My $30K smile Makeover Makes Me Look Like Wallace & Grommit

I am devastated. I had teeth that were a bit small and hard to notice when I smiled. I wanted to get porcelain veneers, but my dentist said getting porcelain crowns instead could make my smile look bigger. As that was what I was going for, I agreed. He placed a dental crown on every tooth . The best way I can describe it is I look like Wallace from Wallace & Grommit. I can’t even close my mouth anymore and it is making my mouth so dry it is painful. Is there anything that can be done? I spent my life savings on this.

Lizzie

Dear Lizzie,

Wallace & Grommit

I placed an image of Wallace and Grommit here for the benefit of those who may not be aware of who they are. I can see why you are so devastated. Based on some things you said, I have a strong suspicion your dentist was in over his head.

The Bad News

The porcelain veneers you originally requested would have done the job of making your teeth look bigger without having to damage so much healthy tooth structure.

Many inexperienced cosmetic dentists will discourage a patient from porcelain veneers and suggest porcelain crowns instead because it is a procedure they are used to doing. Unfortunately, even doing something familiar, like porcelain crowns, requires extra training to do beautifully.

Even worse (for patients especially), doing smile makeovers isn’t something taught in dental school. Instead, a dentist has to invest in a significant amount or post-doctoral training. It doesn’t sound like your dentist invested in this.

In addition to his lack of training, he didn’t just try a smile makeover. Crowning every tooth is known as a full mouth reconstruction. It is one of the most advanced things a dentist can attempt. Getting the bite to come together properly (known as occlusion) requires bringing together a lot of factors. He seems to have missed the boat.

The Good News

If the only thing wrong with your smile makeover was the appearance and the function of your smile was okay, you would be completely out of luck. I hate to say it, but the fact that you can’t quite close your mouth and are now suffering from severe dry mouth works in your favor.

Your teeth depend on the saliva in your mouth to keep them healthy. It is a little known fact that there are minerals in our saliva that help to fight decay. When you have dry mouth, it puts your teeth at risk. Because your dry mouth is a direct result of your full-mouth reconstruction, it will have to be re-done.

Getting Your Smile Makeover Re-Done

Your current dentist is in over his head. This leads me to believe he is unable to fix this properly. Instead of asking for him to re-do it or even a refund, I want you to have him pay for it to be re-done by the dentist of your choosing.

The downside is, you are stuck with dental crowns. There is no way to grow back that tooth structure he removed for the crowns so you can have porcelain veneers. However, a skilled and artistic cosmetic dentist can create a stunning smile with porcelain crowns.

In your place, I’d look for a dentist who is accredited with the American Academy of Cosmetic Dentistry. These are the top 1% of cosmetic dentists in the country. You are pretty much guaranteed to get a smile you can’t wait to share. In fact, some of them even have a beautiful smile guarantee.

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

Can I Get Dental Implants if I’m Allergic to Some Metals?

I have some metal allergies, but I am losing a couple of teeth, in different places. I could get a dental bridge, but that would mean crowning four healthy teeth. I’d really like to get dental implants for those two teeth but don’t know if that is possible with them being made of metal. What do you think?

Benny

Dear Benny,

The Type of Metal Allergy Makes a Difference.

illustraition of a dental implant next to natural teeth

When you said you had a metal allergy, you didn’t mention which metal or metals you are allergic to. That will make a difference in which way you go. Some metal allergies are common, like an allergy to nickel.

Dental implants are made from titanium unless otherwise specified. We’ll get to the non-titanium implants in a moment. Titanium is highly biocompatible and serving in various prosthetics for decades. Very few people are allergic to this particular metal. If your allergy is not specific to titanium, you can just get dental implants without any worries. But, what if your allergy is to titanium?

Zirconia Dental Implants

Metal-free Dental Implants

If it does turn out that you have a titanium allergy, boy do I have good news for you! There are now metal-free zirconia implants. Zirconia is dubbed ceramic steel. They are well witin the requirements to be strong enough to serve as a prosthetic tooth root.

It’s a little trickier to find a dentist who provides these, not because they are sub-par, but because they are newer. Many dentists like to wait until something has been around a LONG time to start incorporating them into their practice. However, it will be worth it to you to find a dentist who does provide them so you don’t have to get those dental bridges. It’s rarely a good idea to place porcelain crowns on healthy teeth. I always recommend keeping as much healthy tooth structure as possible.

Planning Ahead Saves You Money

Another thing I always recommend to someone needing dental work such as a dental crown, whether for an implant, stand-alone, or dental bridge, is they think long term.

If you are ever going to whiten your teeth, the time to do it is before your crown is made. Because the color you choose for your crown is permanent, if you choose to do teeth whitening later, your natural tooth struture will whiten but not the crown. The only way to get your teeth to match then is to replace the crown and have it made the newer color.

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

Can I Get a Refund from this Dentist?

I had a cracked tooth that received a crown. It has been sensitive since then. I can’t eat where that crown is because it hurts to bite down. I called my dentist a week after and he said that some people take longer for the sensitivity to calm down. Three months later and I needed to go in for another dental crown. I begged them to fix the crown from the first tooth while they were there but they just blew me off. They told me it probably just needs to be adjusted and to schedule a follow-up visit for that. Then, the pandemic hit so they canceled my appointment. I went back today and they told me that the tooth needs to be extracted. I feel like this wouldn’t have happened with timely treatment. I wanted a refund for the original crown if I’m going to lose the tooth anyway. They’re saying the tooth being infected isn’t their fault So, not only am I not getting a refund, but now they’re talking about me having to get a dental implant to replace the tooth. Is there anything I can do about this?

Miranda

Dear Miranda,

Woman grabbing her jaw from pain.

You’ve been put through the wringer with this dentist. I’m sorry. It is obvious to me this dentist doesn’t care about your best interest. While it is not uncommon for a tooth to have some sensitivity, the type of sensitivity you described isn’t normal. If there was sensitivity to temperature, I’d have suggested a little time. However, you talked about pain when you tried to chew. That is something completely different.

A well-made dental crown is not noticeable at all. So, either the crown was seated too high and needed adjusting or there was an underlyting infection that was missed. It’s possible, if there was an infection, that it was hard to see.

One thing I don’t understand is them saying the tooth must now be extracted. Have they tried a root canal treatment? My suggestion is to get a second opinion.

When you do, make sure it is a blind second opinion. By that I mean , don’t tell the second opinion dentist who did your work or what they’re recommending. Instead, just tell him the symptoms and let him give you his unbiased recommendation.

I am especially curious as to whether you really need this tooth extracted. You said there is an infected tooth. Normally, the treatment for that is a root canal treatment.

I wish your dentist would take the crown that is giving you pain more seriously. When your bite is off for an extended period of time, It could lead to TMJ Disorder. Regardless of how this turns out, I think you need to find a new dentist. One who cares about his patients.

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

Dentist or Oral Surgeon for denture Extractions

Dentures

I have avoided the dentist my entire life. As a result, my mouth is a wreck and I need to get my teeth extracted for dentures. Is a dentist able to do the extractions or should I see an oral surgeon? I want to go to someone qualified, though I’m thinking an oral surgeon can knock me out to deal with my anxiety. What do you think?

Patrick

Dear Patrick,

You can go to a dentist to have the extractions done, which will save you quite a bit of money over an oral surgeon. Denture extraction surgery should be in the wheelhouse of most dentists. One caution though, I would only have a dentist do it who is able to do both the extraction and the denture placement. Ask them what they normally do in this type of situation. You don’t want a dentist doing this if they normally send someone to an oral surgeon.

Dealing with Dental Anxiety

Woman giving thumbs up in a dental chair

One word about your dental anxiety. You should not have to pay the extra money to an oral surgeon in order to have a stress-free/ anxiety-free procedure. Instead, I would like to recommend in addition to the other issue I mentioned, you also look for a dentist who offers dental sedation options.

In your situation, I believe you would do better with something such as oral conscious sedation. This is administered with a pill and will completely relax you.

You should be aware, however, you will so relaxed that you will need someone to drive you to and from your appointment. You will be too loopy to drive. They will also need to stay with you for a few hours until you are both lucid and steady on your feet again.

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