Tag Archives: dental crown

Dental Implants

Can I Get Dental Implants if I’m Allergic to Some Metals?

I have some metal allergies, but I am losing a couple of teeth, in different places. I could get a dental bridge, but that would mean crowning four healthy teeth. I’d really like to get dental implants for those two teeth but don’t know if that is possible with them being made of metal. What do you think?

Benny

Dear Benny,

The Type of Metal Allergy Makes a Difference.

illustraition of a dental implant next to natural teeth

When you said you had a metal allergy, you didn’t mention which metal or metals you are allergic to. That will make a difference in which way you go. Some metal allergies are common, like an allergy to nickel.

Dental implants are made from titanium unless otherwise specified. We’ll get to the non-titanium implants in a moment. Titanium is highly biocompatible and serving in various prosthetics for decades. Very few people are allergic to this particular metal. If your allergy is not specific to titanium, you can just get dental implants without any worries. But, what if your allergy is to titanium?

Zirconia Dental Implants

Metal-free Dental Implants

If it does turn out that you have a titanium allergy, boy do I have good news for you! There are now metal-free zirconia implants. Zirconia is dubbed ceramic steel. They are well witin the requirements to be strong enough to serve as a prosthetic tooth root.

It’s a little trickier to find a dentist who provides these, not because they are sub-par, but because they are newer. Many dentists like to wait until something has been around a LONG time to start incorporating them into their practice. However, it will be worth it to you to find a dentist who does provide them so you don’t have to get those dental bridges. It’s rarely a good idea to place porcelain crowns on healthy teeth. I always recommend keeping as much healthy tooth structure as possible.

Planning Ahead Saves You Money

Another thing I always recommend to someone needing dental work such as a dental crown, whether for an implant, stand-alone, or dental bridge, is they think long term.

If you are ever going to whiten your teeth, the time to do it is before your crown is made. Because the color you choose for your crown is permanent, if you choose to do teeth whitening later, your natural tooth struture will whiten but not the crown. The only way to get your teeth to match then is to replace the crown and have it made the newer color.

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

Dental Implants

Dentist Feels I’m Too Picky

I had to get a dental implant on a front tooth. The implant itself has done fine but I’ve had the crown replaced three different times. My dentist hasn’t been able to get it to match the adjacent teeth. She said it’s because my teeth are between two shades and I’m being too picky. She also said if I keep having her remove it, I risk losing the implant itself. That scares me. Am I being too picky? Should I just accept that false teeth can’t match perfectly?

Lanie

Dear Lanie,

Woman covering her mouth
Your dental crowns can match

One thing I want to tell you right up front is that you are not being too picky and it is possible for your implant crown to match the adjacent teeth. That being said, it may be above the skill set of your current dentist.

Matching a single front tooth is challenging even for the most expert of cosmetic dentists. They often have to do several try-ins before they are satisfied it matches properly. Notice I said “try-ins”. There is a temporary try-in paste your dentist could have been using this entire time instead of permanently bonding it on and then having to pry it off.

Don’t buy into the fear your dentist hinted at. Your dental implant will be safe having the crown replaced. However, you may have to go somewhere else to have it done.

Matching Your Dental Implant Crown

It’s very possible the color of your teeth is between two standard shades. That happens a lot. However, the tooth can still be made to match. While using one of the standard shades is fine for a back tooth, front teeth need some artistry. Below is a color map a dentist would provide for a ceramist to show them what tints to place and where in order to shade the tooth properly and get it to match seamlessly with the teeth beside it.

color map for a cosmetic tooth
Color Map

Your best bet at this point is to ask for a refund on the crown portion of your dental implant procedure. Then, find an AACD accredited dentist. They’ll be able to provide you with a beautiful, natural-looking porcelain crown that matches perfectly.

This blog is brought to you by Salem, MA Cosmetic 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.

Emergency Dentist

Why Is My Tooth Gray After Dental Visit?

I went to see a dentist because of some tooth pain. He did an x-ray but said he didn’t see anything wrong. He decided to cap the tooth because he said the symptoms reminded him of of a cracked tooth. The tooth pain went away, but now I noticed the tooth next to it is gray. Did the dentist do something to it?

Carla

Dear Carla,

Woman holding her jaw in pain from TMJ

When you have a dental emergency, all you care about is getting out of pain. I haven’t seen your x-rays so I’m having to just draw some possibilities.

First, there could have been a misdiagnosis. The only way to tell this with certainty is to have another dentist look at your x-rays and tell you if the true problem was obvious. If it was, then you have a right to a full refund from the original dentist.

Another option is that you did have a cracked tooth which needed a dental crown, then later, the adjacent tooth was injured by something else. Let’s be honest, this is very unlikely. But, as it is a possibility I mention it.

The third option is much more likely. Both teeth could have experienced trauma at the same time but it took the second tooth a while to show it’s injury.

Is a Gray Tooth a Dental Emergency?

When a tooth is gray it means it is either dead or dying. When that happens it needs a root canal treatment. It’s not a dental emergency yet, but if you don’t get it taken care of can turn into one quickly.

You didn’t seem to feel too confident in the dentist who gave you a dental crown, so you may want to let whichever dentist you go to for your second opinion do your root canal treatment.

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

TMJ

Does TMJ Require Surgery?

I’ve been having jaw pain. I did some research to find out what it could be and all the online articles point to TMJ. They also say it can require surgery to fix. I’m only 25 but am completely on my own financially. I don’t think there is any way I can afford surgery. Are there other options? Can they give you a med that allows you time to save up for surgery?

Melissa

Dear Melissa,

Chart of TMJ and Neuromuscular Dentistry

We’re jumping the gun here a bit. The first thing you’d want to do is see a dentist to see if you are suffering from TMJ Disorder. Even if you are, surgery isn’t generally the first go to. Your TMJ Dentist will look for the cause of the TMJ pain first, before outlining any treatment plan.

As you can see from the chart above, there are many reasons why you could be in pain. Sometimes it is something other than the joint itself. For instance, your bite could be out of alignment and starting to wear down the temporomandibular joint.

If that’s the case, your dentist will decide if you need a temporary orthotic to shift your bite and align it into proper positioning, or if you need some additional dental work like a dental implant or porcelain crown.

Only in very rare cases is anything like a full-mouth reconstruction or surgery necessary.

The Key to Proper TMJ Treatment

To ensure you get the proper treatment, you need to make sure you are going to an experienced TMJ Dentist. There isn’t a recognized TMJ Specialty, so it is up to the patient to find out what type of qualifications their dentist has to give them the right treatment.

Don’t hesitate to ask your dentist what type of TMJ training they have. Dental school isn’t enough. It must be post-doctoral work. I’m going to suggest you click here to look at Dr. Burba’s TMJ Dentist page in order to know what type of training you should look for.

Bear in mind, a good dentist will recommend the least invasive treatment for this type of situation first.

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

Emergency Dentist

Will an Emergency Dentist Charge the Cause of the Accident?

I was at a stag party. We were at a pub when one of the group got a little too drunk. He started trouble which ended up causing a fight. The result of which was my front tooth lost a piece and is now loose. I’m assuming I need an emergency dentist, but I’m broke. Will the dentist charge the fee to the moron who started all this?

Casey C.

Dear Casey,

A chipped tooth in need of an emergency dentist
Tooth trauma requires an emergency dental visit

I’m very sorry this happened to you. It’s hard when you’re trying to be responsible and the people around you cause problems. You’re right that this needs an emergency dentist. Your loose tooth needs to be splinted to stabilize it. There are several ways a dentist can do this. What method he or she uses will depend on what other issues your tooth is facing.

He’ll also want to examine it for trauma to the nerves or pulp. Internal damage could mean a root canal treatment and possible crown.

Once the tooth is secure, if there’s no other damage you can fix the broken piece with dental bonding. You don’t have to have the piece that broke. A skilled cosmetic dentist can sculpt a composite resin onto your tooth which will look just like your natural tooth structure and blend in perfectly.

Who Pays for Emergency Dental Care?

Unless the person responsible comes and agrees to pay for treatment, the dentist can’t bill him. He can only bill the person receiving the services or their legal guardian without prior approval. However, you can ask for a detailed bill of the damage and send the bill to the offender. If he has integrity he may just pay. If he doesn’t, you may have to take him to small claims court.

Just be aware, many dentists are willing to work with patients financially, especially those in emergency situations. Just talk to the dentist ahead of time. If he’s not willing to work with you, try Care Credit, though most dentists offer that in-office. It’s a medical credit card that has low and even no-interest payments.

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