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Advanced cosmetic and general dentistry

My permanent teeth are too small

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My permanent teeth are embarrassingly small. I am 38 years old, but my teeth are the size of a 7 year old child’s teeth. I am a corporate banking professional, and I am frequently giving presentations at our branches. I feel very self conscious when I smile. What can be done to make my teeth look the size of adult teeth? Thanks in advance for your help. – Michaela T.

Michaela – Your concern about the size of your permanent teeth and the embarrassment that your teeth causes is understandable. Genetics or the environment can cause teeth to develop incorrectly.

There are two permanent procedures for which you might be a candidate—porcelain crowns and porcelain veneers.

A porcelain crown requires the natural tooth to be shaved down. The crown is placed over the natural tooth and it completely covers the tooth. A cosmetic dentist will make crowns that look like your natural teeth.

Porcelain veneers cover only the front of the teeth. Usually, teeth are lightly shaved before the veneers are placed. Veneers from a cosmetic dentist will have the color and translucency of natural teeth. They will give you a beautiful smile makeover.

You can schedule a consultation with a cosmetic dentist to find out your options and to get the best results. Cosmetic dentists are dental artists. Find one who has been specifically trained in cosmetic dentistry. You also can check the dentist’s credentials and his or her smile gallery for pictures of smile makeovers that the dentist has completed.

The blog post is courtesy of Lowell cosmetic dentist Dr. Michael Szarek.

Help for patient recovering from bulimia

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Dear Dr. Szarek;

I suffered from bulimia for years, but, with the benefit of counseling and treatment, am now in recovery. The problem is, my illness has severely damaged my upper teeth. They have almost no remaining enamel and are very worn. Also, my upper teeth are very sensitive to hot and cold and this makes it difficult to eat normally. Is there anything that can be done to help? Would the Snap-On Smile be an option?

Thanks,

Liza in Boston

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Porcelain crowns changing color?

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Just over four years ago, my 15-year-old son got porcelain crowns on three of his front teeth. Over the past two years, however, we have noticed that these teeth have gotten significantly darker and are no longer whiter than the teeth on either side. (They were when the crowns were first applied.)

Do you know why this might have happened? What should we do?

-Joyce in Boston

Joyce,

Porcelain crowns, if properly applied and cared for, should not change color. Is it possible that your son had a dental cleaning by a hygienist not experienced in caring for porcelain crowns?

Many dental practices use a device called a Prophy Jet to clean patients’ teeth. The mixture of water and sodium bicarbonate, combined with the force of the spray, can damage the glaze coating the porcelain crowns. Once the glaze is removed or damaged, the porcelain is very vulnerable to staining.

Another common source of damaged porcelain crowns are fluoride treatments with acidulated fluoride. This fluoride can etch the glaze over the porcelain and also leave it vulnerable to staining. Anyone who has had porcelain dental work (crowns or veneers) should be sure to have fluoride treatments with neutral fluoride only.

If you have porcelain crowns or veneers, it’s very important to get regular cleanings from dentists who are experienced with cosmetic dentistry and now how to properly care for and maintain this kind of work. Many general dentists and hygienists do not know that many common treatments can damage porcelain dental work.

As for what to do now: It is possible for a good cosmetic dentist to carefully polish them and improve their appearance. However, if the staining is severe, it can’t truly be reversed without removing the existing crowns and applying new ones.

To learn more about porcelain crowns and cosmetic dentistry by visiting our main website: Michael Szarek, Cosmetic and General Dentistry.