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.

Can Supersmile Remove Stains on Dental Bonding?

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Hi, I have dental bonding on a few teeth because of chips as well as between my two front teeth because of a small gap. They’re starting to stain and it looks weird next to my natural tooth color. Do you know if Supersmile toothpaste works on dental bonding? If so, how long does it take for it to remove the stains? I see they have an accelerator kit. I’m guessing that would be the one to use, right?

James

Dear James,

Supersmile tooth paste image

You have some great questions here. I’m actually going to start with your last question and work my way backward. I would not use the accelerator kit, but just the standard Supersmile Whitening Toothpaste. This is because the accelerator kit adds a whitening ingredient, such as you would get with teeth whitening kits, though not nearly as strong as what you’d get through a dentist. This will utilize a peroxide gel. While that will whiten your natural teeth some, it will do nothing for the bonding. The result will be them having a greater disparity than when you started.

Supersmile toothpaste, on the other hand, is great at removing stains, even from cosmetic dental work, with one exception we’ll get to in a moment. Your second question asked how long it will take the toothpaste to remove the stains. As long as it is a surface stain, it will begin to remove it immediately. This is because, unlike other whitening toothpaste, it removes the stain enzymatically. Its active ingredient is Calprox, which dissolves the protein pellicle layer. Stains attach themselves to the pellicle so when that is gone, the stain is gone.

As for your first question, that depends on the type of stains. As long as your dental bonding is still polished and the stains are on the surface of the polish, then, yes, Supersmile can totally remove those stains. However, if the polish is gone, then Supersmile cannot restore the polish and the bonding will just keep attracting stains. The only way to fix that is to have the polishing repaired or to replace the bonding.

This is one of the reasons I steer patients away from your typical whitening toothpaste. They use abrasives to “whiten” teeth, which damages both the dental bonding as well as the enamel on the surface of your natural teeth.

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

Did the UltraSonic Scaler Damage My Porcelain Veneers

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I had four porcelain veneers placed on my front teeth. I just had a cleaning where a magnetostrictive ultrasonic cleaner. Within two days, a couple of them were fractured. Was that the cause of the fractures or is something else going on? Is this a common problem? How do I get my veneers back to the way they were?

Ellen

Dear Ellen,

porcelain veneer being placed on a tooth

There are two types of ultrasonic scalers.

  • piezoelectric
  • magnetostrictive

While the magnetorestrictive scaler is more gentle than the piezoelectric, there is a greater chance of damaging the tooth if it is not done with the proper technique. In the hands of a skilled dental hygienist this will cause no damage. However if it is done incorrectly, then, yes, there will be damage to your porcelain veneers.

In order to get a crack or fracture on your veneers, the dentists would have had to hold the tip of the scaler on the surface of your veneer. This is a huge NO. I’m not sure why your hygienist would have done that.

They should bear the responsibility of replacing the veneers that they damaged. Then, in your position, I would not stay in a dental office that does not know how to care for your cosmetic dental work. I’m also a bit concerned that they only did four porcelain veneers.

Most smiles are eight to ten teeth wide. This would mean that you have natural tooth structure that is visible next to your porcelain veneers when you smile. My hope is they at least used teeth whitening on them before placing your veneers. If not, your smile will look weird. It’s not too late to get this done if it wasn’t.

If you are not confident that they can properly replace the damaged veneers, then you can get a refund and go to a more experienced cosmetic dentist of your choice to get it done.

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

Fixing a Tooth Gap

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I have the same dentist I have used since I was a child. He really is past retirement age and I’m worried he’s not keeping up with advances. I went to him because I’ve always had a tooth gap that I wanted to fix, but was not in a financial position to do anything about it. Now I am. My dentist is suggesting I see an orthodontist for braces. I don’t really want a mouth full of metal for a couple of years especially because I’m in a professional position. I’m hoping there is another option. I suspect there is, because my dentist doesn’t even do teeth whitening. Any direction you can point me would be greatly appreciated.

Kate

Dear Kate,

You were wise to write. If the only thing you have is a tooth gap, there are much better options. The three that come to mind immediately are Invisalign, dental bonding, or porcelain veneers.

Orthodontics: Invisalign

Image of Invisalign Aligners

If you want to actually close the gap, then I would go with Invisalign. These are the modern take on braces for adults. Instead of using metal wires and brackets, they use clear aligners to close your teeth. No one will even know you are wearing them. Even at a conversational distance they are invisible. These will close the gap for you in no time at.

Cosmetic Dentistry: Dental Bonding or Porcelain Veneers

Dental Bonding

A side by side image of teeth before and after dental bonding

Dental bonding uses composite material to fill in the gap. It has to be done freehand, so I would only want an expert cosmetic dentist to do this procedure. When done well, it will blend in with your natural tooth structure perfectly, as pictured above. This used dental bonding to repair a chipped tooth. Once the bonding is on, the color can’t be changed, so if you were wanting to whiten your teeth at any point in the near future, I would get the teeth whitening done before the bonding.

Porcelain Veneers

I would only recommend porcelain veneers if there was more than just a tooth gap that you were wanting to fix. This is typically used for a complete smile makeover. It’s what celebrities use to get that Hollywood smile. Veneers can change the shape, size, and color of your teeth. Like bonding, it requires an expert cosmetic dentist. It also won’t actually close the gap, but will cover it. This is the most expensive option, so I would only use this if you wanted a full-smile makeover.

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

Dental Implants While Using Fosamax

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I had to have a lateral incisor removed. I wanted to get a dental implant, but my oral surgeon said that I might want to consider something else like a dental bridge because I am on Fosamax. Do you know if I should get something like an Encore Bridge or a Maryland Bridge. I don’t know if I can have a normal bridge with the anchor tooth being a front tooth. Are you aware of situations like this? I will admit that I am disappointed about the dental implant. But, what can’t be helped, can’t be helped. I need to figure something out, though, because I am using a dental flipper right now and hate it.

Percy

Dear Percy,

An image of both titanium and zirconia dental implants

I have some good news for you. If you really want a dental implant, it is possible with some precautions taken and an understanding of the risks. First, the risks. There is a slightly increased risk of bone problems when you have oral surgery while on Fosamax. While I said a slightly enhanced risk, don’t discount the risk because if they happen, they will be serious. A way to get around this is to temporarily suspend taking the Fosamax for the surgery and then resume it at the appropriate time. It would take coordination between your dental implant dentist and the oral surgeon. Also, make sure it is your dentist who plans the dental implant placement and not the oral surgeon.

If you decide you do not want to take the risk with the dental implant or suspend the Fosamax, then a dental bridge is your next best option. I would let your dentist choose which type of bridge, though. This is because you want him or her doing the type of bridge that they are the most comfortable with. That way you know they are skilled at doing it. You can get a regular bridge. A front tooth has been used as an anchor tooth many times. Though, obviously, the dental implant is the better option.

One other consideration. If you are unhappy with the color of your teeth, the time to get teeth whitening done would be before you get either the dental implant or the bridge. This is because the color of your dental crown cannot be updated once it is completed. This way the crowns can be made to match the updated color of your teeth.

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

SmileDirectClub Abandons Its Patients

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A smile direct club illustration with an x through it.
In case you haven’t heard, SmileDirectClub has closed its doors. Leaving patients not quite through with their treatments completely on their own. Here is what happened. Many people didn’t realize that SmileDirectClub had a habit of squelching complaints and negative reviews. They did that by requiring clients who wanted a refund to sign a non-disclosure agreement and remove anything negative they posted about the company. People complied in order to get their money back. Then, this past June a court ordered them to cease that practice, which also released those under the agreement. Suddenly, negative reviews were everywhere and the truth about the company was making itself known. In September they filed for bankruptcy. By December, unable to find a buyer, they closed their business.

They sent a notice out to their remaining clients that they would no longer be helping them, even if they were not done with their treatments. They would not be sending them any more aligners. However, if they still owed money to SmileDirect, they were told they were expected to continue payments. Nice, huh?

This isn’t the only company like this out there. I am sure that many of the clients from SmileDirect are scrambling trying to find a similar company that can help them finish out their treatments. However, there is a danger in that. All of these online companies are working without you being under the care of a dentist. Sure, they say they have a dentist looking at your images, etc., but that is not adequate or safe.

There is no way to tell if a patient has gum disease from an image, unless it is seriously advanced. You do not want to try to move your teeth while you have gum disease because you risk serious problems, including the teeth becoming loose.

There is also the fact that the human body does not always cooperate. This means your treatments have to be adjusted to keep you on track and your teeth roots healthy.

Invisalign is a fantastic treatment when done under the care of a qualified dentist. If you’ve been dumped by SmileDirect, look for an Invisalign dentist and they will be able to help you get your treatment back on track.

There is a hidden benefit to those aligners, as well. They can double as teeth whitening trays. This means your dentist can provide you with some teeth whitening gel to wear with your aligners allowing you to straighten and whiten your teeth at the same time, giving you a mini smile makeover.

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

Looking for a Cheap Smile Makeover

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I want to get my top teeth improved. They’re all discolored. My dentist is suggesting composite bonding for them at a price of just $3000 total. I would jump on that but have one reservation. I chipped a tooth a couple of years ago that knocked a good portion of my tooth off. My dentist fixed it with dental bonding. While my dentist did make the tooth whole again, the bonding part is very obvious and has been from the beginning. Now it is much more stained. I’m not sure I want my front eight teeth looking like that. He said the next option was porcelain veneers but they are really expensive. I have found there are some online veneers that are much less expensive. They pop over the front teeth. Is this a viable option for me or is there something I should be aware of?

Loren

Dear Loren,

porcelain veneer being placed on a tooth

I am going to start with your dentist’s first suggestion of dental bonding. I’m going to strongly suggest you do not use this for your smile makeover. First, he obviously does not have the cosmetic skills required to do a beautiful job with advanced cosmetic procedures, such as the dental bonding. Though, I suspect you have already figured that out.

When you are getting a complete smile makeover, porcelain veneers are the go-to procedure. When done in the hands of a skilled cosmetic dentist, it can give you a beautiful, natural looking smile that will last for years.

The snap on type of veneers you are considering are not at all like the porcelain veneers provided for you by a dentist. The ones online that snap onto your teeth are made of acrylic. They will not look as natural. From close up it will be obvious they are fake. Plus, because they snap over your teeth, they tend to look a bit bulky.

If you truly want a smile makeover, I suggest that you wait and save up for the porcelain veneers. Though, you may want to find a more experienced cosmetic dentist to do the work.

Before you do that, I did have a question. The only thing that you mentioned fixing about your smile was the discoloration. A complete smile makeover would typically be for fixing more than just the color, but also the shape and the size. If that is what you had in mind, then by all means save up for the porcelain veneers. However, if all you needed was to adjust the color, teeth whitening would be the right solution. It will also cost you thousands of dollars less.

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

Should She Finish this Full-Mouth Reconstruction?

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I had a collapsed bite because of teeth grinding. My old dentist never told me that was going on. I had to see another dentist in the same office because of a toothache and they suggested I get a nightguard for when I am sleeping. I did, but think that I waited too long to start it. I ended up moving to another city and it was the new dentist who said that the condition of the teeth was pretty bad. She’s the one who told me about the collapsed bite. I agreed to the smile makeover. She did the crowns on the bottom first. While everything feels better, two things bother me. First, it is whiter and more perfect than I was hoping for. I liked the quirkiness of my smile. Here is my problem. I am not sure I want the upper ones done. I know it seems silly, but I’ve been really emotional about this. However, my top teeth are now much darker than the bottom ones. What are my options?

Julia

Julia,

An image of a woman happily pointing at her smile

You have a couple of options. First, if you absolutely just do not want to complete the smile makeover, I would recommend simply whitening the upper teeth. You can do that in one appointment with Zoom whitening and then you would not have two arches of teeth looking so drastically different from one another for an extended period of time.

However, before you decide, I want you to consider a couple of things. First, on the practical side, if your teeth are ground down, I am sure it wasn’t limited to the bottom teeth. Plus, the crowns and veneers will be harder on your upper teeth than your natural teeth were, which will cause more damage.

Plus, the procedure was planned with both of them. Doing just half of it could throw off your bite and lead to TMJ Disorder.

I could be misreading things, but it sounded like your main concern was the fact that the teeth were too perfect and you wanted some quirkiness. In that case, I would suggest communicating that to your dentist. Most cosmetic dentists would jump at the chance to add some character to the smile. Too often, they’re stuck making perfect smiles. You would be a welcome change.

I hope this helps.
This blog is brought to you by East Cobb Cosmetic Dentist Dr. Cristi Cheek.

Why Did Smile Direct Club Go Belly Up?

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I had been planning on trying that Smile Direct Club that I kept seeing advertised. Originally, I was going to do Invisalign, but then learned that Smile Direct was much less expensive because you didn’t have to use a dentist. Now they’re no longer in business when I’m finally ready to move forward. Do you know why they stopped and if there is anything else like it?

Penelope

Dear Penelope,

A SmileDirect Club ad with an X through it.

I understand why SmileDirectClub was so appealing to so many patients. It promised Invisalign results at a fraction of the cost. The problem they ran into was two-fold. First, they could not live up to the promises they made. Second, a court case killed their ability to hide that.

The reason Invisalign has you work through a dentist is because the human body is unpredictable. While it is true that an advanced software system designs the treatment, teeth tend to not always go to plan and humans can be forgetful, even with the best of intentions. This can throw off treatments and require adjustments.

Often, things would not go well with a SmileDirect treatment plan. Patients were already at a disadvantage by not having the same software system. Then, without a dentist they were often left floundering. They could complain to the company but there was no one really willing to help them. If they tried to complain publicly, they were told they could only get a refund by withdrawing all complaints and filing a nondisclosure agreement, which of course they did in order to recoup their funds.

Back in June of 2023 a court case forbade them from doing that and ordered they release everyone from their non-disclosure agreements. By September of the same year, SmileDirectClub ended up filing bankruptcy. Even worse that that, they’ve left their customers in the lurch telling them that they will not complete their treatments. If they want their money back they’ll need to get in line. Worse, if they owe SmileDirect payments, they expect the patient to keep paying!

While there are a few similar companies still around, such as Byte, NewSmile, and AlignerCo, they run on the same principles. You will not be seen by a dentist and that puts your treatment, as well as your teeth at risk. You are safer under the care of a dentist. One hidden benefit of Invisalign is the aligners can double as teeth whitening trays. Your dentist will provide you with the whitening gel and then you can wear it in the aligners to whiten your teeth at the same time you are straightening them.

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

Getting My Implant Crowns to Look

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I had two dental implants placed on front teeth. My dentist plans on doing the crowns soon, including two additional crowns on the adjacent teeth in order to get everything to match. I want it to look beautiful and have some things that are worrying me. I have a high smile that shows gums. Is there a way to address this? I haven’t heard the dentist mention anything about this. After looking some things up, I think I need to avoid porcelain fused to metal crowns and I would need to get my teeth whitened first, not after. Is that correct?

Misty

Dear Misty,

An image of both titanium and zirconia dental implants

I am glad you are writing before your dentist does this. I am not sure you are with the right dentist to give you the aesthetic result you are hoping for. I see four red flags right off the bat. First, that your dentist did no building up of the gums in preparation for this. Second, he hasn’t discussed with you the crown options. Third, that he is adding two unnecessary crowns in order to get everything to match. Finally, he didn’t address the teeth whitening with you.

I’m going to start with the third one first. Your dealing with front teeth that are particularly tricky to get to look beautiful and natural and it takes a great deal of artistry and experience. If he needs to add crowns in order to just get the color to match, he does not have those qualifications. Why would you want to remove structure from healthy teeth unnecessarily?

Looking at the type of crown you would use. Yes, you will want an all porcelain crown. However, depending on the type of dental implants you received, you may already have a metal base. My guess is your dentist did the traditional titanium implants, which are metal. There are zirconia ones that have a ceramic base, but if your implants are placed, you don’t want to switch them out. This does not mean that you cannot have a beautiful result. What you’ll need is a dentist who knows both how to conceal the border between the implant and your crown, as well as mimic the translucency of a natural tooth while making it opaque enough to cover the base. I’m concerned that your dentist is not the one to do this.

As for the teeth whitening, absolutely you need to do that before your dental crowns are made. The color of your crowns cannot be changed once the are completed.

You found all this information out on your own, without a dental degree. Why hasn’t your dentist? I am going to recommend getting a different dentist for this part of your procedure. Someone who is an expert cosmetic dentist. Don’t try to teach your dentist what to do. It won’t work.

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