unusual about this one? Maybe your crown hit your teeth before the rest of your teeth or possibly tooth pain when you bit down? I could see a crown breaking if it sat way too high, but even then it would take some flaws in the materials for it to break that soon after it was placed.

In general CEREC crowns have less of a chance of having a problem because they’re designed by a sophisticated software program and milled by machine. They should fit perfectly. You didn’t mention pain, which again makes me wonder about something being off with the materials.

Redoing Your CEREC Crown

Going forward, I’d give your dentist an opportunity to fix this. It’s so unusual for this to happen so I doubt it would again. If it does, the dentist would be the problem. If you happen to look up your dentist’s reviews and see this is a regular thing, then my suggestion would be to find another dentist. It probably wouldn’t matter what type of crown he gave you.

In that case, you may want to see an emergency dentist in your area. They can help you get a crown and get you back on your way. You won’t want to wait too long because your teeth will shift into the open space left by the broken crown.

I’m NOT saying this is what happened, but be careful about dentists whose prices are significantly lower than other dentists in the area. There is a huge difference between an affordable dentist and a cheap dentist. Our area was hit hard economically, so it’s tempting for patients to go for the cheapest. It’s also tempting for some (less ethical) dentists to draw in patients by lowering their prices, then buying subpar materials which helps them make up their profits.

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

Invisalign

Did the Oral Surgeon Lie to Me?

When I turned 18 my wisdom teeth began to bother me. We checked them and my dentist said, they don’t have to be removed, but if I wanted to remove them she’d give me a referral to an oral surgeon. We decided to just see what he had to say. He told me I really needed to removed them, otherwise, I’d need braces from crowding. If I had them removed, I’d not have to face that. I’m almost 40 now and suddenly my teeth are crowding. Did he lie to me or is something else going on? What can fix them at this point? I’m a little old for a mouth full of metal. Heck, I didn’t want that when I was young.

Tabitha L.

Dear Tabitha,

A woman placing in her Invisalign aligners

I don’t think the oral surgeon intentionally lied to you, though, admittedly I don’t know who he is or anything about his practice habits. He was, as we’re giving him the benefit of the doubt, overly generous of the benefits of removing your wisdom teeth. While it did prevent your wisdom teeth from causing crowding, it can’t stop other causes of crowding.

Reasons Teeth Can Crowd

There are numerous reasons for crowding aside from wisdom teeth which don’t fit. Here are just a few which could pertain to your situation:

  • Grinding

Most people who grind their teeth don’t even realize they’re doing it. Generally, it’s the dentist who first recognizes the signs of teeth wearing down due to the grinding. Believe it or not, that back and forth pressure can shift your teeth. A simple mouthguard can protect your teeth in these situations.

  • Sucking

I’m assuming you’re well past the pacifier and thumb sucking stage, but even some adults have an oral fixation. You see it when they always seem to need something in their mouth, pens and other things.

  • Losing a Tooth

If you lose a tooth and don’t get it replaced, your teeth will shift to close in the gap. This shifting can cause problems for the remaining teeth. At the very least, things will start to look off. This is one of the reasons it’s quite important to replace a missing tooth with something like dental implants.

  • Shoddy Dental Work

There are unskilled dentists out there. Poorly shaped crowns, bridges, and other work may change the bite or begin to push teeth out of alignment. Often the patient ends up with a serious case of TMJ Disorder.

  • Tooth Trauma

When there is an injury to your teeth it can affect them in a variety of ways, including shifting.

  • Tumors

Don’t panic about this if you get regular checkups with x-rays. Your dentist would have noticed this. But, if you have sudden huge changes in your bite, it’s worth getting another x-ray. It’s rare, but tumors can significantly change your jaw, teeth, and bite.

Repairing a Bite without Braces

There is a simple solution in your case. If it’s just a matter of your teeth shifting and crowding Invisalign is a perfect solution. This uses clear aligners to straighten your teeth. No one will know you’re wearing them, even at a conversational distance.

Talk to your dentist. Let he or she know what’s going on. They’ll help you get the smile you’ve always loved back.

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

Porcelain Veneers

Dentist Blamed My Mouthwash for My Veneers Falling Off

I had porcelain veneers placed on about a month ago. Two of them have fallen off. I went in to see my dentist about it. He agreed to bond them back on free of charge. When I asked them why they fell off, he got offended and blamed my mouthwash. Is that accurate? Am I damaging my porcelain veneers?

Betsy B.

Dear Betsy,

Porcelain Veneer being placed on a tooth

There are certain mouthwashes that could (eventually) cause a problem with your porcelain veneers. I doubt any of them would cause them to fall off that quickly. It sounds like your dentist is passing the buck for his poor bonding technique.

Most mouthwashes are fine to use with your dental implants. The ones to watch out for containing alcohol. Listerine is the biggest culprit. It can contain up to 21% alcohol. If you avoid that ingredient, you should be fine and there are plenty of brands to choose from. Crest Pro-Health and Breath-Rx are two alcohol-free brands. Many dental offices even sell it in-office.

I’m a little concerned with the response your dentist gave you. I don’t like it when professionals don’t take responsibility for their mistakes. The bonding on porcelain veneers is quite strong and, when properly done, lasts the lifetime of the veneers. Yes, there are things which can damage it, but rarely is that seen to wear down so quickly. Is your dentist one who does a lot of cosmetic procedures or just a family dentist who dabbles in cosmetic work? That can make a huge difference in their technical skill, artistry, and even knowledge of their work.

In case they’re not an office with expertise in porcelain veneers, I want to warn you about something before your next check-up. Under no circumstances should your hygienist use any power polishing equipment, such as a prophy jet. This will take the glaze right off your porcelain veneers. Then they’ll become dull looking and pick up stains quickly. In short, it will ruin them. If this isn’t a practice that knows a lot about cosmetics, their hygienist may not be trained in these procedures.

Caring for Your Porcelain Veneers

  • Choose a soft toothbrush

Often, we encounter patients who use hard toothbrushes thinking the firmness means it cleans better. The opposite is actually the case. All the hard brush will do is scratch your veneers and wear down your gums. Even brushing hard can damage your gums, so brush gently.

  • Choose Your Toothpaste Carefully

While we’re on the subject of toothbrushes, let’s talk about toothpaste. First, avoid whitening toothpaste. They have abrasives in it which is supposed to attack stains. They do. But, they also attack the glazing on both natural tooth structure and dental work, like porcelain veneers and porcelain crowns. This will cause them to actually pick up stains more readily. While teeth whitening can help with natural tooth structure, it can’t do anything for dental work.

The best brand of toothpaste for any kind of cosmetic dental work is Supersmile. It’s specifically formulated for cosmetic dental work.

  • Floss every day

This one is pretty self-explanatory. You need to keep healthy gums.

  • Avoid using mouthwash which contains alcohol

We’ve already gone over this in-depth so we won’t rehash it here.

  • Get cleaning from an experienced cosmetic practice

We’ve discussed above the damage power polishing equipment can do. The same is true of a pumice. The problem is there are many things a dentist or hygienist can do to ruin your veneers. That’s why it’s important to go to a clinic who doesn’t need additional training.

  • Consider getting a mouthguard

This is only necessary if you happen to be someone who grinds or clenches their teeth. Those habits can do serious damage not only to your cosmetic work but to your teeth in general. It can lead to chipped or broken teeth and even TMJ Disorder. The problem is most people don’t even realize they’re doing it because they only do it in their sleep. A good dentist keeps an eye out for that and checks for the signs. If you’re not sure, ask your dentist. A mouthguard isn’t very expensive and can protect you from additional harm.

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

Cosmetic Dentist

Solutions for Tetracycline Stains

My twin sister and I both have tetracycline stains from some medicine we took when we were young. She decided to get something done about them. I kind of wanted to wait until I saw how hers turned out. She went to her family dentist. He crowned all her upper teeth and whitened the bottom teeth. He told her the bottom teeth wouldn’t look exactly like the top because tetracycline stains are hard to whiten. We were prepared for that. The crowns took him a couple of tries before he got something my sister was happy with. Though she likes them, I’m not too thrilled with them. To me, they’re so opaque they look like the porcelain you’d find in a bathtub. Is there a way to get it more natural looking? Yes, I know it’s still better than my teeth, but I’m wondering if a different dentist could have done a better job.

Morgan L.

Dear Morgan,

Porcelain Veneer being placed on a tooth
It takes an expert cosmetic dentist to treat tetracycline stains beautifully.

It takes an expert cosmetic dentist to create a beautiful solution for tetracycline stains. Most cosmetic dentists don’t have the technical skill and artistry necessary. It is among the most challenging of cosmetic cases. Because the tetracycline stains show through tooth structure, both natural and manmade, most cosmetic dentists go too far the other way, as your sister’s dentist did. They make them so opaque to cover the brown of the stains, their teeth end up looking like bathroom porcelain.

That doesn’t mean your case will have to turn out that way. In fact, I’m sad to say, those dentists who are highly skilled in their field spend a great deal of their time fixing subpar cosmetic procedures other dentists have done. We’ve had patients come to us from other offices in tears begging Dr. Malone to fix their smile.

I’m curious as to why your sister’s dentist used crowns on all her teeth. Did she have issues on them which required crowns? I don’t understand why he’d remove so much tooth structure if her teeth were otherwise healthy. Generally, I’d use porcelain veneers to cover tetracycline stains. This only requires mild shaving on the front of the tooth.

Finding an Expert Cosmetic Dentist

Even if there were a recognized specialty in cosmetic dentistry, every dentist’s skill level and artistic eye vary. How in the world is a patient to know if one cosmetic dentist is better than another? Would you even know what to ask if you had an opportunity to interview the dentist ahead of time? Of course not!

This is exactly why the American Academy of Cosmetic Dentistry (AACD) formed. They wanted patients to have a resource where they could find expert cosmetic dentists. Any cosmetic dentist can join as a member, however, they have an accreditation program.

If a dentist is AACD accredited, they’re in the top 1% of cosmetic dentists in the country. They’ve passed stringent exams, both oral and physical. They’ve also had to demonstrate their artistic ability by giving examples of a large number of specific cases they’ve personally performed.

I’d go to their website and look up which AACD accredited dentists are near to your area. It’s worth it to travel just a little if you need to.

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

Invisalign

When Sick Do You Change Invisalign Aligners?

I’m in the middle of my Invisalign treatment. I’m loving it but everyone in my family currently has a nasty virus. It’s only a matter of time before I get it too. If that happens, do I have to get a new aligner, like when you throw away your toothbrush? That seems like an expensive proposition.

Amy L.

Dear Amy,

A woman placing in her Invisalign aligners

I’m glad you’re enjoying your Invisalign. It does have a high patient satisfaction rate. On the other hand, I’m sorry your family has been sick. That’s never fun, especially for the mother who always seems to take care of everyone even when she’s sick.

If you happen to get the virus, you won’t have to toss the aligners and get new ones. Once you have the virus, you won’t catch it again from wearing them. Just be certain to clean them (as you normally would).

The only time you’d need to get rid of a pair of aligners is if they’re damaged or if you’ve completed your two weeks with them.

If they’re damaged, how do you know whether or not to go back to your old ones or move on to the next pair?

If You Damage Your Invisalign Aligners

A lot of which aligners you switch to has to do with how long you wore the damaged pair. If you’re still within the first week of wearing them then just go back to your old aligners. If you’re further in, you can skip onto the next pair of aligners.

You don’t want to do that too often. While your teeth move into their new position within the first few days, you need the remainder of the two weeks in order to allow the bone to reform around the roots of your teeth. Without that, your teeth won’t actually have the support they need. They will end up becoming loose and if you continue switching early will lead to you losing teeth.

A Little Known Benefit of Invisalign

Because Invisalign aligners are custom designed for your bite, they also do very well as teeth whitening trays. This can allow you to not only knock out two procedures at once but save money doing it. Talk to your dentist about providing you with some professional teeth whitening gel. You can wear that for a minimum of twenty minutes a day until your teeth are as white as you want.

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

Porcelain Veneers

Can Porcelain Veneers Cause Gum Disease?

I recently received a set of porcelain veneers. Not very long after my gums started bleeding periodically when I brush. At my last dental check-up, the hygienist told me I’m starting to develop gum disease. I don’t understand what is going on. I’ve never had problems with either cavities or my gums and am very diligent with my oral health care. Is it possible that the porcelain veneers caused my problem? Have you heard of porcelain veneers causing gum disease?

Brenda M.

Dear Brenda,

Porcelain Veneer being placed on a tooth

What’s going on with your gums certainly isn’t normal. If you haven’t changed any habits and the problem started shortly after the placement of your porcelain veneers, it makes sense that you suspect them. However, porcelain veneers on their own will not cause gum disease. Poorly placed porcelain veneers, on the other hand, can cause loads of trouble.

Is it possible your regular family dentist was the one who placed your porcelain veneers? Because the problem started after you received your porcelain veneers, there is likely a connection. Sometimes, an inexperienced cosmetic dentist has trouble getting the veneers flush against the gums. That creates a ridge where bacteria can get caught and will lead to things like gum disease and decay. This could sabotage your oral health. Your hygienist may not recognize it as a problem because that’s how she is used to seeing it in their office.

Dealing with Porcelain Veneers with Margin Issues</h2

There are a few ways this can be dealt with:

  • Water Pick: If you’re otherwise fine with your porcelain veneers and love the overall smile makeover, you may want to invest in a water pick and see if makes a positive difference. It may just give you the extra kick you need to keep bacteria out from the ridge.
  • Have Your Dentist Check the Margins: If your dentist double checks whether the margins are properly fit and admits they’re not, he should fix them at no cost to you.
  • Second Opinion: Some dentists have a hard time admitting if they’d made a mistake. If you want to be certain you can get a second opinion from another dentist to find out exactly.

A word of advice about getting a second opinion. Make sure you don’t tell them what dentist did your work. Then you’re putting the dentist in the position of saying something against someone he may be close friends with. Instead, just tell him to look at the work and tell you what he thinks. Nothing else.

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

Uncategorized

CEREC vs. Traditional Crowns

I’m considering getting a CEREC crown. Are they as good as their traditional counterparts?

Matt.

Dear Matt,

A tooth receiving a CEREC crown
Which is better a CEREC or Traditional Crown?

In one corner we have traditional porcelain crowns. Tried. True. Proven. Strong. Beautiful (with the right dentist). Though, they do take a couple of appointments. They’re milled from more than one block of porcelain.

In the other corner are the CEREC crowns. Tried. True. Proven. Strong. Beautiful (with the right dentist). Made in one appointment. Though, they’re milled from one solid block of porcelain.

Each time I type “Though”, I’m showing the downside of that particular type of crown. While two appointments aren’t horrible, it is definitely more convenient to have it done in one. You miss less work. You use less time. You have your permanent crown from the beginning. So, it would seem that the CEREC crown would be the better bargain. After all, the other features seem to be the same.

So, what’s the big deal about the “Though” for CEREC crowns? Why does it matter if you mill a crown from one block of porcelain or more than one block?

The difference comes from a cosmetic standpoint. Your teeth aren’t of identical translucency from top to bottom. The edges, especially at the bottom, are less opaque than the rest of the tooth. It seems to “thin out” a bit as you move down. There’s also a whiter color in the center than you’d find as you move down.

When you mill from a single block of porcelain, the crown will seem the same from top to bottom. They can look a little flatter because there aren’t those subtle varieties.

When a dentist can draw from more than one block and craft them together, you get the subtleties that reflect light a smidge better in natural teeth.

When to NOT Get CEREC Crowns

In most cases, CEREC crowns are fantastic. They’ll still look beautiful. They’ll still match your teeth. They’ll still hold up to the stresses of daily use. The one exception is on a very front tooth. If you’re getting a crown on one of your very visible front teeth, that’s when I would opt for a traditional crown. This will allow the dentist to use his artistry and make sure every subtle variety of light and color comes through.

Other than in that case, you will get a gorgeous crown with CEREC AND save yourself an additional appointment.

One word of caution. No matter which you decide on, once the crown is completed and bonded on, the color cannot be changed. If you’re going to get your teeth whitened, do it before getting your crown designed.

This blog is brought to you by Dr. Mike Malone

CEREC

Can’t Get CEREC Crowns from My Dentist

I’m so sick of temporary crowns that fall off all the time. Every time I’ve gotten a crown it’s been a disaster from the get-go. I get a temporary and it falls off at every meal. It’s impossible to deal with. Now I find out I need another crown. I told my dentist I want a CEREC crown so I don’t have to deal with a temporary. He insists they’re not as good. I’m seriously considering switching dentists over this. What do you think?

Fanny,

Dear Fanny,
A tooth receiving a CEREC crown

I can understand your frustration. While temporary crowns do occasionally fall out (after all, they’re meant to be temporary) what you’ve experienced is way beyond normal. It says a bit about the skill of your dentist. I wouldn’t normally suggest switching dentists simply because you want a one-day crown, but it seems like your dentist lacks skill.

I’m not sure why he means they’re not as good. They’re just as strong as their traditional counterparts. The biggest difference and the only weakness I can see in comparison is CEREC crowns are milled out of a single block of porcelain. Some dentists feel that for your very front teeth it would look better for you to have a traditionally made crown so the dentist can craft it from several blocks of porcelain giving it more natural variety.

Cerec Crowns and Teeth Whitening

One other thing to consider. Hopefully, your dentist told you that once crowns are milled, their color is permanent. If you want your teeth whitened, you should do it before getting this latest crown if it is in a visible part of your smile.

That way your dentist will match your crown to the new color. Of course, if any of your old crowns are visible, those will need to be re-done to match. If they’re on back teeth which don’t show while you smile, I wouldn’t bother changing them though.

Picking a New Dentist

If you do decide to switch dentists over this issue. May I suggest you consider every type of procedure you may want, even future. If it’s just a good general dentist you want, who keeps up with the latest technology, that won’t be too hard to find.

If, however, you have more cosmetic interests in your future you’ll want to find a highly skilled cosmetic dentist. If they keep up with the advances in cosmetic work, you can be almost positive they keep up with the general side as well. So, how do you find an expert cosmetic dentist in your area? I’d check the American Academy of Cosmetic Dentistry’s website. You’ll want to be certain to get a dentist who’s reached accreditation level.

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

Invisalign

Doubling Invisalign Trays for Teeth Whitening

I’m getting Invisalign which I’m very excited about. My dentist also offers teeth whitening. It appears that the trays for teeth whitening and the trays for Invisalign are quite similar. I noticed that I can buy the gel online. This will allow me to get both procedures done for so much less. Could I use the aligners as whitening trays?

Miranda D.

Dear Miranda,

A woman placing in her Invisalign aligners

I’ll start by telling you that, yes, your Invisalign aligners can double as whitening trays. The caveat being, you need to make sure you’re a good candidate for teeth whitening. I would not recommend just purchasing whitening gel online to use in the aligners, especially if this is your first time whitening your teeth.

You’ll want to be under the observational care of your dentist during your first whitening because there are complications that could arise which you won’t know the warning signs for. He (or she) can spot them and take helpful steps before any complications become more serious.

Secondly, you have no way of knowing whether the gel you’re purchasing is reputable or even equally strong as the gel your dentist can provide. Even worse, it could be material that will damage your teeth.

Teeth Whitening Only Works on Natural Teeth

If you have dental work, such as fillings or dental crowns, they will not whiten with the whitening gel. Instead, your teeth will whiten and the dental work will remain the same color. So, if they’re visible when you smile, you’ll want to replace them when the procedure is done. The same goes for dental bonding.

You will likely find that once your Invisalign and Whitening are done, you will have a stunning smile. You’ll gain confidence and smile more. In turn, you’ll appear more positive and successful to others, which will bring you opportunities previously hidden.

Also, keep your final pair of aligners. Keep them clean and stored carefully, then once a year or so, you can ask your dentist for another tube of whitening gel for a touch-up. Many dentists are willing to provide that if you keep up regularly with your cleanings and check-ups.

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

Cosmetic Dentist

Hate Mail Over Cosmetic Dentistry

I saw a post to Dr. Hall of mynewsmile.com where someone was complaining over the prices of cosmetic dentistry. Saying it was unfair to middle-class families who can’t afford such prices but still want beautiful smiles. Being in Louisiana, whose economy has suffered greatly after the hurricanes and oil spill we’ve suffered recently, I was interested in his response.

Why is Cosmetic Dentistry so Pricey?

A woman with a gorgeous smile created by cosmetic dentist Dr. Mike Malone
A gorgeous smile created by cosmetic dentist Dr. Mike Malone

The price generally depends on two things: the type of procedure you have done and the skill and artistry of the dentist who does it.

For example, if you’re getting dental bonding done, it would cost considerably less than something like porcelain veneers. The materials are different and the results don’t last for as many years as the veneers.

As far as the skill of the dentist is concerned, there are dentists who spend years in post-graduate training developing their artistic skill. They put equal time and detail work into creating the most beautiful smile they can for your which takes up a significant amount of time they could have spent on other procedures.

What Happens if You Go to a Cheaper Cosmetic Dentist?

Every dentist works out their own pricing. But some, with less training and artistry, will lower their prices as a means of drawing patients in. You’ll get porcelain veneers alright, but they likely won’t be what you were expecting.

There are many cosmetic dentistry horror stories by patients who had to go to a second dentist to get the work re-done because their “affordable dentist” gave them a disaster of a smile. Dr. Malone has had to fix quite a few patient’s smile makeovers who came to him in desperation after their dentist botched the work.

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