How Can I Find the Best Cosmetic Dentist for My Case?

I live more than 100 miles from your office. I’m looking for a cosmetic dentist that is closer to home. I would like new crowns, but I’ve had trouble in the past with dentists who can’t get my bite or the crown color right. I don’t want to have five consultations and x-rays from each dentist. My time is limited, and I would like to narrow my choices at home before scheduling appointments during the pandemic. Will you please give me some tips on what to look for in a cosmetic dentist? Thanks, Claude


Thanks for your inquiry. Yes, we have some suggestions. There is a lot of information online about dentists and their practices.

1.      Check patient reviews

Look for online reviews about the dentist. You can check Google My Business pages, Yelp, and Facebook reviews. You can type a dentist’s name, followed by the word reviews to find other sources.

2.      Look for the dentist’s website and a smile gallery

An accomplished cosmetic dentist has a website. Read the doctor’s bio to learn about their training, experience, continuing education, and experience. Look for credentials or membership with the American Academy of Cosmetic Dentistry or the American Academy of Esthetic Dentistry. Also, look for a smile gallery of the dentist’s patients and before-and-after photos of the dentist’s work. Look for current pictures with cases like yours.

3.      Schedule a complimentary visit

Most cosmetic dentists offer a complimentary consultation. Tell the scheduler that you want to see the office, meet the dentist, and talk about treatment options. Many dental practices will schedule five or ten minutes with the dentist or staff and talk about your smile goals. You will have an opportunity to decide if you would feel comfortable at the dental practice. Visit at least two cosmetic dentists before you choose a provider.

Burba Dental Partners of Salem, Massachusetts, sponsors this post. We strive to offer some of the best dental care in the Boston area.

Do I Need Root Calcification Treatment?

Two months ago, I noticed yellow staining on the tooth next to my right front tooth. I asked my dentist to check the tooth last week when I had an exam and cleaning. After taking an x-ray, my dentist said the root canal is calcified, and I need root canal treatment and a new crown to prevent the tooth from fracturing. I’ve never heard of root calcification, so I am unsure if a root canal is my only option. I want to get a second opinion but do not want to see another dentist in an emergency because I delayed treatment. Will you please explain my options? – Thank you. Silas from Delaware


 Thank you for your question.

What Is Root Canal Calcification?  

Root canal calcification is a condition that occurs when excess calcium builds up in the root channels. Tooth trauma is the most common cause of calcification. After trauma, the following occurs:

  • Calcium deposits are a reaction to trauma to help the tooth repair itself.
  • The calcium deposit takes up space in the pulp chamber and root canals.
  • Lack of space makes it challenging for the tooth to heal.

In addition to tooth trauma, calcification occurs as we age when we do not have enough calcium and vitamin C. The root canals can calcify.

Does a Calcified Root Canal Need Treatment?

A calcified root canal needs treatment if x-rays show signs of infection. An endodontist (root canal specialist) may treat calcified roots using these tools:

  • Dental microscope – Assists in finding calcified channels
  • 3-D CT scan – Locates calcified canals for preserving more tooth structure
  • Ultrasonic dental instrument – Removes small amounts of tooth structure and helps the tooth retain strength.

What Happens Without Treatment?

Without treatment, infected calcified channels allow infection to spread in the tooth, your bone, and possibly other teeth.

We recommend scheduling an appointment with a root canal specialist in your area to examine your tooth and determine if it requires treatment. Please do not wait until you have an emergency and possibly end up in the hands of a dentist who is unskilled in treating root canal calcification.

Salem Massachusetts dentist Dr. Randy Burba sponsors this post.

Why Do I Have a Cavity Beneath a Crown I’ve Only Had 4 Years?

After my yearly exam and cleaning two weeks ago, my dentist said the x-ray shows a cavity beneath my upper left second molar. I’ve had a crown on the tooth for four years. So, I asked my dentist why I have a cavity beneath it. She did not give me a clear answer but said she would need to remove the crown to treat the cavity.

My insurance will not authorize a new crown because the current one is less than five years old. I prefer to see another dentist for the cavity because my dentist seems indifferent, and I do not want another cavity beneath the crown. What may have caused a cavity to form? Thank you. Julian from Omaha


Thank you for your question. It is good that your symptoms are not TMJ-related. But issues with a relatively new crown can still be disappointing.

Insurance companies expect a crown to last at least five years before paying for a replacement crown. But most cosmetic dentists agree that a well-placed, high-quality crown lasts much longer—sometimes ten years or longer. Still, crowns cover natural teeth. Although decay will not affect a ceramic crown, you can still get a cavity in the natural tooth beneath it if bacteria can leak in.

What Causes a Cavity Beneath a Crown?

If you have a cavity beneath the crown, possible causes include a damaged or loose crown or a gap where your tooth and crown meet.

  • Damaged or loosed crown – Bacteria can get trapped beneath a crown and lead to decay.
  • Loose margin – If the margin—where your crown and tooth meet is not closed completely, bacteria can leak in. The area must be smooth and without any gaps or roughness. Otherwise, the site can attract bacteria,  plaque, and decay.

Treatment for a Cavity Beneath a Crown

If you have a cavity beneath a crown, in most cases, your dentist will remove the crown, clean the tooth, fill the cavity, and replace the crown with a new one.

Get a Second Opinion

If you have a cavity beneath your crown and are disappointed with your dentist’s response, get a second opinion from an experienced cosmetic dentist. After an examination and x-ray, the dentist can recommend a treatment plan to remove the cavity and replace the crown.  If the cosmetic dentist can examine your crown and detect faulty work, your dental insurance company and a new dentist may support you in asking for a refund from the dentist who placed the crown. The Salem, Massachusetts dentists at Burba Dental Partners sponsor