Tag Archives: porcelain crowns

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 apparantely 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 insisiting 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 on 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.

Replacing all Crowns because of One?

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?

Mara Lynn

Dear Mara Lynn,

Side by Side images of dental crowns done by two different cosmetic dentists on the same smile. One is ugly. One is beautiful

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.

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

How Do I Know if I Have TMJ or TMD?

I’m at a loss. I’ve been doing some research and have narrowed it down to two conditions, but I can’t tell the difference between them so don’t know who to see.
Here are my symptoms:

  • Jawpain
  • Headaches
  • Clicking in jaw
  • Teeth have shifted

Do I have TMJ or TMD? Who do I see for it?

Marilyn

Dear Marilyn,

A Chart showing how joints muscles and teeth all work together in TMJ

I understand why you’re confused. These two acronyms are used interchangeably. TMD stands for Temporomandibular Disorder. TMJ stands for Temporomandibular Joint. When the joint is out of alignment, which can happen for several reasons as seen in the chart above, it causes TMD.

Your symptoms are pointing to this disorder, whether you call it TMJ or TMD. You’ll want to see a dentist, but not just any dentist. First, not all dentists treat it because it is so complex. Secondly, some do treat it who shouldn’t. You really want a dentist who’s invested significant training in diagnosing and treating this disorder. As an example, look at Dr. Burba’s TMJ Dentist credentials. This is the type of dentist you want to find in your area.

What to Look for in TMJ Treatment

Because TMJ is so complex, it is imperative your dentist finds the underlying cause of your TMJ in order to begin proper treatment. You also want to start with the least invasive treatment possible. For instance, if it turns out your problem has stemmed from nighttime grinding, the first thing to do is protect your teeth from any further damage.

From there, you can take up repairing the damage. Maybe your teeth are ground down to nubs and you need dental crowns. Or possibly, your teeth have been pushed out of place and you need Invisalign to realign your bite. Maybe you need a combination. The key is a dentist who knows what to look for.

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

Do I Really Need to Destroy Healthy Teeth to Fix TMJ?

I’ve been having horrible jaw pain and merciless migraines. Sometimes it’s so bad I can’t even eat and have to drink my dinner of broth through a straw. I went to several doctors and two different dentists before I was diagnosed with TMU. But, he says the only way to fix it is to crown all my teeth to fix my bite. That would mean not only a fortune in dental bills, but destroying healthy tooth structure as well. Is that really the way to go?

Sydney C.

Dear Sydney,

Sometimes a full-mouth reconstruction is the only option, but it’s usually used as a last resort. There are several other treatments which should be tried before that. Additionally, it takes a significant amount of reconstructive and TMJ training to do a full mouth reconstruction. Done incorrectly, it can cause even more pain then what you’re currently in now.

Also, if you do need it, you may find a dentist who uses the composite resin, like you get for white fillings to adjust the bite instead of porcelain crowns. However, don’t push a dentist to use one type of treatment or another. It’s best they use the materials they’re most comfortable with.

In your place, I’d like to see you get at least two more opinions from dentists with lots of TMJ expertise. For instance, Dr. Burba studied at both the Dawson Academy and Spear Institute. Both of these give advanced training in TMJ. There’s never any harm in asking a dentist what type of training and success they’ve had in specific procedures, especially when you’re talking about such a huge, invasive procedure.

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

Who’s the Best Dentist for a Recovering Bulimic?

I’ve struggled with bulimia for years and am finally on the road to recovery. It’s been hard but I’m doing much better recently.  One of the things I’m doing is trying to repair some of the damage my purging has caused. My teeth are in bad shape and I caused it. I need to find the right type of dentist for this. I don’t want one who’s going to make me feel any worse than I already do.

Meredith G.

Dear Meredith,

Wow! You’re a strong woman. I’m proud of the dynamic recovery you’ve made thus far. I appreciate the steps you’re trying to take. You’re also wise to try to find the best type of dentist for this situation.

You’ll want to work with an expert cosmetic dentist. They have the experience in working with bulimic patients. Plus, you’ll be certain whatever work they do will be beautiful.  The last thing you need at this stage of your recovery is shoddy work which makes you feel worse about yourself.

The dentist will want to look at the damage to the back of your teeth. Your purging causes a lot of acid to attack the back of your teeth. It may be that will cause you to need some all-porcelain crowns, but don’t worry. A good cosmetic dentist will make them stunning.

Your best bet is to get an accredited dentist with the American Academy of Cosmetic Dentistry (AACD).  They’re the top cosmetic dentists in the country and will give you a smile you will be unbelievably proud to share with people.

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

Having Trouble Speaking with Porcelain Veneers

I’ve gotten porcelain veneers. While they look fine I’m finding it difficult to speak with them. They’re bulkier than my teeth and my tongue keeps running into the back of them. I feel like my mouth has been stuffed with something. I’m also a little worried that my top arch seems a bit off. This may be unrelated, but shortly after they were placed, I began getting migraines. Will I get used to this or is something wrong? It’s been six months.

Emily M. – South Dakota

Emily,

If your tongue is touching them on the backs of your teeth, that isn’t porcelain veneers. That sounds more like porcelain crowns. While porcelain veneers are only placed on the front of your teeth and are used for cosmetic purposes, crowns completely surround your teeth. In fact, your dentist had to file down all sides of your teeth to get them to fit.

If you’ve had them for six months and are still struggling, you’re not going to adjust. If your dentist made them too thick or long, which happens, a general adjustment period is a few weeks.

However, you mentioned the additional concern of your arch feeling out of wack and developing migraines. These are both signs of TMJ. That condition can be spurred on my improper placement of your crowns.

Get x-rays of your teeth both before and after your crowns and take them to a TMJ dentist to look at. They’ll be able to give you some idea of whether or not the crowns are causing problems.

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

I need the “best” dentist

I have a real problem. I had two crowns placed. Once they were done, I hated the color. It just didn’t match my other teeth. I mentioned this to my dentist. He told me he didn’t agree and that the color looked fine to him.

I was pretty angry.  I was spending a lot of money and it’s not like these crowns were hidden in the back of my mouth and wouldn’t matter. These crowns are in the front of my mouth. Right now I don’t even want to smile. What I need to know is how I can find out who is the best dentist in my area.

Thanks,

Allysa- Brookfield, IL

Allysa,

Your experience is not uncommon. Most dentists get into their field because they like to fix things.  What you need is a dentist who not only is good at fixing things, but also has an artistic eye. At the very least, you want your teeth to match.

Unfortunately, there is no objective measurement to determine who is the best dentist in your area (or any area). In your particular case, you want to find a dentist who is also skilled in cosmetic dentistry. The surest way of guaranteeing you’ve got an artistic and technically skilled cosmetic dentist is to find someone who is accredited by the American Academy of Cosmetic Dentistry (AACD).

In order to reach accreditation level, dentists have to pass a stringent exam as well as demonstrate their artistry by showing samples of cosmetic work they’ve done that meets the AACD’s qualifications.

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