Tag Archives: Salem MA cosmetic dentist

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.

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.

Straightening Teeth with a Missing Teeth

I never had braces as a child. It’s always bothered me. I want to do something about it now that I’m an adult. I keep hearing about invisible braces, which sounds much better to me than those silver ones all my friends in middle-school wore. The one thing that worries me is I have two congenitally missing mandibular bicuspids. Do I need to get dental implants for those spots?

Katherine

Dear Katherine,

A woman putting in her Invisalign aligners in two stacked images

Invisible braces could refer to one of three things. First, they could be referring to the clear braces you can get these days. They still go on your teeth like the traditional metal wire and bracket braces, but it uses a less visible material.

A second possibility is lingual braces. These are also the traditional type of braces bonded to your teeth, but they are placed behind your teeth where no one can see them. Many child stars have worn these when they’re in the middle of filming a series where they didn’t (or couldn’t in the case of a historical series) want the character to have braces. They’re useful for straightening in secret, but they have a couple of drawbacks.

They can be uncomfortable on your tongue which will bump up against them quite a bit. Braces make oral hygiene trickier because of all the materials you have to get around and the food that continually gets trapped in them. Lingual braces are even harder to keep clean because of their location. You could end up with a lot of unnecessary decay if you don’t stay on top of your tooth care.

Invisalign — Your Best Invisible Braces Option

While both of the above options could be considered “invisible braces”, there’s a much better option. Invisalign, though not technically braces, is an orthodontic system which straightens your teeth in significantly less time than traditional braces. These use clear aligners (think teeth whitening trays) instead of wires and brackets. Even at a conversational distance, people will not be able to tell you’re wearing them.

Because you’re talking about your lower bicuspids, it’s not necessary to get dental implants. Invisalign will close the spaces in your lower arch. Though, if you wanted to, you certainly could get implants placed where you’re missing teeth are. To do that, however, you’d need to work with an experienced implant dentist who also understands orthodontics. This way your work can be done in such a way as to preserve the needed space for the implant.

This blog is brought to you by Dr. Randall Burba. Check out his smile gallery.

Can a Diabetic Get All-on-4 Dental Implants

After my husband died I really struggled. I stopped taking care of myself. I gained 100 pounds, developed diabetes, and even developed gum disease which led to losing several teeth. I didn’t care. Then, one day I was at a park and smiled at a little girl and she asked if I was homeless. I realized then, things had to change. I have a full life ahead of me. I started eating right. I joined a gym. I’ve almost completely lost all the weight I gained and I no longer have gum disease. I asked my dentist about what he recommended for my missing teeth and he suggested all-on-4 dental implants. I was super thrilled about the idea of having a full mouth of teeth again. But, I went home to do some research and learned that diabetics shouldn’t get them. I don’t want to pay all that money if it’s not going to work. What should I do? I really want teeth again.

Carra

Dear Carra,

illustration of a dental implant

First, let me add my condolences. Don’t be too hard on yourself regarding how you dealt with your grief in the beginning. It’s almost suffocating to lose a loved one and we all seem to lose ourselves at first too. You should be really thrilled with the incredible progress you’ve made since then. I think the healthy changes you’ve made are remarkable.

For the most part, dental implants have a 98% success rate when done by an experienced implant dentist. There are some factors which make patients more at risk for implant failure. The biggest of these are:

  • Gum Disease
  • Smoking
  • Uncontrolled Diabetes

You’ve already taken care of your gum disease, which is huge. A responsible dentist will NEVER give a patient who has gum disease dental implants. There’s no way for your body to retain them well, just like when you suffered from gum disease, they couldn’t retain your natural teeth. They will fail. Because you’ve already turned that around it’s not a worry for you.

You didn’t mention anything about smoking, which I hope means you’re not a smoker. Smoking lowers your blood flow in your gums which increases your risk of infection, a leading cause of dental implant failure. You also increase your risk of redeveloping gum disease.

Your diabetes is under control, so again, Yay! not a problem for you. I think you’re likely a good candidate for dental implants.

Are All-on-4 Dental Implants the Right Choice for You?

The only real reason to do the All-on-4 procedure rather than traditional implants is bone loss. Sometimes, with gum disease and tooth loss, you lose so much jawbone structure you don’t have enough to retain dental implants. All-on-4 is one way to get around that. However, there is a better, more reliable option.

If you don’t have enough bone to support traditional dental implants, I’d consider getting bone grafting done. It will build back up your bone structure. Then you’re free to get whatever procedure you want. I hope this helps you make your decision.

Best of luck and congratulations on all your hard work!
This blog is brought to you by AACD Accredited dentist Dr. Randall Burba.

Is a Cracked Porcelain Crown a Dental Emergency?

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.

Lindsey

Dear Lindsey,

A Dental Crown being Placed

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.

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.

New Crown hurts

I got a new crown a few weeks ago. It hits my other teeth funny, which makes it hurt every time I bite. I went to my dentist. He looked at it and said it’s fine and to give it time. I have given it time and it’s still hurting. What do I do?

Cammi

Dear Cammi,

Woman holding her jaw in pain
Damage to a bite can lead to TMJ

“Give it time.” That’s dentist speak for, “I don’t know how to fix this.” Here’s what needs to happen. This crown needs to be adjusted. It’s likely the crown is just too high. When you bite down, the other teeth are hitting the crown before it meshes. The pain you’re experiencing is just part of the deal. If this isn’t adjusted, it can do damage to your bite. Fortunately, there are things your dentist can be doing to deal with this.

First, he needs to determine if the crown problem is simply it is sitting too high. If so, a simple adjustment can fix everything. If that doesn’t work, there is a next step. He can have you bite down on a bite registration paper. Where it registers the bite too high he can make some adjustments.

Of course, dentists with advanced training wouldn’t have this problem to begin with. If they did, they’d fix it with a properly made crown. The key this time is to get you out of pain and make sure your bite doesn’t get damaged. The last thing you want is TMJ Disorder.

What Type of Dentist Can Treat TMJ?

Neuromuscular dentistry requires advanced training. Traning you can’t get simply by going to dental school. It needs post-graduate training. Don’t hesitate to ask where they received their TMJ training. Some schools that are very reputable are:

  • Dawson Academy
  • Spear Institute
  • Pankey Institute
  • Las Vegas Institute of Advanced Dental Studies

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

Porcelain Veneers Staining After Months

I am thinking I did something terrible. My dentist told me that my porcelain veneers would last for years. But, I’ve only had them for a little over seven months and they look awful. They were fine, even at my six-month checkup and cleaning. It was after that they started picking up stains. I don’t know what I did. I thought I was super careful. I researched and got a special toothpaste that’s supposed to be for porcelain veneers called Supersmile. Was that a scam? Did that mess them up? Can this be fixed? I’m embarrassed to tell my dentist, but I really love these veneers.

Cathy

Dear Cathy,

A single porcelain veneer being held up by a dental instrument

You didn’t do anything wrong. The Supersmile toothpaste isn’t a scam. It’s actually the absolute best toothpaste you could have purchased for your porcelain veneers. Great job looking that up. It’s something your dentist should have told you about when you first got the veneers placed.

My suspicion is it’s your dentist’s office that made the terrible mistake. It sounds to me, based on the timeline you’ve given that your hygienist didn’t understand the proper care of porcelain veneers and used something on it like a prophy jet during your cleaning.

This would have removed the glaze from your veneers, leaving them dull and susceptible to staining. Without the glaze, they’ll never look good again.

What Do You Do If Your Glaze Is Removed on Your Porcelain Veneers?

Because it’s your dentist’s office that likely did this they need to fix it. There is a special procedure which requires a special diamond polishing technique which could restore the glaze. Unfortunately, it’s such an advanced procedure I doubt your cosmetic dentist knows it, especially if they didn’t even know how to properly clean your veneers.

My guess is they’re going to have to replace your veneers completely. If they give you any problem with that, you can show them this post. Or, maybe go to another cosmetic dentist for a second opinion. Sometimes, not wanting to look bad in front of your local peers is a great motivator.

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