Is My Dentist’s Recommendation for a Cavity too Aggressive?

My dentist recommends a treatment that I think is aggressive, but I need another opinion. If a porcelain veneer tooth has a cavity, is removing the veneer, fixing the cavity, and replacing the veneer with a crown the right thing to do?  I asked my dentist to give me some time to think about it, but something about this doesn’t seem right. – Thanks for your help. Gabrielle from GA

Gabrielle,

Thank you for your question.

Although one of our dentists would need to examine your tooth and x-rays for an accurate diagnosis, we can provide general information.

Matching crowns and veneers

Few dentists can achieve a perfect match with crowns and veneers. Advanced cosmetic dentistry training is required to get natural-looking results.

Cavity size can affect treatment options

A crown might be necessary if a cavity is so large that much of the tooth structure would be lost when preparing the tooth. A dentist may not preserve enough tooth structure to create a secure bond between a porcelain veneer and the tooth. Other dentists might find ways to build up the tooth and restore it.

Porcelain veneer

If you have porcelain veneers and want to keep them, it is essential to understand the skill level between a general or family dentist and a cosmetic dentist. Family dentists are skilled at regular maintenance. But cosmetic dentists have advanced training and artistic talent. It is unreasonable to expect a family dentist to achieve beautiful results and restore your veneer if they lack the training.

We recommend scheduling a second opinion with an advanced cosmetic dentist to examine your porcelain veneer tooth and x-rays.

The cosmetic dentist at Burba Dental Partners of Salem, Massachusetts, sponsor this post. Please read what our doctors do to provide some of the best dental care in the Boston area.

How do I know which denture implants to choose?

I’ve worn full upper and lower dentures since 2003. My jawbone is shrinking, and my dentist recommends implants. But my dentist would refer me to a periodontist for the implants. I thought about implants in the past, but now that my facial appearance is changing, I am considering them more seriously. I plan to finance the work and complete payments within two years. After researching all the options for denture implants like the snap-on denture, all on 4, all on 6, or implants with bone grafts, I am confused. Then I looked at prices online and found some dental tourism practices in Mexico (not my preference), Portugal, and Costa Rica that charge 40-50% less than the U.S. for denture implants. What can help me decide with denture implants to choose? – Thank you. Karson

Karson,

Thank you for choosing our office for your question. Knowing which implant denture option to choose begins with a 3-D x-ray and exam. An implant dentist, oral surgeon, or periodontist would need diagnostic studies before recommending options for stabilizing your dentures. Only then can you decide on a type of implant dentures.

How Do Implant Dentures Work?

Implant dentures work by support a full arch of teeth with dental implants. You will need at least two implants to keep a denture in place. But four to six implants will increase the stability. You can get implants for an upper or a lower denture—or both.

What Determines Your Choice of Implant Denture?

Several factors can determine your choice of implant denture, including:

  • The level of stability you want
  • Your jawbone quality and volume
  • Your oral and overall health
  • Your implant dentist’s skill, experience, and offerings
  • Your budget

Your implant dentist will explain the differences between types of implant dentures including:

  • Snap-on denture
  • Mini implants
  • All-on-4 dental implants
  • Fixed implant dentures
  • Removable implant dentures

What About Dental Tourism for Implants?

Before signing up for dental tourism for implants consider a few factors:

Implant denture - available in Salem, MA from Burba Dental
  • Dental implant standards vary among countries throughout the world
  • Think about how you could verify the credentials and experience of an implant dentist in another country
  • How does the foreign dental practice handle follow-up care?
  • What will you do if you experience complications?
  • Who will restore the implants with your final denture?
  • Have you considered all the financial costs involved with dental tourism?
  • How can you verify the reputation of a dental practice in another country?

The Academy of General Dentistry published an article on dental tourism that includes Center for Disease Control (CDC) reminders about what to research before seeking dental care outside of the United States. For each country and facility that you are considering for dental care, research the following:

  • Medications
  • Infection control
  • Antibiotic-resistant bacteria
  • Standards by which facilities are measure

Schedule Implant Denture Consultations

Before you choose a provider or a type of implant denture, schedule consultations with at least two skilled implants dentists with post-graduate implant training. Talk openly with the dentists about your options, concerns, and thoughts about dental tourism.

Burba Dental Partners of Salem, MA sponsors this post.

Porcelain Veneers or Bonding for Chipped Teeth?

I asked my dentist for porcelain veneers in June because my old bonding on two chipped front teeth was worn out. My dentist said she preferred to replace the dental bonding rather than grind my teeth down for porcelain veneers. It made sense to me at the time. So I agreed to the bonding, and when my dentist finished, I could see that it did not match my teeth, which she.

My dentist assured me that she would correct the bonding color and gap, so I returned two weeks later. I did not notice any improvement. I talked to my dentist about my disappointment, and again, she promised to correct it. But I have not rescheduled the appointment because I do not trust her, and I am thinking about finding a dentist for porcelain veneers. Is switching dentists the right thing to do? Also, is there anything wrong with asking for veneers, or should I let another dentist try bonding again? Thanks in advance for your suggestions. Toni from Maine

Toni,

Thank you for your question. Your experience shows that it is unlikely that your dentist can match your bonding to your tooth color. Dentists who use bonding must understand how to manipulate color to achieve a perfect match for your teeth. And hand application of the material makes bonding even more challenging. Still, a trained cosmetic dentist with an artistic eye can achieve beautiful results.

Dental Bonding vs. Porcelain Veneers

Both dental bonding and porcelain veneers will conceal chipped teeth. How do they compare?

Dental bonding

  • Material – Composite can beautifully match tooth color, translucence, and gloss.
  • Application – A cosmetic dentist applies bonding by hand directly on your teeth and layers and sculpts them to achieve natural-looking results.
  • Longevity – If you take good care of it, bonding can last about five years. But it will stain over time.

Porcelain veneers

A dental tool holding up a porcelain veneer
  • Material – Porcelain is more durable than tooth enamel, and like dental bonding, beautifully matches natural teeth. Cosmetic dentists work with artistic ceramists to produce natural-looking veneers.
  • Application – After conservative tooth preparation, a dentist will bond a veneer to each affected tooth.
  • Longevity – Veneers can last eight to twenty years, depending on their quality and how well you take care of them.

Your dentist explained that she prefers bonding over grinding down your teeth for porcelain veneers. But porcelain veneers only require light tooth preparation—if any. So, it seems that your dentist also does not understand the porcelain veneers process. We recommend scheduling an appointment with a trained cosmetic dentist to discuss your options for concealing your chipped front teeth.

The cosmetic dentist at Burba Dental Partners of Salem, Massachusetts, sponsor this post. Please read what our doctors do to provide some of the best dental care in the Boston area.