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Can’t Speak after Closing a Tooth Gap

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I had a tooth gap that my dentist closed and talked me into a smile makeover at the same time. I had porcelain crowns done from one canine tooth to the other. Ever since then I have had problems speaking, closing my mouth, my mouth is dry all the time, and my neck hurts constantly. Is there a way to put the gap back? Everything was fine with those things before. I just didn’t like the gap.

Carl

Dear Carl,

woman smiling with a gap between her two front teeth

The easiest way to close a tooth gap is with dental bonding

I want to start with the fact that crowning six teeth is a massive overtreatment for a tooth gap. It wouldn’t even be my solution for a smile makeover. Generally, tooth gaps are closed with dental bonding, which is much less evasive, doesn’t remove healthy tooth structure, and is much less expensive.

However, let’s say you really wanted a total smile makeover. As I said above, porcelain crowns still would not be the best choice. The go-to procedure for a smile makeover is porcelain veneers. The reason a dentist would suggest a porcelain crown if you don’t already have crowns there is because he or she doesn’t feel qualified to place porcelain veneers. That’s not a good reason. It would be better for them to refer you to a cosmetic dentist who would be able to give you a beautiful smile without having to grind down all your teeth. Unfortunately, once all that tooth structure is removed, you are stuck with crowns for the remainder of your life.

As to the issues you are facing, they are not from the gap being closed. Opening that back up won’t help. However, the issues are serious and are a result of the dental crowns not being placed properly.  Based on your description, it sounds like your dentist opened your bite too far. This means he’s either made the crowns too thick or too big for the shape of your mouth. It is imperative this is repaired–The sooner the better.

Here’s what is leading to the problems you’re facing. The neck pain is a result of your bite being thrown off and now you’re straining. Until that is restored, you will continue to be in pain.

Not being able to close your mouth properly is called lip incompetence. This is leading to the dry mouth you are experiencing. While I’m sure you know why the pain has to be dealt with, the lip incompetence is also a serious issue.  Our saliva is a major force in fighting decay in our mouth. Whenever you have dry mouth, you no longer have the minerals from your saliva to protect your teeth. It will lead to massive decay.

To get this properly fixed, I want you to get a second opinion from an experienced cosmetic dentist. Find an AACD accredited dentist in your area. These are the top cosmetic dentists in the country. They can help you get a refund from your dentist and then you can get this done properly so you have the proper function of your bite. Not only will you have a functioning bite, but it will also give you a stunning smile.

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

I’m In Tears After My Smile Makeover

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I had a few teeth with composite bondings to repair some chips. They needed some repair. My dentist retired and said the man who took over his practice said they’d need to be replaced with porcelain crowns because you can’t just replace composite bonding. I didn’t realize at the time that wasn’t true and allowed him to do six dental crowns. The two front teeth look a darker grayish compared to the other teeth. Is there any way to fix this? My dentist insists they’re the exact same color as the others. It almost feels like I’m being gaslighted.

Elaine

Dear Elaine,

Woman covering her mouth with hand.

I’m very sorry you’re going through this. I can tell you the biggest obstacle you face is you have a bread and butter family dentist trying to do cosmetic dental work. One of the big problems in dentistry right now is the fact that cosmetic dentistry isn’t a recognized specialty. This means any general dentist can call themselves a cosmetic dentist regardless of the amount of training they’ve received.

This puts patients in a difficult position. They may not know that smile makeovers and other advanced cosmetic procedures are not taught in dental school. In order for a dentist to become skilled in those areas, it requires a significant amount of post-doctoral training. The best dentists invest in this type of training on a regular basis and are constantly improving their skills. My guess is your dentist didn’t receive that. This is what landed you in this position.

Getting Your Smile Disaster Fixed

A true cosmetic dentist would never tell a patient their smile looked fine when they were unhappy with it. Instead, they would re-do the work until the patient was thrilled. Because they want total patient satisfaction, they’ll use a temporary try-in paste. This allows the patient to get a good look at their smile before it is permanently bonded on.

It is unfortunate you now have dental crowns. You’re stuck with those the remainder of your life because it required your teeth to be ground down. The good news is he misrepresented to you the options available. It is not true that dental bonding could not be replaced. My guess is he said you had to have dental crowns done because that is all he knew how to do. In your place, I would ask for a refund and then go elsewhere to get them done properly.

If you’re happy with all the crowns except the two front ones that don’t match the adjacent teeth, you can just get those re-done. Either way you are going to need to find a top of the line cosmetic dentist. The best are AACD accredited cosmetic dentists. They’ve passed stringent exams as well as demonstrated their artistry on a large number of cases they’ve done.

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

Getting a Smile Makeover Through Yelp?

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I’m having trouble deciding on which cosmetic dentist to use for my smile makeover. I’m looking at the top three recommended in Yelp. I was thinking of doing composite bonding because it is cheaper, but I can’t tell which of them would be better for that over porcelain veneers. Any advice?

Hannah

Dear Hannah,

Brunette with a beautiful smile

AACD accredited dentists are in the top 1% in the country.

I’m glad you are writing. I think I can save you a lot of grief and wasted money. Let’s start with the way you’re going about finding the dentist you want to do your smile makeover. While Yelp is a great resource for many things, I don’t think its algorithms are going to be useful in this case.

They make their recommendations based on reviews. However, they don’t really make a distinction on what type of dental work is done. For instance, if you were to look at many of the reviews of those dentists, how many are based on their work doing smile makeovers? Most are likely just about how friendly the office is or some of the general dental work they’ve had done.

I’ll discuss how to get the best cosmetic dentist for your smile makeover in a moment. Before we do that I want to talk about the two procedures you were considering. You won’t find many great cosmetic dentists who will do a complete smile makeover with composite bonding. It actually takes significantly longer to do it with composite than porcelain and get it to look beautiful. Because of that, they’d actually end up having to charge you more. Plus, composite doesn’t last nearly as long as porcelain, so your investment isn’t as durable. Dental bonding is best done with small areas, such as repairing a chipped tooth or closing a tooth gap.

If you’re going to invest in a new smile and want it both beautiful and durable, then porcelain veneers would be the better investment for you.

Finding a Cosmetic Dentist for Your Smile Makeover

There isn’t a recognized specialty in cosmetic dentistry, nor is doing smile makeovers taught in dental school. That leaves patients in a bit of a quandary. Because of that, the American Academy of Cosmetic Dentistry began an accreditation program. Dentists who pursue accreditation have to pass exams demonstrating their technical knowledge. They also have to demonstrate their artistry by presenting visual evidence of a large number of cases they’ve done. Those are examined carefully to ensure they meet the highest standards. Only then will they be accredited.

If I were getting a smile makeover, I would look for an AACD accredited dentist.

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

Dental Bonding Disaster- Help!

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I had my four front teeth bonded. One of my front teeth sticks out too far over the second one. One of the lateral teeth is too far back and the other one has a big chip. He said he could fix this, but it’s ended up a disaster. First, he ground down the front overlapping tooth, then he added bonding material to the lateral teeth to fill in the missing depth and fix the chip. However, he insisted on doing them yellowish, even though I wanted them white. Now I feel they look ugly, plus the one he ground down is sharp and painful. I know there is no going back, but can this be fixed? My dentist seems to think he did a great job.

Adabelle

Dear Adabelle,

woman giving a thumbs up from the dental chair

Getting a beautiful smile requires a skilled cosmetic dentist

Even though I don’t have a picture of your smile and can’t give you specifics of what was done incorrectly, I do know what the major problem is. Your dentist is likely a very good family dentist who did his absolute best for you, but he was in over his head. Maybe he could have pulled off a basic dental bonding case. Maybe. Those are difficult to begin with because they need to be done free-hand. Your case requires an even more advanced dentist because of the structural issues that need to be dealt with.

This would need a dentist in the top 1-2% of cosmetic dentists, which requires significant training outside of general dental school. They’d need training in color theory, polishing the bonding material, and shaping the teeth. Your dentist obviously didn’t have this. Plus, a true cosmetic dentist would never be satisfied if his patient wasn’t thrilled with the results.

What you need is an AACD accredited dentist. These are the top cosmetic dentists in the country. In order to become accredited, they have to pass stringent exams, as well as have a large number of specific cases they’ve personally done evaluated for technical proficiency, beauty, and artistry. You can locate them by going to the website of the American Academy of Cosmetic Dentistry. Make sure you check you want an accredited or accredited fellow. Being a member isn’t enough.

Once You Have an Accredited Dentist

Once you’ve located an excellent cosmetic dentist in your area, you have two choices to get the smile you want.

Option 1: Re-do the Dental Bonding

Dental bonding is less expensive than the next option I’m going to make you aware of. When done by an expert cosmetic dentist it can blend in perfectly with your teeth, comfortably, with a natural translucency. If you want your bonding whiter than your adjacent teeth currently are, it will be in your best interest to whiten all of your teeth first. This will enable the dentist to blend the bonding material to your beautiful new white color.

Option 2: Get Porcelain Veneers

While these are more expensive than bonding, porcelain veneers can change anything about your smile— the shape, the size, the color, even the character. The other big benefit is they last much longer. Well taken care of porcelain veneers can last a lifetime. The dental bonding will have to be re-done every five years or so. Either one can be made beautifully.

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