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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.

a Maryland bridge is not a temporary tooth replacement

My daughter had a gymnastics accident which damaged a tooth. Three failed root canal treatments later and we need to extract the tooth. My plan is to eventually replace the tooth with a dental implant when she is old enough. In the meantime, we need a temporary replacement. My dentist suggested a Maryland Bridge. I just wondered what you’d think about that. I asked about a partial flipper, but he said she’d lose them because they’re removable and this will bond to her teeth in the back.

Patricia

Dear Patricia,

First, I want to say your choice of doing a dental implant for her permanent replacement is a fantastic idea. It will serve her very well. I’m glad you realize she will have to wait until her jaw is fully developed. Some parents mistakenly think they can get a dental implant right away, while their child is still a teenager.

dental flipper
Dental Flipper

As for a temporary replacement, your idea is better than your dentist’s suggestion. While a dental flipper is removable and, yes, there is always a chance that your daughter will lose her flipper. In all honesty, though, you could replace several of them for the price of one Maryland Bridge.

With a traditional dental bridge, a false tooth is suspended between two crowns. That requires grinding down the two adjacent teeth, which is definitely not something you’d want to do to healthy tooth structure.

While a Maryland Bridge does not require damaging the adjacent teeth, it is not the temporary tooth replacement your dentist is saying it is.

tooth preparation for a Maryland Brdige
Tooth preparation for a Maryland Bridge

While the Maryland Bridge has two metal “wings” which will bond to the back of the adjacent tooth, without cutting a little groove in the tooth for it to hook into, the bonding is not going to stay. Whenever you are doing any removal of tooth structure, that is not a temporary replacement.

Go with your original idea and get a dental flipper for your daughter.

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

can I fix the color of my cerec crowns?

I had a CEREC crown done on one of my canine teeth about three weeks ago. We never really discussed the shade while I was in the office, but as soon as I got home, I realized that it was a bit lighter than the rest of my teeth. Well, once I saw it, I couldn’t un-see it, and now every time I look at myself, all I see is that darn tooth. It looks fake.

I didn’t want to bother my dentist with this at first, so I started playing around with at-home whitening products to try to get the rest of my teeth to match, but I’m just not getting them as bright as that CEREC crown. This probably sounds crazy, but I’m starting to wonder if he can darken it just a bit, so it’s a better match. Is that even possible?

Thanks,

Stan

Dear Stan,

CEREC crown restorations and materials

There are a couple of things about your case that give away that your dentist isn’t really what I would call a cosmetic dentist. Every dentist who is serious about cosmetic dentistry, when they place a crown on a front tooth, will make sure you get a good look at it before it is permanently bonded on. He didn’t do that.

The other problem is that it is a CEREC crown. The CEREC material is a block of material that is a set shade. Unless the dentist is an advanced cosmetic dentist, he won’t know how to use color theory and stains to match a front tooth.

To match a front tooth, a true cosmetic dentist has the ability to customize the shade. Each tooth in your mouth has differences in color from the neck of the tooth to the tip, and it is quite a process to mix different materials to get a crown to match the surrounding teeth.

Tints and Stains Exist

There are tints and stains that can be applied to the CEREC to customize the shade. But on a ceramic, that has to be baked into the crown, so that has to be done before the crown is put in your mouth, obviously.

Sounds Like You Will Have to Have Your CEREC Crown Replaced

You deserve to be happy with your smile and he biffed the color. Hopefully, your dentist will agree to re-doing the crown. However, this time, make sure you get to look at it BEFORE they cement it. Check it out under various lighting conditions—seriously. Look at it in the chair. Get up and go into the bathroom and check it there. Venture to an outside window and view it in natural sunlight. If it isn’t right, don’t let them cement it.

Request a Lab-Made Restoration if All Else Fails

There are crowns that have a core that is made like a CEREC crown and then have porcelain baked over the top. If you want a natural-looking crown on a front tooth, this is the way to go. Although you’ll have to wait two weeks for the lab to make it, the lab technician will be able to tint the crown to match your existing teeth. But the dentist also needs to have a good eye for color and the ability to describe the color variations in your tooth, and your dentist doesn’t sound like he is that much into that. For the best results, you’d really want to switch to someone who specializes in cosmetic dentistry for these sorts of things, but you’ve already started with him, so as long as you’re keen to continue, give him the chance to fix his work too.

If he can’t, look for a dentist who has been accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the country.

This blog is sponsored by Lafayette, LA Dentist Dr. Mike Malone.

does smoking stain porcelain veneers?

I am almost done paying for my porcelain veneers. I’m a little worried because they have started picking up stains around the edges. I do smoke. I’m wondering if my smoking is the problem. If so, shouldn’t my dentist have warned me about this? I was told they were very stain resistant. What should I do?

Ben

Dear Ben,

A single porcelain veneer being placed on a tooth

As long as your porcelain veneers still have their glaze, they are very stain resistant. In fact, they are more stain-resistant than your natural teeth. However, there are things that can damage the glaze. If your hygienist used something like a power prophy jet during your cleaning, or even acidulated fluoride, the glazing would be damaged enough.

Once that happens, they quickly begin to pick up stains. I don’t think this is your problem, though. If that were to happen, the staining would be over the whole tooth and you’re saying it’s just on the edges.

To me, this is saying the major problem you’re facing is with the resin which is used to bond your porcelain veneers to your teeth. Your dentist likely polished these when you first had the veneers placed. However, these can stain. They’ll stain faster if you smoke.

Your cosmetic dentist who did the work should have told you what needs to be done to care for them. Here is a great link about regular maintenance for your porcelain veneers.

In the meantime, you still need to have these stains dealt with. I want you to go back to your cosmetic dentist and have him polish the sides. They should use an ultra-fine polishing strip in this area and a special ultra-fine aluminum oxide polishing paste. This will help with the staining and increase the longevity of your smile investment.

Don’t have your family dentist try to do this. Most of the time, knowledge like this is limited to those who’ve studied cosmetic dentistry.

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

will a dental flipper make my teeth look straight?

I’m too old for braces, but the way my teeth stick out is really holding me back professionally. Is there a way if I put a dental flipper over my teeth it could make my teeth look straight?

Kimberly

Dear Kimberly,

Invisalign aligner
Invisalign: The adult solutions to braces

I think you are confusing a dental flipper with Snap-on Smile. A dental flipper is a temporary tooth replacement that clasps onto the adjacent teeth. It’s designed to be used while you are waiting on the completion of your permanent tooth replacement.

Snap-on Smile is a false tooth arch made of crystallized acetyl resin. It can snap over your teeth. Because this will add bulk to your teeth and you mentioned your teeth are already sticking out, I don’t think this would be a good solution for you. Your teeth would stick out even farther.

Invisalign: The Adult Orthodontic Solution

I know you said you’re too old for braces. As an adult, I wouldn’t want metal wires and brackets on my teeth either. Fortunately, you don’t have to.

Now we have what is the equivalent of invisible braces, called Invisalign. These use clear aligners instead of wires and brackets. These will straighten your teeth without anyone even knowing. They are invisible, even at a conversational distance.

Invisalign has an added benefit. The aligners can double as teeth whitening trays. Now, not only can you have straight teeth, but you can whiten them simultaneously. This is a two for one mini smile makeover. You’ll have a brand new smile you’ll be proud to share.

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

dental bridge or implant

I have to replace two teeth and get a dental crown on another one. I’m trying to decide between dental implants and a dental bridge. What do you think would best work?

Kevin

Dear Kevin,

Both a dental implant and a dental bridge are good tooth replacement options. Which one you get will depend on a couple of things. First, I’ll go over how both of them work. Then, we’ll discuss which to choose.

An illustration of a dental implant among natural teeth
A Dental Implant

With dental implants, a prosthetic tooth root is surgically placed into your jaw. There is a time of healing after the surgery and to allow the bone to integrate around the implant. After that time period, a dental crown will be placed on it

There are benefits to dental implants. They’re completely secure and the closest thing to having a healthy, natural tooth in your mouth again. Additionally, the root form signals to your brain the jawbone in that area is still necessary, thereby preserving it.

Illustration of a dental bridge
Dental Bridge

With a dental bridge, a false tooth is suspended between two crowns. This is secured by being bonded onto the adjacent teeth. It makes more sense when one of the adjacent teeth already needs a crown. Without that, you’re just grinding down healthy tooth structure.

Implant or Bridge?

If you need a false tooth next to the tooth which needs to be crowned, then it would be a good idea to get the bridge. If the tooth which needs a crown is elsewhere, I’d get the dental implants to replace the tooth and then get the single tooth crowned.

I hope this helps. This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone.

Cerec crown is too big

I had a dental crown that was about five years old. It broke and I needed to replace it. I decided to get a CEREC crown to speed up the procedure and get a crown as quickly as possible. I’ve had crowns before. But, this one has been a problem. It feels huge in my mouth. So big that it was hurting and causing problems with my speech and gums. It’s also causing me to bite my tongue at night in my sleep. I went back to my dentist and she tried filing it down but I’m still having problems. I though the CEREC crown would fit better.

Kathy

Dear Kathy,

Block of porcelain for CEREC crowns

It seems to me as if you’ve had two dud dentists recently. Dental crowns shouldn’t break. Normally, with a CEREC crown, a tooth is scanned before it is prepared for the crown. Then they use the shape of the tooth in the software to design the crown.

Without that, the dentist can use the software to form the crown, but it sounds like your dentist doesn’t know how to do that yet. I wouldn’t ask her to fix it with her CEREC machine.

Instead, I would ask her to give you a traditional crown which is done at a lab. It will take a little longer, but you need a well-fitted crown. CEREC is capable of doing that. In fact, the software can design a precise crown. Your problem is the dentist.

Do not settle for a crown where you are biting any part of your mouth. This can lead to tumors. A crown should not be noticeable at all.

Turning this Into a Benefit

If you’re going to have to have the crown re-done, I would look at it as an opportunity to improve your smile. This isn’t at all necessary but could be something beneficial.

One of the first things people notice about us is our smile. A great and inexpensive way to make your smile look years younger is with teeth whitening.

Now I don’t know where this crown is, but if it is at all in a visible part of your smile you should consider whitening your teeth before having the permanent crown made so it can be made to match.

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

Invisalign or porcelain veneers

I wanted to get Lumineers. I have a tooth which is a little crooked. Not enough for full orthodontic treatment. That’s why I was hoping to do Lumineers because I was told they could just go on top of my teeth. My dentist said I could do them, but would need Invisalign first for the crooked tooth. Are both really necessary? That’s more money than I was planning.

Katie

Dear Katie,

Invisalign aligner

Please bear in mind that I haven’t seen your case, but in general you would either do Invisalign or Lumineers, not both. There would be some exceptions in severe orthodontic cases. Based on what you’d mentioned, I don’t think that is your situation.

Let’s go over what you can do with each treatment and you will have an idea of which will most help you meet your smile goals.

Invisalign

These use clear aligners to straighten your teeth. No one will know you are wearing them, even at a conversational distance. That is why some people call them invisible braces.

They are more comfortable than traditional metal wire and bracket braces and usually work in half the time.

The aligners have the additional benefit of being able to double as teeth whitening trays. This allows you to straighten and whiten your teeth simultaneously.

If all you feel your teeth need are a straighter look and whiter color, this method will save you thousands of dollars.

Lumineers

The first thing you should know is that Lumineers are simply one brand of porcelain veneers. Most expert cosmetic dentists prefer other brands. This is mostly because this brand is owned by the DenMat company, which requires dentists to use their labs. This lab is not known for skilled results.

Porcelain veneers, when done by a skilled cosmetic dentist can completely remake your smile. They can change the shape of your teeth, the size of your teeth, and the color of your teeth all at the same time. It is the go-to for celebrities trying to get that perfect Hollywood smile.

While it won’t straighten your teeth, it can make your teeth look straight.

Even without the need to make your crooked tooth look straight, doing a smile makeover is an advanced procedure. Your particular case requires a little more expertise.

If you want to go that route. I’d go to aacd.com and search for an accredited cosmetic dentist in your area. Dentists who’ve reached accreditation are the top cosmetic dentists in the country.

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

covering tetracycline stains

I have pretty bad tetracycline stains, as did my sister. She had porcelain veneers put on them a number of years ago. While they look better than my teeth, they do not look natural. They told her they had to use an opaquer in order to get them to cover the stains. I was hoping in the last few years or so they’ve made some advancements so that if I had porcelain veneers done, they would look more natural. What are my chances?

Avery

Dear Avery,

A single porcelain veneer being placed on a tooth

When it comes to making natural-looking porcelain veneers, the need isn’t for better advancements; rather, it’s for better cosmetic dentists.

The technology has been around for years, but very few cosmetic dentists have the training and skill required to pull it off. To be fair, tetracycline stains are among the most challenging a dentist can face.

The porcelain veneers have to be opaque enough to cover the stains, yet translucent enough to reflect light and look normal. I would say only the top 1% of dentists in the country are capable of pulling this off.

Finding an Expert Cosmetic Dentist

If you want the best cosmetic dentist, and you will need that for tetracycline stains, you will want an AACD accredited dentist.

The American Academy of Cosmetic Dentistry realized, because cosmetic dentistry isn’t a recognized specialty, patients would have a hard time distinguishing who was actually skilled and who just dabbled.

To reach accreditation, dentist have to pass stringent oral and written exams as well as provide a large number of cases which demonstrate they have artistry in their work as well.

Those who reach this level are in the top 1-2% of dentists in the country. You can locate them at aacd.com. Just make sure you check you want an accredited dentist.

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

family dentist versus cosmetic dentist

I had composite bonding done on a chipped tooth. The dentist who did them retired. My new dentist said they couldn’t replace the bonding and suggested a dental crown. He said because it was a front tooth the only way to get it to match was to do two crowns. I trusted. him. Now I have two crowns on healthy teeth and, while the match each other, they’re grayer than the rest of my teeth and look fake. What do I do?

Cameron

Dear Cameron,

a before and after picture of dental bonding for a chipped tooth.

The biggest problem you have here is you’ve got a family dentist who doesn’t understand cosmetic dentistry. You needed composite bonding repaired. He didn’t know how to do that. Instead of telling you that, he says it can’t be done and you need crowns. Why crowns? Because those are what he’s familiar with.

A second issue is the fact that he said you needed two crowns in order to get them to match. A skilled cosmetic dentist can match a single crown to a front tooth.

In your place, I’d suggest you do one of two things. First, tell your dentist you need these crowns re-done. But, only allow him to do it on some conditions.

  • He’ll need to use a temporary try in paste so you can see the crowns in your mouth to make sure they’ll match and you are pleased with them.
  • If you’re not thrilled with them, he needs to be willing to re-do them until you are happy with them.

If he doesn’t agree to that, then my second suggestion is you ask for a refund. He told you the teeth would match and they don’t. He also lied to you about the possibility of just getting the dental bonding repaired. You have the right to a refund.

Once you secure that, it is time to find a good cosmetic dentist to do this properly.

Finding an Expert Cosmetic Dentist

I’m going to suggest you look for an AACD accredited dentist. You can look them up for your area at aacd.com. These are in the top 1% of cosmetic dentists in the country. There aren’t many of them, so it may be hard to find one depending on where you live.

If that’s the case, there is a second resource. Look on mynewsmile.com . They screen cosmetic dentists for both their technical knowledge and training, as well as their artistic ability. Any of their recommended dentists can provide you with two gorgeous crowns

You may want to consider whitening your teeth if you are going to get the crowns replaced, this will essentially give you a bit of a smile makeover.

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