Archives for November 2023

Dealing with a Chipped Lower Incisor

Posted on November 30, 2023 by writeradmin.

I have a lower incisor that is chipped. It is a bit irritating and I’m worried people can see the chip when I am talking. My dentist tried to repair it with dental bonding but that fell off after a few days. Is there a way to just regrow the broken part?

Olivia

Dear Olivia,

A porcelain veneer being held up with a dental tool

With a lower incisor there is always the problem with the upper teeth causing an issue with the dental bonding. This is because the incisal edges hit the insides of the upper incisors every time you close your mouth. Dental bonding is more susceptible to those type of stresses. You would need an expert dentist to who has studied occlusion to know how to avoid those type of stresses. Otherwise, the bonding will break.

Another option for fixing this is with a porcelain veneer. These are a bit stronger and last longer than dental bonding. While bonding will last a few years, veneers can last for decades if well cared for.

With either one of these procedures you will want a dentist with significant post-doctoral training and expertise in both occlusial studies as well as cosmetic dentistry.

In your position, I would look for a dentist who is AACD accredited. These are the top cosmetic dentists in the country and they will have the skills to give you not only a repair that will last, but that will also blend seamlessly with the rest of your smile.

If you can’t find a skilled cosmetic dentist in your area, then a last resort would be to have the dentist smooth out the chip. That would only be a last resort. You may have to travel to a nearby city, but I’m sure you can find a skilled cosmetic dentist.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Dental Crown Disaster

Posted on November 22, 2023 by writeradmin.

I needed a crown on a front tooth. My dentist suggested a CEREC crown because it could be done in one day, but I’d heard that they don’t look good on front teeth, so I asked for a traditional crown. The temporary crown didn’t really match, but he assured me that the temporary crowns would always be worse than the permanent crowns and when they came in it would be a perfect match. When the crown came in, I never really got to see it before it was bonded in. Once I got to look at it I realized (to my horror) that it didn’t really match the tooth next to it. I mentioned that and he said it “looked fine to him” plus it was already bonded so it couldn’t be removed. Then, a few weeks later the permanent crown, that “couldn’t be removed” fell out. I went back to my dentist suggesting that this would be a good time to improve the appearance. He then said that, “While he could redo it, he would have to charge me for it because I have a functional crown.” Otherwise, he could just bond this back on for free. I was so frustrated. Now it has fallen out again. I’m sure he is going to give me the same choice again. Do you have any recommendations for me?

Greta

Dear Greta,

Porcealin crown being placed on a tooth

The one good thing you have going for you is that the dental crown is not staying in. The dental board considers the standard of care functional. While you, unfortunately, would not have any recourse because the crown does not match your teeth, you do have the right to ask for a refund when it does not stay in. Despite what your dentist said, you do not have a functioning crown if it does not stay in your mouth. That is exactly what I think you should do.

Not only has this dentist shown himself to be unethical in how he misinformed you about the temporary versus permanent crown, he also cannot get the dental crown to stay. Do not allow them to do any more work on you. Instead, tell him you want a complete refund. Your crown is not functional. This is the second time it has fallen out.

When you go to get your crown replaced, I want you to go to an expert cosmetic dentist. Matching a tooth to a front tooth is more challenging than for other teeth because the light hits them directly which reveals all the nuances of the teeth. A truly skilled cosmetic dentist would do a temporary try-in to make sure it perfectly matches the adjacent teeth. If not, they would make notes about what changes need to be made and then send them back to the lab to be redone. He or she would not be satisfied, nor would they bond the crown in, until you are completely satisfied.

My suggestion is that you go to an AACD accredited dentist. These are the top cosemtic dentists in the country. They will give you a gorgeous crown that completely blends in with its adjacent teeth.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Which Dentist Should I Trust?

Posted on November 10, 2023 by writeradmin.

I had a dental bridge that went across the front of my mouth. My two canine teeth were the anchor teeth. Then, those became too loose to support the bridge and had to be extracted. At the time, I was going to Comfort Dental. They suggested I replace those teeth with a partial denture. I wasn’t thrilled but did it. I found the partial to be remarkably uncomfortable. Now they are talking about placing mini implants for those teeth, which they said should last me ten years, as well as using a flexible partial for four teeth I am losing on my lower arch. I sort of lost confidence in them so went to get a second opinion. This left me totally confused because this dentist’s plan is totally different. He wants to do three full-sized dental implants that support a bridge. One that is in the center and two on either side of the bridge. He also thinks the bottom teeth need to be dental implants as well. This second option is obviously much more expensive. I’m trying to decide which is better. I’d save money with Comfort Dental, but am not sure I trust them. Do you have a recommendation as you have no skin in the game?

Braden

Dear Braden,

While it is more expensive, I defintely suggest you go with the plan from the second dentist for reasons I’ll explain in a moment. First, I want to talk about why you lost those canine teeth. Using those to support your bridge was a bad idea on the part of Comfort Dental. The twisting forces would lead to those teeth being lost, which is exactly what happened.

Looking at Comfort Dental’s plan, I would not hold out much hope for mini implants to last you ten years. They’re not really designed to do what they’re suggesting. But, let’s say by some miracle that they do last that long. What will you do after that? You can’t just replace dental implants, even mini implants. You have to replace the bone that was lost when they are removed. That means an additional surgery of bone grafting. Only then will you be able to replace them.

Let’s look at the engineering principles for the second dentist’s plan. Here you would still have your canines as anchor teeth, so why is this any less dangerous? It is because he is suggesting a third implant placed in the center (where your front teeth would be). How does that help? Because it stablizes the bridge in a way that eliminates the twisting forces that would damage the canine implants. Done this way, your dental implant supported bridge could last you the rest of your life.

What About the Bottom Teeth?

While you can often get away with a removable denture on your top arch because they are held in with suction, your bottom arch depends on the bone ridge to support the denture. The problem with that is the minute your teeth are removed, your body immediately begins resorbing the jawbone to use elsewhere in your body. This has the unfortunate consequence of slowly shrinking your jawbone. In about ten or so years, you will no longer have enough bone left to support a denture. This is known as facial collapse.

Placing dental implants prevents that from happening by having prosthetic roots in your teeth. This signals to your brain that there are still teeth to support and will leave your jawbone intact.

I hope this helps. This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.