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CEREC or Regular Veneers

I told my dentist I wanted to get a smile makeover. He’s suggesting we do CEREC veneers. Are those as good as the porcelain veneers? I want to make sure I get the right material. Which would you recommend?

Olivia

Dear Olivia,

Block of porcelain for CEREC crowns

It is great that you’re trying to do research ahead of time. I wish more patients did that. I’m going to shift what you are researching though. The materials used do not matter nearly as much as the dentist who is working with the materials. Think of it this way. If two artists were given a block of the same type of marble and told to make a statue of the same person, would the statues turn out exactly the same? Of course not! One artist will definitely be superior to the other. Whether your dentist is creating CEREC veneers or traditional porcelain veneers, what matters most is his skill.

What I’d like you to look at is whether or not your dentist has the technical skill and artistry to pull this off. Doing a smile makeover using the CEREC veneers can be done, but only by top of the line cosmetic dentists. The reason for this is a CEREC machine mills your veneers or porcelain crowns out of a single block of porcelain. However, our teeth don’t have uniform levels of translucency.

In order for a cosmetic dentist to get these to look both beautiful and natural, he or she will need to know a lot of color theory and understand how the different stains available can manipulate the level of translucency and opaqueness in a tooth. Without that, you could end up with teeth that look fake and flat.

Is Your Dentist Good Enough to Do CEREC Veneers?

Before moving forward, I want you to ask your dentist for two things:

1. Ask him to see before and after pictures of recent CEREC veneers cases he’s personally done. If he doesn’t have any, find another dentist. If he does have some and you love the results, you will likely be okay to go ahead as long as he agrees to the second point. If you don’t love the results, find another dentist.

2. Make sure he’s willing to stand behind his work with a form of a beautiful smile guarantee. This should mean that he’ll put the veneers on with a try-in paste when he’s done and let you look at them in several different lightings. If you are not over the moon thrilled with them, he’ll re-do them. No veneers should be permanently bonded until you are ecstatic.

If these two things can’t be met. You need to find a better cosmetic dentist.

Finding an Expert Cosmetic Dentist

If I were getting a smile makeover, I”d want one of the best of the best cosmetic dentists. The easiest way to find those is to go to aacd.com. They have a “Find a dentist” link. You want to look for a cosmetic dentist in your area who has reached accreditation. They have a box you can check for accredited.

AACD accredited dentists have passed stringent oral and written exams as well as demonstrated their artistry on a large number of cases. Any one of them can give you a stunning smile.

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

pain with Invisalign

I know that braces cause pain because all my friends complained about it when I was growing up. I’m old enough to know I don’t want a mouth full of metal while I straighten my teeth. It would just seem unprofessional. However, I want to know what I’m signing up for. Does Invisalign have pain the way traditional braces do?

Laurie

Dear Laurie,

Invisalign aligner

It’s always wise to go into any treatment with a good idea of the pros and cons. The pros of Invisalign are obvious.

  • They work in half the time as traditional braces
  • You can eat and drink whatever you want
  • You can brush and floss much more easily
  • You can straighten your teeth without anyone knowing
  • You don’t have to worry about cuts and abrasions from metal wires and brackets.

There is one point in which Invisalign aligners can ache a bit. You switch aligners every two weeks. For the day or two when you first put in your new set of aligners, they will feel snug and ache a bit.

This is because the aligners are sculpted to the next alignment your teeth should be in by the time the two-week time period is up. After those first few days, your teeth will be in that new position and the aligners will feel loose.

Usually, just some over-the-counter pain reliever is enough to keep the pain at bay.

An Unexpected Benefit with Invisalign

One extra treat you can get out of Invisalign is inexpensive teeth whitening. The aligners can double as teeth whitening trays. So, all you will need to purchase from your dentist is the whitening gel that you can place in your aligners for a period of time each day.

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

Pimple turning tooth gray

I think I need help fast, but I don’t have a dentist. I have a pimple on my gums which is causing serious pain. I think it’s poisoning a tooth tooth because one of my teeth has turned gray. What do I do if I don’t have a dentist?

Brooke

Dear Brooke,

Woman grabbing her jaw in pain needing an emergency dentist
Tooth pain is a dental emergency

I’m very sorry you are in so much pain. You’ve got two things going on here. One of which is considered a dental emergency.

Pimple on the Gums

Let’s start with the pimple on your gums. This is a sign you have an infected tooth. The pimple is known as an abscess. This happens because the infection is severe. Infected teeth are considered dental emergencies.

These infections will continue to spread. In some cases, they become life threatening quickly. This is a result of where they spread and how long they’re left untreated. Your jaw is very close to your brain and heart. If the infection reaches there, sometimes it is too late to do anything. There were too many people who died from tooth infections last year, given how preventable it is.

I do realize you don’t have a dentist. Because this needs to be seen to right away, I’m going to suggest you do an internet search for an emergency dentist. These are general dentists who are willing to see non-established patients quickly in cases of emergencies such as yours.

Often, they’ll do what they can to get you out of pain, prescribe an antibiotic for hold off the infection and schedule a follow-up appointment to give the tooth the entire treatment it needs.

A Gray Tooth

When a tooth has turned gray, that is a sign it is either dead of dying. This tooth was also infected, which is a definite indicator the infection is spreading.

The dead tooth won’t have any pain, but the infection is still there and will need to be removed by the dentist. Unlike medical infections, you can’t just take an antibiotic and be done. Antibiotics will only keep a dental infection at bay, it won’t rid your body of it.

With dental infections, the dentist has to get in there and physically remove the infection with a procedure called a root canal treatment. This often requires the tooth to be crowned as well.

Don’t put off getting this seen.

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

tri-colored porcelain veneers

I’ve got a smile makeover disaster. I have three different colored teeth right now. First, my ugly natural yellow teeth, then I had four porcelain veneers placed. Three of them look okay, but one of them is an uneven gray color. I paid a lot of money hoping to get a beautiful smile, but now I feel ridiculous with three different colors of teeth. I don’t even smile. My dentist said she’d make the gray one thicker to even out the colors, but I’m not sure how that will look and I’m losing confidence in her. What do you recommend?

Laurie

Dear Laurie,

A single porcelain veneer being placed on a tooth

Yikes! I can understand why you are unhappy. It sounds like you went to your family dentist who was in over her head. First, don’t let her make the graying veneer thicker. In fact, I think you need to ask for a refund and start over.

If I’m right about the graying veneer you have a good case for one. Because it is a splotchy gray, I think there isn’t a good bond between the porcelain veneer and the tooth. This is bad for your teeth. It allows things to get between the two, leaving you vulnerable for decay.

When you have this re-done, the first thing the dentist will have you do is whiten your teeth. This will keep your adjacent teeth from being an obviously different color. This is why your natural teeth look so obviously different from your four porcelain veneers.

Finding the Right Cosmetic Dentist to do Your Porcelain Veneers

It is imperative you have an excellent cosmetic dentist to re-do your porcelain veneers. Unfortunately, doing beautiful smile makeovers aren’t taught in dental school. Dentists have to invest time in getting the training they need.

Even with training, as with every art, some dentists have a more artistic eye than others. If you want the best cosmetic dentist, I’d go to aacd.com and look up an accredited cosmetic dentist in your area.

AACD accredited cosmetic dentists are the top cosmetic dentists in the country. They’ve passed stringent oral and written exams. Additionally, they have to provide visual evidence of a large number of cases they’ve done in order to show they are both technically skilled and artistic.

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

3 traits of a great cosmetic dentist

I plan on getting a smile makeover. I keep hearing the dentist is the key, but how in the world do you know if you’ve got the right key?

Amanda

Dear Amanda,

Brunette woman with beautiful smile
Beautiful smiles require great dentists !

You’ve asked a great question and doing so will save you a great deal of agony. There have been countless cosmetic dentistry horror stories of patients from another practice who came to us in tears needing their “smile makeover” fixed.

The problem most patients run up against is there is not a recognized specialty in cosmetic dentistry. That means any general dentist can call themselves a cosmetic dentist if they dabble in one or two cosmetic procedures.

Unfortunately, to get great results in cosmetic dentistry, it takes a lot more than dabbling. Here are three important things to look for in a cosmetic dentist.

Trait One: Empathy

This one is hard to quantify, but you can quickly tell if a dentist has it or doesn’t. Dr. Hall calls this trait, “The root of a good cosmetic dentist.” They know you want a beautiful smile and they will make sure you get one you can be proud to share.

In general dental school, dentists are taught they know better than the patient. Cosmetic dentistry is different. It’s the way the patient sees their smile that matters. They’d never let a patient leave unhappy and will make any changes necessary to make sure it is the smile of your dreams.

Trait Two: Training

How to do stunning smile makeovers isn’t taught in dental school. It requires a dentist’s willingness to invest in extensive post-doctoral training. They’d invest time and money in continuing education at reputable institutions.

Trait Three: Artistry

Smile makeovers are a type of art form. As with any art, some artists are better than others. The evidence isn’t necessarily in the art school they went to but the results of their work. Never hesitate to look at a cosmetic dentists smile gallery to see what type of results they get.

Especially look for specific examples of the procedure you’re getting. if you want porcelain veneers, ask to see those pictures. If you have tetracycline stains, see what type of success they’ve had covering those.

Where to Locate Dentists with these Traits

The American Academy of Cosmetic Dentistry realized the predicament patients were in locating a great cosmetic dentist. Because of that, they began an accreditation program so dentists with the right skills could have a way of letting patients know.

They have to pass stringent oral and written exams as well as provide visual evidence and a large and varied number of cases demonstrating their artistry.

If you’re really looking for the best, go to aacd.com and do a search for an accredited cosmetic dentist.

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

Dental crown looks fake

I’ve had dental crowns before but they’ve always been on back teeth. This is my first one on a front tooth. My dentist did a CEREC crown which was very convenient. I liked that, but for some reason it looks really fake compared to the tooth next to it. It almsot has a painted, dull appearance. Is this typical of crowns? Is there a way to get them to look natural?

Dana

Dear Dana,

CEREC Crown being placed on a tooth
Whether or Not a Crown Looks Natural Depends on Two Things

A crown on a front tooth can look natural and blend in naturally. Whether or not that happens depends on two things:

  • The cosmetic skill of the dentist
  • The materials used

Getting a Beautiful Dental CEREC Crown

CEREC crowns are made of all-porcelain, which is great. Porcelain mimics the appearance of natural teeth by reflecting light. When you get traditional porcelain veneers, they are milled from several different blocks of porcelain.

Our natural teeth aren’t the same all the way down. If you look closely at your front teeth the bottom parts of your upper front teeth are more translucent than the middle parts of your teeth.

Even though it still requires an expert cosmetic dentist to place a dental crown on your front teeth, traditional all porcelain crowns are a little easier simply because they’re milled from several block of porcelain making it easier to get the different levels of opacity versus translucency.

With CEREC crowns, this is more challenging. They are milled from a single block of porcelain. That makes it harder to show the subtle differences in color. Dentists have to be very familiar with color theory and stains to get a front CEREC crown to look natural.

Without that, you end up with a flat looking front tooth as you’re experiencing.

Which Dentists Can Place a Crown on a Front Tooth?

Front teeth are more exposed, making it imperative the dentist has the right skills to match and blend the crown with the adjacent teeth exactly. In your place, I’d only use an AACD accredited cosmetic dentist. Dentists who’ve reached accreditation are the top cosmetic dentists in the world. You can go to aacd.com to find one in a reasonable distance to you.

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

Problems with invisalign

I’ve been considering getting Invisalign, but decided to talk to an acquaintance who’d already used them. She said she’d never had worse breath than when she wore them. I decided to do some online research about that issue and it seems some people have had that same problem, but others absolutely love them. Does that mean that particular issue is preventable?

Marcia

Dear Marcia,

A woman placing in her Invisalign aligners

Absolutely that one is preventable. Invisalign is removable. As such, it allows you to eat whatever you want. Then, you simply pop them back in when you are done. However, your dentist will strongly recommend you brush and floss your teeth after each meal before you put them back on.

There is a good reason for that. Every time you eat, you get some food and bacteria on and between your teeth. If you don’t remove that before you place the aligners back on, they’re going to fester there. That will lead to some seriously bad breath. It would also leave a nasty taste in your mouth. Simply brushing before replacing them completely fixes this problem.

Two Other Common Invisalign Issues

So you are completely prepared for Invisalign treatment, I want to tell you about two other common issues.

The first is some minor aches when you switch aligners. With Invisalign, you wear a pair of aligners which you will switch out every two weeks. Each pair gently moves your teeth into another position.

The first couple of days, the aligners will feel a bit snug. That’s because it is new position. By the third day, they should feel like a perfect fit. The remainder of the two week is to allow the bone time to form around the new root position.

Many patients don’t feel any discomfort. However, if you are one who does, most often some mild over the counter pain relievers is enough to make a difference.

The second common issue is excess saliva. For some patients, when they first start Invisalign, their body thinks of it as a foreign substance in their mouth which needs to be digested. It responds by producing excess saliva. Fortunately, this fades quite quickly.

An Unexpected Invisalign Benefit

While everyone expects to have a straighter smile by the end of their Invisalign treatment, did you know you could also have a whiter smile as well? Invisalign aligners can double as teeth whitening trays.

All you have to do is ask your dentist for some teeth whitening gel, which doesn’t cost much at all. Then, you simply place the gel in your aligners and you’ll have a mini smile makeover at a fraction of the cost.

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

3 Unexpected facts about CEREC crowns

If you’re considering same day crowns, that’s great. They’re useful and convenient. Here are three things your dentist may not have told you yet.

Block of porcelain for CEREC crowns

They are Not Billed Any Differently

When dentists bill your insurance, they use codes. The codes for crowns, whether you are using traditional crowns or same-day crowns, they’re billed by the material used, not the brand.

While your dentist spent a small fortune on the machine, he is making up on lab fees by having it milled right in the office. This means you shouldn’t have to pay more for a CEREC crown than a traditional crown.

Only the BEST Cosmetic Dentists Can Place Them on Front Teeth

Because they’re milled from a single block of porcelain, they don’t have all the subtleties your natural teeth have. A dentist has to be very versed in color theory and have exceptional skills.

If your dentist is recommending a CEREC crown on an anterior (front) tooth, you need to check their qualifications. Ask to see samples of CEREC work they’ve done on front teeth.

If it’s important to you to have the crown done on the same day, you’ll want to take the precaution of going to a dentist who has achieved accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top of their field.

They Don’t Whiten

Often patients decide they want their teeth whiter at a certain point. However, the color made on your dental crowns (CEREC or traditional) is meant to be permanent.

The whitening gel used even in professional teeth whitening only works on natural tooth structure. It saves you money in the long run to whiten your teeth beforeĀ having your dental crown made. This way when the dentist does do it, you’ll have it match the color you’ll be proud of.

It’s not required, of course. You can whiten later. It just means you’ll have to have your crown re-made to match.

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

Does smile direct work?

I keep seeing advertisements on Facebook for smile direct club. They’re offering a free start on their program and it’s much less expensive than Invisalign. Does it really work?

Sadie

Dear Sadie,

The Smile Direct Club is an company which has been in business since about 2013. They’ll mail you your aligners which you’ll wear for three weeks. With Invisalign, you switch the aligners every two weeks.

Their biggest benefit is the money savings. It does cost less than working through a dentist with Invisalign. It appears to work out fine for many patients. But (you knew there would be a but), there are risks.

Dangers with Smile Direct

  • Gum Disease

While you submit a photo and a dentist reviews it, only certain cases of gum disease are able to be diagnosed this way. Dentists will also do x-rays and probe the tissue.

If you do this treatment and have gum disease it will quickly get worse. As it progresses, your teeth can become loose. Combine that with shifting of tooth movements for your orthodontic treatment and you could end up losing teeth.

  • Complications

While for most patients things will go fine, there are exceptions. Sometimes a tooth his supposed to rotate which doesn’t. This affects the entire treatment process.

Another, more common issue, is when there’s crowding. When that is an issue, some of the sides of the teeth have to be shaved down to make room for the correct alignment.

This is something you’ll have to do at a dental office. However, removing the right amount of enamel is tricky. You’d really want a dentist who’s invested in the case to do the work on it. Without that, It might not go as well as you’d like.

So, could it work? Possibly. In many cases it does. The thing to be aware of is what to do if something doesn’t. At the very least, I’d recommend you get a good check up with a dentist ahead of time and make sure you don’t have any signs of gum disease before proceeding.

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

Dental bridge before implant?

I’m a little concerned about what my dentist is recommending for a missing tooth on my 15-year-old daughter. We’re planning on getting her a dental implant when her jaw is developed enough for one. I was looking at some temporary replacements. I thought a flipper would be a good option, but my dentist wants to give her a dental bridge. I think that’s a bad idea, but he said flippers are too temporary. What do you think?

Mandy

Dear Mandy,

woman smiling with a dentist
It’s always okay to get a second opinion from another dentist

I’m glad you wrote about this. While a dental bridge is a more secure fit, I don’t think it is a good fit for a teen aged girl. There are two reasons for this.

First, just like her jaw is still developing for her dental implant, she will need new bridges. That is too expensive to keep replacing as she grows.

Even though the flippers are meant to be temporary, you can replace those in a much more affordable way than the bridge.

There is another reason too which has nothing to do with cost. A dental bridge requires her adjacent teeth to be crowned in order to support and suspend the false tooth. That will mean those teeth will always have to be crowned for the remainder of her life.

If those teeth are healthy, you won’t want to grind down the healthy structure.

It’s Okay to Get a Second Opinion from Another Dentist

A good dentist will give you all of your options. Even then, they will make a recommendation. if you don’t like their recommendation and they’re pressuring you to go with their option, I recommend getting a second opinion.

If your dentist refuses to do the treatment you want you can go to another dentist for that procedure. That means you could get your daughter a dental flipper elsewhere. You don’t have to switch dentists to do that, unless you want to.

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