AllSmiles, Author at Lowell Cosmetic Dentistry Blog

Why is my dentist recommending a crown for a healthy tooth?

September 14, 2021 by AllSmiles

I wonder if my dentist’s business is in a slump, and he is looking for ways to generate income. I’ve had this dentist for four years. He did a root canal on my canine tooth three years ago, and now he says I should consider a crown to prevent the tooth from breaking. I have no symptoms in the tooth, and the x-rays show it is sound. Why would I get a crown? Thank you. Wei from MA

Wei,

Thank you for your question.

Does a Front Root Canal Tooth Need a Crown?

A front tooth with a root canal does not need a crown unless it is weak or is already missing most of its structure. Sometimes, a dentist will place a crown for aesthetic reasons, but an advanced cosmetic dentist might use another option to improve the tooth’s appearance.

How Does Root Canal Affect a Front Tooth?

Root canal treatment removes tooth infection, but it also makes any tooth more brittle. Although it is easy to crown the tooth, more care is needed with a front tooth.

Canine Teeth and Root Canal Treatment

Preparing a canine tooth for a crown requires a dentist to remove about one millimeter of structure all around the tooth. About 50% of the tooth’s fracture resistance will be left. If the tooth weakens over time, it can break and create the need for a dental implant.

Canine teeth have long roots to absorb intense horizontal stress to protect back teeth. So, grinding down a canine tooth for a crown is not advisable when the tooth is in reasonably good condition.

Your dentist’s exam and x-rays show that your canine tooth is sound. So, we recommend not accepting a dental crown. You can ask your dentist for more information on why he recommends a crown if the tooth is in good condition. But based on the information you provided, we would not disturb the tooth and weaken it without good reason.

You may choose to get a second opinion from a nearby accredited cosmetic dentist.

Michael Szarek, DMD, an accredited cosmetic dentist in Lowell, MA, sponsors this post.

What are my options for whitening one gray tooth?

August 30, 2021 by AllSmiles

My upper left incisor is getting grayer each year. My dentist referred me to an endodontist who says the x-ray shows a possible horizontal fracture. She recommended a root canal, but I am wondering about cosmetic options. Will regular teeth whitening or internal bleaching help? – Thank you. Irina

Irina,

Thank you for your question.

Dr. Szarek would need to examine your x-rays, but root canal treatment is unnecessary unless you have a tooth infection, and it will not lighten the tooth. If you have a tooth fracture, root canal files that clean out the tooth might worsen a horizontal fracture.

What Else Can Cause a Dark Tooth?

If your tooth is not infected, it might be turning dark from trauma to the tooth that happened years ago. As your body responds to tooth trauma, it builds secondary dentin beneath your tooth enamel, which can darken a tooth.

Whitening a Dark Tooth

A cosmetic dentist can determine how bleaching gel will affect your teeth

Internal bleaching, dental bonding, and porcelain veneers are ways to whiten teeth, but their purpose varies.

Internal bleaching – The procedure follows root canal treatment for a tooth that a dentist has already opened from the crown. If you do not need root canal treatment, opening your tooth for bleaching is not recommended.
Teeth whitening – Bleaching gel breaks down stains from external factors that darken your teeth, like smoking or drinking coffee or tea. But if your tooth is dark from the inside out, bleaching gel may have limited results. A cosmetic dentist can explain the results you can expect with this option depending on the cause of the discoloration.
Dental bonding – A trained cosmetic dentist can blend dental composite (resin and glass), layer it on your tooth, harden each layer, and conceal the discoloration. Only a cosmetic dentist can perfectly match the bonding to your natural tooth color.
Porcelain veneer – A custom-made shell of porcelain covers the front of your tooth. An artistic cosmetic dentist and master ceramist must create the veneer to mimic the natural translucence of your teeth while hiding the gray beneath it.

Any treatment option that hides discoloration within a tooth is challenging for most general dentists to achieve beautiful results. We recommend looking for an advanced—preferably accredited—cosmetic dentist for natural-looking results.

Michael Szarek, DMD, an accredited cosmetic dentist in Lowell, MA, sponsors this post.

Will porcelain veneers help an adult’s primary adult teeth look larger?

August 25, 2021 by AllSmiles

Two of my upper left permanent teeth grew behind my baby teeth. I’m wondering if two porcelain veneers will work to make the baby teeth look larger. I’m 26 years old and more conscious about my smile than when I was younger. Are porcelain veneers or some other type of cosmetic dentistry best for making my teeth look larger? Thank you. Zenoah from PA

Zenoah,

Thank you for your question. Dr. Szarek would need to exam your teeth for a complete diagnosis and treatment options. But we will explain how dentists, in general, handle permanent teeth that grow behind primary teeth.

What Can You Do About Primary Teeth that Grown Behind Permanent Teeth?

When primary teeth grow behind permanent teeth, a dentist can correct the issue with orthodontics if the permanent teeth have erupted. Brackets attached to your permanent teeth will help move them to the correct position.

Remove primary teeth – Your dentist or orthodontist must remove the primary teeth to make room for the permanent ones and help them erupt in the correct position.
Possibly remove a few permanent teeth – If your teeth are crowded, your dentist might recommend removing some permanent teeth.

When Permanent Teeth Never Develop

When permanent teeth never develop due to disease, a medical condition, or genetics, a dentist or orthodontist can

Use braces to correctly position the tooth on either side of the missing one
Remove a permanent tooth to make room for replacing the missing tooth if necessary
After orthodontic treatment, replace the missing tooth with a dental implant and crown

Will Porcelain Veneers Help Primary Teeth Look Larger?

Photo of a porcelain veneer, which cannot be whitened, held against a natural tooth for Lowell, MA cosmetic dentist Dr. Szarek

At times, porcelain veneers are an option for helping small adult teeth look larger

Although a porcelain veneer can help a primary tooth look larger, it may not be the solution when a permanent tooth is behind the primary one. But at times, porcelain veneers can improve the appearance of primary teeth in adults. Read the March 2017 Operative Dentistry article, Ceramic Veneers for Esthetic Restoration of Retained Primary Teeth, for details.

Conclusion

Each patient’s case is unique, so you will need an exam for a dentist to determine which treatments will work for your case. We suggest scheduling a consultation with an accredited cosmetic dentist and an orthodontist to discuss your options.

Look for accreditation from the American Academy of Cosmetic Dentistry or the American Academy of Esthetic Dentistry. Rather than tell either doctor that you want porcelain veneers, let them examine your teeth and explain your treatment options.

Michael Szarek, DMD sponsors this post. Dr. Szarek is an accredited cosmetic dentist in Lowell, MA.

Eight years of missing teeth, and my face is starting to sink

July 30, 2021 by AllSmiles

I have had three upper tooth missing for about 8 years and one lower tooth missing for about 9 years. I have noticed what feels like a decrease in volume in my jawbone on that side of my mouth. It is also difficult for me to chew on that side, so I chew on the left side of my mouth. When I look at myself in the mirror, I notice that the right side of my face looks a little sunken. Finally, I can get dental implants, but I wonder if this thing with my jawbone and face will get corrected with the implants. Oksana

Oksana – The situation you are describing with your cheek and jawbone is likely an indication that your jawbone is shrinking. When a tooth is missing, your body resorbs the jawbone from the space. A shrunken jawbone can cause the face to sag, as you described.

Can You Get Implants with Bone Shrinkage?

If you have jawbone shrinkage, to receive dental implants, bone grafting, an implant dentist or oral surgeon must build up your jawbone.

After the grafting procedure, when your jawbone heals, dental implants can be placed.
It takes about four months for bone grafts to heal.
Building up your jawbone and placing the implant will help to give your face its natural form again.

Beware of Bargain Implants

Dental implant diagram of component, implant fixture in bone, and crown placement

Dental implants can prevent bone shrinkage and facial sagging

People who need dental implants might be tempted to find the lowest cost possible. The danger in price shopping is that you may receive poor quality in implant fixtures and implant placement. We strongly recommend that you find a few experienced implant dentists with whom you can have consultations.

You will discuss your options with each dentist and decide who you want to complete your implant placement. Be sure to find an implant dentist who is also a cosmetic dentist. They will provide you with natural-looking crowns for your implants.

This post is sponsored by Michael Szarek, DMD of Lowell, MA.

My teeth are still sensitive even with Sensodyne

July 15, 2021 by AllSmiles

I’ve been using Sensodyne toothpaste for over a month because my teeth are sensitive. I have root exposure on a lot of the teeth. Sensodyne isn’t helping, though. What else can I do? I am waiting to get the sensitivity under control before I get teeth whitening from my dentist. I want in-office whitening because it is fast. And I think that if I have to whiten my teeth at home, I probably won’t finish the entire two weeks. I am forgetful. But if I need to switch from Sensodyne to another brand, that’s doable. Thanks. – Gene

Gene,

Please tell your dentist Sensodyne isn’t decreasing the sensitivity in your teeth. They can prescribe fluoride toothpaste. Try the prescription fluoride toothpaste for six weeks to determine if it will minimize the sensitivity.

Options to Decrease Teeth Sensitivity

When your teeth are sensitive, and toothpaste like Sensodyne does not work, your dentist can try other methods.

Fluoride varnish – Your dentist can apply fluoride varnish applied to the exposed roots. You can get varnish treatments after dental cleanings—usually every six months. Your dental insurance may not cover it.
Composite fillings – Your dentist can blend dental composite to match to cover the exposed roots. You will get instant relief. Dental insurance will probably provide some benefits, along with your copay. But after teeth whitening treatment, your teeth will be whiter than the composite, so depending on the length of your smile, your dentist may need to lighten the composite.
Gum grafting – If receding gums contribute to tooth-root exposure, your dentist may perform a graft to cover the roots and decrease sensitivity.

Photo of teeth whitening trays in a case, for information on DIY teeth whitening from Lowell, MA dentist Dr. Michael Szarek.

Resolve tooth sensitivity before whitening your teeth

Your dentist will discuss your options with you. Be patient and ensure the treatment gives you lasting results. Don’t rush bleaching your teeth because it can increase sensitivity in your teeth.

This post is sponsored by accredited cosmetic dentist Michael Szarek, DMD, of Lowell, MA.