Archives for November 2021

Dentist Said Overbite Means I Can’t Have Porcelain Veneers

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I wanted to get a smile makeover, but my dentist said I cannot have porcelain veneers because my top teeth cover my bottom teeth in what he calls an overbite. Instead, he wants to do six dental crowns. Will that work? Should I get my bottom teeth whitened so they’ll match the crowns on my top teeth?

Farah

Dear Farah,

dental crown versus a porcelain veneer

We see this a lot with family dentists. They don’t have cosmetic dentistry training and do not know how to do porcelain veneers, so they tell their patient that they need porcelain crowns. There are a few things to be aware of with this.

First, smile makeovers are not taught in dental school. Putting one crown on a decayed tooth is a LOT different than doing a smile makeover with crowns. If he can’t make porcelain veneers look beautiful, he can’t make dental crowns look beautiful. You will not want him to do your smile makeover.

Second, as pictured above, dental crowns require your natural teeth to be ground down to numbs. If they are healthy, why would you want to do that? Porcelain veneers on the other hand only require minimal tooth preparation.

Third, if you have an overbite, it makes more sense to get veneers instead of crowns. Porcelain veneers only go on the front of your teeth and hug the sides a bit. Porcelain crowns on the other hand have to go around the entire tooth. They will bump up against your bottom teeth.

My advice, find a dentist who is experienced in placing porcelain veneers to do your smile makeover. Make certain they place your veneers with a temporary try-in paste so you get a look at them before they are permanently bonded on. If you are not thrilled with the results, they should go back to the lab.

As for the teeth whitening, you will want to whiten both the top and bottom arches before having the veneers done. Most smiles are eight to ten teeth wide. If you only get six veneers, you will want the adjacent teeth to match.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.
Click here to learn about our free virtual smile makeover consultation.

Gums Burning with My Dental Crowns

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I had six dental crowns placed on my front teeth. The whole thing has been quite the disaster. First, the temporaries felt like they had leakage, which made me worry there was an infection. He agreed to check. He took the temporary crowns off, did a fluoride treatment, and prescribed me an antibiotic for safe measure. When the crowns came in, the bite was completely off, which meant a lot of grinding them down. Then they said there was too much liquid going to the teeth. I wasn’t sure what that meant, but was relieved when he said they’d have to be sent back. I hoped that meant the next set would fit better. I went back to temporaries. The new crowns have arrived and I’ve had burning gums and sensitivity since putting them on. Sometimes it feels like there is a wad in my mouth What do I do? They’re supposed to be permanently bonded in three days.

Eliza

Dear Eliza,

dental crown versus a porcelain veneer

I don’t think this is the best dentist for you. In fact, I believe he is in over his head. One of the reasons I think that is he gave you crowns instead of porcelain veneers. Unless you already had crowns on those teeth or there was something wrong with them, crowns would be a massive overtreatment. Crowns necessitate that a lot more tooth structure has to be removed. If the teeth are healthy, there is no point in doing that. While that is water under the bridge, it is indicative of his skill level. When dentists suggest crowns over veneers unnecessarily, it means they do not have a lot of cosmetic training. This rarely goes well for the patient.

The first thing I want you to do is to call them first thing in the morning and tell them you do not want them bonding these on permanently until two things happen. First, the crowns feel right. When crowns are fitted and placed correctly, they are completely unnoticeable. You can tell your dentist I said that if he tries to disagree with that.

Second, you know why your gums are burning. I’m wondering if he gave you porcelain fused to metal crowns and you are having some kind of allergic reaction. That is one of the first things I would ask. Ask him what the composition is of the crowns he gave you. If he says he doesn’t know, point out that the lab would have given him an identalloy certificate telling him the exact composition of the metal alloy. If there is any nickel in the makeup, that is the most likely culprit. Many people are allergic to nickel. You would need to switch to all-porcelain crowns.

In reality, on front teeth, you would want all-porcelain crowns anyway. The metal-based crowns will eventually develop a gray line at your gumline. This will be visible and unattractive. That is not something you’d want in a smile makeover.

The fluoride treatment he gave you was pointless. Leaking temporaries means that you have bacteria under there. Fluoride remineralizes teeth. It is not an antibacterial. The right treatment for that would have been peroxide or chlorhexidine. Both of those are antibacterials.

What I am going to suggest is you have them use temporary cement, which they already should have done, and then you go to another dentist to get a second opinion on these crowns.

This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.
Click here to learn about our free virtual smile makeover consult.

 

Should I Change Dentists in the Middle of this Dental Implant Procedure?

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I went to see my dentist about repairing two teeth. Both are premolars that have had problems over the years and have both been capped. He suggested I have both teeth extracted, have bone grafting done, and then replace them with a dental implant and crown. The cost will be just over $9,000.00. I was fine with the plan but have recently developed some concerns. The bone grafting is done. Now, I’m in a three-month healing period using two temporary tooth replacements. From there, it will be time to place the implants and crowns. I’ve only had the Maryland Bridges for a little over two weeks and they have fallen off three different times. I’m beginning to wonder if this dentist has the skills necessary to do this procedure correctly. Do you think I should be concerned? If so, can I switch dentists in the middle of my procedure?

Mark

Dear Mark,

Titanium and Zirconia Dental Implants

 

Yes, I think you should be concerned. There are a couple of red flags here for me. One is the choice of the “temporary” tooth replacement. A Maryland Bridge requires some tooth preparation for the bonding to hold properly. This preparation would include putting a notch in the tooth to hold the bridge wings. Anything that changes the structure of the tooth is not a temporary restoration. In order to get the tooth back to its original form would require dental bonding to be done. Most dentists would use a true temporary (and much less expensive) option such as a dental flipper.

The second issue here is that your dentist can’t keep the Maryland Bridge in place. This means that even though he or she chose the wrong replacement, they don’t know how it works. That is a huge warning signal to me that they are in over their head with your case. A bridge is not nearly as advanced a procedure as dental implants. If they can’t get this bridge right I would not hold out much hope for your dental implants.

My recommendation is you switch dentists. Find one with post-doctoral training in dental implants. It will not matter that you are in the middle of your procedure. Your dentist is still under an ethical obligation to provide the new dentist with all the notes and diagnostics related to your case.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.