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?
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.
I recently read on Dr. Hall’s blog about a woman who was having a full-mouth reconstruction. Yes, this is mostly for function, however, it’s important it looks good as well. This poor woman had so many problems. Her dentist made the top teeth darker than the bottom, they weren’t the color she wanted (he told her she picked the wrong color), then one of the teeth were sharp.
When she mentioned that, he essentially said she’s too demanding and he can’t help her. She had the choice between having horrible teeth bonded on or leaving without teeth. She asked him to use a temporary bonding and he refused.
This is a horrific situation. If you want to read her complete post, you can here. However, the more important thing is knowing how to not end up in that type of situation to begin with.
Getting an Expert Cosmetic Dentist
This man wasn’t a true cosmetic dentist. I know that not just by his obvious lack of skill, but also by the manner in which he responded to her about the color as well as her dissatisfaction.
A true cosmetic dentist would have always deferred to the patient’s desires. Not only that, a temporary try-in paste is an automatic given.
If you’re looking for a great cosmetic dentist, your best bet would be to go the American Academy of Cosmetic Dentistry website (aacd.com). They have a “find a cosmetic dentist” link. Now, here’s the thing. Any dentist can become a member of the AACD. What you want is someone who is accredited by them.
Accreditation is only achieved after passing both oral and written exams, as well as proving the artistry of their work. They have to turn in photographic evidence of a large number of cosmetic cases they’ve done.
If you want to avoid a situation like the one I mentioned, make sure you get an accredited dentist. Dentists who are accredited are the top cosmetic dentists in the country. They could give you a gorgeous smile makeover.
I’ve always hated my smile and am considering getting a smile makeover. However, my husband mentioned something that gave me pause. He asked me what happens if I spend all that money and hate my smile makeover? It’s a valid question. He’s not just asking because he doesn’t want to spend the money. Do you have an answer for that? Does it vary from dentist to dentist?
Your husband asks a great question, one I wish more patients would ask before investing in their smile makeover. The answer varies from dentist to dentist. But, that being said, there is a “right” answer your dentist should be giving you. If they don’t give the right answer, go elsewhere.
A smile makeover is a work of art. Therefore, the first thing you should do is make sure you’re getting an artist to do it. If you were going to commission a portrait, I’m sure you’d check out the reputation and skills of the artist first. Please do the same with your cosmetic dentist.
Ideally, you’d want a dentist who’s reached accreditation level with the American Academy of Cosmetic Dentistry. AACD accredited dentists have guaranteed technical skill and artistic prowess. You will get a stunning smile through them.
However, just because something is stunning, doesn’t mean it’s what YOU dreamed of.
What You Should Expect From a Cosmetic Dentist
Your cosmetic dentist should sit down with you and have a consultation about what is your dream smile. You can bring pictures or discuss the character you’re going for. For instance, do you want a sporty smile, an authoritative smile, a youthful smile? All of these are formed with different shapes.
He or she should also let you test drive your porcelain veneers after they’re created using a try in paste. You should get to look at them in several types of lighting and also have your family and/or friends look at them. If you LOVE them (and I mean really love them) great. If not, your cosmetic dentist should be willing to go back to the drawing board.
Most skilled cosmetic dentists call this a beautiful smile guarantee. If they don’t offer one, walk away. Once you’re satisfied, then and only then should you allow him to permanently bond them on.
I hope this helps! Enjoy your new smile. It will bring with it amazing doses of confidence.
My daughter has come a long way. When she was 14 she ran away. She came back this year at 19-years-old. I barely recognized her. She was too thin and completely strung out on drugs. She could barely talk. I couldn’t believe this was the same little girl who used to cuddle in my lap while I read Little House on the Praire books to her. We took her back in. She was addicted to meth but once she could communicate told us she’d do anything to get her life together and she meant it. She’s completely off drugs. She got her G.E.D. and is preparing to go to a local university. I’m super proud of her. One of the things which still embarrasses her and I’m afraid will hurt her employment opportunities is her teeth. She has what I now know as meth mouth. I want to fix her teeth so she can feel confident when she smiles. But, I understand this is a gargantuan task that requires more than your average family dentist. How do I go about finding the best dentist to give her the beautiful smile she deserves?
What a great moment that must have been to get your little girl back. It reminds me of the prodigal son in the Bible. It sounds like you have good reason to be proud of the changes she’s made. None of that could have been easy for either of you. I’m sure just her coming off the meth was a torture you’d never want to experience again.
It’s good that you recognize this is above the abilities of most dentists. These type of smile makeovers require immense skill and artistry. You need not just one of the best dentists. You need the best of the best. My suggestion would be to find a dentist who’s reached accreditation level with the American Academy of Cosmetic Dentistry. AACD Dentists are among the top 1% of dentists in the country. They’ll be able to give your daughter a stunning smile.
Everyone I know who have dentures have an ugly smile. I’m losing my teeth and need to replace them. I am going to save up for dental implants, but in the meantime I need dentures. I don’t want an ugly smile. Is there a way to get attractive, normal looking dentures?
Yes, you can certainly have an attractive smile with dentures. It’s not the procedure which makes the difference in appearance, but the dentist. In order to have a natural and attractive smile, you need to see a cosmetic dentist with a lot of expertise.
There are different levels of artistry in cosmetic dentists, just like there are better and worse painters and sculptors. Any art is a skill which takes both technical skill, natural talent, and lots of practice. So, how do you find such a dentist?
I’m sure your dentist has explained the dangers of dentures to you and that’s why you’re saving up for dental implants. One thing you could do starting out is to get snap-on dentures. This can be done with as few as two dental implants and will at least get you started.
Make sure that whoever you go to for your dentures also has some expertise in dental implants as well, especially because you’re going to be transitioning. They can do your snap-on dentures or even complete removable dentures in a way that will make the process easier.
The Danger of Dentures
In case your dentist didn’t explain why implants are the better option I’m going to put it here for you and for the benefit of others. Once you remove your teeth, your body will begin reabsorbing the minerals in your jawbone to use elsewhere throughout your body. This causes your jawbone to begin shrinking. Eventually, you won’t have enough jawbone left to even retain your dentures, making it nearly impossible for you to eat. This process is known as facial collapse.
Dental implants prevent facial collapse because the root form tricks your body into thinking you still have natural teeth there and it leaves the mineral in place, saving your jaw bone structure.
I had several porcelain crowns placed on my front teeth. They’ve served me well for over fifteen years. One has always had a minor defect you couldn’t see just by looking. My dentist told me about it and offered to do a different crown, but she did say that even our natural teeth have minor defects and it shouldn’t be a problem. I appreciated her honesty and her willingness to make an entire new one. I didn’t feel that was necessary and their longevity has born that out. Today, however, I noticed I can both see and feel the defect. I’m sure it needs to be replaced at this point, I’m just wondering if it is a dental emergency or I can wait. The original dentist has since retired and her replacement and I are just getting to know one another so I don’t yet have the same confidence in her.
It sounds like you and your old dentist had a wonderful doctor-patient relationship. It’s certainly hard to lose a trusted caregiver. Hopefully, her replacement will end up being equally honest and skilled. While this change in your dental crown isn’t necessarily a dental emergency, I don’t want you to get too comfortable and let this slide. You do need to be seen.
The fact that you can now see and feel the defect tells me it’s cracked. It will at some point completely break. Those type of things inevitably happen at the worst possible moments, like when you’re on vacation or out to dinner. It’s much better for you to get this dealt with well before it can become an emergency issue. Plus, it will give you peace of mind knowing it’s no longer at risk of breaking.
Who Should Replace Your Dental Crown?
You’re not familiar with your new dentist yet, so before you allow her to replace your porcelain crown, you will need to research her cosmetic skill. At the very least check out her smile gallery. It’s a collection of before and after pictures of cosmetic work she’s done. You can click here to look at Dr. Burba’s work to get an idea of the type of quality you want. These are front teeth so you want them to be beautiful when you smile.
Some dentists would try to persuade you to replace all the crowns so as to make them easier to match. That’s usually a sign they’re not top-notch cosmetic dentists. The crowns are aging, so if you want to go ahead and replace all of them, that’s fine. But, you mentioned they’re still in good shape. In that case, you really only have to replace the broken one.
Replacing a single crown to your remaining teeth takes an expert cosmetic dentist. I’d suggest you look for a dentist who’s reached accreditation level with the American Academy of Cosmetic Dentistry. AACD accredited dentists are experts in their field both in technical skill and artistry. They’ll match your crown perfectly.
I’ve recently moved and need to find a new dentist. I’ve been to the same one most of my adult life so it feels weird switching. How do I find the best one available?
Wouldn’t it be great if there was some independent, objective measurement to tell us who the best dentists were? Unfortunately, especially when it comes to general dental care, there isn’t. That doesn’t mean I can’t give you some guidelines to help you find the best dentist for your particular needs.
The first thing to ask yourself is what type of services do you need? Are you strictly and nuts and bolts guy who just wants his teeth cleaned and maintained as necessary? Or maybe you also want some cosmetic work done? Once that’s decided, it gets a little easier.
Finding the Best General Dentist
For the basics, I’d simply do an internet search for dentists in your area. Then I’d take two additional steps.
Check their reviews.
You’ll want a dentist people enjoy seeing. One who makes them feel like family instead of just someone they need to get in and out of the dental chair. Reviews are generally written by those who are thrilled with the service they’ve received or hated it. Either one should give you the information you need.
Check their passion
Each state has a requirement for how many continuing education hours a dentist has to do to keep their license. You want a dentist who not only keeps up with the developments in his field but has a passion for it. Make sure they go above and beyond what is required. They shouldn’t be offended to answer a question on how many continuing hours they do.
Finding the Best Cosmetic Dentist
It’s a little easier to find the best cosmetic dentist. Because there isn’t a cosmetic dentistry specialty, there used to be no way for patients to know who would give them a gorgeous smile makeover with porcelain veneers and who would give them a cosmetic horror story.
Fortunately, the American Academy of Cosmetic Dentistry stepped in and created an accreditation program. This tests dentist both with written and oral exams gauging their technical knowledge. Then, it requires them to provide visual evidence of a large number of cosmetic procedures they’ve done to ensure they not only have technical skill but artistry as well.
If a dentist is AACD accredited, that means you will get a stunning smile. In fact, most of them have a beautiful smile guarantee.
I had crowns placed on all my front teeth about 17 years ago. Since then, my dentist passed away. I’ve been happy with his replacement, up until now. One of my porcelain crowns started to feel loose. I looked at it closely and there’s a dark spot on the top edge. I went to see the dentist. He said there’s decay at the edge and the crown needs to be replaced. But, (and here’s the catch) he says I have to replace all of them if I want them to match. That’s a LOT of money. Is that really necessary or can I wait until they need replacing individually?
Dear Mara Lynn,
Believe it or not, the images above are of the same smile. In both pictures the patient had dental crowns placed. The only difference was the quality of the cosmetic dentist she used. I’m guessing your current dentist is more like the one on the left. He’s not a cosmetic-oriented practice, therefore his skill is limited.
It sounds like the margins on your porcelain crown opened, leaving a little ledge ideal for the development of decay. At the very least, the one with the decay needs to be replaced.
When your current dentist says your crowns won’t match if he doesn’t re-do all of them at the same time, he not lying to you. He’s admitting the limitations of his skill. In this case, you have two choices.
Choosing a Cosmetic Dentist to Re-do Your Smile
Just replace the crowns as needed to save money.
You’ll definitely need a new cosmetic dentist in order to do it this way. A good cosmetic dentist CAN just match one crown to the rest of your teeth. They won’t need to do the entire arch. The first thing I’d do, though, is check all the crowns for suspicious marks and open margins. You’ll want to replace any of those at this go-round before they turn into decay. After that, it’s fine to just change them as you need to.
Replace them all at once to save time
Even though this is what your dentist suggested, he did it for the wrong reasons— to cover his lack of cosmetic skill. Because of that, I’m not sure you’d be happy with his results. I believe you’d be better served with another dentist in this case as well.
The top cosmetic dentists in the country are those who’ve reached the accreditation level of the American Academy of Cosmetic Dentistry (AACD). AACD accredited dentists create beautiful smiles. In fact, most of them even have a beautiful smile guarantee.
On a side note, you’ll be much more comfortable using sedation dentistry to have that much work done in one sitting. You can simply go to sleep (if you want to) and when you wake up all the work is done.
I don’t have a very good cosmetic dentist. He’s great for a lot of general dental work, but even he admits his cosmetic work needs work of a different kind. I appreciate his honesty but it leaves me in kind of a bind. I want to get porcelain veneers. He said he’s fine with me going to another, more experienced cosmetic dentist for that particular procedure. He even recommended someone he said was AACD accredited. He said that’s a huge deal. Not sure why. Anyway, I went to the AACD guy and had a free consultation. He was nice and I could tell by his picture gallery of patients that he does great work, but his prices were through the roof. Today I saw this website for press-on porcelain veneers. The pictures looked pretty to me and they were A LOT less expensive than the guy my dentist recommended. Do you know about these press ons? Are they really as good as the ones by a cosmetic dentist?
First, I really appreciate the honesty of your dentist. Some, less caring practitioners might be tempted to just do their “best” porcelain veneers knowing they’d be subpar but wanting the practice or the money. Instead, he was forthright and even suggested another, more qualified, dentist.
Not just that, he was careful to recommend an accredited dentist with the American Academy of Cosmetic Dentistry (AACD). These are the top 1% of cosmetic dentists in the world. Yes, their prices are sometimes a bit higher (though not always). That’s usually because they’re so skilled and artistic that they’re in high demand with patients wanting cosmetic procedures, such as porcelain veneers. In fact, there are people who travel across the country or even from other countries to have their work done by them.
If you went to one of them you would definitely get a stunning smile. Probably every one of them has some form of a beautiful smile guarantee.
Porcelain Veneers versus Press-on Veneers
The press-on veneers you saw on that website are completely different from the veneers you’d get from a skilled, artistic cosmetic dentist. They’re more similar to what you’d get with a snap-on smile. They’re made from a composite resin and just press over your teeth temporarily. While they may look great for a photo shoot, they do not look nearly as stunning or natural in person.
Because the press-ons fit over your teeth, instead of being custom made and bonded to your teeth, they tend to come off a bit bulky and a little long. It can make it difficult for patients to speak when they’re in.
There are some procedures you can shop around and cut corners on. Teeth whitening is one example. It doesn’t really matter which dentist does that procedure. It’s fairly straightforward. Going for the cheapest dentist, in that case, will do no harm. Veneers are different. They require expertise in both technique and artistry.
If you want a true smile makeover, it’s an investment that will last a lifetime, giving you stronger confidence than you’d imagine.
I’ve had dentures for 20 years. I’ve never liked them and have been quite embarrassed about my smile ever since. I now mostly smile with my lips closed. But, things have been getting quite worse. Lately, they’ve been painful and difficult to keep in. They’ve even fallen out once while I was in public. Talk about humiliating. This likely means I need a new pair of dentures. Since there have been 20 years of developments in dentistry, I’m hoping that means dentures can be made pretty now? Pretty please tell me that’s the case.
I hate hearing stories like yours. It saddens me to know you’ve spent this much time ashamed of your smile. You’re right that there have been improvements in the dental field. In fact, there’ve been remarkable improvements. I’ll share several of them in a moment. First, I want you to know that you can definitely have a gorgeous smile, even with dentures. You could have when you first received dentures, too, had your dentist been skilled in the cosmetic end of dental care.
Let’s start with the beauty of dentures. Even back when you received your dentures, a skilled, artistic cosmetic dentist could have prepared a stunning set of dentures for you where you’d be thrilled to share your smile with the world. However, now you have a second chance to get that gorgeous smile.
Fixing Your Denture Problems
The reason your dentures no longer fit properly and are falling out is a condition known as facial collapse. It’s a result of the length of time your teeth have been removed. You can learn more about this on our problems with dentures page. The end result, however, is you no longer have enough jawbone to support any form of tooth replacement, including dentures.
All is not lost, though. The first thing you’ll need to do is have some bone grafting done. This is a relatively simple procedure (if the dentist knows what they’re doing) which can build back up the jawbone that you’ve lost. It can be done in one appointment, but you will need some healing time afterward for the bone to be secure.
After that, you have several options:
Get New Dentures Made
Obviously, the first solution is to just have new dentures made. If you want them to be beautiful, though, you’ll need to go to a skilled cosmetic dentist. There isn’t really a cosmetic dentist specialty, so any general dentist can perform cosmetic procedures. The problem with that is their results vary. So, you need to do some research to determine if this is a skilled artistic dentist or not.
The absolute easiest way to do that is to simply go to an AACD accredited dentist. The AACD is the American Academy of Cosmetic Dentistry. Their accreditation program is designed to weed out the pretenders from the truly artistic cosmetic dentists. If a dentist has reached accreditation level with the AACD, you can be assured you’ll get a beautiful smile.
You do need to be aware, though, is if all you do is get dentures again, you’ll still face your jawbone shrinking and have to go through this whole procedure all over again in about 10 to 20 years.
Get Dental Implants
The best way to prevent dealing with facial collapse after you’ve had your bone structure repaired is to get dental implants instead of dentures. These implant prosthetic roots into your jawbone causing your body to realize there is still a need to support your teeth, which leaves your jawbone completely intact. However, some people find dental implants out of their budget. Fortunately, there is a middle ground.
Get Snap-on Dentures
These are dentures which are supported by dental implants. They’re considerably more affordable than a full set of implants and can help your dentures stay in place. Obviously, the more implants the better the support, but you can get them with as few as two. Then, as you’re able, you can add more implants to secure them further and protect additional bone.