Category Archives: Best Dentist

Best Dentist

Botched Tetracycline Case

I’ve had tetracycline stains most of my life. Originally, I had some work done by having dental bonding done over them, but it was time to replace them. I’d since moved to another city and couldn’t see the original dentist. My new dentist suggested we do six dental crowns because it would “hide the stains better.” I did not do adequate research and just trusted what the dentist told me. Now I regret it. The crowns show the stains underneath, especially in fluorescent lighting. Plus, you can tell these are crowns because they look so different from the adjacent teeth.

What do I do here? He’s offered to send them back to the lab, but I’m not sure the results will get any better. Is it okay to ask for a refund?

Lannette

Dear Lannette,

Tetracycline stains are among the most difficlut cosmetic procedures to do. The stains are so dark and so deep, it takes real skill to get the repair opaque enough to cover the stains while still having that natural translucent look. Your dentist likely had good intentions but was in over his head.

Warning Signs He Didn’t Know What He Was Doing

First, he suggested porcelain crowns instead of porcelain veneers. This automatically shows he is not comfortable with cosmetic dentistry. Dental crowns, for this type of procedure, means unnecessarily grinding down healthy tooth structure.

Second, he suggested only six teeth. When we study in dental school we learn about front and back teeth. The first six are considered the front teeth. However, dentists who study cosmetic dentistry, do not divide things into anterior and posterior teeth. Instead, we talk about the aesthetic zone. This is the number of teeth visible when you smile. For most patients, that is eight to ten teeth. Not six.

With those adjacent teeth showing with the dark stains, it makes it obvious your front teeth are crowns.

I agree with you that this dentist is not going to be able to make it any better. I suggest you just ask for a refund. Then go to an experienced cosmetic dentist to do this. The best cosmetic dentists are AACD accredited, so I would look there. Unfortunately, once you have dental crowns placed you are stuck wtih crowns. The good news is an excellent cosmetic dentist can make them look natural and beautiful.

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

Best Dentist

Dental Horror Story

I need some help and advice. I had 20-year-old porcelain veneers I wanted to replace. My dentist decided my bite needed to be opened up as well so people could see my teeth so in addition to 8 veneers he added two dental bridges to the mix. The whole time I was in temporaries I was miserable. I would literally call every couple of days to tell them how much pain I was in. I felt like they weren’t taking me seriously. Then the day came for the permanent ones and he placed them in under an hour. They felt as bad as the temporaries. All the dentist will say is all his checkpoints are textbook and it is just a matter of me adjusting to the open bite. Aside from the pain, my mouth is so dry my lips are sticking to my teeth. I’ve been sucking on popsicles and drinking water and soda all day long just to keep my mouth moist. I’m miserable. What do I do?

Lydia

Dear Lydia,

This is an absolute disaster and none of it is your fault. Let’s start with the fact that he wanted to open your bite. The only way to properly do that is to crown at least every tooth on one arch, so he’s already going about it wrong. While he did do temporaries, which is good and necessary, the purpose of them is to make sure the teeth occlude properly and the patient is comfortable, which by definition includes pain-free.

He didn’t pay attention to one of your complaints and based on your description, you brought your pain to their attention quite a bit and he plowed right onto the permanent restorations without any regard to what you were experiencing.

It is obvious that he opened your bite too much, which is why you are facing all these issues with dry mouth. All his guff about meeting the checkpoints is nonsense. A key checkpoint is that your mouth closes naturally when at rest. If yours were doing that you wouldn’t be having these dry mouth issues. So he’s not being honest there.

On the note of your dry mouth. Please don’t eat popsicles and drink soda to keep your mouth moist. This is decay waiting to happen. The water is okay.

What to Do Next

He’s caused serious damage to your bite. While bad news, it is also good news. Because your case lacks proper form and function, you are entitled to a refund. However, what I’d like you to do is ask for him to pay for the repairs with a dentist of your choosing.

You need a highly skilled dentist in both occlusion and cosmetics to make this right, especially with the damage he did. The top cosmetic dentists are AACD accredited. For the occlusion of your teeth, I’d look at someone with significant TMJ training.

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

Best Dentist

Dentist Destroyed My Smile

I have some abrasion lesions that my dentist decided to help me repair after much begging. Now I think I may have made a mistake. I had a beautiful smile with the exception of the lesions– emphasis on had.

We did dental bonding on the teeth at the gumline and nothing matches. The color my dentist put on there is way too dark and opaque compared to the rest of my teeth. My friends that have seen it have all been quietly polite, but I have noticed the double takes. Is it safe to remove this and have it done by someone else?

Candace

Dear Candace,

I’m sorry you are in this position. This is just one example of why I always tell people who write to not pressure their dentist into a procedure, even a procedure like this one, which should be within their skill set.

Image of a tooth with abrasion lesions

The image directly above is for the benefit of those who may not know what abrasion lesions are. A dentist can simply remove the dental bonding that was done and put new bonding on. I don’t think your dentist is going to be able to do this.

Though technically, with this procedure, any dentist should be able to do it, in most cases of real cosmetic dentistry work, like a smile makeover, you’d need a dentist who has invested in a lot of post-doctral training. As you are going to need another dentist to fix this anyway, I suggest you get the best cosmetic dentist you can. This way you won’t have to worry about another disaster. AACD accredited dentists are in the top 1% of their field. I’d start there.

If you don’t have one in a reasonably close proximity to you, my next stop would be mynewsmile.com. A retired accredited dentist pre-screens every practicioner who wants to be listed. They can’t just pay to get on. Instead, they have to prove their technical knowledge and skill as well as show their artistry. Anyone listed on that site will do a phenomenal job for you.

A Word about Your Dental Bonding

We used to think the reason for abrasion lesions was brushing too aggressively. The latest research, however, seems to indicate it is more the result of someone who clenches their teeth a lot. Clenching makes the teeth flex somewhat at the gumline, this in turn weakens the tooth there and leads to the abrasions.

Because of the flexing, I’m going to recommend you ask your dentist to use a softer, flexible composite bonding material. Otherwise, with a hard material, it could lead to your bonding popping out.

You may also consider having your dentist offer you a custom nightguard. This will help protect your teeth from clenching and grinding, though the night when you are least likely to notice it.

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

Best Dentist

Her Dentist is Incompetent or Dishonest

I need some advice. I have horrible dry mouth which is wreaking havoc on my daily life. I’m constantly drinking water, which means I’m also constantly in the bathroom. In addition to that, my teeth are getting super yellow. I have one crown and two porcelain veneers. When I talked to my dentist, he suggested replacing all those teeth, plus the remainder of them with crowns. He said a full-mouth reconstruction will take care of my aging restorations as well as whiten my smile. This seems pretty aggressive and I have no idea if it will also fix my dry mouth. What do you think?

Katherine

Dear Katherine,

image advising she stop with this dentist

I do not want you to see this dentist again. Either he is either incompetent or dishonest. This is a massive overtreatment. A full-mouth reconstruction is for the most severe of cases. This is not the treatment you need. So, why is he recommending it? Let’s start with the whitening of your teeth. This would bring your dentist a few hundred dollars. With a full-mouth reconstruction, he can bring in between 30-60 thousand. Which one do you think is the better moneymaker for him? To me, this speaks to dishonesty.

Now let’s talk about those two porcelain veneers. He wants to replace these with dental crowns? That can only be because he doesn’t know how to do veneers well enough. So, instead of sending you to a dentist who knows what they’re doing, he hides the fact he doesn’t do that particular procedure and suggests something more aggressive. The best dentists try to save as much tooth structure as possible. Your dentist is more interested in his reputation and his bottom line.

Now, let’s talk about that full-mouth reconstruction. This is one of the most advanced procedures a dentist can do. My gut tells me your dentist doesn’t have the training or skills to pull this off. Not only can it give you permanent dry mouth, but he could also throw off your bite so significantly you are in constant pain with TMJ disorder.

My very strong recommendation is you find a different dentist. In your case, one with great skills and cosmetic dentistry. Look for an AACD accredited dentist. They will whiten your teeth and replace your porcelain veneers and dental crown in a way that is beautiful and blends seamlessly.

About the dry mouth. This will be detrimental to your oral health, which you already know. I’d like you to talk to your medical doctor. It’s possible he has you on some medication which is causing this. If that’s not it, he or she can do some investigating to figure out what is the true cause and hopefully get you some relief.

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

Best Dentist

A Dentist Who Disagrees with Me

I’m a little tired of you saying that a patient has to see an accredited cosmetic dentist if they want a beautiful smile. First of all, cosmetic dentistry isn’t a recognized specialty. It’s an area of interest. Being AACD accredited doesn’t make you better than a dentist who isn’t. You also act like anyone who uses Lumineers doesn’t know what they’re doing. Why does using a specific brand make you less of an expert? All you are doing are scaring patients. You’re probably just doing it to drive them to you. There are other good dentists.

Dr. H.

Dear H.,

Pretty brunette with a beautiful smile
Can a beautiful smile be guaranteed?

You are right that there isn’t a recognized specialty. That’s part of the problem. Any dentist no matter how much or little training they have in cosmetic dentistry can call themselves a cosmetic dentist and do a smile makeover. When they don’t have the artistry necessary, it is the patient who suffers.

What I did NOT say is that only an AACD accredited cosmetic dentist can do a beautiful smile. I’m sure there are dentists on their way to accreditation who create beautiful smiles. However, my blog is here to help patients, not dentists. It is too hard for a patient to investigate each dentist to know which ones will give them a stunning smile and which ones will make them into the next cosmetic dentistry horror story.

How are they to know which post-doctoral schools to look for in their training? Or how to tell from the smile gallery photos whether the gums are healthy?

Accredited dentists have already proven their technical knowledge and artistry. It is an easy way for the patients to know they are getting the best dentist to do their smile makeover.

I’m not saying you have to get accredited to be good. I’m saying being accredited shows you are and gives the patient some measure of security.

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

Best Dentist

Cure for Fluorosis

I used to catch my daughter in the bathroom sucking down whole tubes of toothpaste. We eventually had to lock them up and then supervise her while brushing. Now she has white spots on her teeth and they look a bit splotchy. I did some reading and I bet it is something called fluorosis. Is there anything I can do to help with this? I’m sure as she gets older it will bother her. I was thinking of teeth whitening. What are your thoughts?

Dennie

Dear Dennie,

white spots on teeth

It looks like you are trying hard to stay on top of your daughter’s oral health as well as her cosmetic appearance. You are right that it could be fluorosis. Teeth whitening, while it sounds like a good idea, will actually not help. It will whiten the surface of the teeth evenly. This means the uneven color will still be there only more evident.

You have a couple of options in the treatment of white spots. In some cases, using a treatment called Icon can work. That would be my first try because it doesn’t require any detailed cosmetic work.

If that doesn’t remove the spots, your other options are cosmetic. She’s too young for porcelain veneers. That will be an option after her teeth are fully developed. I would go with dental bonding. This uses a composite resin the dentist will hand sculpt onto her teeth and cover the white spots. However, this isn’t the type of procedure your average dentist can do. You will need an expert cosmetic dentist.

Finding a Great Cosmetic Dentist

Many people do not realize that cosmetic dentistry isn’t a recognized specialty. Any general dentist can call themselves a cosmetic dentist regardless of the amount of training they have put into developing their cosmetic skills. This is not something dentists learn in dental school. They have to invest time and training post-doctorally.

The best cosmetic dentists have reached accreditation with the American Academy of Cosmetic Dentistry. They are among the top 1% of cosmetic dentists in the country. However, it is not always easy to find one near you. If you run into that problem, an equally good option is to go to mynewsmile.com. They pre-screen cosmetic dentists for their training and artistic ability. They can also do a fine job for your daughter. Most of them are accredited or almost accredited (a process that takes years).

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

Best Dentist

Blacklisted by Best Dentist

I’m afraid I’ve been blacklisted by the best dentist in the area. He came highly recommended by several of my friends. They’ve all been to him for various cosmetic procedures, from whitening through veneers, and everyone says such wonderful things about him. Maybe I built him up too much in my mind, but I recently went in for a consultation about having my teeth fixed up a bit. I have some awkward spacing and one tooth is a little twisted. I wanted to have them straightened out and whitened. Everything seemed fine. I met him and thought he was fantastic. He talked up veneers and I felt great. But, then his assistant came in after and gave me the estimate—it was thousands more than I could afford. I asked if there were alternative solutions and the girl huffed at me a bit and then went and got the dentist. He came back and basically told me that if I didn’t want to do it his way, I shouldn’t be in his office.

I was devastated. I really thought this guy would be great, but I can’t afford to go through with the treatment and my friends keep asking me when I’m going in to see him. I have absolute faith in his capabilities, I just wish he’d work with me on treatment. Is there any way to salvage this?

Thanks,

Anonymous In MA

Dear Anonymous,

Woman giving thumbs up in a dental chair
How do you know if you have the best dentist for your needs?

Let’s be realistic for a moment here. If he was the best dentist, would he be treating you this way? The answer is no.

He’s Not Taking Good Care of You

Perhaps he has amazing artistic skill and can craft beautiful smiles, but that’s only half the battle. Being able to make patients feel comfortable and helping them get around their barriers is equally important. In your case, cost is a barrier.

A good dentist would understand this and pitch solutions that work within your limitations. Perhaps you might be better getting six porcelain veneers instead of two or four. Maybe that is the best way to improve your smile. At the same time, maybe two will provide you with adequate results and be a bit more affordable. Or, perhaps Invisalign combined with teeth whitening is a better option for your budget. There are always multiple approaches. If he isn’t willing to explore them with you, he’s not doing you justice.

You Can Find a Better Dentist

Go have a consultation with another dentist and be upfront about your budget from the onset. A great dentist will go over your options with you. For what it’s worth, you don’t have to explain to your friends why you’re seeing someone else. The prior office has an obligation to keep your information confidential, so unless you tell your friends why you left, they never need to know.

This blog is sponsored by Salem Dentist Dr. Burba.

Best Dentist

Does it matter who does your crowns?

I have been diagnosed with TMJ Disorder. My dentist said he’d like to do what he calls a full-mouth reconstruction to repair it. As he explained it, that means crowns on every tooth. I’ve had a single crown done before. Does it matter that I’m getting all crowned for a TMJ problem? Does that require a specialist?

Sara

Dear Sara,

Woman giving thumbs up in a dental chair
How do you know if you have the best dentist for your needs?

One of the problems patients in your situation run into is there aren’t recognized specialties in either TMJ, recognstructive, or cosmetic dentistry. All of those of important areas of knowledge and skill for a dentist to do a full-mouth reconstruction.

This is a serious procedure which costs a great deal of money. While some pretty severe cases of TMJ Disorder do require drastic treatments, I always recommend you get a second opinion from a dentist with a lot of TMJ training before moving forward to see if this is really what you need.

Finding the Best Dentist for a Full-Mouth Reconstruction

As I mentioned earlier, the best dentists for a full-mouth reconstruction have expertise in TMJ, occlusion and restoration, as well as cosmetic work.

The occlusion, TMJ, and restoration is to make sure the bite is technically correct. You need the bite to line up correctly in order to help aide in the healing of your TMJ disorder. Look for dentists who’ve studied these type of topics at one of the following school:

  • The Dawson Academy
  • The Las Vegas Institute of Advanced Dental Studies
  • The Kois Center

There are other great ones as well, but these are three of the best.

The cosmetic work is important so you’ll have a smile you’re proud of. In reality, it’s a great opportunity to get a stunning smile. If you are looking for the top of the line cosmetic dentists, you want to find a dentist who’s reached accreditation with the American Academy of Cosmetic Dentists. They are in the top 1% of cosmetic dentistry in the country.

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

Best Dentist

Best dental treatment for a chipped tooth

If you have chipped a tooth, what’s the best dental treatment for restoring it?

Examination

A chipped tooth needs to be examined first to determine the extent of the damage. The location of the chip and the extent of the damage  in your tooth affect which dental treatment options will give you the best results.

Treatment options

Minor chip

A minor chip at a corner of the tooth can be quickly restored. If the piece of the tooth that chipped off is saved, it might be possible to bond it onto the tooth.

If the chipped portion is not available, it can be filled in and beautifully concealed with dental bonding. A skilled cosmetic dentist will give you the best results. He or she has a variety of shades of composite that can be mixed and manipulated to create a lifelike appearance that matches the color and translucency of the damaged tooth.

The restoration is usually completed in one visit—provided there is no internal damage to the tooth. Dental bonding stains over time and may need to be removed and reapplied.

Some patients choose to conceal a chipped tooth with a porcelain veneer, but this treatment is more expensive than dental bonding, more invasive, and requires light preparation, or shaving of your tooth, to help the veneer fit properly and prevent it from looking bulky.

Severe chip

If there is a severe chip in a molar tooth, it may need to be protected with a dental crown.

An extensive chip can affect the pulp of a tooth. When the pulp is damaged, the tooth can become infected and the infection can spread. In this case, a root canal treatment is needed.

When a tooth is weakened by a crack or fracture, it’s important to get treatment for it right away. The force of biting or chewing over time can cause the crack or fracture to get worse.

Find an experienced cosmetic dentist to restore the tooth. He or she will let you know your options for restoring your tooth. As the photos below show, you can find if you find one of the best cosmetic dentists in your area, bonding will be so beautifully done that you won’t be able to tell your tooth was ever chipped.

This post is sponsored by the dentists of Burba Dental in Salem, MA.

Best Dentist

Affordable full-mouth reconstruction

I never was able to go to the dentist as a child. My parents never had the money. I used to resent them for that. But, I had saved up money to go to the dentist and now I understand. This dentist told me I need a lot of work and suggested what he called a full-mouth reconstruction. This is way beyond anything I can afford. In fact, it costs more than all the cars I’ve owned put together. Is there an affordable way to get this done?

Keith

Dear Keith,

Woman giving thumbs up in a dental chair
How do you know if you have the best dentist for your needs?

Dear Keith,

Our parent’s actions often seem more understandable as we age, however, avoiding the dentist altogether is never recommended. It will actually end up costing you more money in the long run, something your parents just may not have understood.

That being said, I don’t think this is the best dentist for you to be seeing. He’s jumping a lot of guns. I don’t know if he’s doing that because he’s lazy or because he is trying to milk you for as much as he can. Either way, you want a different dentist.

A full-mouth reconstruction means grinding down all of your teeth and placing dental crowns on all of them. This can only be done by the top 1-2% of dentists in the country.

It takes advanced training in both restorative dentistry and aesthetics. Not many dentists have this. If it’s done incorrectly, it can completely destroy your bite, leading to severe TMJ problems.

Find a Dentist Willing to Work Hard

What you need instead is a dentist willing to work hard to preserve as much of your healthy teeth as he can while taking care of the issues that have further and need treatment.

Affording this is easier too. You simply have the dentist list out everything that needs to be done to your teeth without wasting unnecessary structure.

Ask him to list it out from most urgent to least. This way you can do what’s known as phased treatment. You work on the urgent things so you don’t end up with a dental emergency, then slowly (as you are able) get the next thing done.

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