Archives for April 2022

My New Dentist Wants to Replace My Veneers

Posted on April 30, 2022 by AllSmiles.

My dentist in Colorado placed porcelain veneers on my front teeth in 2017, but I’ve had problems with them since I got them. Now my new dentist wants to replace my veneers. Three of the eight veneers have fallen off in the past, but they still do not feel stable even though my previous dentist re-bonded them. The veneers are on eight upper front teeth, and the teeth are sensitive. I moved to Virginia this past January and found a new dentist. I went for a dental cleaning, x-rays, and exam three weeks ago and talked to the dentist about my uncomfortable veneers. I was surprised that the dentist recommended replacing the veneers with crowns because she can get better results with veneers. I understand what dentists do for crown and veneer tooth prep, so I choose veneers. Although my veneers are problematic, why would a dentist recommend crowns? Why not replace the faulty veneers with new ones? Thank you. Liya from Illinois

Liya,

Thank you for your question.

Although you are experiencing problems with your veneers, we recommend that you do not accept replacing them with dental crowns. As you understand, the aggressive tooth preparation is probably not necessary.

Why Do Porcelain Veneers Fall Off?

Porcelain veneers may fall off due to a dentist’s bonding technique, aggressive tooth preparation, or a patient’s teeth grinding.

Aggressive tooth preparation – Skilled cosmetic dentists remove minimal amounts of tooth enamel. If a dentist removes too much enamel and bonds veneers to dentin (the layer beneath enamel), the weak bond can cause veneers to fall off.
Bonding technique – Without advanced cosmetic dentistry training, a dentist may use faulty bonding techniques that result in unstable veneers.
Teeth grinding – Clenching or grinding your teeth can loosen veneers. Cosmetic dentists recommend wearing a mouth guard while you sleep to reduce the impact of teeth grinding on your natural teeth and veneers.

Schedule a Cosmetic Dentistry Appointment

You mentioned tooth sensitivity and past issues with veneers falling off. A skilled cosmetic dentist will x-ray your teeth and perform a thorough exam to identify the cause of your concerns with veneers and recommend treatment.

Dr. Gilberto Tostado, a San Antonio, Texas, cosmetic dentist, sponsors this post.

Porcelain veneers patient photos from Dr. Gilberto Tostado

I Got Invisalign and Now I Have TMJ

Posted on April 29, 2022 by AllSmiles.

I am 7 months into Invisalign, and now I have what I think are TMJ issues. My jaw hurts, and it locks. Also, I can hear some clicking in my ears. This never happened before Invisalign. So, I am connecting these issues with Invisalign.

I am upset because I specifically wanted Invisalign for my job, which involves a lot of travel and presentations to potential clients. Now the thought of having braces is scary. I know that it will affect my effectiveness and ability to get contracts. How many people are going to take a 46-year-old woman with braces seriously?

It is also disappointing that my dentist didn’t tell me that this might be an issue before getting Invisalign. I anticipate a lot of defensiveness from him because that is just his nature. So, I need to ask an independent dentist before confronting my dentist with this concern. Maybe I will explore lingual braces, although I hear those are painful. Unbelievable. I will have a TMJ dentist do an exam if this is common. Can Invisalign cause TMJ? Thanks, Lashawn from Memphis, TN

Lashawn,

Diagram of the temporomandibular joint and surrounding structures

Temporomandibular joint (TMJ)

Thank you for your question. Although Dr. Tostado would need to examine your teeth and x-rays for an accurate diagnosis, we can answer your question.

Does Invisalign Cause TMJ?

Orthodontic treatment, including Invisalign, does not cause TMJ. Still, movement of your bite can cause pre-existing joint dysfunction to worsen. The manufacturer of Invisalign cautions that oral appliances may aggravate TMJ disorder. It would be best to tell your dentist about the jaw-joint problems you are experiencing.

Your dentist will interrupt your orthodontic treatment to address your TMJ discomfort. It is essential to address the issue first to prevent it from worsening. Your dentist will later determine whether your treatment with Invisalign should continue or if another type of orthodontic treatment would be best for your case.

If you feel you need a second opinion, schedule an appointment with a dentist trained in diagnosing and treating TMJ.

San Antonio prosthodontist Dr. Gilberto Tostado sponsors this post.

Should I Get a Dental Implant or a Bridge?

Posted on April 15, 2022 by AllSmiles.

Last September, I had a root canal that went bad. My dentist tried to save the tooth, but he couldn’t. So last week, he extracted the tooth. It’s a front tooth, too. I’m going back and forth with whether to replace it with a dental bridge or an implant. And I’m not sure if I’ll let my dentist do the work or find a new dentist to do it. Other than the cost, would I be making a mistake if I asked for a bridge? Thanks, Octavia from Charleston, SC

Octavia,

There are several factors to consider when you have a missing tooth. It is essential to replace the tooth for function and appearance, but you should consider the long-term effects of treatment on your budget and your oral health.

Dental Implant vs. Bridge

Model of a dental crown and dental implant with a crown

Dental implant considerations: If you receive a dental implant, it will not affect teeth on either side of the missing one. A dentist or surgeon places the implant in your jawbone. After a healing period, your dentist will attach a dental crown. You can get an implant and a temporary replacement tooth on the same day. Dental implants are generally more expensive than a dental bridge, but they are also permanent. The implant will look and feel like your natural teeth. High-quality implants can last a lifetime.

Dental bridge considerations: The bridge work will be less expensive than an implant. The tooth on either side of the missing tooth must be shaved down for the bridge to fit over it. The missing tooth is suspended between the two crowns. If you take good care of it, a bridge can last ten to fifteen years. It will eventually need to be replaced.

In either case, select an artistic cosmetic dentist to do the work. Whether you choose a dental implant or a bridge, you will get natural-looking results. If you choose an implant, avoid looking for cheap implants or insisting on getting the lowest cost for them. Costly implant mistakes can occur when shortcuts are taken.

We suggest that you schedule consultations with at least two cosmetic dentists to discuss your options and the cost.

San Antonio dentist Dr. Gilberto Tostado sponsors this post.