Archives for July 2024

Options for Fixing My Nephew’s Smile

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For my Nephew’s graduation, I gave him a gift of fixing his teeth. His mother never had enough money for braces and I didn’t want him spending his entire adult life feeling uncomfortable about his appearance. I was thinking orthodontics, but his dentist told him that he could get his smile fixed much faster with Lumineers without having a mouth full of metal, but he’s asking close to $25,000! Is there some other option for him that is faster than braces, but not as expensive as Lumineers?

Selena

Dear Selena,

A comparison of braces versus Invisalign

I’m glad you wrote. If the only thing wrong with your nephew’s smile was that fact that his teeth were misaligned then what his dentist is recommending would be a massive overtreatment. Lumineers are a brand of porcelain veneers. When someone is looking for that Hollywood smile, that is when they get porcelain veneers. They can change the shape, size, and color of your teeth at the same time. If you’re just looking to straighten your teeth, or even straighten and whiten your teeth, then there is a much better option.

Invisalign uses clear aligners to straighten a patient’s teeth. Even at a conversational distance, no one would be able to tell that your nephew is wearing orthodontics. They also work in half the time of traditional braces. If he does need teeth whitening, you can save money here because the aligner can double as teeth whitening trays. His dentist can simply provide him with the gel, which he can wear in the aligners at a point in the day or night that is most convenient for him.

What If He Wants a Total Smile Makeover?

A porcelain veneer being held up to a tooth

Let’s say there is more wrong with his teeth and he does need a total smile makeover, and it is something you are wiling to pay for, I would not go to a dentist who is recommending Lumineers to have this procedure done. This particular brand of porcelain veneers are highly marketed to inexperienced cosmetic dentists as being easy to place. Unfortunately, this does not mean that it is easy to create beautiful smiles. In fact, smile makeovers are not adequately taught in dental school. In order for a dentist to do it well means that they need to invest in post-doctoral training.

A second problem with Lumineers is the fact that their parent company requires dentists to use their lab, which is not known for creating good results. What you would want instead, is to find an expert cosmetic dentist and let them choose the brand as well as the lab.

This blog is brought to you by Marietta Cosmetic Dentist Dr. Cristi Cheek.

Treating Enamel Hypoplasia

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I have been dealing with enamel hypoplasia for years. Now I have finally saved enough to do something about it. Can you tell me my treatment options from a completely objective perspective? I live in a completely different part of the country from your practice, so I feel confident asking someone who cannot profit from the procedure chosen. I hope that doesn’t offend you. I just find I am likely to receive more accurate information by those who don’t gain any pecuniary gain from it.

Sylvia

Dear Sylvia,

I am not offended in the least by your question. It is always wise to get an unbiased opinion on something. In fact, I often recommend when patients get a second opinion from a dentist, that they do not tell the second dentist who their dentist is. This way there is no pressure to agree with a peer that they consider a friend.

As to your question about hypoplasia, the treatment you get will depend on the severity of the damage. For those who are unaware of this condition, enamel hypoplasia is when the enamel of the tooth does not fully form. This can happen from a medication taken during the development of your teeth or from a genetic defect.

Two examples of enamel hypoplasia

If you are dealing with the severe type of hypoplasia, then I recommend you have porcelain veneers placed. With this procedure, your dentist will place tiny wafers of porcelain over the teeth after some mild tooth preparation. This is also the standard procedure for patients who are looking for a complete smile makeover. It’s also the go-to for celebrities. So, if there was anything you wanted to change about your smile, including the shape, size, and color, this is the procedure to use.

If you are dealing with mild hypoplasia, then the solution would be to use either dental bonding or porcelain veneers. With dental bonding, the area with the damage is gently removed with microabrasion and then a composite bonding is placed on top of it and it will be polished to a high shine to match your teeth.

Both of these require someone with post-doctoral training in cosmetic dentistry. Don’t go to any dentist. Plus, make sure you check out their smile gallery to see that they have an artistic eye and can produce beautiful results with the procedure you choose.

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

A Full-Mouth Reconstruction Causing Problems

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I am in the middle of a full-mouth reconstruction, and things are not going well. It’s a bit of a mixed bag with two dental implants and the rest are crowns and bridges. I am a bit worried, because the first round went well and I thought I would be good to go. Unfortunately, that has not been the case. Once the permanent ones were bonded on things went really wonka-donk. The teeth are not meeting together the way I had always considered normal. I thought at first maybe it felt different because I was used to it the wrong way. But, now I’m having trouble chewing both because of the way the teeth are meeting (some of them don’t even touch) and the fact that my jaw isn’t moving properly. I don’t think this is because it is unfamiliar to me. Do you have any advice? I’m in quite a bit of pain.

Sandy

Dear Sandy,

An image of a woman holding her jaw while in pain.

Bear in mind that I have not examined you. However, if I am getting an accurate understanding of your description, there is a real problem here. First, for those who are not aware of what a full-mouth reconstruction is, it is when a dentist uses crowns, in some form, on every tooth. In this case, there is a mixture of dental implants, along with crowns and bridges.

Doing a full-mouth reconstruction is a very advanced procedure which very few dentists are actually qualified to do. It takes significant post-doctoral training. Based on your description, the way this was done is a serious problem and it sounds like it has completely thrown off your bite and you are now dealing with both poor occlusion of your teeth as well as TMJ Disorder. If that is the case it needs to be fixed as soon as possible.

One thing that puzzles me is the fact that you said the temporary placements were fine. Your permanent crowns and bridges should have been modeled after your temporaries. Also, your dentist should have used a temporary try-in paste and made sure everything still lined up properly. It does not sound like he did that.

I want you to get a second opinion by a dentist with significant TMJ training. Look for someone who has post-doctoral training in TMJ Disorder. Look for training at one of the following institutions, which are known for their great TMJ instruction:

  • The Dawson Academy
  • The Pankey Institute
  • The Las Vegas Institute of Advanced Dental Studies

One word of advice. When you do get your second opinion, make sure it is a blind appointment. That means that you do not tell your dentist who did your full-mouth reconstruction. If they ask, just tell them you want an unbiased opinion and would prefer he or she gave their thoughts without knowing who the dentist is.

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