Tag Archives: porcelain crowns

My $30K smile Makeover Makes Me Look Like Wallace & Grommit

I am devastated. I had teeth that were a bit small and hard to notice when I smiled. I wanted to get porcelain veneers, but my dentist said getting porcelain crowns instead could make my smile look bigger. As that was what I was going for, I agreed. He placed a dental crown on every tooth . The best way I can describe it is I look like Wallace from Wallace & Grommit. I can’t even close my mouth anymore and it is making my mouth so dry it is painful. Is there anything that can be done? I spent my life savings on this.

Lizzie

Dear Lizzie,

Wallace & Grommit

I placed an image of Wallace and Grommit here for the benefit of those who may not be aware of who they are. I can see why you are so devastated. Based on some things you said, I have a strong suspicion your dentist was in over his head.

The Bad News

The porcelain veneers you originally requested would have done the job of making your teeth look bigger without having to damage so much healthy tooth structure.

Many inexperienced cosmetic dentists will discourage a patient from porcelain veneers and suggest porcelain crowns instead because it is a procedure they are used to doing. Unfortunately, even doing something familiar, like porcelain crowns, requires extra training to do beautifully.

Even worse (for patients especially), doing smile makeovers isn’t something taught in dental school. Instead, a dentist has to invest in a significant amount or post-doctoral training. It doesn’t sound like your dentist invested in this.

In addition to his lack of training, he didn’t just try a smile makeover. Crowning every tooth is known as a full mouth reconstruction. It is one of the most advanced things a dentist can attempt. Getting the bite to come together properly (known as occlusion) requires bringing together a lot of factors. He seems to have missed the boat.

The Good News

If the only thing wrong with your smile makeover was the appearance and the function of your smile was okay, you would be completely out of luck. I hate to say it, but the fact that you can’t quite close your mouth and are now suffering from severe dry mouth works in your favor.

Your teeth depend on the saliva in your mouth to keep them healthy. It is a little known fact that there are minerals in our saliva that help to fight decay. When you have dry mouth, it puts your teeth at risk. Because your dry mouth is a direct result of your full-mouth reconstruction, it will have to be re-done.

Getting Your Smile Makeover Re-Done

Your current dentist is in over his head. This leads me to believe he is unable to fix this properly. Instead of asking for him to re-do it or even a refund, I want you to have him pay for it to be re-done by the dentist of your choosing.

The downside is, you are stuck with dental crowns. There is no way to grow back that tooth structure he removed for the crowns so you can have porcelain veneers. However, a skilled and artistic cosmetic dentist can create a stunning smile with porcelain crowns.

In your place, I’d look for a dentist who is accredited with the American Academy of Cosmetic Dentistry. These are the top 1% of cosmetic dentists in the country. You are pretty much guaranteed to get a smile you can’t wait to share. In fact, some of them even have a beautiful smile guarantee.

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

Problem Speaking After Porcelain Veneers

I had ten porcelain veneers put on ten teeth. Ever since then, I have had trouble speaking. I’m not sure what to do. It feels like the backs of my teeth are too thick and my tongue is pushed. It’s making me talk weird. My dentist has no idea what is wrong. Have you heard of this?

Brooke

Dear Brooke,

A single porcelain veneer being held up by a dental instrument

Looking at the image of porcelain veneers above, you can see that it doesn’t have any part of it that goes on the back of your teeth. It won’t affect your speech there. However, there are some dentists who place porcelain crowns and tell their patients it is porcelain veneers. If they surround your teeth, they’re crowns. If they just go on the front of your teeth, they’re porcelain veneers. Sometimes the length of porcelain veneers can affect your speech, but you said it was bothering you from the back. That’s not the same.

If it turns out he place crowns, then he’s not only been dishonest, he’s also thrown off your bite. If that’s what happened, you can get him to pay for these to be re-done by a dentist who has both cosmetic dentistry training (preferably someone who is an AACD accredited dentist) as well has having done post-doctoral TMJ training. That’s the kind of dentist who will know how to repair the bite’s position as well as give you a beautiful smile.

Another possibility is your dentist did place porcelain veneers and the thick feeling in your tongue is completely unrelated. You could have had an allergic reaction to something and that is why you’re having trouble speaking.

How Can You Get Help

The first thing I would do is get a second opinion. I again suggest going to a skilled cosmetic dentist. There is a trick to this, though. Dentists know each other. They are one another’s peer group. So one dentist might hesitate to say something unkind about work their friend did.

This is why you won’t tell them who did the work. First, ask him if you received porcelain veneers or dental crowns. Then, ask him if he knows why you’re having trouble speaking. If he asks for the name of the dentist tell him, you want a blind, unbiased second opinion so you won’t be sharing any names.

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

Root Canal with Porcelain Veneers

I have eight porcelain veneers on my upper teeth. Recently I learned I had a periapical abscess and my dentist says I need a root canal treatment. First, how did I end up needing a root canal to begin with? Second, how do I keep this from ruining the look of my porcelain veneers?

Kaleigh

Dear Kaleigh,

I’m sorry this happened. I can understand your concern about needing a root canal treatment. Most expert cosmetic dentists go their entire careers without a porcelain veneer they’ve placed needing a root canal treatment.

teeth being prepared for porcelain veneers

The picture above is the right way to prepare a tooth for porcelain veneers. Using a depth limiting diamond bur, your dentist should place grooves in the teeth only 1/2 millimeter in depth. Then, they’ll go back and prepare the remainder of the surface to even out with the grooves with a traditional diamond bur. When done this way, there is little stress to the tooth causing the need for additional treatment.

Unfortunately, not all dentists understand that.

illustration of a tooth prepared for a dental crown

Some dentists will be too aggressive in their preparation of the teeth and get all the way down to the dentin. Others do a crown preparation, as seen above. They are actually placing porcelain crowns and just call them porcelain veneers.

This type of aggressive preparation is much more likely to stress the tooth and cause problems. This is likely what happened to you.

Protecting a Porcelain Veneers During a Root Canal

There is no way around getting the root canal. If you leave the periapical abscess there, the infection will cause serious problems and could even put your life at risk. Dental infections still lead to death when untreated.

The good news is, there are steps your dentist can take to preserve the color integrity of your veneer. The majority of darkening which takes place after root canals is because of left behind dentin and root canal filling material. Your dentist needs to thoroughly clean out the crown of your tooth.

From there, he’ll need to place a fiberglass post down into the root. The remainder should be filled with a light colored composite resin.

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

Does a Tooth Infection Cause a Fever?

My child’s dentist told me that a dental infection will not cause a fever. I’m a little confused by this because I was previously under the impression it could. They didn’t seem to want to explain anything. I came across your blog and thought I’d ask you. Can a dental infection cause a fever? Why or Why not?

Camille

Dear Camille,

Woman holding her jaw in pain from TMJ

I think there was likely a communication error here. What they likely meant to say is that a dental infection doesn’t always come with a fever. Often, a dental infection is contained within the tooth and a fever won’t be a symptom. Sometimes, however, it will create a fever. It is an infection. Another symptom some patients have is a feeling of being run down. In fact, I’ve known doctors who when they can’t figure out why a patient feels so poorly will send them to the dentist. If it turns out they have a dental infection, having it removed makes them feel better.

If you and your child are getting regular dental care, it is unusual for a tooth to suddenly blow up. Most of the time cavities can be caught early and you can get a small composite filling. However, if you delay going in or don’t see the dentist regularly, it can grow without you realizing it.

If they decay get’s too large, you will go from needing a small filling to needing a dental crown. If it grows even further, then you’re talking about it reaching the pulp and a root canal treatment will become necessary in addition to the crown. Preventative care is the least expensive dental work you can have.

When Patients Avoid the Dentist

It doesn’t sound like you are someone who avoids dental care. However, I’m saying this for the benefit of others who might be reading this who do struggle. In general, people avoid the dentist for two reasons. The first is financial. The second is fear of the dentist.

If finances keep you from the dentist there are a few options. Some dental plans are inexpensive. They’ll cover your cleanings and check-ups and give mild discounts on the larger ticket items. However, getting those check-ups usually prevents you from needing any of the bigger treatments.

Additionally, most dentists are compassionate and went into the field because they want to help people. If you explain financial issues, they may be willing to allow you to pay out your treatments.

If fear keeps you from the dentist, there are dentists who are great at working with patients who suffer from anxiety. You can do an internet search for them and it may give you the positive experience you’ve been needing to get back to the dentist regularly.

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

Should Dental Crowns Touch

I got a dental crown on a left rear molar. I’m a little concerned that it isn’t touching the opposing tooth. Does that matter or am I making a mountain out of a molehill?

Mike

Dear Mike,

Chart of TMJ and Neuromuscular Dentistry

I’m glad you are checking on this. It matters very much that your dental crowns touch. In fact, it even matters how they touch, this is called occlusion and it is important for proper function of your bite and jaw. If your jaw is properly aligned all your teeth touch when you clench them together.

One way to test this is to place a thin strip of plastic, 0.05 mm thick and the width of a tooth, on your back teeth. You should be able to clench your teeth together and prevent the strip from being withdrawn.

When you have back teeth which don’t touch, they will eventually drift toward each other, but that doesn’t mean they will meet in the right place. A misaligned bite is one of the causes of TMJ Disorder. That is a lifetime of pain which can be avoided by your dentist properly placing your dental crown.

Have your dentist re-do this. If you have trouble getting him to agree, show him this post.

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

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.

Does Cosmetic Dentistry have to be a Fortune or a Failure?

Several years ago, I had four dental crowns placed on my front teeth. I decided it was time to upgrade my smile and had a consult with my dentist. I told him I wanted something which would improve my smile but not cost a fortune. He suggested teeth whitening. I went ahead with that. The rest of my teeth look great, but the crowns now look dingy compared to the rest of them. I don’t know what went wrong, but my dentist said it was probably time to replace them anyway. When he did the temporaries, I realized that the crowns would be ugly. I didn’t want that either, it’d be no better than leaving them as is, but without the extra cost. I decided just to get a consult from one of those touted cosmetic dentists. He agreed the crowns needed to be redone, but insists I need work on eight teeth because of the width of my smile. That will be quite a pretty penny. Do I have to spend a fortune or be left with an ugly smile?

Andrea

Dear Andrea,

Woman giving thumbs up in a dental chair
If you want to have a smile in the dental chair you need to choose the best dentist

You’re in a bit of a tough spot and it’s all because your family dentist didn’t know (and apparently still doesn’t) know a thing about cosmetic dentistry. He should have told you that the teeth whitening procedure you had done would bleach your teeth but have zero effect on your crowns.

However, you were smart to not go through with his re-do of your crowns. His cosmetic skills are non-existent and you’re talking about your front teeth. You want the best cosmetic dentist you can find. The dentist who’s telling you that eight crowns are necessary is likely trying to give you a perfect smile. If you have a wide smile, eight porcelain veneers are common. Sometimes, even ten are necessary.

However, you don’t have to have all eight done. If you’re happy with the color and shape of the two teeth adjacent to either side of your four front teeth, then you can just get four all-porcelain crowns to go with them. A great cosmetic dentist can make your smile look stunning even with those limitations.

Finding the Best Cosmetic Dentist

You may have to find a different cosmetic dentist than the one insisting on eight teeth. Some will only do the ideal. However, you can find incredible cosmetic dentists who will work within your desired smile.

My recommendation is for you to look at two different online resources. The first is the American Academy of Cosmetic Dentistry’s website (aacd.com). The second is mynewsmile.com. Both of these will recommend the best of the best cosmetic dentists in your area. If you use the AACD site, make certain you check that you want an accredited dentist or an accredited fellow. Those are the best.

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

BEST Dentist to Fix Meth Mouth

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?

Linda

Dear Linda,

A pretty blonde with a pretty smile.
The best cosmetic dentists create beautiful smiles

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.

It’s likely they’ll do a combination of teeth whitening, porcelain veneers, and porcelain crowns. Many of them even have a beautiful smile guarantee, so you’ll be sure to get the smile you want.

I’m glad you guys are getting your daughter back.

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

Is a Gray Tooth a Dental Emergency?

I have a tooth that’s turning gray. I’ve tried whitening it but it didn’t help. I wondering if something serious is wrong. Is this like a dental emergency? What if I don’t have a regular dentist?

Carrie

Dear Carrie,

Woman giving thumbs up in a dental chair

A gray tooth is usually a sign that the tooth is dead or dying. Is there a chance that you’ve had some recent trauma to your mouth? That would explain the tooth. You do need to see a dentist soon. You’re going to need a root canal treatment and porcelain crown.

If you don’t have a regular dentist, that’s okay. There are emergency dentists. That’s not a specialty. It just means that they’re regular dentists that are willing to see non-established patients in the case of an emergency. This would be what you need. They’ll take x-rays and get a good look at the damage and go from there.

How Not to Need an Emergency Dentist

Trauma can’t always be avoided unless you’re someone who likes to hang out in front of a ball machine. That’s not recommended.

But, certain things, like tooth infections, can almost always be avoided. The key is regular check-ups. There are usually two reasons people avoid going to the dentist regularly. The first is financial. They don’t have dental insurance so they feel they can’t afford it. Most dentists are willing to let you pay out your treatment. You just need to talk to your dentist ahead of time.

The second is fear of the dentist. Most dental anxieties start in childhood. Some dentists enjoy helping patients with anxiety. Dr. Burba realized that with patients, their fear stemmed from the shot. That’s why he invested time learning how to give pain-free shots. In fact, most of his patients don’t even realize he’s administered the shot at all.

Planning Ahead with Dental Crowns

Like your gray tooth. porcelain crowns will not whiten, even with professional teeth whitening. That’s why it’s important to get them the color you’d like them to be when they’re placed. Your dentist can create them to any whiteness you desire. But, you’ll want your natural teeth to match, so make sure you whiten your teeth before the final color of your crown is decided.

This blog is brought to you by AACD accredited dentist Dr. Randall Burba.

Can Children Get Porcelain Veneers?

My son is almost nine and he fell and chipped his front tooth. It’s a permanent tooth so I want to repair it in a way that will both last and look natural. I had porcelain veneers done several years ago because of stained and chipped teeth and love them. Can children have veneers done? I think he’d only need one.

Carla T.

Dear Carla,

A chipped tooth
Can Porcelain Veneers Fixed Chipped Teeth?

It’s fantastic that you’re looking out for your son’s smile. I especially like that you’re thinking through a permanent solution for him. While porcelain veneers can repair chipped teeth, I don’t recommend them in children.

Their jaws are in almost constant development throughout their childhood. That keeps the way their bite relates to its surroundings in flux as well, making it nearly impossible to keep on without changing it often. While technically do-able, it’s an expensive way to repair his chipped tooth, especially when there are better options.

Repairing a Chipped Tooth Without Porcelain Veneers

There are three basic options for repairing a chipped tooth. I’ll list them from most expensive to most affordable. You can click on each link to learn more.

You’ll have the same problem with porcelain crowns that we discussed above regarding porcelain veneers. However, this also will require grinding down a great deal of healthy tooth structure. Rarely do I suggest that.

Additionally, your son has experienced tooth trauma. You need to schedule an emergency appointment with your dentist so he can check for nerve damage and can take steps to deal with that, if necessary.

Dental bonding is the standard treatment for chipped teeth and it is a lot more affordable. While it will have to be updated every once in a while, it will hold up much better on a growing jaw because of its design.

Because dental bonding is done freehand, you will want to make sure you have an artistic cosmetic dentist to do the procedure.

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