Category Archives: Uncategorized

Will I Need Bone Grafting for Dental Implants?

I think I will need bone grafting for dental implants. I lost most of my teeth to disease and injury and probably need extractions. I’m guessing, though, because I’ve only seen my family dentist about this. Although my dentist says he can do the implants, I am not confident that he has enough experience. I am not comfortable. How will a dentist determine if I am a candidate for bone grafting? Thank you. Rochelle from Denver


Thank you for your inquiry. Your decision to get dental implants will improve your oral health. And you are wised to be cautious when choosing an implant dentist.

Will You Need Bone Grafting for Dental Implants?

You will need bone grafting for dental implants if your teeth have been missing for years and do not have enough bone volume to support implants. Your dentist must take a CT scan to measure your bone volume.

What Is Dental Implant Bone Grafting?

Dental implant bone grafting is a procedure that builds up jawbone volume. When your teeth are missing, your body takes minerals from your jawbone in those areas and uses them elsewhere. As your jawbone shrinks, it will become challenging to support dental implants.

Snap on Dentures
Snap-on denture

Whether you need implants to replace individual teeth or to support a snap-on denture, it may require bone grafting to give implants enough support. The bone grafts need to heal before your dentist places implants.

Bone sources for dental implant grafting

Bone grafting for dental implants can come from your bone—perhaps your hip or below your knee. Other bone sources included a tissue bank or artificial bone.

Are You a Candidate for Dental Implant Bone Grafting?

An implant dentist will need to take x-rays and a CT scan to reveal your oral anatomy, bone volume, and bone health. But you are probably a candidate for implant bone grafting if the following is true:

  • Good oral health
  • Good overall health, including free of gum disease
  • A non-smoker

How to Find a Dentist for Implants

Look at dentists’ websites and review each doctor’s biography for post-graduate training in implant dentistry or partnership with a specialist in implant surgery.

After identifying two or three dentists who meet the qualifications, schedule consultations to discuss details about your case. You can prepare questions and take notes to compare dentists’ qualifications and whether you liked their interaction with you.

Best wishes.

The Salem, Massachusetts, dentists at Burba Dental Partners sponsor this post.

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.

Do I Need Root Canal or an Extraction and Implant?

Three years ago, my wife and I got in an accident that released the airbags in our van. I took a hard blow to my face, and since that time, my front left tooth has been sensitive on and off. My dentist said she would watch the tooth, but it began to turn dark last fall.

I saw my dentist last week for the first time since Covid, and she referred me to an endodontist for a root canal. The endodontist will complete the root canal next week. Will the root canal improve the tooth color, or will I need to see a cosmetic dentist? If I need a root canal and a cosmetic dentist, who will probably recommend a porcelain veneer? Should I get an extraction and dental implant anyway? – Thank you. Gordon from Tampa, FL


Thank you for your question.

Will Root Canal Treatment Lighten a Dark Tooth?

Root canal treatment will not lighten a dark tooth. It often makes a tooth darker. Why would root canal treatment darken a tooth? When a dentist leaves root canal filling material and cement in the portion of the tooth above the gumline, the tooth darkens.

Preventing a Tooth from Darkening After Root Canal Treatment

Your dentist can minimize the darkening effects of root canal treatment with these steps:

  • Remove root canal filling and cement from the tooth crown
  • Bleach the tooth internally
  • Seal the bleaching solution inside the tooth
  • Insert a flexible fiberglass post in the tooth and fill the tooth with composite, or correct the color with a porcelain veneer

When you have most of the structure left on a front tooth, preparing it for a crown can weaken it and increase the risk of it breaking. A cosmetic dentist can correct the color with a porcelain veneer after root canal treatment if your front tooth is intact.

illustration of a dental implant in three stages
Saving your tooth with root canal treatment is better than a dental implant

Unless your tooth is severely damaged and the endodontist (a root canal specialist) cannot save it, it is best to preserve it and avoid extraction and a dental implant. We recommend scheduling a second opinion with an advanced cosmetic dentist to examine your tooth and discuss your treatment options.

The Salem, Massachusetts dentists at Burba Dental Partners sponsor this post. Please read why our patients say we offer some of the best dental care in the Boston area.

My Bulky Dental Bonding Nightmare

My teeth were stained and chipped, so my dentist offered dental bonding as a solution. She said that porcelain veneers were too aggressive. When she finished the bonded, my teeth looked bulky, and even my dentist agreed that the bonding changed my speech. She asked me to give it some time to see if I adjusted. Otherwise, she would remove the bonding.

Last week, my dentist removed the bulky bonding because I could not adjust to how it felt. Also, it made my smile look horrible. Now my teeth look worse before. Not only do I still have chips in my teeth, but they also look patchy. I’m not sure if my dentist knows what she is doing, so I am afraid to let her try again. But what do I ask for from a new dentist – bonding or veneers? Thank you. Shan F. from NJ


Thank you for your question. One of our dentists would need to examine your teeth to see what happened, but we can over some advice.

How Can Bulky Dental Bonding Affect Your Smile?

When dental bonding is too bulky, it can affect you in several ways:

  • Interferes with your speech
  • Creates an unattractive smile
  • Traps food and can lead to tooth decay or disease

Removing Dental Bonding

A skilled cosmetic dentist knows which tools and techniques to use to remove composite bonding without damaging your tooth enamel. Your description sounds as if your dentist might have removed a small amount of tooth enamel.

Rather than covering teeth with veneers as shown, a cosmetic dentist may renew them with veneers

Instead of allowing your dentist to correct her work, we recommend that you schedule a consultation with an advanced cosmetic dentist who will look at your teeth and recommend treatment. Eventually, you will need an examination and possibly x-rays to look for any damage to your teeth. Afterward, the dentist will explain your options and how bonding and porcelain veneers compare.

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

My mouth is swollen and I feel weak

I’ve had a toothache for 2 weeks. Now my mouth is swollen, and I feel weak.  I felt the toothache bothering me in my sleep last night, and my mouth was very dry. After I woke up this morning, I went to the bathroom and saw that the the whole left side of my face is swollen. Also, my eye is almost swollen shut.

It hurts so bad to open my mouth to brush my teeth, and I have to sip water from a straw because I can’t open it wide enough for a cup. I am starting to feel weak, too. I am terrified of the dentist which is why I am in this mess. Is there anything at all I can do to make the swelling go away without going to a dentist? I have an antibiotic that a doctor gave me for an infection in my hand that would not go away. Can I get a refill of this and help the tooth infection? – Alyson


This is not something that you can treat yourself. You have a serious tooth infection that can spread to other teeth, your jawbone, and beyond. If you feel weak, the infection may already be in your bloodstream.  Find a dentist who accepts emergency visits and likes seeing anxious patients. They will offer will understand your fear but also get you the help you need right away.

You can receive sedation to calm you for your dental procedure. The dentist will also give you an antibiotic to take after removing the infection. But you cannot get rid of the infection with an antibiotic alone.

If you need assistance, ask someone for help finding a dentist who will see you right away and offer sedation. You didn’t mention your location, but if you are nearby our office, give us a call.

Burba Dental Partners of Salem, Massachusetts sponsors this post.

Why Did Her Dentist Stain Her Lumineers?

I recently went to the dentist about a smile makeover after I received an advertisement from him about Lumineers. I spoke with him extensively ahead of time about the type of smile I wanted. One of the requests was to have a very white smile. When the Lumineers were placed on my teeth I realized they were darker than I expected. When I questioned him about that he told me he ordered a stain on them so they’d look like natural teeth. He told me I’d realize he was right in a few days. After a few days, I called him back asking him if he could make them whiter. He had me come in and then he drilled off the outer layer to get to the white underneath, but it looks uneven and dull. What do I do?


Dear Melody,

I am glad you wrote. You are dealing with a family dentist who is in over his head trying to do cosmetic work he doesn’t have adequate training for. My first hint was when you said he advertised Lumineers.

This particular brand of porcelain veneers is highly marketed to inexperienced cosmetic dentists as being easy to place. They say this because the veneers are thinner than some other brands which in some cases means there doesn’t need to be any tooth preparation. Unfortunately, in most cases, they end up looking bulky.

A second thing that told me he was not an experienced cosmetic dentist was his attitude. In dental school, we are taught that we know better than their patients. This philosophy does not work with cosmetic dentistry. With smile makeovers, we are creating an image the patient has in their head. Their dream smile. He doesn’t get to tell you what you’ll like.

The stain is also something taught in general dentistry. Most people have at least some stained teeth so your dentist thought that to make your smile look natural he’d have to add one to yours. However, patients don’t pay to get a smile makeover that looks like every other smile. They want something that looks exceptional.

Finally, he bonded your Lumineers on before letting you see them on your teeth to approve them. Experienced cosmetic dentists will use a temporary try-in paste for you to see the smile makeover. If you don’t absolutely love it, instead of bonding it on, they will send it back to the lab to make any necessary changes.

Unfortunately, you can’t get a refund on a smile makeover just because it is ugly. The standard is function. In your case, this is good news. When he filed away the stain, he also took the protective glazing with it. Now they have no protection and will pick up stains quickly. You should be entitled to a refund because of this.

If he gives you a hard time, contact us again and I’ll tell you how to get a refund from a dentist.

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

Can’t Afford the Number of Implants My Dentist Requires

I am losing my teeth and wanted to get implant-supported dentures. My dentist is insisting I get twelve, six per arch. He says it is the only way they will be completely stable. If I can’t afford that am I stuck with regular removable dentures?


Dear Daisy,

illustration of snap on dentures

I’m sorry he’s pressuring you. While it is true that the more dental implants you use to anchor the dentures, they more secure they’ll be. However, implant overdentures can be done with four implants per arch and give you both security from them slipping as well as protection from facial collapse.

If that is out of reach financially, you still have options before having to revert to complete removable dentures.

You could get snap-on dentures, which can use as few as two implants. They will move, but won’t fall out on you. They also give you some protection from facial collapse where the two implants are. This may get you started and you can save up for full implant-supported dentures as you are able.

It doesn’t sound like this is the best dentist for your situation. Some dentists will only do the ideal treatment, not caring about the hardship it puts on their patients who may not have a budget that can accommodate the ideal. In your place, I’d look for a more compassionate dentist.

He was ethically obligated to give you all your options, even if he wasn’t willing to perform them. This also bothers me. As he may not be willing to do the procedure you need for your financial constraints, this is the perfect time for you to find another dentist.

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

Considering a Smile Makeover

I’m seriously looking into investing money in my smile. Are there certain things I should be looking at?


Dear Miranda,

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

You’ll love having a smile makeover. You didn’t mention what you wanted to change about your smile so I’ll give recommendations from a minor makeover to full-blown makeover along with what you should look for in the dentist.

Mini Smile Makeover

Teeth Whitening Alone

If the only thing which bothers you about your smile, then I’d recommend teeth whitening. It is fast and inexpensive all while making a dramatic improvement to your smile. This one procedure can make you look years younger.

Whitening with Dental Bonding

before and after a chipped tooth is repaired

When there are chips and gaps in your teeth, you can repair those with dental bonding. This is where a dentist uses a composite resin and sculpts the missing structure onto your teeth. It’s done freehand so you’ll want to make sure they’re a skilled cosmetic dentist.

If you’re also going to whiten, do the teeth whitening first. The bonding won’t respond to teeth whitening gel so you’ll want your teeth to have the color you’re proud of before having it done.

Whitening with Invisalign

Another option is orthodontics with teeth whitening. These days you don’t need unsightly and uncomfortable metal wires and brackets. Instead, you can straighten your teeth using clear aligners from Invisalign. They’re invisible even at a conversational distance so no one will know you’re straightening your teeth.

There is an added benefit that the aligners can double as teeth whitening trays, which allows you to straighten and bleach your teeth simultaneously. This saves you money.

Complete Smile Makeover with Porcelain Veneers

A single porcelain veneer being placed

If you’re out to get the full-blown celebrity smile, then I’ll suggest you have porcelain veneers done. These use tiny wafers of porcelain to completely reshape your smile. They can change the shape, size, color, and character of your smile simultaneously. It’s the top of the line.

However, doing great smile makeovers isn’t taught in dental school. You’ll want to find the best cosmetic dentist you can to get this done right. In your place, I’d look for an AACD accredited dentist. Dentists who’ve reached accreditation are the best in the country. Most of them even have a beautiful smile guarantee, though you won’t need it.

If you’re just after whitening and Invisalign, any dentist can do that.

Best of luck with your new smile.
This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.

How Do You Avoid a Smile Makeover Disaster?

My friend Cecilia just spent thousands of dollars on a “smile makeover” and it’s awful. The teeth are thick and bulky. They look opaque. In all honesty, she went from having an okay, but not beautiful smile to having horse teeth. I didn’t even have to tell her it was bad. She burst into tears the minute she walked through my door. I told her to ask for a refund or to have it re-done, but she said the dentist thinks it’s beautiful and the problem is in her mind. If I go with her and tell the dentist I agree with her will it help? I was planning on having my own smile makeover. I still want to do it but would love to know how to avoid my friend’s issue. Any tips?

Lucy S. – Seattle


I can tell you right away what went wrong with your friend’s makeover. She went to a family dentist who doesn’t have a great deal of training or experience with cosmetic dentistry. Based on the description you gave of your friend’s new smile, it sounds like her dentist placed Lumineers on her teeth. That wouldn’t surprise me because they’re often marketed to inexperienced cosmetic dentists as being easy to place. Unfortunately, horse teeth are usually what you end up with when someone without skill places them.  They’re just a brand of porcelain veneers. A brand most cosmetic dentists don’t prefer.

I don’t think you going and telling the dentist he did a bad job is going to change his mind. Your best bet is to have her go to an expert cosmetic dentist and have THAT  dentist tell him it was a bad job. An expert cosmetic dentist would never be satisfied with a case in which the patient is dissatisfied. Ever. However, a family dentist, who doesn’t do much cosmetic work will be more interested in what his peers think. If colleague thinks his work is subpar, he won’t want to look bad by not re-doing it.

So, your friend’s problem is how to find an expert cosmetic dentist.  This is your issue too, because you want a gorgeous smile makeover when you decide to go forward with yours. You want to go to an AACD accredited dentist. The AACD is the American Academy of Cosmetic Dentistry. Now bear in mind any dentist can become a member of the AACD, but accreditation has to be earned. Only the top cosmetic dentists reach this level. If you get a smile makeover by them, you’re pretty much guaranteed a gorgeous smile. In fact, many highly skilled cosmetic dentists (like Dr. Burba) have a beautiful smile guarantee.

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

What If My Dentures No Longer Fit?

I’ve had dentures for a long time. They’ve gotten to the point where they won’t stay in.  It’s like my jaw has changed.  Is there anything I can do?

Jeannette N. – Brooklyn


I know exactly what was going on. When your teeth are removed, your body begins to reabsorb the minerals from the roots of your teeth to use elsewhere in your body. It’s a very efficient system…unless you happen to wear dentures. Eventually so much of your jawbone is gone that you can’t wear your dentures anymore.

There is a way to repair this. You’ll need to have some bone grafting done. This will restore bone structure to your jawbone. Then you can have your treatment restored. Ideally, you’d want to get dental implants to replace your teeth. This prevents your body from reabsorbing the minerals and protects your jaw.

If you can’t afford dental implants, you could get snap-on dentures. This will affix your dentures to your jaw using as few as two implants, which saves you a lot of money. Then, as you’re able to, you can add implants.

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