Category Archives: Uncategorized

Help! My Front Tooth is Loose

I am terrified. I discovered my front tooth is loose. I don’t remember hitting it and I don’t think the other teeth are loose. Can a dentist fix this? What if it can’t be fixed? Do they make dentures for one tooth? Help me!

Samantha

Dear Samantha,

A woman with a gorgeous smile created by cosmetic dentist Dr. Mike Malone
A gorgeous smile created by cosmetic dentist Dr. Mike Malone

First, I want you to take a deep breath. You will not end up with a space where a front tooth should be for the rest of your life. The first thing you need to do is schedule an emergency appointment with your dentist. If the tooth is loose, regardless of the cause, it needs to be splinted to keep it secure.

Next, your dentist will need to determine why it’s loose. Do you have gum disease? Was there trauma? He’ll want to do some x-rays to see if the pulp was damaged. If so, you’ll need a root canal treatment.

Dental Solutions for a Missing Tooth

If you do end up losing this tooth, which would surprise me if this is the first sign of a problem and you don’t remember any trauma, there are solutions. We’ll go over each of them, from the least desirable (and least expensive) to the highest quality replacement, which is also more pricey.

Removable Partial DentureYes, there are “dentures” for a single tooth. It’s called a removable partial denture. It connects onto your other, healthy teeth, with a false tooth attached. It does put pressure on the teeth it hooks to so it’s not the ideal solution, but depending on your budget, you might use it as a temporary solution while you save up for one of the more preferable treatments.

Illustration of a dental bridgeThe next best solution is a dental bridge. This suspends a false tooth between two dental crowns. In reality, this makes more sense if your adjacent teeth (which will receive the crowns) need work anyway. In that case, it’s like knocking out two problems with one. However, if they don’t need work, I wouldn’t want to remove any healthy tooth structure.

Dental Implant DiagramThe top of the line replacement is to get a dental implant. It’s like having a healthy, natural tooth back. If your budget allows, this would be the treatment I’d choose. A prosthetic root is implanted where the natural root was, then a porcelain crown is placed on top. You can eat, brush, and floss just like you normally would. They’re very strong and last for many years.

Getting a Beautiful, Natural-Looking Tooth

You’re talking about replacing a front tooth, so you want to be certain the dentist is also a skilled cosmetic dentist. Whatever crown he creates for your front tooth needs to look just like the adjacent tooth. Above all else, make sure they give you an all-porcelain crown and not a porcelain-fused-to-metal crown.

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

CEREC vs. Traditional Crowns

I’m considering getting a CEREC crown. Are they as good as their traditional counterparts?

Matt.

Dear Matt,

A tooth receiving a CEREC crown
Which is better a CEREC or Traditional Crown?

In one corner we have traditional porcelain crowns. Tried. True. Proven. Strong. Beautiful (with the right dentist). Though, they do take a couple of appointments. They’re milled from more than one block of porcelain.

In the other corner are the CEREC crowns. Tried. True. Proven. Strong. Beautiful (with the right dentist). Made in one appointment. Though, they’re milled from one solid block of porcelain.

Each time I type “Though”, I’m showing the downside of that particular type of crown. While two appointments aren’t horrible, it is definitely more convenient to have it done in one. You miss less work. You use less time. You have your permanent crown from the beginning. So, it would seem that the CEREC crown would be the better bargain. After all, the other features seem to be the same.

So, what’s the big deal about the “Though” for CEREC crowns? Why does it matter if you mill a crown from one block of porcelain or more than one block?

The difference comes from a cosmetic standpoint. Your teeth aren’t of identical translucency from top to bottom. The edges, especially at the bottom, are less opaque than the rest of the tooth. It seems to “thin out” a bit as you move down. There’s also a whiter color in the center than you’d find as you move down.

When you mill from a single block of porcelain, the crown will seem the same from top to bottom. They can look a little flatter because there aren’t those subtle varieties.

When a dentist can draw from more than one block and craft them together, you get the subtleties that reflect light a smidge better in natural teeth.

When to NOT Get CEREC Crowns

In most cases, CEREC crowns are fantastic. They’ll still look beautiful. They’ll still match your teeth. They’ll still hold up to the stresses of daily use. The one exception is on a very front tooth. If you’re getting a crown on one of your very visible front teeth, that’s when I would opt for a traditional crown. This will allow the dentist to use his artistry and make sure every subtle variety of light and color comes through.

Other than in that case, you will get a gorgeous crown with CEREC AND save yourself an additional appointment.

One word of caution. No matter which you decide on, once the crown is completed and bonded on, the color cannot be changed. If you’re going to get your teeth whitened, do it before getting your crown designed.

This blog is brought to you by Dr. Mike Malone

Can an Adult Tooth Be Saved Once it’s Knocked-Out?

At my son’s football game one of the young men had a tooth knocked out. He just tossed it aside and kept playing. I’ve been wondering about that ever since. Could the tooth have been saved? Are there steps that need to be taken?

Arlene

Dear Arlene,

hockey player missing a tooth
How to Save an Adult Tooth

It’s good that you’re asking about this ahead of time because there is very little time to actually save a tooth during the trauma of the event. At max, you have 30 minutes. If a series of unfortunate events take place which causes an adult tooth to get knocked out here are the steps to take:

  • Grab the tooth by the crown only. That’s the visible part of your tooth when you smile. DO NOT touch the roots.
  • The tooth needs to stay moist. If milk is available, place the tooth in a cup of milk.
  • Call your dentist’s office and let them know you have a knocked out tooth and are on your way in. They’ll know time is of the essence and will be ready for you when you arrive.
  • It’s also a good idea to keep a short list of emergency dentist numbers on hand who see non-established patients, even after hours, in case you can’t reach your dentist.

What to Do if the Dentist Can’t Save the Tooth?

Sometimes you and the dentist can do everything right, but the tooth cannot be saved. In that case, you’ll want to know about your tooth replacement options.

Fortunately, the advances in dentistry have been useful. Your best option, if you’re a good candidate is to get dental implants. Depending on the age of your son, he may not be a good candidate. Teenager’s jaws are still developing.

If that’s the case, your dentist will go over temporary options for him that will give him a false tooth and hold the space available for implants in the future. Make sure he knows you son is in a contact sport so he takes that into consideration with any temporary replacement.

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

Should I Call an Emergency Dentist for a Lost Filling?

Is it a dental emergency if I lost a filling? It’s the New Years Weekend and I don’t really fancy spending it in the dentist’s office.

Mark C.

Dear Mark,

A man holding his jaw in pain in need of a dentist

What??? You don’t want to ring in 2018 from a dental chair? I can’t imagine why not. What could be more invigorating?

In the case of a lost dental filling, you have a couple of good options. Before I give you those, let me tell you what not to do…ignore it. If you don’t do anything bacteria will get into the newly created space and blow up into a tooth infection. Depending on how fast-moving everything is, you could spend the beginning of the New Year in the hospital.

Besides, having a hole in your tooth will not allow you to enjoy all the New Year’s Eve goodies the way you could if it were filled.

You do have a couple of good options:

Ask Your Dentist for an Emergency Visit

I know. I know. You said you didn’t want to go in. But, seriously, a filling takes hardly any time and you’d be back to normal without this weight on your back of having to go to the dentist’s office at some very near date. Who wants to spend New Years dreading the New Year?

Replacing a filling is normally quick and painless. However, the dentist will want to investigate to find out why the filling came out in the first place. You’ll especially want to make sure there’s no new decay developing which could sabotage your weekend plans.

Get Temporary Filling Material

Some pharmacies stock a temporary dental filling material. This will NOT actually replace your filling and is designed to be temporary— a few days at most. But, it could hold you over through your parties, etc. Then, first thing January 2nd, you’ll really need to get in to see your dentist. No excuses.

If you put it off, you won’t be looking at a filling, but rather a dental crown or tooth extraction. That is definitely not how you want to start the year.

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.

If I Get a CEREC Crown Will It Fall Off?

I have a friend who got a dental crown. The temporary one fell off three times before his permanent one came in, then his permanent one fell off–twice. I’m wondering if it is because he got a regular crown. Would the same thing happen if he had gotten a CEREC crown?

Danny P.

Dear Danny,

In reality, neither crown should fall off. The temporary is more excusable because they’re designed to come off easily. However, the permanent one, when bonded properly should have stayed fixed. A well-made crown could stay affixed without bonding (assuming you don’t eat anything extremely chewy). But when it’s made well and bonded, you’re safe.

It sounds like this dentist isn’t the best when it comes to a proper understanding of either porcelain crowns or bonding. Hopefully, you’re not going to the same dentist.

CEREC crowns are a little safer. They’re milled by computer so are more likely to be cut precisely. Plus, you don’t have to worry about the hassle of a temporary crown.

I’m not sure where you’re getting the crown, but if it’s somewhere visible and you plan on doing any cosmetic work, such as teeth whitening, you’ll want to get the whitening done before the crown is designed. You can’t whiten crowns once they’re done. So, the wise thing to do is whiten your teeth and then have your crown made to match the new color.

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

Can CEREC Crowns Give Me Vampire Teeth?

I just found out I need a crown on my cuspid. I’m kind of excited about it. I’m a huge Goth fan and have always wanted vampire teeth, so I’m thinking about getting both cuspids crowned. My dentist uses a CEREC machine. Will that be able to give me vampire teeth?

Abby S. – Branson, MO

Abby,

There’s another Abby who’s a Goth fan, but she’s a fictional character on NCIS. If you haven’t seen that particular program, I bet you’d enjoy that character. In regards to your request, there are a few things to consider here. First, just in answering your question, yes, CEREC crowns could shape you pointy cuspids. However, that doesn’t mean your dentist will be willing to do it.

Every year, generally around Halloween, dentists get requests for vampire teeth. Most patients are satisfied with some temporary teeth. Every once in a while we get someone who wants them permanent. Dentists are hesitant to do that because they don’t want to be responsible for damage done to another person as a result of their cosmetic work.

Discuss it with your dentist. He or she may be willing or they may only be willing to give you temporary vampire teeth that are easily removable. This way you can use them in appropriate situations like a party or CON, but it won’t interfere with your everyday life. In fact, you might find it difficult to obtain employment with vampire teeth, which is something to consider.

Finally, I’d like you to think about the drawback of putting a crown put on a healthy tooth. Dental crowns, whether they’re CEREC or otherwise, require a large amount of tooth structure to be ground down. Your tooth essentially is reduced to a nub. I wouldn’t recommend doing this to a healthy tooth. If your dentist agrees to permanent vampire teeth, then I’d suggest getting the healthy tooth reshaped using porcelain veneers instead of crowns. You can get the appearance you want with minimal disruption to healthy tooth structure.

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

Can a General Dentist do Dental Implants?

I need to replace a tooth. Everyone says dental implants are the best replacement. Are there implant specialists or can a general dentist do them?

Max L. – Connecticut

Max,

First, I’ll say, yes, dental implants really are the top of the line tooth replacement. Be aware that not everyone is a candidate for dental implants. There are some conditions which are contra-indicative, like gum disease. Or, if you’re a smoker, you’ll be hard-pressed to find a good dentist willing to go forward with the procedure. If it turns out you’re not a candidate, there are other good options which we’ll discuss momentarily.

As to whether or not you need a dental implant specialist, that’s a yes and no. There isn’t actually a recognized specialty in implants, so any dentist who does them is a general dentist. However, it takes some additional training than what they get in dental school to be skilled in this procedure.

Dental Implants are an advanced procedure, with potentially severe complications if things go wrong. Because of that you’ll want to be bold in asking the dentist some blunt questions. Some things to ask are “What type of implant training have you had?” “How many implant procedures have you performed?” “What percentage of them are successful?”

So, what if you’re not a good candidate? Whatever dentist you go to should give you all your options. For instance, the next best procedure would likely be a dental bridge. In fact, if your adjacent teeth need a crown, a dental bridge might make more sense for you.

The important thing is you find a dentist you trust and then have them explain all the procedures you’re a candidate for.

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

I Want an Implant and My Dentist Wants Me to Get a Bridge

I have two teeth that need work. They’re right next to each other. One needs a crown. The other needs to be extracted. I want to do a dental implant and a crown. My dentist wants to do a bridge. I’d think he’d be more excited about a dental implant because they’re more expensive, but he seems pretty insistent about a bridge.  Is there a real medical reason for this?  I’m not too excited about the idea of a bridge.

Brenda C. – Michigan

Brenda,

My guess is your dentist isn’t comfortable with dental implants.  It’s an extremely advanced procedure. I wouldn’t push your dentist if that’s the case. When it’s not done perfectly, there can be serious complications.  It’s a credit to your dentist that he’s not just taking your money and doing the procedure halfway.

A bridge is fine in your case. You already need work on one of the adjacent teeth, so it’s like getting two procedures knocked out in one—no pun intended. However, your other tooth is healthy so you might not want to grind down healthy tooth structure. I understand your desire to go with an implant and crown.

My suggestion would be to get the implant and crown, but with another dentist. I’m not saying leave your current dentist, just have this particular procedure done with someone else. Then, you can continue with your current dentist for general treatments and cleanings afterward.

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

Are CEREC Crowns Worth Switching Dentists?

I need to get a dental crown. My sister told me to make sure and get a CEREC crown, but my dentist said he doesn’t do those. My sister seemed to think it was really important. Is it worth switching dentists to get one?

Amelia L. – Ft. Worth, TX

Amelia,

The only real benefit to CEREC crowns is they can be done in one appointment.  While it is convenient, I wouldn’t necessarily think it’s worth switching dentists.

The reason it can be done in one appointment is that it is milled on site from a single block of porcelain.

The bigger issue would be where the crown is being placed. If it is a front tooth, you’ll want to be certain your dentist is experienced and artistic with cosmetic issues. You want to make sure that he can make the crown look both beautiful and natural.

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