Archive for September, 2010

Porcelain crowns for front teeth are causing lots of trouble.

Tuesday, September 21st, 2010

Well my sr. year i saved enough money to get my teeth fixed. one of my teeth in the front was cracked. my two front teeth are porcelain crowns all the way around. my dentist put in the normal crowns at first but this wasnt what we had discussed so he replaced them with the porcelain all around. well now after 8 months my teeth underneath them are dead. could the reason my teeth are dead be from the dentist? i take pride in my teeth i had braces for 5 years and i brush and floss my teeth everyday. i havent had any problems before. i’m afraid i wont be able to pay for what is a head for my teeth.
- Kendra from Kentucky

Kendra,
Ooooh, this sounds like a tough situation.

Yes, the reason your teeth died is undoubtedly because of the crowns. Now you need root canals, and you should also have glass fiber posts placed inside the teeth to strengthen them, because the next problem you could be facing down the road is that the teeth will just break off at the gumline and then you’ll need to go to implants. Not metal posts. Glass fiber posts. This is important. If your dentist is one whose first thought would be to put porcelain fused to metal crowns on two front teeth, he may not be very familiar with glass fiber posts. A glass fiber post will flex with the tooth and thus will reduce the risk of later root fracture.

If you’re around age twenty or younger, your front teeth would have large pulps. When you do a crown on a front tooth, you have to remove quite a bit of tooth structure, and there is a risk of getting close to the pulp and damaging the pulp. And if you had the crown procedures done twice, that would increase the risk of damage. That’s not to say that the dentist did anything wrong, but at a minimum, you should have been warned that this was a risk.

Another factor in your case is that your dentist clearly didn’t feel comfortable doing all porcelain crowns. Dentists that know how to do all porcelain crowns will far prefer them for front teeth, because they are so beautiful and natural looking compared to the porcelain fused to metal crowns. So this suggests to me that maybe he wasn’t all that familiar with the proper bonding procedures for this type of crown. So maybe, just maybe, something wasn’t done right in bonding them.

I think this would be something that this dentist should take responsibility for. Approach him with that, explain how your finances are limited, and ask him to help with this.

And, if he is the one to do this followup work, be careful about the posts. Ask how many glass fiber posts he has placed. Pin him down. If he doesn’t use this type of post routinely, I would have another dentist do that part – a dentist who does a lot of cosmetic dentistry. If he has placed a couple dozen or more, to me that would indicate a satisfactory comfort level with this type of post.

I wish you the best. Take these next steps carefully, because you’re a long way from out of the woods on this.

Nightguard makes her teeth sore.

Saturday, September 18th, 2010

Is there any way that I can loosen up a mouthguard (custom-made at a dental office), so that it will fit more comfortably on my teeth? Right now it pushes against my teeth; and when I wake up in the morning, my teeth are somewhat sore, and it feels as if braces were trying to realign my teeth. Is there any way I can make it fit looser, so that I don’t have to have another one made?
- Angie

Angie,
It’s very difficult even for a dentist with all the tools they have to adjust appliances like this to adjust the fit of a nightguard on the teeth. It needs to precisely fit every tooth – its shape and inclination. For a lay person to do that without the knowledge of dentistry and with household tools is pretty impossible.

But if I am interpreting accurately what is happening here, this could be a significantly unhealthy situation. It sounds like this nightguard is pushing your teeth into a new position every night. Therefore, you may be having a continual back and forth motion on your teeth, which can contribute to making them loose. Whether or not this is a problem depends on how far the nightguard is moving your teeth.

If this nightguard isn’t very old, the dentist should adjust it or remake it for no extra charge. If you have had it for a while, you will probably have to pay to get this done.

Background information and other links:
A nightguard is usually a treatment for TMJ disorder. Click here to read more about TMJ disorder.
Dr. Rota has great expertise in treating this disorder, but there is no recognized specialty in TMJ treatment, so it wouldn’t be accurate to call him a TMJ specialist.

What can I do about tetracycline stains?

Saturday, September 4th, 2010

I’ve heard about Supersmile toothpaste and that it’s good for stains on teeth. How does it work on tetracycline stains. If it helps, I want to buy some.
- Jeff from Arizona

Jeff,
Supersmile won’t have any effect on tetracycline stains, because those stains are embedded in the teeth. The tetracycline antibiotic, if it is taken while the permanent teeth are forming, will deposit in those teeth and cause a brown or gray stain that is deeply embedded in the teeth. Supersmile removes other surface stains by dissolving away the protein pellicle that the stains attach to. So it is great for tobacco stains, Peridex stains, and other similar stains.

Tetracyline stains are one discoloration, also, that doesn’t respond well to Zoom whitening or bleaching. Bleaching will lighten them a little, but not a lot. They are best treated by covering them with porcelain veneers. Even then you need to be careful to have this done by a highly experienced cosmetic dentist, or the results could be very disappointing. Dentists who try this without a lot of experience tend to make the porcelain veneers too translucent, and the dark brown or gray shows through.