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Can I Get a Functional and Beautiful Smile?

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I had a full-mouth reconstruction done because of a combination of both tetracycline stains and the fact that I sometimes grind my teeth. While the new teeth look okay, my mouth has been hurting ever since. I can’t tell what the problem is but it hurts the most when I bite down to chew. I’ve been back to the dentist who did the reconstruction and he said everything looks fine to him. I don’t know what to do at this point and I’m barely eating. Is it possible to get a beautiful smile that still functions well and doesn’t hurt?

Lacey

Dear Lacey,

Woman holding her jaw from TMJ pain

I am sorry this is happening to you. I’m curious as to the shape your teeth were in before the full-mouth recontruction. If there was nothing wrong with your teeth with the exception of the tetracycline stains, I am confused as to why he used dental crowns instead of porcelain veneers. If there was minor damage from teeth grinding, then wearing a mouth guard would help with that, even with the porcelain veneers, which are the typical treatment for a smile makeover.

As for the dental crowns, if your mouth hurts when you bite down, then everything is NOT fine. You can get a beautiful and functional smile, however in order to do that you need to see a dentist who has training in both cosmetic work as well as neuromuscular dentistry. This would include training in TMJ Disorder.

I think you will need to get a second opinion on your reconstruction case. It could be as simple as some of the crowns are sitting too high. However, it could be more serious. A full mouth reconstruction is one of the most advanced porcedures a dentist can do. If he or she doesn’t have the right training, then it can completely throw off your bite leading to painful TMJ disorder.

When you get your second opinion, you will be better served if you make sure it is from a dentist who has the right training. I would look for someone who has training from one of the following institutions:

  • The Pankey Institute
  • The Los Vegas Institute of Advanced Dental Studies
  • The Dawson Institue

They can give you the right diagnosis for what is wrong with your reconstruction, as well as make any necessary repairs.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

My New Dental Crowns are Turning Yellow

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I had very white teeth and was ready to take the next step in improving my smile by getting a smile makeover. I spoke to my dentists and he suggested six porcelain crowns on my upper front teeth. I selected the whitest color available to me. Yet, when the crowns were put in, they did not seem to be the whiteness I had intended for them. Now, to top it all off, the dental crowns are starting to turn yellow. I haven’t even had these a year yet. Can I whiten them along with my teeth? How do I keep them from turning yellow again?

Melody

Dear Melody,

Extended shade guide

First, I want to make sure your dentist is using the updated shade guide. Before teeth whitening, the whitest shade was B1. Now, with the popularity of teeth whitening, the shade guides have been updated and BL1 is now the whitest. That may be the issue with the color discrepancy.

That doesn’t, however, explain the new staining. If your crowns are truly porcelain crowns they should be very stain resistant as long as the glaze on the porcelain is intact. This leaves me to wonder if something happened during one of your dental appointments to damage the crowns. Two possibilities are if the hygienist used an acidulated fluoride or a power prophy jet.

With the acidulated fluoride, it will etch the surface of the crowns, leaving the crowns very susceptible to staining. The power prophy jet can remove the glazing, causing staining take place even faster. Unfortanately, teeth whitening only works on natural teeth, so that would not be a good solution for you. The first step is to find out if the glazing has been damaged. I recommend seeing a good cosmetic dentist who can examine your crowns and ask them to give you an idea of why these are picking up stains.

One other quick question. I’m curious as to why your dentist chose crowns for this smile makeover. The standard for that type of procedure is porcelain veneers because it removes much less tooth structure. Was there damage to these teeth that required crowns?

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

What are the Best Materials for Implants and Crowns?

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I am getting a smile makeover, which will probably include at least eight dental implants on my upper arch. I am trying to do my homework ahead of time and have some questions. First, as far as implants go, are the Astra Implants from the UK reliable?  I also wondered if zirconium was okay for crowns. I did read that porcelain fused to metal can leave a black line, but wanted something strong. I’m worried zirconium will be clear colored, though. Any help you can give will be appreciated, my appointment is coming up fairly soon.

Valerie,

Dear Valerie,

An assortment of titanium and zirconia dental implants.

 

I am glad you are trying to do research. However, I would like to steer you in a different direction. The most important thing to research is the dentist doing your dental implants procedure. That has a much greater impact on your result than the materials used. Before we get into what to look for, I want to ask you a question. You mentioned that the reason for your dental implants was a smile makeover. However, unless the teeth needed to be extracted, that is a gross overtreatment. The typical procedure for a smile makeover is porcelain veneers which hardly removes any tooth structure. A dental implant requires you to lose the entire tooth.  I just want to make sure the implants were necessary before you go through with this.

Dental implants are quite an advanced procedure. So advanced, however, that dental school is not enough training. It takes significant post-doctoral training to be able to do this the way it needs to be done. There is no way you can learn enough about the materials in the time you have. Plus, so much of it will also depend on your specific case. Look for a dentist with implant qualifications. As for the zirconium. That will be white, not clear. I hope that puts your mind at ease.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

 

Porcelain Veneers and Teeth Whitening

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I need to whiten my teeth. Well…I want to whiten my teeth. What worries me is that I have porcelain veneers on only four of my teeth. It’s the teeth next to the porcelain veneers that need the whitening. My smile is about eight teeth wide. I wish I had the money to do more veneers so they’d all match but I didn’t. I want to whiten the teeth to match but I’m worried that the whitening gel will hurt the porcelain veneers. Will I damage them if I use something weak like Crest Whitestrips?

Corinne

Dear Corinne,

teeth bleaching trays

Teeth Bleaching Trays

I am glad you wrote. I wish your dentist would have whitened your teeth before doing your porcelain veneers. That is pretty standard operating procedure when a person can’t get enough veneers to cover the width of their smile. The good news is, while it won’t be as easy, it is still possible to get them whitened.

Crest Whitestrips will not do any damage to your porcelain veneers. In fact, neither will professional strength teeth whitening. If you decide to use the Whitestrips, you need to be aware of some limitations. First, they’re not very big. In fact, they’ll only cover your first six teeth. With four of them being veneered, that would mean you are wasting a significant amount of whitening. With them being only a fraction of the strength of professional whitening, I don’t think you’d be truly satisfied with them.

My suggestion would be to have your dentist make you custom fitted trays that can be shaped around your porcelain veneers. This will enable you to whiten those teeth at full strength, while under the care of a professional. Plus, you can keep the trays and use them for touch-ups every couple of years. Then, you’ll only need the inexpensive gel.

This blog is brought to you by Duluth, GA Dr. David Marion.

Dry Mouth After Full Mouth Reconstruction

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I had crowns put on all my teeth, top and bottom. Ever since the procedure, I’ve had a hard time keeping my mouth closed all the way and I’ve got horrible dry mouth as a result. My dentist did what he called opening my bite so that you could see more of my smile. I was really looking forward to having a beautiful smile but this is miserable. Should I have him grind them down? I feel all the money I saved up for this has been wasted.

Shannon

Dear Shannon,

woman covering her mouth

Putting crowns on all your teeth is known as a full-mouth reconstruction. This procedure is extremely complicated and is usually reserved for some of the more serious dental cases, such as advanced TMJ Disorder. It’s unusual to use it for cosmetic reasons. The standard procedure for a smile makeover is to use porcelain veneers. Substituting crowns for this tells me he doesn’t have advanced training in cosmetic dentistry so he did crowns, which he felt confident in. The problem is placing one crown is much different from than crowning all the teeth, which would take advanced reconstructive training. It appears your dentist does not have that either.

It appears when he opened your bite, he caused what is known as lip incompetence. This means your mouth does not close while it is in repose. There is good news and bad news here. First, the good news. Your dentist messed up and he messed up badly enough that this case will need to be redone AND it should be redone at his expense. You will get a second chance for that smile you have always wanted.

Now for the bad news. Lip incompetence, which leads to the dry mouth you are experiencing, can destroy the health of your teeth. Because of that, you will need to get this repaired rather quickly. Dry mouth means you are not getting enough saliva in your mouth. Most people don’t realize this, but saliva is one of the main defenses our teeth have in fighting decay. Saliva is loaded with bacteria killing minerals. Without your saliva, your teeth will quickly start decaying.

I want you to get a second opinion from an expert in reconstructive dentistry. Look for someone with qualifications like you can read about in Dr. Marion’s bio. If what I is think is going on, he or she can fix this at your original dentist’s expense.

Unfortunately, because you have dental crowns, you will always need dental crowns.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Whitening Porcelain Veneers

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My coffee drinking habit seems to have stained my porcelain veneers. Would having teeth whitening done get them to look as white as they used to? If not, is there something I can do? I used to be so proud of this smile.

Becky

Dear Becky,

A porcelain veneer being placed on a tooth.

The type of glaze used with porcelain veneers is glass-like and quite stain resistant. Even drinking coffee should not have affected them. If they are picking up stains, it means they are damaged in some way. There are a couple of ways this could have happened.

First, if you’ve been using something abrasive on them while brushing your teeth, such as baking soda or over-the-counter whitening toothpaste. Because of their abrasiveness, these will scratch the glaze that protects your porcelain veneers, leaving them vulnerable to stains. A second possibility is that your hygienist used something to damage the glazing, such as a power prophy jet or acidulated fluoride. If it was something your dental office did, they are responsible to make this right. As such, they should replace them so that you have the glaze back.

If you are the one responsible, then you will need to be the one that fixes this. Teeth whitening will not whiten anything except your natural tooth structure, so that won’t help you. What can be done is either to replace them or to have your dentist polish them up. This will remove the stains and make them more stain-resistant. But, you’ll have to be careful because they will not be as stain-resistant as they were originally.

Your dentist should have talked to you about proper maintenance. It does not sound like that happened. The best toothpaste for cosmetic dental work of any kind is Supersmile Toothpaste. It is specifically designed for porcelain type work. Rather than using an abrasive to help whiten your teeth the way over the counter whitening toothpaste does, it removes the stains chemically using a protein pellicle. I highly recommend it.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

A Full Mouth Reconstruction for Teeth Whitening??

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I have an old dental crown that really needs to be replaced. They’re quite old. I have several porcelain veneers about the same age. These were all done by a dentist from another city where I used to live. My new dentist wants to replace all my teeth with dental crowns. This suggestion is because my teeth are not very white and he thinks this is the best way to make sure everything matches. This seems rather drastic to me. Can’t I replace them all with porcelain veneers instead of dental crowns? That way I don’t have to grind down my teeth that are healthy. Isn’t that a better solution?

Kathleen

Dear Kathleen,

woman covering her mouth

Yes, that would be a better solution. However, I have an even better one that will save you a significant amount of money. Unless you have a reason for wanting veneers on the teeth that don’t currently have them, such as wanting a complete smile makeover, then the simplest solution to your teeth not being white enough is to do teeth whitening. I’m absolutely appalled he is suggesting crowning all your teeth instead of whitening them.

Such a procedure is known as a full-mouth reconstruction. It is one of the most difficult and advanced procedures there is. In order to do it properly takes extensive post-doctoral training. Not only that, but if your dentist doesn’t do it correctly, it can completely throw off your bite leaving you with painful TMJ Disorder.

Here is my suggestion. If you just want to replace the old dental work. First, get your teeth whitening. Then, get the dental work replaced. You will only need one crown. Replace the porcelain veneers with more veneers. However, I am going to suggest you find a different dentist to do this. I don’t trust this one. You will want one who does beautiful cosmetic work. Check out their smile galleries to see what type of results they get.

If you want a full smile makeover, you would do the same as above, but you could add more porcelain veneers to the procedure, rather than just the ones you need to replace. Again, you will need a dentist better than the one you have.

I hope this helps.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Will Teeth Whitening Fix My Dental Bonding

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My dental bonding has been picking up stains. They used to be very white. I was hoping to get them back to where they were.

Karl

Dear Karl,

Before and After Dental Bonding

Unfortunately, teeth whitening will only whiten natural tooth structure. It will have no impact on your dental bonding. You didn’t mention how long you have had this bonding or what type of stains you are dealing with. That will have some impact on the best advice to give you. Here is some general help, though.

If your bonding still has the polish on it and you are dealing with surface stains, I am going to recommend Supersmile Toothpaste. Unlike most whitening toothpastes that use abrasives which damage your bonding, Supersmile uses an ingredient Calprox, which will enzymatically remove the stains. It does this by dissolving the protein pellicle on your teeth and the stains attach themselves to the pellicle. Get rid of the pellicle; get rid of the stains.

However, if the polish to your dental bonding is gone, then they have been damaged and the best thing you can do is have them re-done. If you haven’t had these long, then I would go back to your dentist and see if he or she will be willing to fix them. If you have had them a while, it may just be time to replace them. Dental bonding does not last nearly as long as porcelain veneers, so I would expect to replace them every few years.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

A Collapsed Bite

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I wonder if you can advise me. I am very self conscious about my smile. When my mouth is at rest, but not completely closed, there is just a black cavern. You cannot see my teeth at all. My jaw also hurts from years of grinding my teeth, which I just found out recently was an issue. My dentist made a night guard for me to wear at night. When I wear that, my jaw hurts less and it gives the slight appearance of my teeth being visible. This makes me think I need to add something to my teeth to make them “show up”, plus it may help with the jaw pain. I asked my dentist about it and he suggested porcelain veneers. Before I make such a big investment, I want to make sure it is the right choice. Have you seen patients in my situation? If so, what worked for them?

Caroline

Dear Caroline,

woman holding her jaw in pain

I am glad that you wrote. I think I know what has happened here and if it is not done right it can completely mess up your bite and leave you in a lifetime of pain. As for porcelain veneers, while if you see an excellent cosmetic dentist it would help with the appearance related issues, it would not solve the root of your problem or the jaw pain, which is like TMJ Disorder as the result of the grinding.

Based on what you have described, it sounds like your teeth grinding has led to a collapsed bite. I wish a dentist would have intervened sooner and protected you from this. However, that is water under the bridge and you need a solution. When your teeth are that ground down, the only real solution is a full mouth reconstruction. This is done by crowning the ground down teeth in order to get your bite in proper alignment and occlusion. However, this is one of the most advanced procedures in dentistry and has to be done very carefully.

A dentist would have to do this starting with provisionals to make sure everything lines up perfectly. It takes years of post-doctoral study to be able to do this well. Look at Dr. Marion’s bio to get an idea of the type of training a dentist would need to work on your case.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Porcelain Veneers or Invisalign?

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I have been saving up for quite some time to get my smile makeover done. There’s nothing too major. I want the color whiter, there are some chips here and there, and I have one slightly crooked front tooth. It’s not crooked enough where I ever considered braces. However, my dentist is suggesting I have Invisalign done before getting the porcelain veneers. He said that way there wouldn’t be any need for tooth preparation because he’s using Lumineers. I am not too keen on the idea of adding another 9 months to my smile makeover. Is this completely necessary? I thought porcelain veneers could make a tooth look straight. Am I misunderstanding anything?

Patricia

Dear Patricia,

invisible braces

Bear in mind that I haven’t examined you, but I am skeptical of what your dentist is telling you. In almost all cases, you would either do porcelain veneers or Invisalign–not both. You had the right idea that porcelain veneers can make your teeth look straight. My guess is your dentist is trying to get you to do the Invisalign because he doesn’t know how to shape teeth with porcelain veneers.

He also suggested Lumineers for your case, which is a brand of porcelain veneers highly marketed to inexperienced cosmetic dentists as being “easy to place” because they don’t require tooth preparation. However, in most cases, Lumineers end up looking bulky without some tooth prep. Not to mention inexperienced cosmetic dentists do not generally know how to produce beautiful results. Smile makeovers aren’t taught in dental school.

At this point, you have two choices if you want to get porcelain veneers, I would get them but with a different dentist. Look at their smile galleries to make sure you like the type of results they get. You want to know that they can produce beautiful, natural-looking smiles. Also, make sure they have some type of beautiful smile guarantee.

A second option is to do get Invisalign or another brand of invisible braces to straighten your teeth and whiten your teeth simultaneously using the clear aligners as teeth whitening trays. This will be significantly less expensive than porcelain veneers, but will take longer. You mentioned a few chips on your teeth. You didn’t mention how many or how large, but in most cases, these are repaired with some dental bonding.

Truthfully, wanting all three things repaired, which is what would be necessary for a complete result, the porcelain veneers will be a better idea. I just don’t think your current dentist is the one to do it. He sounds to be in over his head but not wanting to admit it.

This blog is brought to you by Duluth, GA Dentist Dr. David P. Marion.