Tag Archives: White Fillings

Whiten or Replace Fillings First?

I plan on replacing my old silver fillings with the nicer white fillings. I wondered if it is better to whiten my teeth first and then get the white fillings or to get the white fillings and then whiten everything at the same time?

Adelaide

Dear Adelaide,

Teeth Whitening Trays

These are good questions and I am glad you brought them up. One important principle of teeth whitening is that only natural tooth structure is impacted by the whitening gel. Because of that, it will be important that you whiten your teeth to the color you want first. Then, you can get the white composite fillings done.

This way your dentist can match your fillings to the new tooth color you have. This is especially important if any of your fillings are visible when you smile.

Sanitary Amalgam Removal

One thing I do want you to be careful about is who you have to switch out these fillings. I do not know if you are aware of this but the silver amalgam fillings are made mostly of mercury. That is not an element you want to be swallowing or inhaling as it is a known toxin.

What you need is to go to a dentist who knows how to do a sanitary amalgam removal. It is a process that requires special equipment and knowledge. I would look for either a mercury free dentist or a holistic dentist. Either one of them should be familiar with the procedure.

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

Metal showing on my maryland bridge

I’ve had a Maryland Bridge for 20+ years. I’ve never had any problem with it. However, a week ago I needed a crown placed. In order to get a comfortable placement, my dentist had to adjust my bite a bit, which included grinding a bit on the Maryland Bridge. The next morning, I noticed a silver spot where the metal was showing through. I went back and he said the problem was likely because I grind my teeth. He bonded a composite filling on it, but that was gone by the next day. He still insists it is from my grinding and says there is nothing more he can do to fix it. I’m finding that hard to believe as I’ve not had a problem with this bridge until he messed with it. It’s a little intimidating to argue with him, though. What do you recommend here?

Penny

Dear Penny,

Diagram of a Maryland Bridge
Maryland Bridge

While I haven’t seen the tooth, I think you and I both know that he is the culprit here. However, he’s the dentist and therefore in the authoritative position which makes it tricky for you to confront him, especially if his pride interferes with his integrity.

One thing I’d like you to do is get a second opinion. Some dentists will even give you a free second opinion. They’ll be able to tell if he caused the damage. If you drag a metal explorer over glazed porcelain, it won’t leave a mark. However, if the porcelain has been ground on with a dental bur, a distinct mark on the porcelain will be visible.

Once the second dentist has armed you with the information you need, you may be able to get him to admit his error. In truth, every dentist has had this happen. The shame is more in not being willing to try and make it right.

A Possible Fix for Your Bridge

There is a possible way to fix this without having to replace the bridge. It is worth a try, though it doesn’t always work. When your dentist placed the composite filling. it doesn’t sound like he did anything to prepare the metal.

Here’s the procedure I’d recommend. You are welcome to show him this post. There is one bonding cement which will bond to metal— Panavia.

The first step will be to grind away more metal to make way for the materials needed. Then, use a micro-etcher to prepare the spot. From there, prime the metal and then add a thin opaque layer of Panavia over the metal and cure it. After that is when your dentist can place the composite.filling.

If that doesn’t work, your best option is to replace the bridge.

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

dental filling disaster

I had never had a cavity until I switched dentists. My insurance changed so we needed to go to a different practice. On my very first appointment, he said I had a cavity, which surprised me. I went ahead and had it filled. The filling caused continual pain even after he adjusted it. It got to the point where he said I’d adjust to it. I waited out the full year with my insurance than switched to one that allowed me to go back to my old dentist.

When I did, he said I likely didn’t even need the filling at all. He said there’d been a spot on my x-ray for years that hadn’t changed. He said he’d replace the filling to make it better. The pain was instantly better, but the filling was uneven I guess and food would get trapped in it.

He decided to adjust that because he said it would become an issue. Since he’s adjusted it I’ve had problems with a serious sensitivity to hot and cold. Now my dentist is talking about extracting the tooth. I don’t want that so I’m afraid to go back. Is there anything I can do?

Betty

Dear Betty,

A blonde woman hodling her left cheek and jaw in pain

It’s unusual for a dentist to fake diagnose a single filling. It’s not a financial gain for him or her. In all honesty, it is more of a hassle. So, I don’t think you were taken for a ride by the new dentist. I’m actually more concerned that your original dentist saw a spot on your x-ray for years and never even mentioned it.

The trouble I’m seeing here is you have two incompetent dentists working on your teeth. The dentist who did your filling couldn’t do it correctly and rather than repair it he said, “You’ll adjust”. That’s dental speak for, “I don’t know what to do.”

When a dental filling is done right, you don’t even notice it.

Then, when you went back to your original dentist, he couldn’t get the filling right either. Now he’s talking about extracting the tooth?! I don’t think so.

My guess is your insurance has a preferred provider list. They do that to keep the fees cheap. But, the better dentists won’t sign on to plans like that. So often (not always) preferred provider means less than adequate dentist.

I’m going to suggest you go to an out of network dentist who has good reviews. You need this fixed. Don’t let your dentist extract your tooth.

The last thing you need after all of this is another expensive procedure and, believe me, tooth replacements cost a pretty penny.

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

No White Fillings for Children?

I’m not sure what to do. I noticed that you see children and you do white fillings. Do you give the white fillings to children? My pediatric dentist says that’s not possible. I don’t fancy the idea of putting mercury in my son’s mouth and he has his first cavity. We’re just watching it right now, but want to be prepared. If it were your son, what would you do?

Lori

Dear Lori,

Boy smiling and holding a toothbrush
Can Children Get White Fillings?

I’m very sorry about your son’s cavity. To answer your question, yes, children can get white fillings, but it’s not always easy. The biggest problem is they have to sit very still because the composite resin has to stay free of moisture during the placement process. But, it can be done. Usually, just some nitrous oxide is all that’s needed to keep a wiggly child still during their filling process. In fact, most of them sleep through the procedure.

It sounds like your pediatric dentist prefers to do things the way he’s always done them and isn’t that interested in keeping up with the advancements in dentistry. In your place, I’d find a new dentist, one who keeps up with the newer technologies and studies, especially when it regards putting a toxin in a child’s body.

Can General Dentists Treat Children?

Yes. Many general dentists love working with children. One way to know if they’re good with them is the age they first agree to see them. If they’ll see them in their toddler/preschool years, they love working with children. If they ask to wait until your child is about 8 or older, I’d look elsewhere.

Parents find it convenient for everyone to go to the same practice. You can book everyone’s appointments and get things done in one day. Plus, a dentist knowing the parent’s dental history knows what to look for in the children. It helps prevent issues that their parents may not have been able to avoid.

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

Can I Use Mouthwash With Porcelain Veneers?

I just invested a lot of money with porcelain veneers and really love them. I feel beautiful for the first time in my life. I’ve always been a mouthwash user. It’s just a habit I’ve developed over the years to avoid bad breath. I don’t want to do anything to damage them and wondered if it’s safe to use my mouthwash on them.

Sarai S.

Dear Sarai,

Porcelain Veneer being placed on a tooth

I’m thrilled you’re pleased with your smile makeover with porcelain veneers. Under a skilled, artistic dentist they can be absolutely stunning. It’s also fantastic that you are looking for ways to take care of them right from the beginning.

Mouthwash isn’t necessary and often is the cause of bad breath which makes you continue using it, but there are mouthwashes that are safe to use with your porcelain veneers. The most important thing is to check the ingredients. You want a mouthwash that is alcohol-free.

Alcohol will eat away at the bonding material that keeps your porcelain veneers secured to your teeth. You’ll start with micro-leakage then the veneers themselves can fall off. Using alcohol-free mouthwash won’t negatively impact your bonding.

Caring For Your Porcelain Veneers

There are important steps you can take to ensure your veneers last for a long time. The most important thing is good oral hygiene. On top of brushing twice a day, make sure you’re regularly flossing. While the veneers protect the parts of your teeth they cover, you can still develop decay in the exposed parts of your teeth. Then you’ll be looking at getting a filling by your porcelain veneers which can be tricky.

The toothpaste you choose is important. You can use over-the-counter toothpaste, just make sure it’s not a whitening toothpaste. Those contain abrasives which can scratch your veneers. The scratched portions can pick up stains. If you want a toothpaste specifically designed for cosmetic work, order Supersmile Toothpaste. This is the ideal toothpaste, but it costs more than your typical over-the-counter brand.

Finally, make sure you’re going to a dental practice that understands cosmetic dentistry for your check-ups and cleanings. They’ll train their hygienists not to use anything like a prophy jet which can remove the glaze from your veneers.

This blog is brought to you by AACD accredited dentist Dr. Mike Malone.

Dentist Won’t Let Me Get a CEREC Crown on Front Tooth

One of my front teeth needed a dental crown. I am tired of going to the dentist’s office and told him I’d prefer the one visit crown. But, he told me he never does those on front teeth. Shouldn’t that be my choice?

Mel

Dear Mel,

Machine for CEREC Crowns

I realize you said you’re tired of going to the dentist. But, let me ask you if going one more time meant the difference between a beautiful, natural-looking smile or something that looked good but just a bit off, would you be willing to make the extra trip?

CEREC crowns are wonderful. They’re attractive, they’re strong. But, they’re milled from a single block of porcelain. Your front teeth are so visible and receive much more light than the rest of your teeth that they need all the natural subtleties that you can only get by using different porcelains. Traditional all-porcelain crowns don’t have that problem because your dentist can craft them using more time.
image of a tooth Notice that as you go down the tooth it becomes more translucent but at the edges it’s a little more opaque. You can’t get that without baking different layers on. To accomplish that with a CEREC machine, you’d need an expert cosmetic dentist.

How to Find a Dentist Who Can Give You a Gorgeous CEREC Crown

Very few dentists can give you a stunning CEREC crown on a front tooth. But, if you absolutely cannot handle the idea of two appointments, you’ll need to go to the right dentist. Ideally, you’ll want a dentist who is accredited by the American Academy of Cosmetic Dentistry (AACD). These dentists have past stringent exams and demonstrated their artistry in creating beautiful smiles.

Something you should also be aware of is any type of dental work, such as dental crowns, white fillings, or porcelain veneers will not whiten like your natural teeth. The color your dentist makes them is permanent. If you’re considering whitening your teeth, you’ll want to do so before you get your crown so it can be made to match your new whiter teeth.

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

How Do I Purchase Invisalign For a Christmas Gift?

I want to get my wife a mini smile makeover for Christmas including Invisalign and teeth whitening (if I have enough for both). Unfortunately, I’m having trouble getting my dentist to agree to let me pre-purchase. He says she has to come in for an exam first to see what it will entail. If I ABSOLUTELY had to, I will but I’d hate to ruin the surprise. I like seeing people’s eyes light up when they open something. She doesn’t even realize I know she wants them. Is there a way to get them without her finding out ahead of time?

Marvin G.

A woman placing in her Invisalign aligners

It sounds like you’re a thoughtful and attentive husband. I love that you noticed something your wife had on her heart without her telling you. I bet we can find a way for you to surprise your wife, but I’ll explain what your dentist is likely thinking.

It’s hard to totally pre-purchase Invisalign because so many things factor into the cost. In addition to the possibility she not a good candidate, the price is determined by the amount and type of movement needed, the number of aligners required, etc.. All of that will factor into the payment. But, that doesn’t mean you can’t get it ahead of time.

I’d suggest to your dentist you make an estimated pre-payment and then if it turns out she’s not actually a good candidate, you can get a refund. If he’s still resistant, you could just make up a beautiful “announcement” using a free graphic design program, like Canva, and put that under the tree for her. Then, after Christmas, she could head to the dentist’s.

Invisalign and Teeth Whitening

It shouldn’t be too hard to pay for both the Invisalign and teeth whitening. Most dentists will allow you to use the Invisalign aligners as teeth whitening trays. That actually ends up saving you money in the long run.

There is something to be aware of with the limitations of teeth whitening. If she has any other dental work, such as fillings or dental crowns, they won’t whiten with her teeth. The whitening gel only works on natural tooth structure. That doesn’t mean she can’t have it done. But, once she’s attained the level of whitening she wants, you can have them re-made to match. Today, with white fillings, it’s very easy to get dental work to match whatever shade you need, as long as you have a qualified dentist.

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

Can CEREC Crowns Handle Night Grinding?

My dentist recently purchased a CEREC machine he’s very excited about. I have a cavity that he feels is too large for a filling. He wants to me have a crown done using the machine. I just wanted to get a second opinion as to how they hold up as well as normal crowns. My dentist said I grind my teeth at night. I’m assuming he would only give me a crown that would hold up against that, but just wanted to double check.

Lizza

Dear Lizza,

Machine for CEREC Crowns

This is one of those yes and no answers. CEREC crowns are every bit as strong as traditional crowns. The biggest difference is they’re able to milled at the time of your appointment, eliminating the need for either a temporary crown or a second appointment.

However, I’m truly concerned about your grinding. When your dentist mentioned to you your teeth showed evidence of nighttime grinding, did he suggest anything to you, such as a nightguard? Your teeth need protecting. The stress of grinding will not only wear down the enamel of your teeth down, but can also lead to your teeth cracking and breaking.

When your enamel wears down it leaves you vulnerable to decay. With decay, you’ll be looking at a mouth full of fillings. Even worse, would be the possibility of losing a tooth. Then you’re looking at getting a tooth replacement, such as dental implants or a dental bridge.

While your choice of crown is fine, just like your natural teeth, it won’t stand up under grinding without you having some type of nightguard to protect both your natural teeth and your crowns.

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

What Happens if You Dry Your Invisalign Aligners?

I feel like a complete moron and I’m super worried this is going to throw my treatment off. I’ve been looking forward to finishing so I could whiten my teeth. After breakfast this morning I accidentally put my Invisalign aligners into the washer and dryer. I have no idea how they got there. I couldn’t find them after breakfast which worried me. I was about to call the dentists office when my dryer buzzed. I pulled out my clothes and there they were. I put them on but they’re tight. Did the dryer shrink them? Is it okay to still wear them? I feel too stupid to call the dentist’s office now.

Esther M.

Dear Esther,

A woman placing in her Invisalign aligners

First, you have no reason to be embarrassed. These type of things happen all the time. And believe me, your dentist has seen and heard it all. I would not continue to wear this set of Invisalign aligners. That would be more likely to throw your treatment off. If you were close to the end of this two-week cycle, you can just ask your dental office for the next set of aligners. Then, you’ll actually be a smidge ahead of schedule instead of behind.

It’s okay to do that this once, but if you skip to the next pair early much more than that you risk losing your teeth. Your teeth actually move into their new position just a few days after you place the aligners. The remainder of the time is there to allow the bone to reform around the tooth root in its new position. Without that, the teeth will become loose.

If you’d recently started the new set, don’t move forward. That would be too much movement at once. However, your dentist can provide you with a new pair and you’ll be right back on track.

Invisalign and Teeth Whitening

You wouldn’t necessarily have to wait until your Invisalign treatment is over to start your teeth whitening. Tell your dentist of your interest. If you’re a current candidate for teeth whitening, your aligners can double as teeth whitening trays.

Just be aware if you have any fillings or other dental work somewhere, it won’t whiten with your teeth. You’ll have to have your fillings redone to match after the whitening procedure is done.

The key is always open communication with your cosmetic dentist. If he knows what all your goals are, even long-term, he can give you the most efficient way to get there.

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

Why do I have pain after getting a filling?

Ten days ago I had a white composite filling placed in one of my molars. Almost immediately, I started feeling really extreme pain in my jaw, radiating up to the top of my head and down to my neck, on the same side as the new filling. I’m getting by taking Motrin constantly, but this can’t go on. Other than labor, this is the most severe pain I have ever felt.

My dentist said it might be from grinding my teeth, so I bought an appliance that is supposed to help, but it didn’t. He then tried to adjust my bite by grinding off some teeth, but that  didn’t help at all, either.

This CAN’T be normal! I really think I need a second opinion, but what type of specialist should I see?

Thanks,

Leatha in Connecticut

Dear Leatha,

Teeth grinding does not sound like the culprit behind your pain.

Many different things can produce pain in a tooth, and dentists typically try to find what types of things create or worsen pain. Constant, very serious pain usually mean the tooth has an infection. If the pain is provoked by cold but then recedes when the tooth warms up, most likely it is just an irritation and not an infection. Pain while biting can mean a bite that is out of adjustment, or an abscess, or an infected ligament holding the tooth to the bone.

So, the source of your pain may a variety of things. Pain immediately following a filling could mean an undetected infection was present and it has now worsened, or that an improper technique was used to place the white composite filling.

A second opinion is definitely in order. You don’t necessarily need any kind of specialist, just a good general dentist.

This blog post courtesy of Lafayette Louisiana cosmetic dentist Dr. Mike Malone.

To learn more about Lafayette Louisiana CEREC crowns, visit our website.