Titanium Versus Zirconia Dental Implants

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I have a few dental implants in my mouth already and may soon need another if I can’t save this latest tooth. I’m writing because I recently read that titanium can cause neurological problems. Do you think I should switch mine out for the zirconia dental implants?

Ethan

Dear Ethan,

dental implant being placed in three stages

I’m not sure where you read this. Is it possible it was an article on the internet? While a wonderful tool which allows for the free flow of information, we have to remember not everything we read is accurate. There is no current scientific literature that I am aware of which backs up that claim. Instead, I see the opposite. Titanium has been used safely for decades. It’s very biocompatible.

You may be aware its uses go far beyond just dental implants. It’s also used in hip and other joint replacements as well as a host of other purposes. It’s been proved to be very safe. I wouldn’t switch out your implants unless you had a medical reason. Even patients with metal sensitivities, rarely have an issue with titanium.

I don’t want you to think I am opposed to zirconia dental implants, I just don’t want you to unnecessarily switch perfectly good implants. Additionally, if you do remove the first implants, it will require another procedure in addition to the replacement surgery. Removing the dental implants means some bone will be removed as well. Because bone is so necessary for retaining your dental implants, you’ll need to have bone grafting done in order to have enough retention.

Zirconia Dental Implants

Zirconia is very strong and has been dubbed ceramic steel. It can uphold the pressures of biting forces. The only downside to them, at this point, it doesn’t have the same long-term tracking record as the titanium counterpart. This is simply because they haven’t been in use long enough for us to know enough about their longevity. It’s possible they’ll hold up equally well. We just don’t yet know.

Getting a Beautiful Smile with Dental Implants

It’s always important to think long-term. If you do decide you want to switch. First, you’ll want to make sure you use a dentist who is both experienced in placing dental implants, but also skilled in cosmetic dentistry. This way you can know the implant crowns will blend and match your teeth in such a way that it looks completely natural. This is also an opportunity to upgrade the appearance of your smile.

Whatever color the crowns are made initially is permanent. If you’ve considered whitening your smile, the time to do that is before the crowns are fashioned. This way, they can be made to match your brighter, white smile. Once they’re completed, teeth whitening won’t work on them. Only your natural teeth will whiten and your crowns will stay the same. It saves you money in the long term to have the whitening done ahead of time.

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

Invisalign or Porcelain Veneers?

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I’m ready to fix my smile. I’ve been going back and forth between Invisalign and porcelain veneers. I’ve heard that the Invisalign fixes your teeth without anyone knowing and it’s much less expensive than the porcelain veneers. But the porcelain veneers should be faster. Is there a significant difference in their results? Are the porcelain veneers worth the extra cost?

Amaya

Dear Amaya,

Which procedure you get depends on two things. First, what your needs are for your smile. Second, the skill of the dentist you are working with. Let’s go over what each of them do.

Invisalign

Invisalign Aligner

Invisalign Aligner

Invisalign is specifically orthodontic related. If your teeth need to be straightened, this is the procedure to go with. It will straighten your teeth without anyone even knowing you are doing orthodontics.

It has an additional cosmetic benefit, too. The aligners used to straighten your teeth can also double as teeth whitening trays. This allows you to straighten and whiten your teeth simultaneously, thereby saving you both time and money.

Both of these procedures are fairly simple and will not require your dentist to have done extensive post-doctoral training in cosmetic work.

Porcelain Veneers

single porcelain veneer being held up by a dental tool

A Porcelain Veneer

This is more for those going for a total smile makeover. Porcelain veneers use tiny wafers of porcelain to completely remake your smile. They can change the shape, size, and color of your teeth simultaneously. While they can’t straighten your teeth, a skilled cosmetic dentist can make them appear straight.

This is the go-to procedure for celebrities to get their Hollywood smile. However, this does require some expertise on the part of the dentist. Unfortunately, smile makeovers aren’t taught in dental school. A dentist has to invest their time after they graduate learning the procedures, as well as developing their artistry. Without that, I’m afraid you’ll be sorely disappointed in the results.

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

Unexpected Benefits of Same Day Crowns

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My dentist has switched to only doing same day crowns. I’m a little concerned with getting it in the same appointment it will end up being rushed and not fit or look right. Am I being silly or should I find a dentist who does traditional crowns?

Carrie

Dear Carrie,

porcelain block for CEREC crwons

Most people know the obvious benefit is not having to have two appointments and getting your crown the same day. However, there are some unexpected benefits as well which should allay some of your concerns.

No Gooey Impressions

With CEREC same-day crowns, you don’t have to worry about gooey, messy impressions. Instead, digital 3-D scans will be made of your tooth.

A Perfect Fit

Using CAD-CAM Technology, a sophisticated software program designs and then mills your crown right there in the office. With the accuracy of computers, your crown will have a great fit. It’s not rushed because computers can do computations and milling much more efficiently than humans.

A Natural Looking Tooth

Because these crowns are milled out of blocks of porcelain and do not have a metal base as some traditional crowns do, they will have the natural translucency the teeth next to it have. This allows the crowns to blend very well with the adjacent teeth.

A Cosmetic Consideration with Same Day Crowns

CEREC crowns can be matched to any tooth color. The one consideration is to know the color will be permanent and cannot be changed once it is made. If you are happy with the color of your teeth then you are good to go. However, if you’ve ever wondered about whitening your teeth the time to do it is before you have your crown made.

Doing the teeth whitening first will save you money. If you wait until later, your teeth will whiten, but the crown will not. Then, after the whitening is completed, you’ll have to have a new crown made to match the more youthful color of your teeth. You don’t have to endure weeks of teeth whitening. Instead, you can get your teeth whitened in just one appointment with a dentist who offers Zoom Whitening.

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

Dentist Keeps Pressuring Me to Get Porcelain Veneers

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I have a lovely dentist but he is really into cosmetic dental work. Every time I go to an appointment he keeps telling me how beautiful my smile will look with porcelain veneers. First, I can’t afford anything close to porcelain veneers. Second, he is starting to make me feel quite uncomfortable about my smile. Now whenever I see my smile, all I see are how much darker they are than when I was younger. I just can’t afford to make them look younger. Is it really the norm now to get porcelain veneers?

Susan

Dear Susan,

Dr. Cheek with patient

I’m going to say two things right off the bat which make me uncomfortable with what your dentist is doing. First, you should never feel pressured into any procedure, let alone one that isn’t a medical necessity. Second, a dentist’s job is to make you feel good about your smile. This may not be the right dentist for you. While it is great that he is pursuing his passion for cosmetic dentistry, it sounds like you are more into basic dental care. The best dentists help their patients meet their goals with their teeth. They don’t try to create needs which aren’t there.

As to your question about norms, it really depends on quite a few things. For instance, your area of work. More people in Los Angelos will get porcelain veneers placed on their teeth than in many other cities. This is because of the emphasis for celebrities to have perfect teeth. Another example would be pageant contestants. These groups have a higher than normal percentage of smile makeovers.

However, in more “normal” cross-sections of society, it isn’t the norm.

You Don’t Have to Get Porcelain Veneers for Younger Looking Teeth

Now that your dentist has given you doubts about your smile, it is likely going to bother you for a while. However, that doesn’t mean you have to have a complete smile makeover to get that younger look for your teeth.

Teeth whitening is simple and inexpensive. Not only that, just whitening your teeth, takes off more than stains, it takes years of your appearance.

In your place, I’d just do that and tell your dentist you are content with your smile. If he still doesn’t let the idea of porcelain veneers go after that, it will be time to get a new dentist.

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

Do You Have to Quit Smoking for Dental Implants?

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I want to get dental implants to replace some missing teeth. My dentist said he won’t place them unless I quit smoking. Is this really necessary or is he trying to force his own agenda on me?

Kevin

Dear Kevin,

An image of a dental implant crown being placed in three stages

I don’t think your dentist is trying to force an agenda on you. Instead, he’s trying to give your dental implants procedure the best chance at success.

The Risks of Nicotine with Dental Implants

  • The Reduction of Blood Flow

Any form of tobacco, including cigarettes, vaping, smokeless tobacco, or dipping restricts your blood vessels. In some cases, it cuts off the blood flow completely.

  • Poor Osseointegration


    • One of the keys to a successful dental implant procedure is when the implants fully integrate with the bone. With reduced blood flow, this hinders healing which slows down the integration. This will lead to a loose implant which will fall out.

    • Increased Risk of Infection

    Because your reduced blood flow hinders healing, it increases your risk for infection at the implant location. The leading cause of dental implant failure is an infection.

    Options for Dental Implants When You Smoke

    Obviously, you can accept the risk and move forward. You will be able to find a dentist willing to provide the procedure even while you smoke.

    On the other end of that spectrum is to quit smoking. You can talk to your doctor about options to aid you in that process. There are options to help with the withdrawal symptoms.

    Another possibility is to meet somewhere in the middle. You can quite for several weeks before the surgery and during the healing time. Then, when everything is secure, you can smoke again. However, you may find during that time period that you don’t really need that tobacco as much as you thought you did.

    A Cosmetic Consideration with Dental Implants

    Smoking causes serious tooth stains. Often, patients want to get a whiter smile when they’re replacing their teeth. You may want to consider getting your teeth whitened before having your implant crowns made. This way they can match the porcelain crowns to your new, whiter tooth color. Giving you a youthful, healthy looking smile.

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

Tri-Colored Porcelain Veneers

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I’m really disappointed in my porcelain veneers. I spent a fortune and now I have three different colored teeth. My natural teeth are yellowed. Then, I have four porcelain veneers, but two of them have splotchy gray patches. They look to be from underneath the veneers and shining through. Will teeth whitening help this?

Vera

Dear Vera,

a porcelain veneer being placed
Porcelain veneers are a great option for smile makeovers…when done by an artistic cosmetic dentist

There are a few things going on here. The biggest issue is you have a dentist in over his or her head with porcelain veneers. Smile makeovers aren’t taught in dental school. In order to do it well, dentists have to invest years of post-doctoral training on their own time to become skilled.

Your dentist has made three pretty basic mistakes, which tells me they didn’t do that.

Porcelain Veneers Mistake #1

You said you were provided with four porcelain veneers. You also said that you can see your natural, yellow-stained teeth. This means you were not given enough porcelain veneers. Most smiles require six to eight porcelain veneers. Wider smiles will require ten.

Sometimes, getting fewer porcelain veneers is the choice of the patient, even though the dentist recommends more. Often, this is for budgetary reasons. When that happens, there is a good solution. This leads me to the next issue.

Porcelain Veneers Mistake #2

When you don’t have enough porcelain veneers to cover the teeth which are visible when you smile, the most affordable solution is to have your teeth whitened.

This makes the teeth white and closer to matching what your veneered teeth will look like. This would have kept your yellowed teeth from standing out against your veneers because the stains would be gone.

Porcelain Veneers Mistake #3

The two veneers you have which have splotchy gray stains sounds to me like they’re not bonded properly. This causes what is known as micro-leakage. When the veneers aren’t bonded on properly it allows things to get between the veneer and your teeth. This shows up as blotchy stains.

If this is the case, you have a very good case for a refund. This isn’t functional for you. Not because of the unattractiveness of the veneers, but because of the danger of decay. You have food and other bacteria getting trapped in there. Your teeth will develop cavities as a result.

Where to Go from Here

The first thing I want you to do is ask your dentist for a refund. If he or she refuses, then I want you to get a second opinion from another cosmetic dentist. If they confirm you have micro-leakage, then it will be easy for you to get a refund and get the case done properly.

Decide whether you want to have more porcelain veneers placed on the visible teeth or get your teeth whitened instead. If you decide on teeth whitening, get that done first.

I hope this puts your mind at ease.

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

Smile Care Club Versus Invisalign

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I’m really wanting to straighten my teeth but don’t have a ton of money. I keep hearing about this smile care club. They advertise heavily on Facebook. It seems much more affordable than Invisalign. Is it safe? Does it do the same thing?

Carol

Dear Carol,

Invisalgin Aligner
Inviaslgin Aligner

Smile Care Club is what boils down to a “do it yourself” Invisalign treatment. The biggest difference is you are not under the care of a dentist. That’s where you’re savings comes from. That’s also where the risk comes.

For the majority of cases, Smile Care Club will work fine. However, there can be problems. One big problem patients run into is gum disease. If someone has gum disease, getting any type of clear braces treatment will aggravate it. You will need the help of a dentist in order to make sure you can keep your teeth.

With these companies, you essentially just submit pictures to see if you “qualify”. However, only certain cases of gum disease can be diagnosed from pictures. Most would require both x-rays and probing.

There are two other issues which can pop up. The first is if the teeth need some mild shaving because of crowding. They will send you to a dentist for this. However, that dentist isn’t personally invested in your case. It can be tricky to get the right amount of shaving done on the sides while maintaining the proper shape of your teeth.

Another issue is if teeth don’t rotate the way they were supposed to. That also needs dental intervention.

Bottom line. You could save money as long as everything goes perfectly. If there are any side issues, you could end up with a disaster.

A Side Benefit of Invisalign

One thing patients will love about Invisalign is the ability for the aligners to double as teeth whitening trays. This allows you to whiten and straighten your teeth at the same time, essentially giving you a mini smile makeover.

However, that will need to be under the care of the dentist in order to protect your gums.

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

Am I Being too Picky about these Porcelain Veneers?

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Amelia

I had four porcelain veneers placed on my front teeth. The veneers themselves looked good. The teeth next to them stood out a bit so I plan on whitening my teeth to help that. My big concern is with one of the front veneers. I noticed on the drive home it had a strange divot that went across the middle of the veneer. I turned around immediately and went back to see what I needed to do. He told me not to worry and that he’d fix it right away. He did some kind of repair and it felt smooth again. Now it is a couple of days later and that part looks more dull than the rest of the tooth. Am I being too picky? It does bug me but I don’t want to be “that” patient.

Dear Amelia,

single porcelain veneer being held up by a dental tool

You are not being too picky. In fact, it sounds like the repair your dentist did on your veneer has damaged it. It’s possible he just sanded the area around the divot a bit to make it even. Unfortunately, that will have the devastating result of taking off the glaze of the veneer in that area.

The glazing is what protects it from picking up stains. This needs to be repaired or replaced. I’d do it now, while the faulty “repair” is fresh in his mind. If you wait too long he could try to blame you for the damage.

Have this Dentist Replace Your Porcelain Veneer

There is a repair that can be done on this using diamond polishing equipment. Unfortunately, I don’t think your dentist will know this technique. It’s quite advanced. Your dentist isn’t an expert cosmetic dentist, so you’re better off just having him replace it.

I’m not just being arbitrary in saying that. All the things you mentioned above are evidence. First, the number of porcelain veneers he gave you. When a dentist is doing a smile makeover, they’ll make sure as many of the teeth visible when you smile are covered as possible.

At a minimum, that means six teeth, unless you have an unusually narrow smile. Patients with wide smiles often get ten. Granted, there are sometimes financial considerations and patients can’t afford to cover each visible tooth. In that case, your dentist will make sure you whiten your teeth, before you have your smile makeover done. Yours didn’t even tell you to do it at all. You had to come up with that.

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

Boss Wants Me to Straighten My Teeth

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My boss called me into his office. He started off by telling me he felt awkward saying this but he thinks I’ll understand in the long run. I was so afraid I was about to be fired. Instead, he said, “I want to give you a big promotion, but you’ll need to straighten and whiten your teeth to get it.” I was puzzled until he explained that I’ll be their Public Relations person as well as a division leader. The PR post would require me doing media interviews, which means I’d need a pretty smile in order to make a positive impression. The money would be super worth any expense. It’s a huge promotion and he was right that I’d completely understand. I want to do this right. What do you suggest?

Madison

Dear Madison,

side by side of a smile with braces and a smile with Invisalign

First, let me say congratulations! What a promotion that is. I’m sure you’re thrilled. You have a couple of great choices to meet your cosmetic goals.

Straighten Your Teeth With Invisalign

Invisalign is a type of invisible orthodontics which is ideal for adults who which to straighten their teeth without a mouth full of metal. They use clear aligners. The image above shows a comparison of someone smiling with both braces and Invisalign. They tend to also work more quickly than braces as well.

If you go this route, the aligners can double as teeth whitening trays allowing you to straighten and whiten your teeth at the same time.

Remake Your Smile with Porcelain Veneers

If you don’t care about straightening your teeth and just want them to look straight, you can get a total smile makeover with porcelain veneers.

These use tiny wafers of porcelain to change the shape, size, and color of your teeth simultaneously. They have two big benefits for you.

  • They will be a faster procedure than Invisalign
  • They can completely change your smile, making it celebrity beautiful almost instantly

Their drawback is they’re much more expensive than the first option I gave you. Either one will give you the smile you need for your promotion.

Best of luck to you and enjoy the fruits of your labor.

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

Dental Implant Won’t Whiten

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I had an empty spot because of a lost tooth for some time. I came into some money and finally replaced it with a dental implant. It made my smile look much more attractive. I was inspired and decided to go one further and whiten my teeth. I’ve been doing the bleach with trays my dentist made for me. My teeth are whitening, but not the dental implant. Does that take longer or does it need a different formula?

Lorraine

Dear Lorraine,

An image of a dental implant crown being placed in three stages

I’m thrilled you are enjoying having your smile back. You’ve chosen a fantastic tooth replacement as well. In fact, a dental implant is the top-of-the-line in tooth replacement options. It’s like having a healthy natural tooth back.

The dental crown, which goes on top, can be made to any color you want. Unfortunately, once it’s color is baked on, it is permanent. The color doesn’t change. Your dentist should have warned you about that when you told him (or her) that you wanted to whiten your teeth.

It’s not just dental implants. When you bleach your teeth, the bleaching gel will only work on natural tooth structure. In order to get it to match the new white color of your teeth, it will have to be redone. Fortunately, it’s only the crown which will need to be redone, not the implant itself. That means it won’t cost you nearly as much.

What Type of Crown Should You Get?

I don’t know what type of crown your dentist provided for you. I hope it was an all-porcelain crown. If not, this is the perfect opportunity to get the “right” one. If it’s visible when you smile, the all-porcelain crowns look completely natural and reflect light the same way your natural teeth do.

If he gave you a metal-based crown, then you’ll end up with something much more opaque then you’d want. Plus, they always end up with a gray line showing up at your gumline, which will be very unattractive. The all-porcelain crowns never do that.

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