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Advanced cosmetic and general dentistry

My First Premolar Tooth Is Sensitive to Cold

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My upper left first premolar tooth is sensitive to cold and air. My dentist’s diagnosis with the air test was too fast. She did not tell me what had been causing the sensitivity. I fear an infection will affect the porcelain veneer tooth in front of it. Addison from Tacoma, WA

 

Addison,

Sensitivity in a tooth can be easy to diagnose, and an air test is the primary way to assess it. At other times, it is more complicated

Air Test for Tooth Sensitivity

An air test helps a dentist identify unprotected and sensitive areas. A dentist may apply a desensitizing bonding agent to coat the tooth and minimize sensitivity.

What Causes Tooth Sensitivity to Cold?

The cause of tooth sensitivity depends on several factors, including the type of pain and the tooth’s condition.

Type of pain

  1. Brief pain – Irritated tooth pulp or nerves can cause brief pain. The irritation will heal.
  2. Lingering pain – A tooth infection causes lingering pain. Your dentist may recommend root canal treatment.
  3. Pain around a tooth filling – Bacteria can leak in any space between a tooth and the filling, causing sensitivity.

Tooth condition

  1. New filling – It is normal to feel sensitivity after a new tooth filling. But if bacteria from tooth decay is left behind during the filling process, the tooth can become infected. Root canal treatment will remove the infection.
  2. Tooth decay – Decay or infection can cause sensitivity to heat or cold. It will not spread and infect your porcelain veneer tooth if a dentist catches the decay and treats it.
  3. Fracture – A fracture from trauma or wear can irritate tooth nerves and cause sensitivity. Untreated pulp damage can require root canal treatment and a dental crown.
  4. Gum recession – If your gums pull away from a tooth, it can be sensitive to cold or heat. You can use desensitizing toothpaste, or a dentist may recommend a gum graft or another technique to restore gum tissue.
  5. Worn tooth enamel – Worn tooth enamel exposes dentin (the layer beneath the enamel). Dentin contains small tubes that lead to tooth nerves that can become sensitive.

Dr. Michael Szarek, an accredited cosmetic dentist in Lowell, Massachusetts, sponsors this post.

Large Tooth Gap Left After Gum Disease

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There is a very large gap between 2 teeth on the front left side of my mouth. I went to the dentist 2 weeks ago and found out that I have gum disease, which is causing the gap. I have an appointment with a periodontist on the 26th of this month. I know she will get the gum disease under control. At least, I hope she can, but what can be done about the gap between my teeth? What are my options for closing it? Thanks, Michele

Michele –

Thank you for contacting Dr. Szarek’s office

You are correct. Getting your periodontal disease under control is the first priority. Afterward, a cosmetic dentist can examine your teeth and evaluate your oral health to determine if you are ready for cosmetic dentistry for the gap.

How Can You Close a Large Gap Left from Gum Disease?

The severity of the periodontal disease and the gap size will affect how the space between your teeth should be treated. Two options include porcelain veneers and dental implants, both of which require good oral health before treatment begins.

Porcelain Veneers

A porcelain veneer held next to a tooth

Porcelain veneers can close a tooth gap after you achieve good oral health

If the teeth can be saved, porcelain veneers may be used to close the space between them. Or, it is possible that braces can be used to move your teeth into position. Dental bonding works for small gaps.

Dental Implants

If the teeth cannot be saved, a dentist can replace them with dental implants and ensure the results look natural, without a gap between your teeth.

A cosmetic dentist is concerned with the appearance of your smile—that it is beautiful and natural looking. If your dentist is not a cosmetic dentist, consider finding one to restore your smile after treating your periodontal disease.

Lowell, Massachusetts, accredited cosmetic dentist Dr. Michael Szarek sponsors this post.

I Still Have Gum Disease After Two Years of Deep Cleanings

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After searching for three weeks, I found an affordable dentist to treat me for gum disease. I had called several offices, and their fees were too high. Although I have dental insurance, most fees exceed my budget, so I selected my current dentist. My concern is that in June of this year, it will be 2 1/2 years since treatment started. I go for a deep cleaning about every four months, and I still notice that my gums bleed when I brush my teeth, and some of my teeth are still a little loose. My dentist doesn’t think it is cause for concern.

The situation is a little better, but I still don’t think I made the right choice. I have two missing teeth and need porcelain veneers for two chipped teeth. We were waiting until the gum disease was under control to take care of the issues with my teeth, but I’m beginning to think it will take another two years to complete my treatment. Was it a mistake to choose a dentist with low fees just to get treatment? I’m concerned that I will have to go into debt to get the care I need. Thanks. Kristina from Saginaw, MI

Kristina -Thank you for contacting Dr. Szarek’s office.

The length and frequency of your treatment suggest that although your dentist is making treatment affordable for you, he might not be able to resolve your periodontal disease.

Can I Get Porcelain Veneers or Dental Implants with Gum Disease?

Your gums must be healthy before a dentist places porcelain veneers or dental implants.

  • Porcelain veneers – Custom-made shells of porcelain are made to fit the fronts of your teeth. Your gum tissue will frame the veneers like natural teeth. Bleeding and inflamed gums will worsen with porcelain veneers.
  • Dental implants – Healthy gums and bone support dental implants and keep them stable. Unhealthy gum tissue can prevent your dental implants from healing.

Gum Disease Signs and Symptoms

The signs and symptoms of gum disease include:

  • Bleeding, sore, and inflamed gums
  • Infected or inflamed gums
  • Gum recession
  • Gum tissue separates from teeth
  • Loose teeth
  • Chronic bad breaths

If you are experiencing the signs and symptoms, they must be controlled before you get cosmetic dentistry treatment or dental implants.

What Can You Do If  Gum Disease Will Not Go Away?

If you are still experiencing discomfort and some of the signs and symptoms of gum disease after a series of deep cleanings, it is time to ask your dentist for a referral to a periodontist (gum specialist). If your dentist is unwilling to refer you to a specialist, you can self-refer if your dental insurance allows it or get a second opinion.

Does Affordable Treatment Result in Low-Quality Care?

Drastically lower fees may indicate that a dentist takes shortcuts or lacks the skills or experience to resolve specific issues. Still, even dentists with high prices can provide inadequate treatment if they don’t have expertise in an area.

A porcelain veneer held next to a tooth

You need healthy gums for porcelain veneers

We recommend getting a second opinion. A conscientious dentist will let you know if they can resolve the issues with your gums. If not, the dentist will refer you to a periodontist—a specialist in diagnosing and treating problems with your gums.

Find a dentist who will provide care yet work with your budget. But look for dentists with advanced training in treating periodontal (gum disease). There are several ways a dentist can make care affordable for you, including:

  • Completing dental work in phases whenever possible
  • Offering payment plans
  • Offering financing options

The condition of your teeth and your gums are closely related. After your gum disease is controlled, a cosmetic dentist can let you know your options for improving the appearance of your smile with porcelain veneers and dental implants. For now, it’s crucial to get a second opinion. Remember to check with your dental insurance company for dentists and periodontists within the network. It will help you avoid unnecessary out-of-pocket costs.

 

Lowell, Massachusetts, accredited cosmetic dentist Dr. Michael Szarek sponsors this post.

 

Did I Ruin My Porcelain Veneers with Whitening Toothpaste?

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Did whitening toothpaste ruin my porcelain veneers? I’ve been using it since I got the veneers in September. I only use it weekly to keep the veneers white. I do not remember if my dentist told me not to use toothpaste on my veneers. I just found out online that some toothpaste scratch cosmetic dentistry work, and embarrassed to tell my dentist what I have done. Will the scratches be visible? Can I get the veneers touched up before my next dental exam and cleaning? Thank you. Zoe from Fresno, CA

Zoe,

Thank you for your question. We understand your concerns about the appearance of your smile and your investment in porcelain veneers.

Does Whitening Toothpaste Ruin Your Veneers?

Although whitening toothpaste may not ruin your veneers, the abrasiveness can scratch the surface of veneers. But you would need to use the toothpaste consistently and long-term for it to scratch. You have used the toothpaste ten to twelve times, so if you have scratches on your veneers, they are minor if they exist.

Your dentist will tell you if the veneers are scratched during your next dental exam. An expert cosmetic dentist can polish veneers.

What Kind of Toothpaste Can You Use on Porcelain Veneers?

A porcelain veneer held next to a tooth

Use nonabrasive toothpaste on porcelain veneers

You can use nonabrasive toothpaste that is specifically for cosmetic dentistry work. Otherwise, the toothpaste formula may wear away the bonding between the porcelain veneers and your teeth. Look for Supersmile® toothpaste or another low-abrasion toothpaste.

How Can You Keep Porcelain Veneers White?

Brushing your teeth twice daily and flossing between them keeps porcelain veneers white because they are stain resistant. During dental cleanings and exams, your dentist and hygienist will use specific tools and materials for cosmetic work. Cosmetic dentists use tools and polishing pastes to restore the shine of porcelain veneers as needed. You will not need teeth whitening products or treatment to keep your veneers bright.

Although you are embarrassed, it was a mistake. You may schedule an appointment with your cosmetic dentist or another dentist to check your veneers. Your dentist will be happy to examine your porcelain veneers and the bonding for any signs of damage and correct them to prevent further damage.

Lowell, Massachusetts, accredited cosmetic dentist Dr. Michael Szarek sponsors this post.

Can I Get Oversized Dental Crowns Replaced with Veneers?

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My new dentist replaced four old crowns on my front teeth in June, but they were too thick and too big. She redid the crowns, but they were still oversized and uncomfortable. The crowns make my lips protrude. Although my dentist says she is willing to try again, I’m done and want to switch dentists. Can I get the oversized crowns replaced with veneers? Thank you. Darlene from Mobile, AL

Darlene,

Thank you for your question. We understand your frustration. Dr. Szarek would need to examine your crowns to determine when they are so bulky, but we will answer your question about switching from dental crowns to veneers.

Can You Replace Oversized Dental Crowns with Veneers?

Photo of dental forceps holding a single porcelain veneers, from the office of accredited cosmetic dentist Dr. Szarek of Lowell, MA.

Porcelain veneers bond to fronts of teeth, but dental crowns cover the entire tooth

You are unable to replace dental crowns with porcelain veneers. Preparing a tooth for a crown requires shaving it down every side of the tooth—making it too small to support a porcelain veneer. In contrast, tooth preparation for porcelain veneers is different. Sometimes, veneers do not require any preparation at all. When a skilled dentist must prepare your teeth for veneers, they will only remove a fraction of a millimeter from the front of each affected tooth.

Your teeth are already prepared for dental crowns, and insufficient tooth structure is left to support porcelain veneers. Also, veneers would leave the backs of your shaved-down teeth exposed and susceptible to decay. You can only replace dental crowns with new crowns.

Get a Second Opinion

Although a cosmetic dentist can only replace your existing crowns with new ones, you do not need to repeat an unpleasant experience with another dentist. Please look for dentists with post-graduate training in cosmetic dentistry and years of experience practicing the art.

Tips on selecting a dentist:

  • Read the dentist’s patients’ reviews. If you cannot find any reviews, be cautious.
  • Schedule a consultation with one or two advanced cosmetic dentists to discuss how to resolve your concerns.
  • Ask to see before-and-after patient photos of the dentist’s experience with crowns.

An experienced cosmetic dentist can replace your crowns and make them look natural.

 

Lowell, Massachusetts, accredited cosmetic dentist Dr. Michael Szarek sponsors this post.