Tag Archives: Porcelain Veneers

Uncategorized

Porcelain crowns for front teeth?

I have been talking to my dentist about what to do to restore my smile. I have significant wear on my top teeth, and a gap between my two front teeth that has bothered me most of my life. Before I talked to my dentist about this, I did all kinds of research on the different kinds of available treatments, especially looking at different kinds of porcelain crowns. I really think–and my dentist confirmed this–that porcelain crowns will be the best way to fix my teeth.

The thing is, we don’t agree on what kind of porcelain crowns would be best. Both my dentist and his partner say they will only do porcelain fused to metal crowns. Everything I have read makes me believe that porcelain fused to metal crowns will not look as nice as I want them to look when we are done. Their reasoning for this is that I sometimes grind my teeth, and can’t stand wearing a night guard. They both say that the all ceramic Zirconia crowns like I want are not strong enough to last if I continue to grind my teeth. Both my dentist and his partner have impressive credentials, which is the main reason I chose them.

In your experience, do all ceramic crowns like Zirconia tend to sustain damage if used on an occasional grinder? It is not all the time, just intermittent.

I have waited a really long time to get this done, but I just can’t get excited about the porcelain fused to metal crowns. My dentist is all ready to get it done, but I think they will look fake, and I don’t want to spend that amount of money on something that is not exactly what I want.

I could really use your help on this.

Thanks,

Jerry in Indianapolis

Dear Jerry,

I think you’re going to need a second opinion. The Zirconia porcelain crowns that you mention are indeed very strong, certainly strong enough to withstand great stress. If your teeth grinding is not constant or severe, they might well work as a great option for you. An added bonus is that the all-ceramic or all-porcelain veneers can be made thinner than porcelain fused to metal crowns, and so less of your natural tooth structure has to be removed to place the crowns.

It is possible that despite the impression credentials your dentist and his partner take more of an engineering approach to restoration rather than an artistic one. It is also possible that your grinding problem is worse that you think it is. I strongly encourage you try again with the mouth guard. Teeth grinding can cause very serious, life-long issues.

In either case, if you are determined to go with the Zirconia crowns, then you would be best served to seek another dentist. It is always a bad idea to push a dentist to do something he does not want to do. For whatever reason, your dentist and his partner are not comfortable with the Zirconia crowns, and you are fortunate that they have the professional integrity to be completely honest with you about this. Insisting on a treatment plan your dentist is not comfortable with often ends badly, so if you are certain the Zirconia crowns are what you want, you’ll need to find a dentist who is comfortable placing them in your situation.

 

Porcelain Veneers

Porcelain crowns for a smile makeover?

This may seem like it is coming after the fact, but I am curious about something. I recently had a smile makeover done. I thought I was going to have all porcelain veneers placed, but when I look at the backs of my teeth, it looks like the porcelain goes all the way around. Is it normal to place porcelain crowns instead of porcelain veneers for purely cosmetic reasons? I thought crowns were just for teeth that were damaged. I guess the reason this concerns me is that maybe my teeth were in worse shape than I though, if they needed crowns.

I’ve since seen my general dentist, and she seemed very impressed with the work, so I am not concerned about the quality of the workmanship. Is this standard, to have crowns instead of veneers for a cosmetic smile makeover?

Thanks for your insight,

Ben in Oregon

Dear Ben,

Porcelain crowns and veneers differ only in degree–there really is no specific line of demarcation where a veneer becomes a crown. The fee for a porcelain veneer is usually the same or nearly the same as that for a porcelain crown, because the effort to place each type of restoration is about the same.

It is actually quite common to see porcelain crowns used on the front teeth for cosmetic reasons rather than protective ones. If your teeth were not weakened or damaged, your dentist might have decided to go with crowns to control your bite.

It is surprising that the dentist did not discuss this in detail with you during the course of your treatment. Typically, smile makeovers involve a great deal of give and take between the dentist and the patient, because the dentist will want to make absolutely sure he or she knows exactly what the patient wants.

The simplest solution is simply to ask your cosmetic dentist why he decided to go with porcelain crowns rather than veneers. Crowns are the more aggressive form of treatment, and require more reduction of the natural tooth structure. Veneers require only a little bit of shaving on the front of the tooth. For that reason alone, I would expect your dentist to have a sound reasoning for choosing the crowns. Most dentists will always pursue the least aggressive form of treatment and strive to preserve as much of the natural tooth structure as possible.

Uncategorized

Brown spots won’t respond to whitening products

I am in my early 20’s and just recently graduated from college. For almost as long as I can remember, my front teeth have been discolored. I have ALWAYS taken really good care of my teeth (no cavities!), but my mother told me the discoloration was caused by an illness I had as a small child. Now I am trying to get my professional career off the ground, and I feel like my teeth are making an awful first impression.

With the support of my dentist, I have tried almost every over-the-counter teeth whitening product available. If anything, my teeth look WORSE now. The spots did not change in color one bit, but the contrast with the surrounding tooth material (which whitened considerably) is even more noticeable and ugly. Now my dentist is suggesting a “trial” treatment, where he will grind away at the spots until they are gone. The problem is he doesn’t know how much he will have to grind, and I just cannot imagine how this will ever look good!

What about professional whitening? I just really need to get this issue addressed. My teeth are holding me back, and my self-confidence is really taking a beating. I don’t want potential employers to think that I am the type of person who doesn’t even properly care for their teeth!

Thanks so much for your help,

Leta in Albany

Dear Leta,

First and foremost, find a different dentist. Your current dentist obviously does not understand the principles of teeth whitening or he would not have had you wasting your time and money on repeated attempts of the same treatment. Professionally whitening is unlikely to yield the results you want, either. And the idea of grinding away the spots could go horribly wrong.

You need to seek the services of a talented, experienced, educated cosmetic dentist. Make sure you thoroughly check their credentials, and ask to see pictures of their work.

Depending on the severity of the spots, there is a very small chance that a technique called microabrasion might work. This is often used with white spots, but is only effective with brown spots when they are very superficial.

If the spots are small, dental bonding may work to cover them. This is one of the most difficult and artistically demanding skill sets in cosmetic dentistry, so make very sure the dentist you chose is not just competent, but exceptional. If bonding will not work, porcelain veneers may be a solution. Both of these treatments require a high degree of artistry and skill.

I hope you can find the right dentist to help you.

Porcelain Veneers

Teeth very sensitive after removal of braces

I had braces for two years, and have just recently had them removed. Ever since they were taken off, I have noticed that my teeth are incredibly sensitive to temperature. If I try to eat or drink anything hot or cold, it is really painful. I can also feel rough patches and dips on the front of my teeth, almost as if the enamel is gone. Could my orthodontist have damaged my teeth when she removed the brackets? I am also noticing that my teeth seem to be getting darker every day. I don’t drink coffee or cola very often, but my teeth seem to soak up every stain like never before.

What should I do? I did not go through two years of ortho to have ugly teeth!

Thanks for your time,

Savannah from Council Bluffs

Dear Savannah,

I don’t think your orthodontist caused this damage, though it is not unheard of that damage can happen during bracket removal. The patches you describe sound like areas of decalcification. These are areas where your teeth have lost some minerals, and those areas are porous, which is causing the staining you are seeing. Those spots may eventually turn brown, and even chip away, leaving pitted holes in your teeth. I am sure this is NOT what you envisioned as you went through orthodontic treatment, and that missing enamel is what is making your teeth so sensitive.

Teenagers are not always as diligent as they should be about brushing their teeth after eating, and when a teen has braces, the problem is magnified. The brackets allow food to sit against your tooth, and underneath the brackets, the acid in your saliva that helps digest food is busy working away at the surface of the tooth. The extent of the problem becomes really evident when the braces come off.

It is important to address the issue before it gets any worse. Bleaching will not help the stains. It will probably make them look worse, so I would not recommend going that route. If the damage is just to a few small spots, a treatment choice might be dental bonding. Freehand dental bonding is one of the most challenging cosmetic dentistry techniques from an artistic standpoint, and if it is not done well, you will not be happy. Make sure you chose a cosmetic dentist who is trained and experienced. Direct dental bonding requires a very high degree of artistry and technical skill that very few dentists possess.

If the damage is extensive and/or severe, you may be looking at porcelain veneers. That is a daunting prospect after two years of orthodontic work, but it is better to be prepared.

If you have friends that still have braces, you can be their cautionary tale. People with braces simply MUST brush after every single time they eat. At the very least, they must rinse thoroughly with water if brushing is impossible. It is very frustrating to go through all those years of ortho work, only to continue struggling with dental issues when you are done.

Porcelain Veneers

How to fix fluorosis stains?

We are having a lot of problems with my 10 year old daughter’s teeth. The permanent teeth that have come in are extremely yellow, and very blotchy. Our dentist says the blotchiness was caused by too much fluoride. I thought fluoride was good for teeth! She has braces right now, so we have a little time to figure out how we should fix the discoloration and blotchiness. We are trying to address these issues now, because she is very self-conscious about her teeth, and we want to start making positive changes before she hits puberty.

Thanks for your help,
Rochelle in Baton Rouge

Dear Rochelle,

The blotchiness is caused by fluorosis, and it is indeed a symptom of too much fluoride while your daughter’s teeth were forming. Most communities have to add fluoride to their water, but some naturally have too much fluoride, and if it is not detected and removed, extended use can cause fluorosis. This can also happens when people drink untreated well water that is naturally high in fluoride. Fluorosis can even be caused by years of swallowing too much fluoridated toothpaste.

Whatever the root cause, if your daughter’s fluorosis stains are severe, you will probably have to treat them with porcelain veneers. In mild cases of fluorosis, the spots can sometimes be treated with bonding to cover only the affected spots. Severe staining will require more extensive coverage, and that indicates that porcelain veneers would be the treatment of choice.

The good news is that there is no minimum age for porcelain veneers, so you could conceivably get something in place when her braces come off. If you do choose to pursue veneers when she is in her early teens, make very sure you choose a highly skilled cosmetic dentist who has experience doing veneers for teenagers.

Invisalign, Porcelain Veneers

What is faster than braces?

I am getting married a year from now, and searching for “The Dress” was an eye-opening experience, and not in a good way. After a while, all I could see in the mirror was my crooked, crowded teeth! I really want to look and feel my best for my wedding day. I had a consultation with an orthodontist, and she told me that straightening my teeth with braces will take at least two years. I don’t have that kind of time! Is there a faster way to have a really beautiful smile for my wedding day?
–Kimberly in Bangor, ME

Dear Kimberly,

If you have crowded, crooked teeth, there are a couple of different ways you CAN have a beautiful smile in just a few months, but only if you consult the right professional. You need to talk to an expert cosmetic dentist, not an orthodontist. An expert cosmetic dentist (especially one accredited by the American Academy of Cosmetic Dentistry) will be able to offer you options that a traditionally trained orthodontist is not qualified to provide.

Invisalign braces can straighten your teeth in six to nine months, depending on the degree of crowding. Extremely crowded teeth might take a little longer, but treatment with Invisalign braces rarely takes more than a year. An added bonus to using Invisalign is that even if your treatment is not completely finished by the day of your wedding, the aligner can simply be removed for the big day and pictures. If your teeth are otherwise intact and attractive, Invisalign might be the way to go.

An even faster option is to go with porcelain veneers, but here especially you must be very careful about choosing the right dentist. Many dentists have the technical skill to place the veneers, but they lack the artistic sense to make your smile truly beautiful and natural. If your teeth are discolored or misshapen, porcelain veneers can give you a really gorgeous wedding day smile quite quickly.

The bottom line is that you really should have the advice of an expert cosmetic dentist that has experience with both treatment types before you make any decisions. Choose your dentist very carefully, and then you know you can count on their advice to be sound.

Good luck, and congratulations on your wedding.