Tag Archives: teeth whitening

Finishing Invisalign without a Dentist

I have moved and have the last three sets of aligners left for my Invisalign. If my treatment has gone very smoothly, can I just continue the treatment on my own or do I need to find another Invisalign dentist in order to finish?

Mary

Dear Mary,

Clear Invisalgin Aligner

There are times when an Invisalign case is more complicated. For instance, when some teeth need to be shaved to make room or when buttons are necessary in order to grip the aligners and help them shift. You said your case wasn’t complicated. So, in all honesty, you could probably finish off your treatment without needing another dentist if you have the aligners.

If you don’t, you can ask your original dentist to send them to you or he can transfer all your information to another dentist. He is ethically obligated to send all treatment and diagnostic information to your new caregiver.

In all honesty, because you haven’t had any issues and it doesn’t seem like there have been additional treatment processes necessary, you can probably get along just fine without another dentist. That will give you time to settle in and find a new caregiver you are pleased with.

Retainers after Invisalign

In almost every case, after orthodontic treatment, there is a need for a retainer. This helps train the teeth to stay in place and doesn’t allow them to scoot now that they are free. The mynewsmile.com website has a great post about wearing retainers. Because your last pair of aligners have your teeth in their correct position, these can double as retainers, which means you won’t have to pay for a traditional retainer. I have a suggested method for doing this.

  • Month One: Wear them all the time.
  • Month Two: Wear them only at night
  • Month Three: Wear them every other night
  • Month Three Test: If it is harder to put your “retainer” in, that means your teeth have moved and you’ll need to go back to every night for a while. If they’re fine you can move on
  • Month Four: You can try using them once a week, then not at all. Just keep your aligners available to periodically check them.

You should know those aligners can also double as teeth whitening trays, so when you’re ready to whiten your teeth, just ask your dentist for some gel.

Best of luck on your new location!
This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.

Blacklisted by Best Dentist

I’m afraid I’ve been blacklisted by the best dentist in the area. He came highly recommended by several of my friends. They’ve all been to him for various cosmetic procedures, from whitening through veneers, and everyone says such wonderful things about him. Maybe I built him up too much in my mind, but I recently went in for a consultation about having my teeth fixed up a bit. I have some awkward spacing and one tooth is a little twisted. I wanted to have them straightened out and whitened. Everything seemed fine. I met him and thought he was fantastic. He talked up veneers and I felt great. But, then his assistant came in after and gave me the estimate—it was thousands more than I could afford. I asked if there were alternative solutions and the girl huffed at me a bit and then went and got the dentist. He came back and basically told me that if I didn’t want to do it his way, I shouldn’t be in his office.

I was devastated. I really thought this guy would be great, but I can’t afford to go through with the treatment and my friends keep asking me when I’m going in to see him. I have absolute faith in his capabilities, I just wish he’d work with me on treatment. Is there any way to salvage this?

Thanks,

Anonymous In MA

Dear Anonymous,

Woman giving thumbs up in a dental chair
How do you know if you have the best dentist for your needs?

Let’s be realistic for a moment here. If he was the best dentist, would he be treating you this way? The answer is no.

He’s Not Taking Good Care of You

Perhaps he has amazing artistic skill and can craft beautiful smiles, but that’s only half the battle. Being able to make patients feel comfortable and helping them get around their barriers is equally important. In your case, cost is a barrier.

A good dentist would understand this and pitch solutions that work within your limitations. Perhaps you might be better getting six porcelain veneers instead of two or four. Maybe that is the best way to improve your smile. At the same time, maybe two will provide you with adequate results and be a bit more affordable. Or, perhaps Invisalign combined with teeth whitening is a better option for your budget. There are always multiple approaches. If he isn’t willing to explore them with you, he’s not doing you justice.

You Can Find a Better Dentist

Go have a consultation with another dentist and be upfront about your budget from the onset. A great dentist will go over your options with you. For what it’s worth, you don’t have to explain to your friends why you’re seeing someone else. The prior office has an obligation to keep your information confidential, so unless you tell your friends why you left, they never need to know.

This blog is sponsored by Salem Dentist Dr. Burba.

Flipper to Help teeth look straight

I don’t want braces. They take forever, look ridiculous, and from what I’ve heard from every middle-schooler, feel horrible. I have three teeth which stick out and are crooked. I wonder if a dental flipper can make them look straight. What do you think?

Ben

Dear Ben,

A woman putting in her Invisalign aligners in two stacked images
Invisalign: The Modern Orthodontic Solution

A dental flipper isn’t the solution you think it will be. It’s actually designed to be a temporary replacement for missing teeth and uses wires to clasp onto adjacent teeth.

There is something called snap-on smile which can snap over your teeth to make them look straight. They’re acceptable looking but not stunning. Because they snap over your teeth, some people have found that they look a bit bulky. If your teeth are sticking out they might look even more bulky.

Invisalign: A Great Alternative to Braces

You don’t have to get braces anymore. These days we have alternatives. Invisalign uses clear aligners to straighten your teeth. They’re completely invisible even at a conversational distance. This means you don’t have to worry about unsightly metal wires and brackets.

Because of that it is also comfortable. Plus, it works in about half the time of traditional braces. You can have naturally straight teeth sooner than you realize.

A Surprise Benefit to Invisalign

Many people don’t realize that the aligners Invisalign used to straighten your teeth can also double as teeth whitening trays. This means you can simultaneously whiten and straighten your teeth at the same time.

It’s like getting a mini smile makeover. You’ll feel confident and look years longer.

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

Blade Implant Not Healing?

I don’t know what’s going on. I had a blade implant placed over 12 months ago and it still isn’t healed. Is something wrong or is this normal? Do I just wait it out?

Catherine

Dear Catherine,

Illustration of a dental implant

I’m curious as to why your dentist decided on a blade implant. While they have been in use for many years, there are better options in current practice. It’s generally used for people who don’t have a thick enough jawbone to retain a traditional screw implant but don’t want to do bone grafting.

Unfortunately, while traditional dental implants (pictured above) have a 98% success rate, blade implants only have around a 50% success rate. This should have healed within twelve months. At this point, something is wrong. You need to return to your implant surgeon and have them look and advice you.

Dental Implant Options

A woman's profile twice, one with facial collapse, one after
Wearing Dentures Leads to Facial Collapse

Bone loss in your jaw is usually the result of having missing teeth with no replaced root. For instance, if you removed your teeth but didn’t replace them or replaced them with removable dentures, the minerals in your bone start to resorb into your body. The result not only ages your appearance years, but it will also make you a denture cripple, forced onto a liquid diet the remainder of your days. This is known as facial collapse.

If you want to replace those teeth with an option which provides a prosthetic root, thereby preventing facial collapse, you need to have enough jaw bone. If you don’t, you have two great alternatives to blade implants.

Bone Grafting

This is a simple outpatient procedure which adds bone structure back into your jaw. The biggest benefit to this is it allows you to get screw implants which have a significantly higher success rate to the blade option.

All-on-4 Dental Implants

This doesn’t require grafting. Instead, the all-on-4 implant procedure places the implants at an angle helping them retain with less bone structure.

Cosmetic Considerations with Dental Implants

While it is wonderful to have a full mouth of teeth. If they’re not attractive teeth, you might not smile nearly as much as you would if you were provided with a stunning smile. Whether you are getting all new “teeth” or just a couple of implants, you’ll want a dentist who can make them match your teeth. You don’t want natural teeth next to obviously fake teeth.

One or Two Implants

I recommend before your implant crowns are made, you whiten the rest of your teeth. It’s an inexpensive way to drastically improve the aesthetics of your smile. But, the real reason for doing it before getting your crowns is the permanence of your crown color. Even professional teeth whitening only works on natural tooth structure. That means if you get the crowns first and then decide to whiten your teeth, your natural teeth will whiten. Your tooth replacements will not. Doing the whitening first means your implant crowns can be made to match the beautiful new color of your teeth.

A New Smile with Implant Overdentures

If you are getting a new smile with your implants, you want an expert cosmetic dentist to do the work. You are talking about a complete smile makeover made from dental crowns. Finding an expert cosmetic dentist is a lot easier than it used to be. The American Academy of Cosmetic Dentistry has an accreditation program which helps patients to know who can give them a stunning smile.

Just go to aacd.com and click on find a dentist. Just make sure you put a check by “accredited dentist”. This way you get a list of those who are experts in their field.

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

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.

Do It Yourself Invisalign

I keep seeing the advertisements for at-home Invisalign. You only have to submit photos, etc. Do they work?

Cecil

Dear Cecil,

A woman putting in her Invisalign aligners in two stacked images

There are several of these type of companies at the moment. None of them are actually aligned with Invisalign, which is a specific brand. They’re just sort of leeching off the name recognition to get people to click and learn about them.

Some of them work and some of them are outright dangerous. However, all of them have one thing in common which gives me pause. You rarely, if ever, see a dentist. Yes, you submit photos. Yes, a dentist looks at those photos. What they’re not saying is there are things which even the best dentists can’t discern from a photograph, such as gum disease.

While there are some cases, depending on their severity, which are obvious even in a picture. Most of the time it requires x-rays and some probing of the gums. Plus, molars are very difficult to see in pictures. Your oral health needs to be checked during treatment. Gum disease can derail your treatment process as well as your teeth. If gum disease progresses untreated you can lose bone mass and teeth.

Benefits of Seeing a Dentist for Invisalign

Seeing a dentist and getting the real deal when it comes to your Invisalign treatment means you get a jump start on fixing any issues which develop, such as the gum disease listed above or decay and tooth pain.

Other times teeth have to be shaved in order to make room for treatment with crowded teeth. If those cases, you will be sent to a dentist even with these “do it yourself” treatments. But, you’ll likely be working with a dentist who is not invested in your case in any way. It actually takes some cosmetic dentistry skill to do this in a way which still allows the teeth to look natural.

Additionally, there are other cosmetic procedures you can do simultaneously when you work with a dentist. Your Invisalign aligners can double as teeth whitening trays, essentially giving you a mini smile makeover between the straighter teeth and a whiter smile.

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 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.

Press-on Veneers versus Cosmetic Dentist

I don’t have a very good cosmetic dentist. He’s great for a lot of general dental work, but even he admits his cosmetic work needs work of a different kind. I appreciate his honesty but it leaves me in kind of a bind. I want to get porcelain veneers. He said he’s fine with me going to another, more experienced cosmetic dentist for that particular procedure. He even recommended someone he said was AACD accredited. He said that’s a huge deal. Not sure why. Anyway, I went to the AACD guy and had a free consultation. He was nice and I could tell by his picture gallery of patients that he does great work, but his prices were through the roof. Today I saw this website for press-on porcelain veneers. The pictures looked pretty to me and they were A LOT less expensive than the guy my dentist recommended. Do you know about these press ons? Are they really as good as the ones by a cosmetic dentist?

Veronica M.

Dear Veronica,

A single porcelain veneer being held up by a dental instrument

First, I really appreciate the honesty of your dentist. Some, less caring practitioners might be tempted to just do their “best” porcelain veneers knowing they’d be subpar but wanting the practice or the money. Instead, he was forthright and even suggested another, more qualified, dentist.

Not just that, he was careful to recommend an accredited dentist with the American Academy of Cosmetic Dentistry (AACD). These are the top 1% of cosmetic dentists in the world. Yes, their prices are sometimes a bit higher (though not always). That’s usually because they’re so skilled and artistic that they’re in high demand with patients wanting cosmetic procedures, such as porcelain veneers. In fact, there are people who travel across the country or even from other countries to have their work done by them.

If you went to one of them you would definitely get a stunning smile. Probably every one of them has some form of a beautiful smile guarantee.

Porcelain Veneers versus Press-on Veneers

The press-on veneers you saw on that website are completely different from the veneers you’d get from a skilled, artistic cosmetic dentist. They’re more similar to what you’d get with a snap-on smile. They’re made from a composite resin and just press over your teeth temporarily. While they may look great for a photo shoot, they do not look nearly as stunning or natural in person.

Because the press-ons fit over your teeth, instead of being custom made and bonded to your teeth, they tend to come off a bit bulky and a little long. It can make it difficult for patients to speak when they’re in.

There are some procedures you can shop around and cut corners on. Teeth whitening is one example. It doesn’t really matter which dentist does that procedure. It’s fairly straightforward. Going for the cheapest dentist, in that case, will do no harm. Veneers are different. They require expertise in both technique and artistry.

If you want a true smile makeover, it’s an investment that will last a lifetime, giving you stronger confidence than you’d imagine.

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