Crown Feels Weird

I had an upper molar crowned. It doesn’t quite feel right. It’s like it is too big for the tooth under it. They hit together before all my other teeth and it hurts. My dentist said to give it some time and I will get used to how a crown feels. It is my first dental crown so maybe this is what happens. However, it has been over two weeks and it still hurts. Would it damage the crown to maybe shorten it so they don’t hit together so soon?

Lindsey

Dear Lindsey,

Your dentist’s statement, “Give it time and you’ll get used to how a crown feels” is dental code for he has no idea how to fix this and he is hoping you will just clam up about it.

The reality is when a dental crown is done properly, you should not notice it at all. This includes when you are chewing. It should mesh perfectly with your natural teeth. It is fairly normal for some adjustments to need to be made to a new crown, but it seems like your dentist isn’t aware of the procedures to do this.

So what will happen if you don’t get it adjusted? Well, maybe nothing. Maybe you will “get used to it”. Or, maybe if this is left without adjustment, it can lead to serious problems, such as TMJ Disorder.

Most dentists would adjust the crown and have you bite on some registration paper to see where the teeth are not occluding properly. If your dentist hasn’t done that, then he is further behind in his field than I expected.

Don’t push him into doing something he isn’t comfortable with. It will end up worse than your original issue. You could go to another dentist to have this adjusted. You could ask for a refund and have the crown re-done elsewhere.

If you are otherwise happy with your dentist, you could stay with him for your general care, such as cleanings and checkups and then go elsewhere when some other procedure comes up. Another option is to switch dentists completely. The best dentists keep up learning and train in the new technologies and advancements that are made in their field. Your current dentist has not even mastered the basics yet, so I wouldn’t expect too much from him.

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

Porcelain Veneers With an Overbite

I am finally in a position where I can get a beautiful smile. I’ve had tetracycline stains on my teeth for years, which always left me self-conscious about my smile. I wanted to get porcelain veneers but my dentist said my overbite will prevent that because my top teeth pretty much completely cover my bottom teeth. Instead, he is suggesting four porcelain crowns. I have some questions though. First, have you heard of my type of bite being an issue with porcelain veneers. Second, Do I whiten my bottom teeth to come close to matching the top?

Melissa M.

Dear Melissa,

Porcelain Veneers require real expertise.

I am glad you wrote before going through with this procedure. I have some concerns about your dentist’s qualifications to give you a beautiful result. Let’s start with his choice of treatment–porcelain crowns. When dentists suggest porcelain crowns when a patient asks for porcelain veneers, it is most often because they are not comfortable doing porcelain veneers but don’t want to admit that to their patient.

I will give your dentist credit for his creative excuse, even if it is totally invalid. When you have an overbite, porcelain veneers actually make more sense. Veneers only cover the front of your teeth and hug the sides a smidge. Dental crowns have to go around the whole tooth. If your top teeth are covering your bottom teeth, that will be a challenge.

A second issue is your dentist suggesting four dental crowns. Unless you have an unusally narrow smile, this means your adjacent teeth, with their tetraycycline stains, will be visible when you smile. Most smiles need somewhere between eight to ten veneers to get all their visible teeth.

For the bottom arch, it is possible to have some teeth whitneing done, but tetracycline stains can be pretty resistant to most whitening methods. Kor Whitening has had the best results with these type of stains.

The Key to a Beautiful Smile Makeover

The one constant in beautiful results will be tied to the dentist you choose to do your porcelain veneers. Smile makeovers are not taught in dental school. On top of that, cosmetic dentistry is not a recognized specialty. A dentist has to decide to get the post-doctoral training necessary to produce beautiful results.

In your place, you need an expecially well-trained dentist. Tetracycline stains are one of the most challenging cases. Your dentist will have to get the veneers opaque enough to cover the stains but still look translucent to give it that natural reflective shine. To get this result, I would look for an AACD accredited dentist. These are the top 1 % of cosmetic dentists in the country.

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

Do Dental Implants Look Better Than Dentures?

I had dentures made a few weeks ago and they look awful. My dentist insists they’re fine, but I think my old messed up teeth even looked better. I did dentures to save money. Now I’m thinking maybe if I got the dental implants instead, they’d look better. Is that true or would it just be more money for the same ugly teeth?

Monica

Dear Monica,

Implant Overdentures

I’m glad you wrote. While I think dental implants are a good change. It is not for the reasons you would think. Whether or not your new smile looks beautiful or even just natural does not depend on whether you had dentures versus dental implants. The thing that makes the biggest difference is the cosmetic skills of the dentist doing your procedure. You could have a stunning smile with dentures and an ugly one with implants or vice-versa.

What you need is to find a skilled cosmetic dentist. The best cosmetic dentists are AACD accredited. I would start there. While you could just have dentures re-made more beautifully if you can at all afford dental implants I am going to highly suggest you get them. There are serious long-term consequences to dentures that I hope your dentist warned you about.

The Danger of Dentures

When your teeth were removed, you body recognized that you no longer had any tooth roots in your jawbone. In an effort to be as efficient as possible with your body’s resources, it immediately began to resorb the minerals in your jawbone in order to use them elsewhere in your body where it perceived they would be more useful. While an excellent method of resource conservation it will result in your jawbone shrinking.

After about ten years, your jawbone will shrink so much that your appearance will be aged by decades. Even worse, you will no longer have enough jawbone left to retain your dentures, leaving you without a way to chew your food.

The way to prevent this is by getting implant overdentures. This takes between four to eight dental implants and anchors a denture to them. The dental implants serve as prosthetic tooth roots and signal to your body that you have teeth and need the minerals in order to retain your jaw.

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

Can I Switch Dentists During Invisalign Treatment?

I am in the middle of my Invisalign treatment. I do love my Invisalign treatment. It is comfortable and I am can see the results. However, the dentist I am using is intolerable. He’s rude and always talks about controversial issues. He’s angry all the time. Plus, he’s got bad breath. I could live with the latter, though it isn’t pleasant. I just don’t want to spend the rest of this time dreading my appointments because of all his rants. It’s like getting Invisalign from Stalin. Is it possible to switch Invisalign dentists during treatment? He isn’t my normal dentist. I love my regular dentist and have checkups with him on schedule, but he doesn’t offer any orthodontics. I had a Groupon for this guy. but it has been too difficult.

Help.

Laura

Dear Laura,

Invisalign Aligner

I am sorry you have had such a horrible experience. I was surprised to hear you had a Groupon for Invisalign. My guess is this dentist has a hard time keeping patients so this was a way to draw new ones in.

Your happiness with your Invisalign itself doesn’t surprise me, though. It has one of the highest patient satisfaction rates of any dental treatment. The good news is you can definitely switch dentists in the middle of your treatment. Additionally, your dentist is under an ethical obligation to provide your new Invisalign dentist with all your diagnostics and treatment notes.

The only downside may be that because you did this through Groupon with Dr. Stalin, you may have to pay a little more with the second dentist who may not offer this same price. From what you have described, it will be worth it though to be rid of this dentist, though.

A Bonus Benefit with Invisalign

There is a way you can get a little bonus treat, however. I doubt your current Invisalign dentist mentioned it. Because the Invisalign aligners are custom-fit to correct your bite into proper alignment, they can also double as teeth whitening trays.

This means you can just get the professional-strength teeth whitening gel from your dentist without the expense of having to have bleaching trays made. Between that and Invisalign, it is like getting a mini smile makeover at a fraction of the cost.

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