Archive for December, 2009

Can a dentist “reverse” dental bonding?

Wednesday, December 30th, 2009

I am really unhappy with some recent dental work I had done, and want to ask your advice about what to do about it. I asked my dentist to fix the gap in my front teeth. Besides the gap, they were also chipped into the shape of a “V”, and I saw a show on TV where a dentist used dental bonding to fix teeth that looked just like mine. My dentist didn’t seem very enthusiastic, but she agreed to do it. The problem is, I don’t feel like she did a good job! I still have a gap, and there are places where the bonding material is actually visible, and I don’t think you are supposed to be able to see that. My smile looks better, but it is still not at all what I had in mind.

What should I do? Do I just have to live with this? Should I ask her for porcelain veneers instead? I need your help.

-Florence from Orlando

Dear Florence,

There is good news. The bonding you had done on your teeth is absolutely reversible. The bonding material can be taken off using a special sandpaper that any dentist should have on hand, right down to the original enamel.

Before you ask your dentist to do anything, though, you should first think about finding a new dentist for this kind of work. If you dentist was not comfortable doing the dental bonding work, it was probably because she is not properly trained in the techniques necessary to do a really beautiful job. Only a really talented and highly trained cosmetic dentist has the skill to do bonding work on front teeth. Make sure you put this task in the hands of the right professional. Your regular dentist may be fine for routine dental care, but very few dentists have the skills and training to do that kind of  freehand bonding work. Check to make sure the dentist you choose is accredited by the American Academy of Cosmetic Dentistry.

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I need an implant, but want to wait.

Tuesday, December 15th, 2009

One of the molars in my lower jaw is going to have to come out. My dentist and my endodontist say there is no help for it, because it has decayed below my gumline. My budget is tight, so I don’t want to get an implant right after the tooth comes out. How long can I wait?

Lily from Tulsa

Dear Lily,

You’re making a good choice to replace your missing tooth with a dental implant. While you do need to give the infection in the socket time to heal, you should not wait too long to get the implant placed.

When a tooth is removed, the teeth that surround the empty socket start moving into that space in just a couple of weeks. The neighboring teeth begin to tip in. The corresponding tooth in your upper jaw (the one that would line up with the missing tooth with your mouth closed, called the “opposing tooth”) will super-erupt. That means that it will grow to try and meet a tooth that is no longer there. These are all natural tooth movements. Your teeth naturally shift so that they are touching each other, and so that they meet when you bite down. That missing tooth can really cause serious problems that could turn into headaches, TMJ issues or serious bite discrepancies. If you let the situation continue too long, your cost to fix the problem goes up a lot. I strongly recommend that you don’t put this off.

Another thing to consider is that the root form of the implant will need time to heal and become integrated with the bone of your jaw. This can take several weeks, on top of the healing time for the infection. In the meantime, then, your dentist should give you some kind of temporary partial denture (called a “flipper”) to wear to keep your other teeth from drifting. When the surgical site has healed, your permanent crown can be placed on the root form.

If you would like to read more about the dental implant procedure, see our website page on dental implants. We also have a page that talks about dental impants vs. bridges that you might find helpful.

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Should I get porcelain crowns or veneers?

Tuesday, December 1st, 2009

Hi,
A few years ago I saw one of those extreme makeover shows and it really inspired me to do something about my awful teeth. I’ve been self-conscious about my smile for most of my life. My teeth are stained and crooked and shaped wrong, and I am missing one of my lateral incisors (it just never came in).

I’ve been saving for a long time for this, and I want to make sure I get what I really want. I’ve been looking for information on the Internet about different treatments, and I am kind of confused about when you would use porcelain crowns, and when you would use veneers. Based on what I told you, what do you think would be best for me? I don’t want to ask my dentist for the wrong thing and then regret it forever.

Thanks very much for your help,
–Alex in Santa Fe

Dear Alex,

First of all, congratulations to you on deciding to take this very important, life-changing step, and on your determination in working towards making your dream a reality. You really deserve to have an amazing smile!

The most important advice I can offer you for your future dental care is to find an expert cosmetic dentist that you can really trust. The decision to go with porcelain crowns or porcelain veneers should be made with the guidance of an experienced, preferably accredited cosmetic dentist. Many factors will help determine which option—or combination of options—is best for you.

To answer your question about using crowns or veneers, it will really depend on the condition of your existing teeth. In most cases, a dentist will strive to maintain as much of your natural tooth structure as possible. Porcelain veneers require just a small amount of preparation on the front of the teeth, while porcelain crowns generally require more of the tooth structure to be removed all the way around the tooth.

If one or several of your teeth are structurally weak or have large existing fillings, your dentist might chose to protect what remains with a crown.

Another consideration for you is that missing lateral incisor. You should seek an expert cosmetic dentist who also does dental implants.

The most important decision you have to make in this situation is who is going to do the work for you. Anyone can say they do cosmetic dentistry. It is up to you to check their credentials and education, and to view their case studies to make sure you really believe they have both the technical skills and the artistic sense to make your smile everything you could hope for.

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