Tag Archives: Salem MA cosmetic dentist

Considerations Before Getting Dental Implants

illustration of a dental implant
Dental Implant Diagram

You’ve lost a few teeth and need to replace them. While all the buzz is about dental implants when it comes to tooth replacement options, there are some things to ask yourself before deciding. Here are some questions to consider:

Have All My Options Been Explained?

Yes, dental implants are a fantastic way to replace missing teeth, but it’s important you know your options so you can be sure you chose the correct option for you. For instance, if you’re only replacing one tooth, but one or more of the two adjacent teeth need crowns, then a dental bridge would make more sense. If you’re missing all your teeth, getting a dental implant on every tooth would cost up to $84,000. Getting implant overdentures addresses all the same needs with significant cost savings. Be sure to ask your dentist to explain all your options along with their pros and cons when you book your consultation.

Are You Committed to Proper Oral and Health Care?

If you’ve lost your teeth because you have gum disease, that will have to be addressed before getting dental implants. Gum disease will cause the implant to fall out just the way your teeth did. Once your gums are healthy, it’s fine to go ahead and get the implants. However, if you’re not willing to care for your teeth with regular brushing and flossing, along with visits to the dentist, you’ll end up right back where you are now. In that case, you’d be better off not investing in something you won’t care for. Removable partial dentures may be a better option for you.

If you’re a smoker, this is a larger contributor to both gum disease and dental implant failure. The reason behind that is smoking causes a reduction of blood flow in your gums. This slows healing time, which often leads to infections. You’ll want to consider quitting or at least severly cutting back if you’re serious about dental implants.

Think About Your Long-Term Goals

These are meant to be a permanent replacement. That’s great, but if you’ve been unhappy with a dingy smile, you’ll want to take care of that before getting your implants done. Get your teeth whitened. This way when your dentist creates your implant crowns, they can be made to match your beautiful new fresher, whiter color. It’s a great way to come away with not just a full set of chompers, but one you’re proud to share as well. Make sure you discuss with your dentist any long-term goals you have for your smile at your consultation. This way the two of you can work out a logical plan that will save you money in the end.

Make Sure You Book with an Experienced Implant Dentist

This is an advanced procedure which requires extensive post-doctoral training. Don’t hesitate to ask the dentist where they received their dental implant training as well as the number of cases they have performed, as well as their success rate. It should be around 98%.

While not everyone is a dental implant candidate. They are the closest option to having healthy natural teeth in your mouth.

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

My Mouth Is Sinking In

I need some advice. You can barely see my front teeth when I smile. It makes it look like I don’t have any and is embarrassing. I do have jaw pain which I wear a night guard for. My face feels more comfortable and natural when I wear it. But, most of the time, my jaw tightens and I have trouble forming certain letter sounds. My dentist suggested porcelain veneers but I wanted to get a second opinion. What do you think?

Pamela

Dear Pamela,

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

I’m concerned by some things I’m hearing. I think you need a different dentist. While it is true that getting porcelain veneers can give you a gorgeous smile, it will not help the root of your problem. In fact, it’s likely to make it worse, specifically your jaw pain and issues with pronunciation. You may actually end up with a locked jaw.

Go see a dentist with a lot of training and experience in TMJ Disorder. You’re probably thinking, “Great, that’s not a specialty. How do I find one of those?” Well, I’m glad you asked. You can look on their website or ask their staff where they received their TMJ training. If they only mention their dental school, that’s insufficient. Here are some great institutions. I’d want them to list at least one of them:

  • The Pankey Institute
  • Dawson Academy
  • Spear Education
  • The Las Vegas Institute for Advanced Dental Studies

It sounds like this has happened over time, which may mean you’ve worn your teeth down causing them to oveclose. If that’s the case, then it’s very likely you’ll need a full mouth reconstruction. Picking the right dentist for that is just as important as finding an expert in TMJ Treatment.

You want to have a functional smile, but one you’ll also be proud to show everyone. In your place, I’d start by finding an expert TMJ Dentist, but then also see if they’re an expert cosmetic dentist. It is possible to get both. For cosmetic dentistry, the ideal is to get a dentist who has attained accreditation with the American Academy of Cosmetic Dentistry.

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

Why Are My Gums Bleeding After Porcelain Veneers?

I’m a little concerned. Around six months ago I had porcelain veneers done. My gums were irritated from the beginning. I called the office. They said it is normal to have a little irritation after dental work and it should resolve itself. Then a month or two later the gums started bleeding when I brush. Not every time I brush, but enough that I wondered what’s going on. Now I went in for my six-month check-up and the hygienist said I’m not brushing and flossing well enough because I’m developing gum disease. I was horrified. I always am so careful about my oral care and have never had a problem before. Is this a common side-effect from porcelain veneers? My dentist said no, but I didn’t have any issues until I had them placed.

Carina

Dear Carina,

A single porcelain veneer being placed

It’s not a side-effect of porcelain veneers, but like you said, it’s rather suspicious it started when you had them placed. I have an inkling of what may be going on here. Is it possible your dentist is a family dentist who doesn’t do cosmetic work as a large portion of his practice?

My guess is your dentist isn’t a skilled cosmetic dentist and maybe just dabbles. With your gums being affected, it sounds like your dentist didn’t get the veneers flush against your teeth. When that happens, it’s what’s known as bulky margins.

What this does is create a tiny “shelf” at the top of your veneers, which allows for food and other bacteria to get trapped there. This is what is probably what is irritating your gums and leading to the bleeding and gum disease.

Who Should Replace Your Porcelain Veneers?

Here’s what I’m going to recommend in your place:

First, you have a great case for a full refund. In your case, I wouldn’t consider developing gum disease a functional case, which is the standard for whether or not you’d get a refund. If he gives you a problem about that you can get a second opinion from another dentist. Tell him what’s going on with your gums without making a comment about bulky margins. If he or she gives you that diagnosis as well, then the dentist will be more likely to refund you. Dentists have pride and don’t want to look bad in front of their peers.

One tip. Don’t tell the second opinion dentist who placed them, just in case they’re buddies. If he asks, tell him you just want an unbiased opinion and would prefer he not know. He should be fine with that.

Once you’ve gotten your refund, you need to go to a different dentist to replace them. Ideally, you’d want to go to a dentist who’s reached accreditation level with the American Academy of Cosmetic Dentistry. AACD accredited dentists are in the top 1% of cosmetic dentists in the country.

I wouldn’t be surprised if when you had your new case made that you found the end result to be much more beautiful. In fact, most expert cosmetic dentists have a beautiful smile guarantee.

If there’s not an accredited dentist within a reasonable distance from your home, you can go to the mynewsmile.com website. They recommend expert cosmetic dentists by zip code. Not all of them are accredited, but every one of them are skilled and artistic enough to give you the stunning smile you deserve.

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

What if You Hate Your 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?

Brittany

Dear Brittany,

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

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.

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

My Husband’s Dentures Hurt

I don’t know what to do for my poor husband. He had to get dentures because he lost his teeth, but he absolutely cannot wear them. They hurt. The dentist keeps telling us he’ll adjust to them but he hasn’t. Now it’s getting impossible for him. Is there any way to help him?

Lena

Dear Lena,

Mature couple smiling
You can have a gorgeous smile that feels good no matter what your age!

It’s a shame your dentist hasn’t been more helpful to you. It doesn’t sound like he’s even tried to make any adjustments on your husband’s dentures. That’s the first thing I’d do. However, from what you’ve said, it sounds like you’ll need to see a different dentist to do it. One who is compassionate about his patients. Sometimes, all it takes is some small adjustments and all that pain goes away.

You should be aware, while many patients do fine with dentures. Others spend a lifetime hating them. I don’t know where your husband will fall in that spectrum. Do you know if your dentist told him about options before giving him dentures? Technically, he’s obligated to present all options, but I’m not feeling complete confidence in the thoroughness of your dentist at the moment.

A Helpful Option to Dentures

If adjustments don’t help him, you may have him look into switching to implant overdentures. These anchor his dentures to a series of dental implants, usually four or six. Aside from him never having to deal with the friction of dentures. They’re perfectly secure.

They have a more important function as well. With each passing year, your husband’s jawbone is shrinking. The reason for that is the loss of his teeth roots. When his extractions took place his body recognizes he no longer needs the bone support for his teeth, so it resorbs the minerals from the jawbone to use elsewhere in his body. This leads to a condition known as facial collapse. Eventually, he’ll have so little bone left he won’t have a way to keep his dentures in.

Having implants placed will help his body to understand that bone is still necessary. That will completely save him from losing his jaw bone and giving him a lifetime of healthy tooth replacements. They’ll look and function just like his natural teeth did when they were healthy.

There are other options as well. The key for you guys is finding a dentist which you believe in and can trust. Then ask him to give you all your options.

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

Tired of Dealing with Dentist. Can I Get Dentures Instead?

It seems like every single time I go for a checkup and cleaning my dentist finds several things wrong. Then, I spend the next few months fixing them. All my money goes to my dentist. Can I just extract them and get dentures so I can use my money on things I want?

Dan

Dear Dan,

An illustration of both a denture and a dental implant

I understand your frustration. However, I’m going to warn you that this decision, if you follow through with it, can ruin your life. Here is why. It sounds like you’re still pretty young. Unless you’re in your eighties, I wouldn’t recommend dentures. Instead, I’d recommend dental implants to prevent you from losing your jawbone.

When your teeth are removed, your body reabsorbs the minerals in your jawbone to distribute elsewhere throughout your body, where it deems it more needed. This slowly shrinks your jawbone. After about ten years or so, you no longer have enough jawbone left to retain a denture. This is known as facial collapse.
So, unless you plan on going on a liquid diet in about ten years for the remainder of your life in about ten years, you need a better plan.

Alternatives to Removable Dentures

If you’re determined to remove your teeth, the ideal solution is a to get dental implants. You can see one in the illustration above. This is a surgical procedure which puts prosthetic tooth roots in your jawbone, using either titanium or zirconia. Then, after a healing time, you can have dental crowns put on top, or in your case, you’d have a set of dentures anchored to them. This protects you from facial collapse. It also avoids all the other problems that come with dentures.

However, dental implants, especially the amount you need, is going to cost you way more money then if you just really bore down and had your teeth fixed.

Another alternative is to get snap-on dentures. These just use two implants and your dentures snap on to them. They’re not as stable as implant overdentures, but it will keep them in your mouth.

Truthfully, though I’m sure this isn’t what you want to hear, your best solution is finding out why your teeth are struggling so much. Go over your oral hygiene routine with your dentist to see if you’re missing any important steps. Also, until your teeth are back up to snuff, you can request to have a prescription fluoride to take home and use in order to give them some extra protection.

If you can get your decay under control, you’ll save a lot more money and have a much higher quality of life than if you simply extracted and replaced your troublesome teeth.

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

Dental Implants Turned My Gums Gray

I’m worried something is seriously wrong. I had two dental implants placed on my front teeth. They’ve been on for a few months now. While I sort of like how the implant crowns look, the surrounding gums have turned gray. Are the implants causing an infection? Will I lose the implants?

Melissa

Dear Melissa,

illustration of a dental implant

The good news is that you’re probably not dealing with an infection. If you were, there would be a fever and pain involved, neither of which did you mention. More likely, the titanium from your dental implants is showing through your gums. This could be from one of two reasons or a combination of both.

You probably have thin gum tissue which contributes to it. The placement of the implants is also a big factor. If your dentist isn’t experienced in placing dental implants, he may have placed them without factoring in the depth of your gum tissue. I suspect that’s the issue. Another reason I’m wondering about the skill of your implant dentist is your disappointment with the look of the crowns. But, first, let’s talk about your options for your gray gums.

Obviously, your first option is to live with it. If it’s not visible when you smile, that may be acceptable to you. If the gums are visible, then you won’t want to leave them. In that case, you’ll need to have them re-done. If it turns out they weren’t properly placed for the thinness of your gums, you could get at least a partial refund. A second opinion by an expert implant dentist can tell you that.

When you have them replaced, you can either get titanium implants again or you can get Zirconia Implants. These are white and more easily masked. These are also great for people who have severe metal allergies because they are metal-free.

Can Dental Implant Crowns be Beautiful?

When you’re talking about getting restorations on your front teeth, it especially important you find a skilled and artistic cosmetic dentist. Ideally, you’d want an AACD accredited dentist. They’re the cream of the crop when it comes to cosmetic dentistry. But, very few dentists are accredited so you may not find one at a reasonable distance from you. In that case, look on the mynewsmile.com website.

They only recommend the best cosmetic dentists. Many of them are on their way to accreditation, which is a lengthy process. If a dentist is on their list, they’ll give you a beautiful smile.

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