Tag Archives: Salem MA cosmetic dentist

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?


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

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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.


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.

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How Do I Know If My Dentist Is the Best for My Smile Makeover?

I’m worried I should go to a different dentist for my smile makeover. He’s a really nice man, but when I suggested I get porcelain veneers he said that crowns would be a better option. I told him I didn’t want to grind my teeth down when they’re healthy. He said he was willing to get certified to place Lumineers for me. He’s super sweet and I love that he’s willing to learn something to help me but I’m not sure I want to be his first case, especially because this will essentially wipe out my life savings. What do you think?

Carrie E.

Dear Carrie,

Woman with beautiful smile

Your gut instinct is right. It does sound like you have a very caring dentist, but he won’t be the best dentist for your smile makeover. You need someone who’s had significant training and skill in cosmetic dental work. It takes a lot of training and artistry. It doesn’t mean you have to switch dentists altogether. Just for your smile makeover. You can still see your regular dentist for everything else.

Look for a dentist in your area who is accredited with the American Academy of Cosmetic Dentistry (AACD). These are the dentists who have the skill you need to create a gorgeous smile. In fact, most of them have a beautiful smile guarantee.

The Best Way to Care for Your New Smile

Now one thing to understand is your dentist won’t know the right way to care for your new smile after you finally get it. The important thing will be to make sure they don’t use anything like a prophy jet or other power jet to clean your teeth. That will remove the glaze from your porcelain veneers and they’ll quickly become ruined.

He sounds like a responsible dentist. It might not be a bad idea for him to learn about how to properly care for them for your further cleanings and check-ups. I bet he’d be willing to do that, especially because he offered to get certified in Lumineers for you.

By the way, tell him if he’s truly interested in learning about placing porcelain, not to waste his time with the Lumineers seminar. He’d be better off learning about true aesthetic dentistry at somewhere like LVI. Obviously, he’d probably take that better from a peer than a patient, so feel free to show him this post.

Best of luck with your smile makeover.
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Can a Cosmetic Dentistry Disaster Be Fixed?

I spent a small fortune on a smile makeover. The “teeth” aren’t nearly as white as I wanted. My dentist says it’s because they need to look natural. They’re also a little wider than I expected. One of them keeps falling off. I’ve had my dentist put it back on three times, which he has done without charging me. But, he’s getting tired of it because the last time he casually mentioned that it’s a tooth that didn’t need much work and probably doesn’t need the veneer anyway.  I don’t think he wants to keep putting it back on. I don’t know what I’m doing to keep knocking it off. Can this be fixed?

Stacey L. – Virginia


He said what!? Seriously?  Believe me, you’re not the problem. This dentist is.  I’m sure he’s a fine family dentist. He’s just not the best dentist for your in this situation. Though not a recognized specialty, cosmetic dentistry is an entirely different beast than general dentistry.

To do it well requires significant post-graduate training and an artistic eye. Some things can’t be taught. Ideally, you’ll want a dentist is who is accredited with the American Academy of Cosmetic Dentistry (AACD). That’s more than just a membership. These dentists are among the top cosmetic dentists in the world.

You’re not the problem with this porcelain veneer falling off. He is.  He’s not bonding it properly. Yet another evidence he doesn’t have the skill required here. And to answer your question, yes, it can be fixed, just not by this dentist. If it falls off again, don’t go to him. Go to a qualified, skilled cosmetic dentist to get a second opinion on your case. It’s possible you can get a refund and have it done by someone who can give you a stunning smile. One that is as brilliantly white as you dreamed.

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Is This White Sore in My Mouth Cancer?

I’ve got this painful white sore in my mouth. It’s making it hard to eat. Do I have cancer? Should I see a dentist?

Missy P. – Kentucky


I couldn’t tell you if it was oral cancer without examining it.  Before you panic, though, it could just as likely be a canker sore. Your dentist should be doing regular examinations for oral cancer. If you don’t have a dentist, you can see an emergency dentist if it turns out not to be a canker sore.

True canker sores usually clear up between 10-14 days. It will just be a matter of managing the pain until then. There are oral antiseptics you can purchase over the counter.  They won’t take care of all the pain, but they can take the edge off of it.

If it doesn’t clear up in that amount of time, it’s time to get it checked out.  As I said before, if you don’t have a regular dentist an emergency dentist will see you. I have seen that most people who avoid the dentist do so out of fear.  There are dentists who are compassionate with fearful patients, who have methods of giving you a pain-free dental appointment.

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My Dentist Has Me Terrified I’m Going to Be Humiliated

I’m caught between a rock and a hard place. I want dental implants, but can’t afford them. I’m stuck with dentures. But, my dentist keeps telling me these horror stories about people’s dentures falling out in public situations. I’m terrified I’m going to be humiliated. Is this a given? Am I eventually going to be on one of the “funniest videos” shows?

Amanda L.  – Missouri


I think it is unfair for your dentist to try to scare you into a procedure. He’s supposed to tell you the pros and cons of each procedure, but not this way.  This is histrionics.

The real downside to dentures as opposed to dental implants is the loss of jawbone. When your teeth are removed, your body begins reabsorbing the minerals in your jawbone to use elsewhere. Eventually, that causes your jawbone to shrink and your dentures to slip.

Let me say, that takes several years to happen, so you have a couple of options. First, you can get snap-on dentures. While they’re not as ideal as implants, they’re a great option for people in your position. They anchor the dentures to your gums. You can get them as few as two implants. You can get more, of course, but two are the most affordable.

That also helps with your second option. Get dentures (or snap-on dentures) while saving up for implants. You can gradually add more implants as you’re able.

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Worried I’m Losing My Dental Implants

I struggle with gum disease. It’s been affecting my teeth and now I’m worried it’s affecting my dental implants. A few months ago I had dental implants placed after losing two teeth. My dentist tried to save them. He knew gum disease was in issue. In fact, we even doubled my dental appointments, getting me cleanings every three months. Unfortunately, despite his best efforts the teeth were lost. He said it was important I replace the teeth or the remaining ones will shift. His recommendation was dental implants. I LOVE them, but now am worried. They’re feeling a little loose. Am I at risk of losing those too?  Please tell me it’s not too late to save them?

Abigail W. – New Hampshire


I’m concerned about some of the things you’ve written. First, let’s talk about your gum disease. Simply increasing your cleanings and check-ups, while a good start is not enough.  They should have been doing specific treatments for your gums.

If you have gum disease he should have never given you dental implants. Gum disease is contraindicative for implants. Without intervention quickly, you’re going to lose your implants. If you think about it, it’s only logical. If your gums weren’t healthy enough to retain your teeth, they’re not going to be able to retain your gums either.

My recommendation for you is to see a different dentist who treats dental implants.  This one has obviously not given you the proper care.

If you get in quickly, there’s a chance you can save your implants.

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

Help! My Tooth Crumbled Into My Food

I just received a temporary filling and am getting a root canal treatment in just a few days. I was eating some sticky rice at an Asian restaurant when I felt something weird going on with my tooth. Then I felt grains of what I think is my tooth structure in the my food. I think my tooth is crumbling. Can this wait until my root canal appointment or do I need to be seen in an emergency visit?

Marsha V. – Nashville


That depends on whether it’s the actual tooth structure crumbling or just the temporary crown coming apart. They’re designed to come out fairly easily so that is a real possibility. Sticky foods can also help that along.

Here’s what I’d like you to do, if you haven’t already. Look at the tooth. Does it look like it’s the tooth structure itself that’s coming apart, or is there a divot where the filling was placed?

If it’s the tooth itself, I’d call the dentist and ask if he wants you to come in for an emergency dental visit. If it’s the temporary filling, you’ll be fine.

There is dental filling material you can purchase at a local pharmacy. It’s also designed to be temporary and will not be a good subsititute for a permanent filling. You’re the exact type of case this store bought filling is used for. It will help keep things in place until you go in for your root canal treatment.

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Want a dazzling smile

I’m going to have some cosmetic work done and I’m trying to find the best dentist in to do it.  My dentist suggested veneers and showed me his before and after pictures of cases he’s done.

I wasn’t that impressed with his pictures and wanted my smile to be more of a dramatic dazzle kind of thing. I want my smile to light up a room. How do I find a dentist who can do that?

Olivia R. – Virginia


You’re wise to look for a different dentist to do your cosmetic work. There are many well meaning family dentists, who are awesome at general dentistry, but just don’t have the artistic training for really gorgeous cosmetic work.

It’s a good idea to look for a smile gallery on each candidate’s website, so you can get a feel for whether his cosmetic work is something you’d be proud to show off. But, there are other things to look for as well.

Have they done significant post-graduate training in cosmetic work? Do they guarantee their work? Many good cosmetic dentists have something akin to a  “Beautiful Smile Guarantee,” which simply means that if you aren’t happy with your smile after the cosmetic work is done, the doctor will be glad to correct it. The procedures not considered finished until you’re thrilled.


There is a definitive way to be certain you’re getting the best possible dentist for your cosmetic work. If I were in your place, I’d want a dentist who was accredited with the American Academy of Cosmetic Dentistry (AACD).  There is a difference between membership and accreditation, so make sure he’s accredited.

These are among the top 1-3% of cosmetic dentists, not just in the country, but in the world.

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

Invisalign or Porcelain Veneers

I went to my dentist to discuss a potential cosmetic change. I want to whiten and brighten my teeth and I have mildly crooked front tooth. I thought I’d get porcelain veneers, but my dentist is suggesting invisalign first and then porcelain veneers. Porcelain veneers are so expensive, I was hoping not to have to add any additional expense.  Is it normal to do invisalign and porcelain veneers?

Paige W. – New Mexico


Hmmm…this is answer can only be considered in light of the fact that I haven’t actually seen your case.

What I can tell you is that, generally speaking, dentists either do invisalign or porcelain veneers.  My recommendation would be to get a second opinion from an expert cosmetic dentist.

See if there’s anyone in your area (it’s worth a drive too) that is accredited from the American Academy of Cosmetic Dentistry. You can also check the mynewsmile.com website. They have recommendation for artistic cosmetic dentists.

You have a few options. First, is porcelain veneers. When done properly, veneers can make crooked teeth appear straight. They’re a good options, especially if you want to change anything else about your teeth, such as their shape.

But, if you are happy with the shape of your teeth and just want to brighten and straighten them, then you might just want invisalign with teeth whitening, instead of porcelain veneers.

This blog is brought to you by Randall Burba.