Archives for April 2019

Porcelain Veneers with an Overbite

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I have tetracycline stains on my teeth and really wanted to get a smile makeover. I also have an overbite where my top teeth cover my bottom. My dentist said because of that I can not get porcelain veneers. Instead, he’s suggesting I get four dental crowns. I have a couple of questions about this. Why are crowns better than veneers for my bite and will they need to whiten my bottom teeth because they’ll show some?

Catherine

Dear Catherine,

A porcelain veneer being placed on a tooth
Porcelain veneers done by an expert cosmetic dentist will give you a gorgeous smile.

I’ll give your dentist points for creativity, but not for accuracy. If you think about it, porcelain veneers would make more sense than dental crowns. The veneers only cover the front of the tooth which won’t interfere with your bottom teeth. The crowns cover the entire tooth. Plus, they’d required you to grind your teeth down to nubs. That’s not what you want for healthy teeth.

I’m going to seriously recommend you find a different dentist to do your porcelain veneers. Smile makeovers aren’t taught in dental school. Dentists interested in cosmetic work have to invest time and money post-doctorally to learn those skills. As with any artform, some are better than others in creating beauty.

Tetracycline stains are especially tricky and require a dentist who knows how to use opaquers to cover the stains but still make them look beautifully translucent.

You’re correct that you’ll want to whiten the teeth as well. Again, tetracycline stains make this a bit tricky. The Kör deep bleaching system seems to be working the best on tetracycline stained teeth.

Finding an Expert Cosmetic Dentist

The key to you getting a beautiful smile will be choosing the right dentist. The American Academy of Cosmetic Dentistry realized the situation patients were in separating the sheep from the goats when it comes to finding a great cosmetic dentist.

Because of that they started their accreditation program. If a dentist wants to become accredited, they have to pass stringent oral and written exams as well as demonstrate their artistry by providing visual evidence of a large number of cases they’ve done.

Any AACD accredited dentist can give you a gorgeous smile.

This blog is brought to you by Lexington Cosmetic Dentist Dr. Fred Arnold.

Premedication for Dental Implants

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I’m getting mixed messages from dentists. About seven years ago I had a hip replaced. I’ve had no problems with it. Now I’m looking into getting a dental implant. I’ve been to two dentists for consultations. One feels strongly I need to be pre-treated with antibiotics because of my hip replacement in order to have the dental implant surgery. The other thinks that is unnecessary. Is there one answer that is correct?

Liv

Dear Liv,

dental implant diagram

Either philosphy is fine. However, I’d like you to understand the thinking behind both philosophies.

Until 2012, both the American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association (ADA) recommended that anyone with hip replacements that is in need of invasive dental treatment (including dental cleanings) should be pre-treated with antibiotics.

The theory behind it was bacteria could be introduced during the procedure which could invade and infect the area where you had surgery. It was a means of protection.

However, in 2012, both organizations have since said there is not enough evidence to make that an across the board requirement. This essentially leaves it up to the patient and dentist.

Infection and Dental Implants

When done by an experienced implant dentist, there is usually a 98% success rate. That’s very good. That last 2% falls in there because sometimes everything can go perfectly, but your body just rejects the implant.

Whether or not you get pre-treated with antibiotics is up to you. Either way, it’s important you keep an eye on the implant site during the healing and integration process. The leading cause of dental implant failure is infection.

At the first sign of any issue, you need to have your dentist look at it and evaluate whether or not an antibiotic is warranted. Don’t wait until there is a full blown infection and you now have a dental emergency on your hands.

This blog is brought to you by Lexington, KY Dentist Dr. Fred Arnold.

Arnold Dental
699 Perimeter Drive, Suite 200
Lexington, KY 40517
Phone: 859-269-1000
Email: info@lexingtonsmiles.com
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