smile makeover Archives - Arnold Dental

Gap Back After Three Rounds of Braces

Posted on December 6, 2024 by writeradmin.

I’ve had braces in my teens, and two other times in adulthood. I keep having tooth movement that requires a fix. This time, my front teeth feel too prominent to me and the tooth gap has returned. I don’t want to do braces again, but want to do porcelain veneers. I was wanting two veneers for the front teeth, but my dentist says I need six. Is there no way to do just the two?

Madeline

Dear Madeline,

I want to go over the tooth movement first. Adult tooth movement happens to many people. Your orthodontists should have provided you with retainers after your treatments. For some people, using these for the first year or so after treatment are enough to keep the adult movement in check. For others, you need to wear the retainer, at least overnight, for the remainder of your life. It sounds like you are one of the latter.

As for the porcelain veneers, there are three possibilities here. The first is that your dentist is a highly skilled, ethical dentist who knows that just doing the two front teeth will not give you the smile you want. There are several reasons this could be. The second reason could be that he’s just trying to get you to buy more veneers, which is unethical. A third reason is that he is not skilled enough to just do the two teeth and match them to your adjacent teeth. He’s requiring the six to make it easier for him. However, unless you have a narrow smile, six would not be enough in that case. Most smiles are eight to ten teeth wide.

That does not mean you should get more than you need because the dentist lacks the skill to match things. What you do in that case is find a dentist who is skilled enough.

Do you know the cosmetic skill level of your current dentist? Cosmetic dentistry is not a recognized specialty. Any dentist can legally do cosmetic dentistry even if they have hardly any training on the procedures. Dental school alone will not be enough. Beautiful smile makeovers are not taught there. You need a dentist who invested in post-doctoral training as well as having an artistic eye. The best cosmetic dentists are accredited by the American Academy of Cosmetic Dentistry (AACD). I would do an internet search for an AACD accredited dentist in your area and get a second opinion.

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

Can You Bond a Maryland Bridge to Two Implant Crowns?

Posted on November 23, 2024 by writeradmin.

I have two dental implants with crowns on them. Between those two teeth is a natural tooth that, up until now, was completely healthy. Now my dentist is hinting that we may not be able to save this. Is it possible to put a Maryland Bridge between the two implants and bond the bridge to the two implant crowns?

Benedict

Dear Benedict,

While technically you could attach a Maryland Bridge to the two adjacent dental crowns, it will be risky. You would need a dentist who is skilled in the special requirements in placing a Maryland Bridge. Unfortunately, most dentists just think all you need to do is grind a bit of the tooth in order to make room for the bridge. However, there need to be grooves placed carefully as well in order to deal with the twisting forces. Most of them end up with a short life span as a result (the bridge’s not the dentists).

You have an added complication of needing to bond your Maryland bridge onto porcelain instead of natural tooth structure. The bond is strongest when affixed to natural tooth structure. Bonding it to porcelain will not have as strong of a bond.

Ideally, your dentist would have planned ahead for the possibility of you losing the tooth between the two dental implants. If so, he would have placed the abutments parallel and used screw attachments. That way if you lost the middle tooth it would be a simple matter of taking off the crowns and then placing a dental bridge in their place.

If that is not something your dentist prepared for, you can see if there is enough room for another single dental implant to be placed.

Hopefully, one of those solutions will work for you. You are certainly able to try a Maryland Bridge, but just go into it with your eyes wide open.

This blog is brought to you by Lexington, KY Cosmetic Dentist Dr. Fred Arnold.
Click here to read about smile makeovers.

Inflamed Gums After Porcelain Veneers

Posted on October 18, 2024 by writeradmin.

I had four porcelain veneers done in Columbia. I took the precaution of making sure it was done by a N.Y. dentist that lived there now. I’ve realized that I probably should have had more than four done because my other teeth are showing when I smile and they do not match up. I want to get at least four more, but can’t get any more time off to get back to Columbia. I was wondering if you knew whether or not there was a dentist who uses my Emblem Health Dental Insurance. I also wondered if you can tell me how to fix the redness and inflammation that are affecting the gums with the porcelain veneers. I probably should get the gum problem under control before adding new veneers.

Ellie

Dear Ellie,

My guess is that you went to Columbia in order to save money on your porcelain veneers and that is also why you are looking for a dentist that gives discounts through your health insurance. This is actually what lead to the problems with your gums. This N.Y. Dentist thing doesn’t mean he had any skills or that he was actually trained in New York.

I looked at the list of cosmetic dentists in the area you went. Only a handful had a connection with New York and even those were tenuous and showed no actual training in cosmetic dentistry.

Two things signal to me that your dentist in Columbia does not have the training that you need. First, knowing that you only had four porcelain veneers done, your dentist should have suggested you do teeth whitening first. Most smiles are eight to ten teeth wide. That would ensure that the teeth blended in with your porcelain veneers. This is pretty much standard operating procedure.

Second, the problem with your gums indicates that he doesn’t have the technical skill needed to do them correctly. The redness and swelling indicate that you have gum disease. This is likely due to the fact that your dentist did not place them seamlessly against your teeth. This can lead to a ledge of sorts by your gums which will trap food and other bacteria. Guess what that does? Breed gum disease.

This has to be repaired before you can move on to getting your other teeth done. That repair may be a simple one like removing excess bonding that was not properly removed, or it could mean that the veneers need to be replaced.

In your place, I would get this checked out by an expert cosmetic dentist. If you leave gum disease unchecked, you can end up losing those teeth. Go to a dentist who is AACD accredited. This is completely different from being a member and will ensure that the dentist has expert technical expertise as well as artistry.

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

Floss Catching Under My Porcelain Veneer

Posted on September 28, 2024 by writeradmin.

I need some advice. I recently had six porcelain veneers done. They do make my smile look better, but whenever I floss, the floss string gets caught under the front two veneers. My dentist says it is not a problem because you can’t see the problem when I smile. However, I’m worried that if my floss can get trapped there, so can other things. The last thing I need is decay so close to the root of my tooth. Am I worrying over nothing?

Emma

Dear Emma,

It is a shame that your dentist either does not understand the seriousness of this situation or she just doesn’t want to take responsibility for her mistakes. It doesn’t matter if you can see a problem. It is still a problem. Just because you can’t see cancer, doesn’t mean you should ignore it.

You are correct that things can get trapped there and cause decay. Even more likely, though, is your gums will get red and inflamed. Eventually, you will end up with a serious gum disease problem.

It is important that your dentist fix this. It sounds to me like you have a margin irregularity known as an overhang. This happens when the dentist had problems with the impression taken after your teeth were prepared for the porcelain veneers. Because the impression did not accurately record the upper end of the tooth preparation. This creates a bit of a bump or lip that things, such as your floss.

As I said, your dentist needs to fix this. The only way to do that is by replacing the porcelain veneers that have the problem. If your dentist has a sense of ethics, he or she will take care of this quickly and at their cost. If they don’t, it is still important you get it replaced, even if that means going to see a different dentist to do it. While you are waiting to get this replaced, make sure you continue to carefully floss the area. I know that is a bit challenging, but it is important.

This blog is brought to you by Lexington, KY Cosmetic Dentist Dr. Fred Arnold, an AACD accredited dentist.

Will Supersmile Toothpaste Whiten Dental Bonding?

Posted on September 6, 2024 by writeradmin.

I have dental bonding to repair a gap in my teeth. It has started picking up stains, which makes my front teeth look odd. I have been told that teeth whitening won’t work for them. I’m curious if the Supersmile toothpaste will do better. It has been advertised as being specific to cosmetic work.

Jared

Dear Jared,

You didn’t mention how long you’ve had your dental bonding, but they should last you several years. They are not as stain resistant as porcelain veneers so I would expect to replace your bonding periodically. That doesn’t mean you can’t prolong their life. One of the things that can do that is Supersmile Toothpaste.

You are correct that teeth whitening will not improve your dental bonding. Supersmile will remove surface stains on them. In fact, it is the only whitening toothpaste which I would recommend for cosmetic dental work. Over the counter whitening toothpastes use abrasives, which will cause damage to both your natural teeth as well as your cosmetic work. Instead, Supersmile removes it chemically in a way that is completely safe to both natural tooth structure as well as dental work.

There are a number of ways that bonding can pick up stains. If the stains are more than just on the surface level, but have gotten into the bonding itself, then not even the toothpaste will help. In that case, you will want to replace it. As I mentioned earlier, this is something I would expect to do several times over your lifetime.

When You Want More Out of a Smile Makeover

If all that you wanted to improve with your smile was the tooth gap, then sticking with your dental bonding makes complete sense and I would do that. Just make sure if you want some whitening done, then I would do the whitening before you have the bonding replaced so that they can match perfectly.

However, if you have other issues that bother you with your smile, you may be better off with porcelain veneers. This is the go-to for celebrity smile makeovers and can completely transform anything you want about your smile, including the shape, size, and color of your teeth. The additional benefit to these is, when well cared for, they can last a couple of decades instead of just a few years.

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

Comparing the Costs of Lumineers and Durathin?

Posted on May 9, 2024 by writeradmin.

I’ve been looking at both DuraThin and Lumineers. I like the pictures I’ve seen of DuraThin a little better, so I guess it is down to price. Do you know which one will cost me less money?

Joanne

Dear Joanne,

While I like the fact that you are doing research, I want to redirect the way you are going about it. If you are going to purchase something like a pair of Prada shoes, as long as they are truly Prada, the quality will be the same no matter where you get them. The same is not true of porcelain veneers or most other types of cosmetic dentistry. The way to think about it would be commissioning a piece of art.

If you had a beginning art student as well as Michelangelo, and gave them identical tools and materials to work with, the sculptures would still end up vastly different even if you commissioned them to sculpt the exact same subject. This is because the results depend mostly on the skill and artistic eye of the dentist. Picking the brand will not give you the best results, and there are a LOT more brands than just Durathin or Veneers. You have to pick the dentist. Then, tell them the type of smile you want. They’ll know the best porcelain veneers to give the results you want.

Smile makeovers are not really taught in dental school. In order to do beautiful work, it really requires serious post-doctoral cosmetic training. The problem most patients face is that there is not a recognized specialty in cosmetic dentistry. That means any general dentist can do cosmetic work regardless of how little training they’ve had. So, how do you go about finding the artist you need to do your smile makeover?

The American Academy of Cosmetic Dentistry (AACD) recognized the problem patients faced. As a solution to help both dentists and patients, they developed an accreditation program. In order to get accredited, dentists have to pass stringent exams to prove their technical knowledge, as well as show a specific and large number of actual cases they have done to an examination board in order to demonstrate their artistry. My recommendation is that you look for an AACD accredited dentist. These are in the top 3% of cosmetic dentists in the world. They will give you a stunning smile no matter what the brand.

Don’t be surprised if they recommend something other than Lumineers. This particular brand of porcelain veneers is highly marketed to inexperienced cosmetic dentists as being easy to place. Unfortunately, the company that owns Lumineers insists that dentists use their lab. Most expert cosmetic dentists find their lab to produce sub par results.

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

Cosmetic Dentist Wants to Restore All My Teeth

Posted on March 29, 2024 by writeradmin.

I am going to say upfront that I am a very nervous dental patient, so that is probably factoring into my hesitancy here. I went to see a cosmetic dentist about improving the look of my smile. He wants to put crowns on all my teeth. Most of these teeth have nothing wrong with them, so I am uncomfortable with the idea of grinding them down. On the plus side, he does put a three year guarantee on his work. I’m supposed to see the wax mock up in a few days but I’m becoming more anxious abut the whole treatment plan the closer we get. Do you think I am panicking over nothing?

Christine

Dear Christine,

A tooth being prepared for porcelain veneers

Teeth being prepared for porcelain veneers.

This is an awfully aggressive treatment for someone who just wants to improve the appearance of their smile. Maybe there is something you haven’t mentioned that is significant, such as having been diagnosed with TMJ Disorder. Without something serious such as that, I would not agree to this treatment. Crowning every tooth is known as a full-mouth reconstruction. This is one of the most advanced procedures in dentistry. It takes a lot of post-doctoral training to do this right. When it is done wrong, it can cause serious problems that can leave you in pain for the rest of your life.

Typically, if you are wanting a smile makeover, the standard procedure is to get porcelain veneers. This will not grind down your teeth, the way preparation for a dental crown will. Often, dentists who do not have a lot of cosmetic training will prefer dental crowns because this is one of the first things taught in dental school. Unfortunately, the only thing taught is the mechanics, not the skill and artistry required to create a beautiful result. I want you to look for an AACD accredited dentist to do your smile makeover. These are the best cosmetic dentists in the country and will have the skill and artistry to create a stunning smile for you.

Dealing with Dental Anxiety

You are not alone in your nervousness about going to the dentist. What I don’t want is for you to spend your life that way. I am going to suggest that you, in addition to see an accredited dentist, make sure they are a sedation dentist. If you have a pretty easy procedure, then you can relax with just some nitrous oxide. If you have a procedure that even the idea of it scares you, then what you would want is oral conscious sedation. This is administered by a pill but is incredibly strong. You will need to have a driver to get you to the dentist and back. They’ll also need to stay with you because you will not be as steady on your feet for a few hours.

That being said, it will be the most relaxing dental appointment you have ever had. In fact, many patients who use oral conscious sedation simply sleep through their appointment.

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

Dentist Put Stain on My Lumineers

Posted on December 20, 2023 by writeradmin.

I had ten Lumineers placed. My dentist and I had an indepth discussion about what type of smile I wanted, which included explicit instructions on the fact that I wanted them very white. For some insane reason, he put a stain on them. When I asked him why in the world he would do that, he told me that they still needed to look natural. I was very clear about how unhappy I was. He asked me to give it time and if I still didn’t like it, then he’d make them whiter. I gave it a couple of weeks, but most of that time was spent stewing about how miserable I was with the results. When I went back, the way he made them whiter was by drilling off the top layer. Now I have uneven, dull looking teeth. Is there anything I can do about this? I spent $15,000 on this.

Jenna

Dear Jenna,

I’m sorry to hear that this happened to you. Often, when a dentist asks you to give it time, it is because he is hoping you will feel like a pest and give up. When you didn’t (and good for you, by the way) he was stuck. He told you he’d make them whiter but didn’t know how and resorted to butchery.

Lumineers is a brand of porcelain veneers that is heavily marketed to inexperienced cosmetic dentists as being able to place. This means a lot of dentists, without the adequate amount of post doctoral training, get in over their heads. Under normal circumstances, if you don’t like the appearance of your cosmetic case, there is nothing you can do about it so long as it is functional.

Here is where your dentist’s incompetence paid off for you. By drilling off the top layer of your Lumineers, he destroyed them. That top layer contains the glaze that protects them. Because of that, you have every right to ask for a refund. He may offer to replace them for you, but don’t do that. He will not be able to give you the smile you really want. Tell him you’d rather have the refund. Then you can go to a dentist who has real cosmetic skills and training to get this done. If you want the best cosmetic dentist, then look for a dentist who is AACD accredited.

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

Premium Home Whitening

Posted on September 21, 2023 by writeradmin.

I am trying to whiten my teeth from home instead of using the Zoom method that my dentist uses. I came across something called Premium Home Whitening. Can you tell me if it is safe and effective? I don’t want to waste my money.

Craig

Dear Craig,

I took a look at this and will give you what I like and don’t like about it. First, I’ll go over their special light. I don’t think this actually does anything to benefit the whitening and is simply a piece of psychological manipulation. That annoyed me and I was dubious that the rest of it would be any better. However, they surprised me on one aspect— the whitening ingredient. They use 35% carbamide peroxide. This is a valid teeth whitening agent and, under the right conditions, will do a good job whitening your teeth.

Unfortunately, I am a bit concerned the the remainder of the product hinders that. Here’s why. The big problem is the whitening trays they have you use. They’re going to be a bit loose, which compromises effectiveness and safety. When you get your teeth whitened with a dentist, they provide you with custom-fitted trays that are snug and tailor fit to your bite. This serves multiple functions. First, it protects your gums. Second, it keeps your whitening gel on your teeth. Third, it prevents saliva from leaking into the trays. Why is this important?

Protecting Your Gums

Whitening gel is only meant for your teeth. When it gets on your gums, it can cause irritation. No one wants a painful experience in order to get a beautiful smile.

Keeping the Whitening Gel in Place

The longer the whitening gel is on your teeth, the more effective the whitening process. If you have gel leaking out of your trays, then it is not whitening your teeth. It’s essentially being thrown away and wasted.

Saliva encroachment

In addition to the whitening gel getting out, you will have saliva leaking in. This dilutes the gel that actually stays in the tray. This weakens the effectiveness even further.

Getting the Teeth Whitening You Want

In the long run, I think you will end up spending more money with this kit than if you went through your dentist, simply because you would need several kits to match the same efficiency. That does not mean you have to have Zoom Whitening done.

Many dentists who offer Zoom, also offer the at-home tray method. Talk to your dentist and see if he or she does. I bet they’d be willing to accomodate you. If they don’t, you can always go to another dentist for this procedure. Just make sure you do it about the same time you need to get your next check up and cleaning because many dentists require this before teeth whitening.

There is good reason for this. They need to make sure there are not any underlying problems with your teeth you may not have been aware of, such as the formation of new decay. They also are trying to give you the best result and if your teeth aren’t their cleanest, you could end up with splotchy results.

This blog is brought to you by Lexington, KY Cosmetic Dentist Dr. Fred Arnold.
Click here to learn more about smile makeovers.

Dental Bonding Staining After Just a Few Weeks

Posted on April 17, 2023 by writeradmin.

I recently had dental bonding done on some of my teeth to improve my smile. It’s only been about two and a half weeks and they’re already starting to stain. The only thing that I can think I may have done to them is drink coffee, but my dentist never told me not to. Will I have to avoid coffee from now on? (Please say no). Also, someone told me Supersmile might help. Is that true?

Kevin

Dear Kevin,

I’m glad you wrote. While it is true that dental bonding will start picking up stains after a while, you haven’t had them long enough for this to be normal. Supersmile is great for picking up surface stains without damaging the dental work, but it will not work in this case. You have a different problem than surface stains. It sounds like you went to a dentist who is not as skilled in cosmetic work. Maybe he’s a fine general dentist, but he hasn’t invested in the training necessary to do beautiful cosmetic work. Cosmetic dentistry is not a recognized specialty so it is up to the dentist how much, if any, training he receives. It has to be post-doctoral training too because these techniques are not taught in dental school.

Different Types of Dental Bonding

The composites used in dental bonding are a blend of a plastic resin with inorganic fillers. These fillers vary in their properties, including their particle sizes. Hybrids are strong, but the large size of their particles means they cannot be polished to a high shine, which is necessary to keep them looking beautiful.

Microfills are the opposite. Their tiny particles mean they can be polished up to a shine that will make them look like your natural teeth. However, they are not quite as strong. There are some newer nanofiller composites that are claiming to have both durability and high polishability. I’m looking forward to seeing if this is accurate.

An experienced cosmetic dentist would have put the high durability composites on the interior of the teeth, then apply a microfill to get that high polish. It sounds to me like your dentist either doesn’t have the requisite polishing equipment or does not stock the needed variety of composites.

Where to Go From Here

My suggestion is to go back to your dentist and give him or her a chance to make this right. You can show them this post and see if they can get it right. If not, request a refund and then go to an expert cosmetic dentist to have them do this. However, I will say if you are covering the entire surface of the tooth a better solution would be to have porcelain veneers placed. These will last much longer.

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