Tag Archives: Teeth Whitening

A Serious Problem with smile care club

During a YouTube binge, an acquaintance come across this video by a young woman called Rosie Posie. She’s been documenting her experience and treatment with Smile Care Club. In one of her videos, posted directly below, you see her struggling to get her aligners in. It takes quite a while.

Eventually, after twenty mintues of trying to put them in, she gives up. In a follow-up video, the problem was discovered and resolved. Smile Direct Club inadvertantly mixed up her aligners giving her ones that were a month ahead of where she really was in her treatment.

To give you an idea of how serious this is from a medical standpoint, it would be like a surgeon accidentally doing surgery on the wrong body part.

The stress put on her teeth from being a month ahead and then going back to an earlier treatment often leads to root resorption. This can lead to premature tooth loss. It would be interesting to look at before and after x-rays of her teeth roots as a result of this mistake.

Patient Floundering

Here lies one of the big problems with services such as Smile Direct Club. Patients are left to flounder. If it weren’t for the fact that she’d been documenting her treatment on YouTube and it caught the attention of Smile Direct Club, she likely would have been left trying to shove these on every day, causing serious ireparable damage.

Many people are attracted to these mail order services because of their discounted prices. What makes their prices so low is you do not have a dentist you see regularly that check on your treatment. Bodies are unique. Because of that, even when someone is given the correct aligners, the treatment may not respond as it was supposed to. That is one of the important ways being under the care of a dentist is important. Early intervention in these cases can save the treatment and the patient’s teeth.

Affording Invisalign

If you want to safely straighten your teeth, I recommend Invisalign. It has one of the highest patient satisfaction rates of any treatment. If the cost makes you feel you could more quickly get your teeth straightened with a mail order service, consider talking to your dentist.

Most dentists are willing to work with patients under financial strain. Some have in-house payment plans that will allow you to pay things out as you go. Almost all dentists work through Care Credit. This is a medical payment service that pays for your procedure, and allows you to pay them back with extraordinarily reasonable interest rates.

A Hidden Benefit with Invisalign

There is a way to “double-up” your treatment in a way that saves you a lot of money while giving you a mini smile makeover. Because your aligners are custom fit and you are under the care of a dentist, your dentist is able to provide you with the professional teeth whitening gel that you can wear in your aligners as you straighten your teeth. This enables you to whiten while you straighten.

This blog is brought to you by Lafayette Dentist Dr. Emily Foreman.

CEREC Crown Disaster

I’d been hearing how wonderful CEREC crowns were. You could get them done in one appointment and they’d fit perfectly, designed to your tooth. I have experienced something quite different.

First, she said my tooth was in such bad shape that she had to take a generic image off the database. Then, it didn’t fit . She spent three hours grinding down on the sides and top of the crown so much that the top of the crown is flat and shorter than the rest of the teeth. Additionally, the gums are super sore where the crown is. It’s been over a week.

Is this normal?

Katelyn

Dear Katelyn,

porcelain block for CEREC crown

No , this is not normal. I’m a bit thrown off by her saying she had to get a generic image from the database because your tooth was in bad shape. Of course it was in bad shape. That’s why you needed a crown.

The CEREC Crown software is designed to build up a tooth. Your dentist starts by telling it which tooth needs to be crowned. In turn, it builds up what that tooth should look like. Then, your dentist adds the information for the remainder of your bite and the software designs the perfect dimensions.

It sounds to me that one of two things is going on: either your dentist didn’t know what she was doing with the software or there is information she didn’t pass on about your case, such your gums bleeding so much she wasn’t able to get a clear image.

Either way, her decisions after that give me some doubts about her skill with dental crowns as a whole. I’m going to suggest you get a second opinion from another dentist. If it is as bad I think, it will need replacing. In that case, don’t ask for a refund. Instead, have your current dentist pay for the repairs. It will likely cost more to get it re-done than you were originally charged.

Tips for Getting a Second Opinion

When you go to get your second opinion, don’t tell them who the original dentist is. The dental world is a small one. Often dentists are friends with one another. He or she may have a bit of difficulty saying something negative about a friend’s work.

Instead, just tell him you want his opinion, without any previous information, as to what he thinks about the CEREC crown.

Thinking Ahead

Normally, your dentist would have already relayed the information I’m about to give you, but I don’t have the highest confidence in your dentist at the moment.

You didn’t say where they CEREC crown was being placed. If it is in a place that is visible when you smile, you will want to make sure your teeth are the color you want in the long term.

While the CEREC crown can be made any color you want, the color will be permanent. If you’re not completely happy with the color of your teeth, you may want to get your teeth whitened before the crown is made. This way you will be sure to have the color you want for the long term.

Otherwise, if you don’t and decide later to whiten, the crown will have to be replaced again in order to get it to match the new color.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

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.

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.

cerec crowns on front teeth

I was in a car accident and damaged both my front teeth. I need to get crowns on them. I am trying to decide between regular crowns and CEREC crowns. Is one better than the other?

Benjamin

Dear Benjamin,

porcelain block for CEREC crown

CEREC crowns are made out of single block of porcelain. This will give it a very uniform look. This works fine on most teeth. However, our front teeth are much more visible and exposed to light.

Natural teeth aren’t uniform. Look at this image of a tooth directly below. There are varying levels of translucency and opaqueness depending on where you are on the tooth.

image of a tooth

When a dentist does a traditional crown, it is built in layers with varying shades of porcelain. This can make a crown look more natural. However, even then, you’d need an expert cosmetic dentist because this takes a high level of skill.

If you really want a CEREC crown, then having an expert cosmetic dentist is even more important. They need to have a high level of skill in color theory so they can use various stains to give it that variated look while keeping that natural translucency.

Cosmetic Considerations with Dental Crowns

The dental crown can be made to match your teeth exactly. However, the color is permanent. If you are happy with the color of your teeth, then you do not need to take any further steps. However, if you want your teeth any whiter, the time to take care of that is before having the crowns designed.

In that case, your first step is to have your teeth whitened. You can do that in one appointment if you see a dentist who does Zoom Whitening.

Then, give it a couple of weeks for the color to calm down. That’s when your dentist can match the permanent color for you.

When you’re talking about front teeth, whether you get a traditional or CEREC crown, you will need a dentist capable of the skills required. I suggest you see an AACD accredited dentist.

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

Invisalign with Missing Teeth

I have two missing second bicuspids and want to get my teeth straightened. I feel like I’m too old for braces. I was thinking of getting Invisalign. I went to see an orthodontist and he doesn’t think Invisalign is all it is cracked up to be. He wants me to get traditional braces. Is that my only option?

Katherine

Dear Katherine,

Invisalign aligner
Invisalign: The adult solutions to braces

My guess is your orthodontist is more comfortable with traditional metal wire and bracket braces. However, Invisalign should work fine in your case, though you may have better success with a dentist who treats with Invisalign than with a traditional orthodontist.

It will do fine with the missing teeth. It could close the spaces so that you wouldn’t even need to replace them with dental implants. However, let your dentist evaluate that.

If he thinks replacing the teeth is necessary, just make sure he has post-doctoral training in restorative dentistry.

A Fun Benefit to Invisalign

There is another perk to Invisalign aside from straightening your teeth. Because the aligners are custom-fit to move your bite, they are very snug. This makes them ideal for doubling as teeth whitening trays.

Your dentist can provide you with whitening gel that you can place in your Invisalign aligners at a time convenient to you. This allows you to straighten and whiten your teeth at the same time. It’s like getting a mini smile makeover at a discount.

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

Solution for huge tooth gap

I have a large tooth gap. It was last measured at 9mm. I thought about doing Snap-on Smile, but after all the tests and things, it turned out I wasn’t a candidate for that procedure. I’m too old for braces, so I’m thinking about Lumineers. I have scheduled an appointment with a Lumineers certified dentist in a couple of weeks but thought I’d check and see if you thought that was a waste of my time and money.

Kevin

Dear Kevin,

I am very glad you wrote before going through with this plan of Lumineers. While I am sure you could find a dentist willing to do it for you, it would end up a disaster!

The size of your gap is enough to fit another tooth. Unless the dentist is a top of the line, expert cosmetic dentist you are going to end up with something that looks ridiculous. And I will tell you right off the bat, dentists who advertise as placing Lumineers tend to be at the bottom of the barrel of cosmetic dentists.

The Lumineers company markets themselves to inexperienced cosmetic dentists as being easy to place because they don’t require any tooth preparation, the way other brands of porcelain veneers do. There are two problems with that.

One, that rarely turns out looking anything but bulky. Some people have described it as horse teeth. And, two, there is a whole lot more to creating a beautiful smile than just the tooth preparation.

An Invisible Alternative to Braces

side by side compairison of braces
Braces versus Invisalign

You mentioned you were too old for braces. Has your dentist discussed Invisalign with you yet? These are sometimes called invisible braces.

Both people in the image above are wearing orthodontics. The one on the left is wearing traditional braces. The one on the right is wearing Invisalign. No one will be able to tell you are wearing them even at a conversational distance.

With the size of the gap you are talking about Invisalign would be my number one recommendation for repair. It has an added benefit as well. Invisalign uses clear plastic aligners to straighten your teeth. Those aligners can double as teeth whitening trays. This will allow you to straighten and whiten your teeth all at once.

If you don’t like the idea of any orthodontics, then you will need to go with porcelain veneers. However, as I mentioned above, you will need an expert cosmetic dentist in your case. I would only see an AACD accredited dentist to do your porcelain veneers case, if that is what you decide on.

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

Thumb Sucking

I sucked my thumb until I was in junior high school and was finally able to quit. Now I’m an adult with a huge overbite. Is it possible to fix this without metal braces?

Cami

Dear Cami,

Invisalign aligner
Invisalign: The adult solutions to braces

I’m glad you wrote. It is never too late to repair and improve the appearance of your smile. Plus, because of the advancements in orthodontics, you no longer have to wear ugly and uncomfortable braces with their metal wires and brackets.

My suggestion is you see a dentist who offers Invisalign. These use clear aligners. No one will even know you are wearing them, even at a conversational distance. One of the hidden benefits is the aligners can double as teeth whitening trays. This will enable you to straighten and whiten your teeth at the same time, though you don’t have to.

Thumb Sucking

I’m saying this for the benefit of parents who have a thumb sucker. Don’t panic! Most children give the habit up by the time their adult teeth start to come in.

If you make a big deal out of it, there’s a good chance it will backfire and make it harder for your child to quit. If they get to the point where their permanent teeth are coming in and they can’t seem to quit, let them know you can help.

You don’t have to take them to a pediatric dentist and do anything expensive. The simplest solution is to purchase Thum. This is a bitter-tasting liquid you can “paint” on their thumbs. Most of the time they stick their thumb in their mouth without even meaning to because it’s a subconscious habit. This liquid will help them realize it.

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

Three Different Color Teeth with Porcelain veneers

I had four porcelain veneers placed on my front teeth. Unfortunately, the two in the very front are turning gray. This has left me with three different colored teeth. First, there are my natural yellow teeth, which still show on either side of my porcelain veneers. Then, there are the white veneers next to them, and the two front teeth which have turned gray. I feel this whole endeavor has been a disaster. What can be going on and what can fix it?

Marla

Dear Marla,

A single porcelain veneer being placed on a tooth

The main problem you are facing with your smile makeover is the inexperience of your dentist. First, the porcelain veneers on your front teeth are defective. This can happen to a new cosmetic dentist. However, an even more basic error was made.

If you are only getting four porcelain veneers and your teeth are yellow, your teeth need to be whitened before your veneers are placed. Your dentist didn’t even know enough to do that.

As for the grey veneers, there are two possibilities I can think of immediately. I couldn’t tell you which without a photo, but I can describe it to give you an idea of what to look for.

If they are uniformly grey, then it’s likely the glaze has been removed somehow. This destroys your porcelain veneers because the glaze is what protects them from picking up stains.

If the gray is uneven, you may have what is known as microleakage. This means the bonding isn’t done correctly and you’ve got things getting between the porcelain veneers and your teeth. This will not only give them a splotchy look, but it will lead to decay.

Fixing a Porcelain Veneer Disaster

Because your family dentist is in over their head, I don’t think they’re going to be able to fix this. You need to ask for a refund and have this case redone by an expert cosmetic dentist. They’ll likely first suggest you whiten your teeth. Then they’ll do the case from scratch.

My suggestion is look to see if there is a dentist who is accredited by the American Academy of Cosmetic Dentistry in a reasonable distance from you. AACD accredited dentists are the top cosmetic dentists in the country. They will provide you with a stunning smile you will be proud of.

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

Fixing a single front tooth

The tooth just to the right of my front tooth is crooked. It goes a little behind the other teeth. I’ve had one dentist say braces were my only option. Another suggested I just pull that tooth. I don’t like either suggestion, but given the choice between the two, I’d pick pulling the tooth. I have a last ditch effort to keep my tooth. Is there any chance Invisalign would work in my case?

Penny

Dear Penny,

Whatever you do, don’t let anyone pull the tooth. Your smile would never look right. Even if people didn’t know exactly why, an uneven number of front teeth will always look off.

You have two great options for straightening your tooth.

Option One: Invisalign

Invisalign aligner
Invisalign: The adult solutions to braces

Yes, Invisalign is an option for you. It used to be that it could only handle the ideal cases, but that is no longer true. Advancements in Invisalign have enabled it to take on more challenging cases these days.

It has an additional benefit as well. The aligners can double as teeth whitening trays. This will enable you to straighten and whiten your teeth at the same time. It’s like getting a mini smile makeover.

Option Two: Porcelain Veneers

A single porcelain veneer being placed on a tooth

These are more useful if you want to change more about your smile. Porcelain veneers are the go-to procedure for total smile makeovers. It can simultaneously, change the shape, size, and color of your teeth.

While it won’t straight the crooked tooth the way Invisalign will, it will make your smile look completely straight.

One thing to be aware of is while any dentist who offers Invisalign can use it with equal skill, it takes an expert cosmetic dentist to do a beautiful smile makeover. The best cosmetic dentists are AACD accredited. They can create a stunning smile for you.

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