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.

Does Smile Direct Club Work?

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I know it probably seems weird that I am asking you, a dentist, about an online orthodontic service when you sell Invisalign. But, I live clear across the country from where you practice, so you won’t lose any business by telling me the truth. Hahaha. So here is my question. Every time I get on Facebook, I see an ad for Smile Direct Club. They do have quite a few good reviews. But, I thought before I invested in it I would like to get a real dentist’s opinion. Does Smile Direct work?

Rebekah

Dear Rebekah,

SmileDirectClub Advert

I’m glad you wrote. And don’t worry, you aren’t the first person to ask about this particular service. My duty is to ensure those who are seeking dental advice from us get the best and understand their options. So, never hesitate to write with questions. Yes, I am not surprised you see the ads a lot. They are heavily advertised. As for the good reviews, that doesn’t surprise me either, but not for the reasons you think.

Recent investigative journalism has uncovered Smile Direct Clubs’ habit of only offering refunds to unhappy clients if they sign a release saying they won’t post any negative reviews and will remove any negative content they have already placed. In other words, we won’t get a true picture of their reviews because patients with bad experiences don’t talk about it in order to get a refund.

However, let me just go into what we know for a certainty about how this program works.

Problem One: Missing Diagnostics

A good dentist will do a full mouth series of x-rays and a comprehensive dental examination. This would include looking for things such as signs of TMJ Disorder, tooth decay, and gum disease. Skipping this step can cause the patient a lifetime of pain and unnecessary dental work that could have been avoided. To me, it is inexcusable to skip this step.

Problem Two: DIY Impressions

In order to get a truly accurate treatment plan, it is imperative the impression is done carefully. That means there will be no bubbles, tears, or other defects. This step is so important that some dentists won’t even allow their assistants to take it. With Smile Direct, they just send you a kit to do your own impression at home. I find it doubtful this will give you the best orthodontic treatment.

Problem Three: Adding Space

Most cases of patients needing braces have crowded teeth. This means they will either need some shaving of a few teeth or some back teeth extracted. This needs to be done by a dentist invested in you and the case. Unfortunately, Smile Direct has a shortcut to this too and I worry about its impact on patients.

Problem Four: Inadequate Follow-Up

When you do a treatment, such as Invisalign through a dentist, you are getting follow up care every two weeks when you are given your new aligners. This prevents so many problems. While the treatment is pre-planned, sometimes our teeth don’t cooperate. Maybe teeth don’t turn the way they are supposed to or more space is needed than we originally thought. Without that follow up, your teeth could end up in a worse position than they were to begin with.

What does this mean for you? Well, you could try Smile Direct Club. It might turn out well for you and you’ll save some money. However, first I would get a complete examination from your dentist just to make sure you don’t have any underlying conditions that could cause a problem. But, you are taking chances. So go into it with eyes wide open.

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

Tanda Pearl Ionic Teeth Whitening

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I have professional teeth whitening trays that my dentist said to wear for an hour a day to get optimum whitening. That has been aggravating my TMJ. I recently read an ad for Tanda Pearl Ionic Teeth Whitening. This one says you only have to wear it for 5 minutes twice a day. That appeals to me and I think it would be easier on my jaw. Are you familiar with this system? Would you say it works and, equally important, is safe?

Cyndy

Dear Cyndy,

Tanda Pearl Ionic System

The Concept

The Tanda Pearl system works using the same process that you’d get with the teeth whitening your dentist offers, though milder. The gel goes in a tray that you wear.

The Tray

There is a big difference in the Tanda tray and the tray you get at your dentist. With a professional tray, your dentist custom fits it to your bite, with a separate tray for each arch. This should be the type of tray you have. With the Tanda system, there is only one tray that you hold in by biting down on it. You could not sleep with it and certainly wouldn’t want to be seen with it in public, unless you enjoy weird stares. Plus, holding the tray in place will aggravate your TMJ Disorder significantly more.

The Time

My guess is they only have you wear it for 5 minutes because any longer than that would be painful. There is no magic to either that amount of time or the time your dentist prescribed. The longer you wear them the more the gel has time to work. If one hour a day is too hard for your jaw, then wear the trays for less time. I’d also talk to your dentist to make certain your trays are properly fitted to your bite. It shouldn’t be uncomfortable. In fact, usually, all a patient has to worry about with extended wear is the sensitivity of their teeth.

The Safety

As to whether or not it is safe, I would say yes. I don’t see anything that would make it unsafe. It has a mild teeth whitening strength, that combined with the short amount of time you wear it, there is little chance of sensitivity.

However, I think you’d still get better results just sticking with the teeth whitening you’ve already paid for with your dentist. I would lower the amount of time you are wearing the trays to minimize the aching in your jaw. I’d also make sure your TMJ problems are being addressed and not just diagnosed.

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