Picking the Whiteness of My Porcelain Veneers

I have a highly recognized AACD accredited cosmetic dentist who just did ten porcelain veneers for me. I will say they look beautiful. The only thing that disappoints me is their color. Yes, they are very white, but I was hoping for even whiter. My dentist said he is willing to re-do them and send them back to the lab but said they would have to add an opaqueness to them to get them any whiter. He did tell me many celebrities choose this option but warned some people think they look a tad more fake than the more translucent veneers. Would they be obviously fake? Should I go for the more translucent to sacrifice the whiteness I was hoping for?

Kristin

Dear Kristin,

A single porcelain veneer being placed

From what you’ve described it sounds like you have a very good cosmetic dentist. AACD accredited dentists are the top cosmetic dentists in the country. That is the number one factor in determining how beautiful your smile will turn out. Cosmetic dentists often have patients who want teeth whiter than a natural white. They want that dazzling Hollywood smile. Many cosmetic dentists call this “ballistic white”. Some patients love them and some want a slightly more translucent smile.

So here’s your choice. Do you want a smile that dazzles from across the room but may look slightly more opaque close-up or would you rather have a slightly more translucent natural white? Still beautiful. Still shiny. But, not ballistic white. There’s not a right or wrong answer. It is what appeals more to YOU.

I will say, while some patients who received ballistic white porcelain veneers wish they’d gotten them a little more translucent, most who want a change wish they’d gone whiter.

I can’t answer which one is right for you. The good news is, your dentist should let you try them in with a temporary try-in paste and get a great look at them before the final bonding. So, you’ll have a chance to change your mind.

This blog is brought to you by Cosmetic Dentist Dr. Randall Burba.

New Denture Won’t Stay In

I’ve had a new denture for a month. He did an impression, a wax bite, and two wax try-ins. Even after the second wax try-in, they weren’t staying in, but he said that’s because it’s not the real denture. But, when the real dentures came, it still didn’t want to stay in. At first, my dentist suggested I give it time for my gums to adjust. When that didn’t work, he did some grinding. That didn’t help either. Now he’s talking about a reline. Will that help any more than the others or is it another useless step?

Marcy

Dear Marcy,

Dentures

I’m sorry you are having so much trouble with your denture. I don’t know why your dentist suggested your gums would adjust. That wouldn’t happen. Your gums are what they are. The best I can think is it was a stalling tactic. The big problem with this fit seems to be he skipped a step. However, dentists commonly do this. Most of the time it results in a decent fitting denture. In yours, it didn’t.

When the impression is made, we’re taught to do a two-step impression. First, with a heavy impression material and then with a light material. Some dentists will just do a one-step with a medium material. This is to save money. Most people who get dentures are looking for the lowest cost solution. Doing a one-step impression allows them to charge less, bringing in more business.

The reline should help with the fit quite a bit. This is a better step to take than the others you’ve had done so far. If he hasn’t done the new impression yet, make sure you ask him to do a two-step, which he should have done to begin with.

The Danger with Dentures

Even the best fitting dentures will reduce your chewing capacity by 50%, so I wouldn’t expect the secure feel you are used to with your natural teeth, though of course, they should actually stay in.

There is a bigger problem with dentures, though. When your teeth were removed, your body recognized that. In a continual effort to be efficient with its resources, your body will resorb the minerals in your jawbone to use elsewhere in your body where it deems they’d be more useful.

The big problem this causes is the gradual shrinking of your jawbone. Eventually, you won’t have enough jawbone left for you retain your denture. This is known as facial collapse. There is a way to prevent this.

If you get implant overdentures, it tricks your body into thinking you still have teeth and will preserve your jawbone.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.

Getting Dental Implants after Years with Dentures

I’ve had dentures for close to 30 years. I now can’t even keep them in. Is there any hope I can get dental implants at this point?

Cassidy

Dear Cassidy,

before and after side images of a woman suffering from facial collapse
Years with Dentures will Lead to Facial Collapse.

What you’re dealing with is facial collapse. When your teeth were first removed, your body recognized that. As an effort to be efficient with its resources, it begins to resorb the minerals in your jawbone that were previously used to support the roots of your teeth. This slowly begins to shrink your jawbone and is the reason you are no longer able to return your dentures.

As to whether you can get dental implants at this stage, the answer is yes…but. In order to have implants which will stay secure in your jaw, that missing bone structure will have to be rebuilt. There is an outpatient procedure, called bone grafting, which can build back up your missing bone structure. Then, after a period of healing, you can begin the dental implant process.

Dental Implant Overdentures

You won’t get a one to one ratio of dental implants to teeth (or in your case dental crowns). It would be prohibitively expensive to do it that way. Instead, I suggest you do implant overdentures.

dentures about to be secured to six dental implants
Implant Overdentures

This utilizes between four and six dental implants and then, when osseointegration has taken place, your dentist will anchor a new set of dentures for you to them. These will be much more secure and comfortable than the dentures you had previously. Because they’re anchored, there is no slipping or falling out. You’ll also find your chewing capacity significantly increases, improving your quality of life.

Your Chance for a Dazzling Smile

This is a fantastic opportunity for you to get the smile of your dreams. If you go to an expert cosmetic dentist, they can not only fashion your dentures, but they can do it in a way that makes you look years younger and thrilled to share your new smile.

This blog is brought to you by Salem, MA Cosmetic Dentist Dr. Randall Burba.

Her Dentist Isn’t Helping Her

I have a puzzle I’m hoping you can help me with. I had a check-up just a couple of months ago. They said everything was good to go. Yet lately, I’ve been having this weird pain on one of my back teeth. It feels like someone is pulling at the tooth briefly and then letting go. It is sort of hard to describe. I haven’t had a cavity before so I don’t know what they feel like. The only other thing I can think of is my husband says I grind my teeth at night. Could that be it? What do I do? I don’t want to go back to the dentist unnecessarily.

Paula

Dear Paula,

Woman grabbing her jaw from pain.

I know you said your dentist gave you the all-clear, but I am quite concerned you’re not getting the proper care from your dentist. Some “bread and butter” dentists, especially those from discount clinics will check your teeth for cavities, but ignore all the peripheral issues, such as gum disease and teeth grinding. Both of those issues are extremely important to deal with.

Bear in mind I haven’t examined you and am going just on the pain as you described it. It could be either from your grinding (known as bruxism) or from gum disease. Usually, by the time you feel pain from gum disease, there has been some bone loss and that is dangerous for you. It could lead you to losing your teeth.

The grinding should have visible evidence at this point. Not only will it lead to TMJ Disorder, but eventually your teeth will be ground down to nubs requiring a full-mouth reconstruction. This means putting a dental crown on each one of your teeth that are worn down. I can pretty much guarantee your current dentist isn’t qualified to do that procedure. It takes advanced training.

You Need a Second Opinion by a TMJ Dentist

I’d like you to see another dentist. Almost all dentists should know how to recognize and treat gum disease. That won’t be the tricky part. I want you to see a dentist with advanced TMJ training. This isn’t a recognized specialty. Instead, a dentist has to take the initiative and decide it is something he or she wants to treat and get the training to enable them to do it well.

Some of the more reputable post-doctoral centers that do great training in TMJ are The Las Vegas Institute for Advanced Dental Studies (often called LVI), The Dawson Center, The Kois Center, and the Spear Institute. Look for someone with training from at least one of these schools.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.