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Dentist Broke Tooth “Fixing a Porcelain Veneer”

I had several porcelain veneers done and they ended up looking awful. I never got to see them before he bonded them on so had no idea how bad they were until I got home. He agreed he’d redo them after I called him and told him how miserable I was about how they looked. Unfortunately, when he tried to remove the first one, he broke the tooth. It broke so completely he ended up having to extract it and now I’m having to get a dental implant. I have a flipper for now because I told him not to remove the others until I have a chance to get a second opinion on what’s going on. I know he’s the professional, but I feel like he can’t be trusted. What’s going on?

Jennifer

Dear Jennifer,

A single porcelain veneer being placed on a tooth

I have to tell you this is gross incompetence on the part of your dentist. If I am truly understanding what you’re saying here, it sounds like your dentist tried to “pop” or pry off the veneers from your teeth. That is absolutely NOT how this is done.

Instead, porcelain veneers will be gently ground off, sort of how the dentist prepared your teeth the receive the veneers to begin with. If he broke your tooth so badly it couldn’t be saved, I wouldn’t let him anywhere near the rest of your teeth. He doesn’t have a clue about cosmetic dentistry.

1. He didn’t let you see them with a try-in paste before permanently bonding them on.
2. He didn’t make them to your standards.
3, He didn’t know how to remove them.

You’re going to need an expert cosmetic dentist. I’ll tell you how to find one of those in a moment, but first I want to make sure you don’t get stuck with this bill. You’re going to have to be pretty tough and tell your dentist you won’t sue him if he pays for the repairs with the cosmetic and implant dentist of your choice. If he’s wise, he’ll do it.

Finding an Expert Cosmetic Dentist

The problem many patients run into is the skills necessary to go stunning cosmetic dentistry requires significantly more training than they received in general dental school. It takes significant post-doctoral training to know what you’re doing.

You want a dentist who’s invested that time in the additional studies as well having an artistic eye. To find that type of dentist you can look at two resournces, The first of those is the American Academy of Cosmetic Dentistry website. Once there, you can list a location were you’d like to be treated. The key here, though, is checking you want an accredited cosmetic dentist. These are among the best dentists in the world.

They can give you a stunning smile. However, because it takes many years to reach accreditation, there aren’t many of them around the country.

There is another list. This one is called nynewsmile.com. Like the aacd.com website, they have a link to find a cosmetic dentist. You’ll input your zip code along with how far you’re willing to travel and they’ll give you a list of incredible cosmetic dentists. Many of them are close to being accredited if they’re not accredited already.

Have one of these dentists re-do your smile makeover as well as plan your dental implant. You shouldn’t have anything to worry about with one of them. In fact, most of them have a beautiful smile guarantee.

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

Help! Which Crown Should I Get?

I need to get a dental crown on a tooth. My dentist threw all these options at me. While he did explain everything, it was all so fast I can’t remember. I told him I’d let him know this week. I tried to do some research but everything is so confusing. Help!

Lacey

Dear Lacey,

CEREC Crown being placed on a tooth

Sometimes dentists think you can understand everything in 5 minutes that they studied all the way through dental school. Sounds easy, right?

It’s good that you’re doing some research. It’s important to go into these type of decisions informed. One thing to be aware of is that you should always feel free to tell your dentist to slow down and to repeat himself if necessary. You should never feel rushed.

To help, I’ll go over the three most common types of dental crowns.

Three Most Common Dental Crowns

The first has been in place for many years and it’s been a staple in the dental diet. These are conventional crowns, also known as porcelain-fused-to-metal crowns. As their name implies, these have porcelain on top and a metal base underneath. These are best used for back teeth because of the amount of biting force we use with our back teeth. If you have a metal allergy, there are metal-free options.

The second type is all-porcelain crowns. These have porcelain all the way through, even as it’s underside. These are especially useful for front teeth because they look more natural than their metal-based counterparts. With front teeth, there is a completely different biting force and these can withstand the pressure.

Thirdly, there are CEREC crowns. These are also all-porcelain. The biggest differences are they are milled by machine using a single block of porcelain. As a result, they’re able to be done in just one appointment. Be aware, unless you have a highly skilled cosmetic dentist, these won’t have the same subtleties that the non-machine milled crowns will have which are made from several different blocks that have different shades.

There’s really not a horrible choice, though I never recommend metal-based crowns on front teeth. You won’t like the results. I hope this helps.

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

Invisalign and Bad Breath

I need some help for my mom. She has always had teeth which embarrassed her. She was so excited to get Invisalign. She is very diligent to keep them in and I know she’s going to have a beautiful smile when it’s done. The only thing is, her breath smells really bad now. I don’t want to tell her and make her feel weird about something she’s wanted for so many years. But, I also don’t want her going around with bad breath. Is there a gentle way to help her or is this just part of Invisalign?

Carrie

Dear Carrie,

Image top: A woman putting on her Invisalign aligners. Image bottom: a woman smiling with Invisalign on her teeth

You are such a sweet daughter. You made me as happy for your mother as you are. You’re right, she’ll love her smile at the end. Invisalign doesn’t automatically mean bad breath. However, there are a few common things which we see in patients that can lead to it.

Keeping Your Breath Fresh with Invisalign

  • Don’t eat or drink with them in

Patients are allowed two hours a day when they can take the aligners out. That’s intended to give them plenty of time to eat their meals without the aligners in. It’s possible your mom is so excited about the procedure she’s not taking a break. If you see her eating with them in, remind her she’s supposed to remove them.

  • Brush and floss your teeth after each meal

Food always gets stuck between our teeth when we eat. Unless you remove that, it will make your aligners pretty pungent. It will also lead to decay pretty quickly. I know you don’t want to talk to her about her breath, but if there’s a way you could gently tell her. Or, if you’re uncomfortable with that, you could just say you’re on your way to brush your teeth after meals together as a reminder to her that she’s supposed to be.

  • Hydrate regularly with water

Not drinking enough water can cause not just dehydration, but some pungent breath as well. The added benefit is she can drink that while her aligners are in. It’s the one thing she can drink while she’s wearing them.

  • Use the cleaning kit that comes with the aligners

Cleaning your teeth isn’t enough. Occasionally, your aligners need a good clean as well. If she can’t find her kit. She can give them a quick clean with a soft-bristled toothbrush and a baking soda and water mixture.

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

Matching a Crown on a Front Tooth

I needed to get a crown on a front tooth. The first one came back way too white. He sent it back and tried again, but the second one he looked at it and said, “That’s better.” then proceeded to bond it one without me seeing it. When I got home, I realized it didn’t match the other tooth. What do I do?

Lacey

Dear Lacey,

A tooth receiving a dental crown
To match a crown to a single front tooth takes an expert cosmetic dentist.

The procedure you need, matching a single crown to your other front tooth, is an extremely advanced procedure. Only the top cosmetic dentists can do it. Even the best will usually charge up to 40% more for a crown on a front tooth. That’s because it regularly takes four or sometimes more try-ins before it is matched completely to the adjacent front tooth.

There are two things your dentist did which make me think he’s not a skilled cosmetic dentist. First, he thought two tries was enough. A truly skilled cosmetic dentist will not be satisfied with anything less than perfection. He would do it over and over again until they matched.

Second, he permanently bonded on your dental crown before letting you get a look at it. He didn’t want to risk you saying it didn’t look right so he tried to take away your ability to say so. You have two choices in getting this fixed.

Finding the Right Cosmetic Dentist to Fix This

You really do need an expert cosmetic dentist if your dentist isn’t willing to put forth the effort for excellence. I’d look at the American Academy for Cosmetic Dentistry’s website (aacd.com). They have a section which allows you to look for a cosmetic dentist.

You need an accredited cosmetic dentist. These are the cream of the crop. Not only are they capable of matching a single crown, but they won’t be satisfied until you are.

If money is a factor, you may want to see if your dentist is willing to get it right at no additional cost. But, if it’s not a huge factor, you’re better served to find a better cosmetic dentist.

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

Should I Have Gone to a Cosmetic Dentist for a Root Canal?

Both my sister and I received root canals within the last year. My dentist put a crown on mine, which meant filing down the tooth to a nub. It’s not that attractive either. It’s toward the back so isn’t completely visible but it still bothers me. My sister sees a cosmetic dentist. When he did her root canal, he put a porcelain veneer on hers. It looks so much nicer than mine and she hardly had any of her tooth structure removed. Did I make a mistake not going to a cosmetic dentist?

Betty

Dear Betty,

Porcelain crown on left and porcelain veneer on right

You should know there isn’t a recognized specialty in cosmetic dentistry, which means every cosmetic dentist is just a general dentist who prefers to also do cosmetic work. However, before we get into choosing a dentist to do cosmetic work, let’s talk about a root canal restoration.

Whether or not you get a dental crown or a porcelain veneer restoration depends on a few things. First, the location. If it’s a back tooth, a crown is more important. After a root canal, a tooth becomes more brittle. The crown will protect it from the biting forces which affect your back teeth.

If it’s on the front teeth, you may have a choice. Most of the time crowns are done because there was so much decay on the tooth there is not enough structure left for anything but a crown. However, if the tooth needed treatment because of trauma and is still fully intact, then you could get a porcelain veneer. This is more effective because of the type of forces your front teeth undergo.

However, you’re talking about getting a porcelain veneer on a single front tooth. This requires a cosmetic dentist with superior aesthetic skills.

When You Need a Skilled Cosmetic Dentist

Most of the skills required to do a beautiful smile makeover are not taught in dental school. The dentist has to invest post-doctoral time in learning the skills required. However, there is an aspect that can’t be taught— an artistic eye.

Like any art form, there are different skill levels. So, how do you find the right dentist? The American Academy of Cosmetic Dentistry realized the quandary patients found themselves in. To remedy that, they began an accreditation program.

To become accredited, dentists have to pass stringent oral and written exams. Additionally, they have to provide evidence of a list of cases they’ve done showing they can give beautiful results. Any AACD accredited dentist can give you a gorgeous smile makeover. They can also match a single porcelain veneer to the rest of your teeth.

If you’re ever in the need or porcelain veneers, make sure you go to aacd.com and find an accredited dentist in your area.

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

CEREC Crowns and Thyroid Issues

I have severe thyroid issues and find it important to make sure my dental work is metal free, as well as containing no lithium. I’m considering CEREC crown. I asked my dentist about these issues and he said my information is false and there’s no point in even answering the question. This annoyed me and made me wonder if it was safe for me to get one. Do you have information for me?

Alyssa

Dear Alyssa,

Block of porcelain for CEREC crowns

Before we start, I’m going to let you know this isn’t the best dentist for you. While I won’t say you’ll need a holistic dentist, you will need a dentist who will be willing to care about your concerns. This one obviously doesn’t.

CEREC Crowns are Metal-Free

Because CEREC crowns are milled from a single block of porcelain, you don’t have to worry about a metal base. Though you can get all-porcelain crowns even with traditional crowns, there are also some that have a metal base, so if you ever get a traditional crown, make sure to specify you want an all-porcelain crown.

CEREC Crowns can be Lithium Free

Dentists have quite a few options in the types of tooth-colored materials available in block form. Only one of them is lithium disilicate-based. There haven’t been any studies to date on this lithium with the thyroid. The lithium which is under scrutiny for leading to hypothyroidism is the lithium prescribed to bipolar patients.

However, for your own peace of mind, it’s best if you let your dentist know of your concerns ahead of time. It’s simple enough for him to avoid that one type for your sake. Just give him a head’s up.

Dentists should factor in the concerns of their patients. Though many try to assume they know more because “they’re the professional who has the dental degree”, it’s your body. No one knows your body better than you do.

Additionally, neither dentists nor doctors have accumulated the sum of all knowledge and understanding when it comes to medical care. We’re still developing knowledge. Therefore, if a patient feels a type of material has a negative impact on them, we should listen.

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

Can I Bill Ex-Husband for Emergency Dental Work?

I’ve been divorced for about ten years. I left my ex-husband because he was abusive. It wasn’t until recently I developed the confidence to start dating again. When my ex-husband found out, he showed up at my apartment after one of my dates and beat me pretty badly. Thankfully, a neighbor noticed what was happening and called the police. He’s been arrested. But, I’ve been left with one chipped tooth and three loose teeth. I’m worried I’m going to lose them if I don’t get seen by a dentist, but I don’t have any money. Would an emergency dentist be willing to bill my ex?

Tanya

Dear Tanya,
Woman covering her mouth

I’m so sorry you had to experience that. You’ve been through a lot. Unless your ex-husband signs something saying he’ll pay for the appointment, there’s no legal way for the dentist to bill him. However, given the situation, I am pretty positive any dentist would be willing to allow you to get the services you need to save your teeth and pay out the bill a little at a time. Even if they don’t offer in-office payment plans, they’re sure to work with Care Credit.

It’s a medical “credit card” of sorts. It’s more financially friendly than your typical credit card, allowing the patient to get a much lower interest rate than would otherwise be possible. There’s also no penalty for an early payoff.

Given your ex-husband has been arrested for the assault, if you took him to small claims court you’ll be quite likely to win your money back.

You Need to See a Dentist Right Away

With you having some loose teeth, you don’t want to put off seeing a dentist. This needs to be dealt with immediately. If you don’t currently have a dentist, do an internet search using the term “emergency dentist“. These are general dentists who are willing to see non-established patients in cases where urgent care is needed.

They can splint your teeth and fix the chip with dental bonding. They’ll also do an x-ray to make sure there’s no internal damage to the teeth. If there is, they’ll do a root canal treatment and provide a dental crown.

You should know, there is a charity called “Give Back a Smile” that does free dental work for those who’ve suffered domestic abuse. After you get this emergency work done, you should apply.

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

Will Invisalign Work if I Have Missing Teeth?

I want to get Invisalign but I have a couple of missing teeth. Is Invisalign still possible?

Dan

Dear Dan,

A woman placing in her Invisalign aligners

Invisalign does fine with missing teeth. It used to be that Invisalign could only take certain types of cases but it’s becoming more and more advanced and can take even cases of crowding at times these days.

The key to a successful Invisalign case, when there are missing teeth involved, is communication with your dentist. Are you looking to replace those teeth? Do you want a permanent replacement, such as dental implants? Or, do you just want to close up the spaces? Those will work different ways during treatment so make sure you and your dentist discuss your goals thoroughly.

Invisalign Versus Other Cosmetic Work

What Invisalign will do is straighten your teeth. If that’s all you want to be done, then that’s the perfect treatment solution. If there are other things about your smile you want to tweak, there are several options.

If another issue you have is the whiteness of your teeth, your Invisalign aligners can double as teeth whitening trays. That allows you to simultaneously whiten and straighten your teeth.

If you’re looking for a total smile makeover, porcelain veneers are the way to go. These can change absolutely anything about your teeth— the shape, the size, the color, or any combination of those. One word of caution when it comes to smile makeovers.

While just about any dentist can do Invisalign or teeth whitening, to get a beautiful smile with porcelain veneers takes some additional training and skill. In fact, you’ll want an expert cosmetic dentist. Ideally, you should get an AACD accredited dentist.

These are the top cosmetic dentists in the world. Most, if not all of them will have a beautiful smile guarantee.

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

What If I Can’t Get Porcelain Veneers?

I’m disappointed with my smile, but my dentist said I can’t get porcelain veneers because I grind my teeth. Is there anything else I can do to improve my smile? I have a gap between my teeth and they are quite discolored.

Mandy

Dear Mandy,

A single porcelain veneer being placed on a tooth

I think your dentist may be a little confused. If the only issue is that you grind your teeth, there is a way for you to get porcelain veneers. It’s possible that he’s not comfortable doing smile makeovers and rather than admit that he’s trying to discourage you from moving forward with that. Don’t pressure him. You will not be happy with the results.

Here’s what I’d recommend. The first thing I want you to do is to get a second opinion. But, make sure you do it with a dentist who’s accredited with the American Academy of Cosmetic Dentistry (AACD). These are the top cosmetic dentists in the country.

In all honesty, in order to get the gorgeous smile you’re hoping for that’s the type of dentist you’d want to do your veneers anyway.

If Porcelain Veneers Aren’t an Option

There are some cases, where other work has to be done before you can get porcelain veneers, such as when you have gum disease. In other cases, they’re good candidates, but this type of makeover is just over their budget. That doesn’t mean you can’t get an upgraded smile. Here are some great, affordable options:

  • Teeth Whitening: This is the most affordable way to brighten your smile dramatically. It will make you look years younger.
  • Invisalign: This is a great option to straighten your teeth without anyone knowing your wearing orthodontics. Plus, it works in half the time of traditional orthodontics.
  • Dental Bonding: This can repair chips and gaps on teeth.

As you can see there are many ways to upgrade a smile. However, no matter what you do, you’ll want to protect your teeth, especially after investing money in improving it. If your dentist hasn’t suggested a night guard to you, knowing that you’re grinding your teeth, then it may be time to get another dentist.

This is a simple orthotic device you’d wear over your teeth and it will take the pressure off of your teeth when you grind them. Without this, your natural teeth will eventually be worn down to nubs, requiring you to get each tooth crowned.

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

Cosmetic Dentistry Disaster

My dental bonding for a chipped tooth needed to be replaced. I had a new dentist who suggested I get porcelain veneers instead. He’d do four so they could match. Then, when he saw one of them had a cavity, he said I’d need crowns. So, now I have four crowns on my very front teeth and even though he said he had to do four in order for them to match, the two very front teeth look a weird grayish color. What do I do?

Valerie

Dear Valerie,

Porcelain Veneer being placed on a tooth

There are so many things which went wrong here I hardly know where to start. First, any dentist who says you have to do more than one crown or veneer is not a qualified cosmetic dentist. Yes, it takes skill and artistry to match a single front tooth, but isn’t that what you’re paying them for when it comes to remaking a smile—skill and artistry?

Second, you can still have porcelain veneers bonded to a tooth which has a cavity as long as that cavity isn’t so large that it would require a crown under normal circumstances. That would have prevented you from having to grind down healthy tooth structure.

Sadly, the only way to do this is to have the two front teeth re-done. Hopefully, he’s the type of dentist who cares about the quality of his work and will be willing to replace the crowns free of charge.

However, that’s not enough. You need to make sure he’s willing to get a professional try in the paste. These are clear enough to show the color of the underlying teeth on them, giving you a clearer picture of what the crowns will look like once they’re permanently bonded. Then, he needs to let you try them in and get a good look them in several types of lighting and you’ll approve them before they’re bonded.

If he’s not willing to do that, you aren’t likely to get any better results. In that case, it’s in your best interest to find an expert cosmetic dentist.

Finding an Expert Cosmetic Dentists

Unfortunately, now that you’ve had crowns placed, you have to replace them with that forever. However, a skilled cosmetic dentist can give you gorgeous porcelain crowns. There are two places you can look to find a qualified cosmetic dentist in a reasonable distance from you. The first is at AACD.com. Do a search for an accredited cosmetic dentist. You need to check that you want them to be accredited and not just a member. There’s a difference.

The second is mynewsmile.com. This site only lists artistic and skilled cosmetic dentists who can give you a beautiful smile. You’ll be safe with anyone on their list or anyone who’s been accredited.

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