6745 Sugarloaf Parkway
Suite 200
Duluth, GA 30097

(770) 279-8800

Can I Get a Functional and Beautiful Smile?

Posted on by .

I had a full-mouth reconstruction done because of a combination of both tetracycline stains and the fact that I sometimes grind my teeth. While the new teeth look okay, my mouth has been hurting ever since. I can’t tell what the problem is but it hurts the most when I bite down to chew. I’ve been back to the dentist who did the reconstruction and he said everything looks fine to him. I don’t know what to do at this point and I’m barely eating. Is it possible to get a beautiful smile that still functions well and doesn’t hurt?

Lacey

Dear Lacey,

Woman holding her jaw from TMJ pain

I am sorry this is happening to you. I’m curious as to the shape your teeth were in before the full-mouth recontruction. If there was nothing wrong with your teeth with the exception of the tetracycline stains, I am confused as to why he used dental crowns instead of porcelain veneers. If there was minor damage from teeth grinding, then wearing a mouth guard would help with that, even with the porcelain veneers, which are the typical treatment for a smile makeover.

As for the dental crowns, if your mouth hurts when you bite down, then everything is NOT fine. You can get a beautiful and functional smile, however in order to do that you need to see a dentist who has training in both cosmetic work as well as neuromuscular dentistry. This would include training in TMJ Disorder.

I think you will need to get a second opinion on your reconstruction case. It could be as simple as some of the crowns are sitting too high. However, it could be more serious. A full mouth reconstruction is one of the most advanced porcedures a dentist can do. If he or she doesn’t have the right training, then it can completely throw off your bite leading to painful TMJ disorder.

When you get your second opinion, you will be better served if you make sure it is from a dentist who has the right training. I would look for someone who has training from one of the following institutions:

  • The Pankey Institute
  • The Los Vegas Institute of Advanced Dental Studies
  • The Dawson Institue

They can give you the right diagnosis for what is wrong with your reconstruction, as well as make any necessary repairs.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

What are the Best Materials for Implants and Crowns?

Posted on by .

I am getting a smile makeover, which will probably include at least eight dental implants on my upper arch. I am trying to do my homework ahead of time and have some questions. First, as far as implants go, are the Astra Implants from the UK reliable?  I also wondered if zirconium was okay for crowns. I did read that porcelain fused to metal can leave a black line, but wanted something strong. I’m worried zirconium will be clear colored, though. Any help you can give will be appreciated, my appointment is coming up fairly soon.

Valerie,

Dear Valerie,

An assortment of titanium and zirconia dental implants.

 

I am glad you are trying to do research. However, I would like to steer you in a different direction. The most important thing to research is the dentist doing your dental implants procedure. That has a much greater impact on your result than the materials used. Before we get into what to look for, I want to ask you a question. You mentioned that the reason for your dental implants was a smile makeover. However, unless the teeth needed to be extracted, that is a gross overtreatment. The typical procedure for a smile makeover is porcelain veneers which hardly removes any tooth structure. A dental implant requires you to lose the entire tooth.  I just want to make sure the implants were necessary before you go through with this.

Dental implants are quite an advanced procedure. So advanced, however, that dental school is not enough training. It takes significant post-doctoral training to be able to do this the way it needs to be done. There is no way you can learn enough about the materials in the time you have. Plus, so much of it will also depend on your specific case. Look for a dentist with implant qualifications. As for the zirconium. That will be white, not clear. I hope that puts your mind at ease.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

 

Trying to Figure Out This Smile Makeover

Posted on by .

Can you help me figure out what is necessary for my smile makeover? I want to get porcelain veneers. My dentist said that I’ll need to get my teeth whitened first, which seems odd to me because the veneers should change the color, right? The other question I have is he wants me to get Invisalign first as well because I have one front tooth that is a bit crooked. I really just wanted the porcelain veneers. Is that possible?

Cadance

Hi Cadance,

porcelain veneer being held up near a tooth

I am glad you wrote. Your dentist’s advice here is about 50/50. His recommendation for teeth whitening before getting your porcelain veneers done is solid. It is actually to save you money. Most people cannot afford to get a porcelain veneer placed on each and every tooth. What you don’t want is part of your smile to look beautiful and white from the porcelain veneers and the others to look dingy and stained. That ends up making your veneers look fake.

So, unless you are planning on getting a porcelain veneer on every tooth, getting teeth whitening done helps the natural teeth to blend in with the veneered teeth, giving you a smooth, natural looking smile makeover.

The Invisalign is completely unnecessary in your case. A skilled cosmetic dentist can make a slightly crooked looking tooth appear straight when he plans your smile makeover. This begs the question “Is your dentist a skilled cosmetic dentist?” If he doesn’t know how to make that took look straight, then I would say he is not.

You will be better served getting your smile makeover done elsewhere by someone who does have the technical skills and artistry to give you a smile you will be proud of. I highly recommend looking at a dentist’s smile gallery to see if they can deliver the type of results you are looking for. If they do not have a smile gallery that is a red flag. Move on.

The other thing to look for is some type of beautiful smile guarantee. This means that your veneers are tried on with a temporary paste and you get to see them up close and in various lightings before approving them. If there’s something you want changed, the dentist should be willing to change that before any permanent bonding is done.

I hope this helps.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Concerned About My Porcelain Veneer Repair

Posted on by .

A couple of weeks ago I had some porcelain veneers placed. While I was there everything looked fine. However, when I got home I noticed a small horizontal scratch across one of them. I could even feel it with my tongue. I went directly back in and showed them. They got the dentist who said he could fix it right then. He sat me in a chair and smoothed it out, which was his description of the repair. I looked and couldn’t see the scratch and everything felt normal with my tongue so went home satisfied. Now I am noticing that the area he repaired seems duller than the rest of the tooth and I’m wondering if the fix could have changed the color at all. Should I be worried about this? I paid a lot of money for this smile makeover.

Beatrice

Dear Beatrice,

porcelain veneer being held up near a tooth

It sounds like when your dentist buffed out the scratch, he did it by removing the glaze on the veneer. This needs to be repaired as quickly as possible. It is the protective glaze that protects your porcelain veneers from picking up stains. Left the way it is, that area of your tooth will soon be a completely different color than the remainder of your smile.

Because he caused the damage, he needs to make this right. Generally, when this happens, the repair is simple, but it does require some technical knowledge and equipment that includes using a diamond polishing paste. Because he didn’t use this in the original repair, I suspect he does not do a lot of cosmetic dentistry and will not know how to do the repair this way.

In that case, you are better off asking him to simply replace the porcelain veneer. That should be easy to do because he already has the instructions ready from when he did it last time. Don’t put off calling him about this. The longer it stays this way the more stains the veneer will pick up and he may even try to blame you for it. Calling him now connects it with his repair.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Dry Mouth After Full Mouth Reconstruction

Posted on by .

I had crowns put on all my teeth, top and bottom. Ever since the procedure, I’ve had a hard time keeping my mouth closed all the way and I’ve got horrible dry mouth as a result. My dentist did what he called opening my bite so that you could see more of my smile. I was really looking forward to having a beautiful smile but this is miserable. Should I have him grind them down? I feel all the money I saved up for this has been wasted.

Shannon

Dear Shannon,

woman covering her mouth

Putting crowns on all your teeth is known as a full-mouth reconstruction. This procedure is extremely complicated and is usually reserved for some of the more serious dental cases, such as advanced TMJ Disorder. It’s unusual to use it for cosmetic reasons. The standard procedure for a smile makeover is to use porcelain veneers. Substituting crowns for this tells me he doesn’t have advanced training in cosmetic dentistry so he did crowns, which he felt confident in. The problem is placing one crown is much different from than crowning all the teeth, which would take advanced reconstructive training. It appears your dentist does not have that either.

It appears when he opened your bite, he caused what is known as lip incompetence. This means your mouth does not close while it is in repose. There is good news and bad news here. First, the good news. Your dentist messed up and he messed up badly enough that this case will need to be redone AND it should be redone at his expense. You will get a second chance for that smile you have always wanted.

Now for the bad news. Lip incompetence, which leads to the dry mouth you are experiencing, can destroy the health of your teeth. Because of that, you will need to get this repaired rather quickly. Dry mouth means you are not getting enough saliva in your mouth. Most people don’t realize this, but saliva is one of the main defenses our teeth have in fighting decay. Saliva is loaded with bacteria killing minerals. Without your saliva, your teeth will quickly start decaying.

I want you to get a second opinion from an expert in reconstructive dentistry. Look for someone with qualifications like you can read about in Dr. Marion’s bio. If what I is think is going on, he or she can fix this at your original dentist’s expense.

Unfortunately, because you have dental crowns, you will always need dental crowns.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

360 Veneers Disaster

Posted on by .

I went to my dentist asking for e-max veneers. He said he thought I would be a better candidate for 360 veneers. I specifically asked how much tooth structure had to be removed for the 360 veneers. They assured me not much at all would need to be removed. I agreed to their suggestion. When I first got the temporary veneers, a few of them kept falling off. I noticed then that my teeth were down to small nubs, which was much more removal of tooth structure than they implied I would need. I expressed my concern about them falling out all the time. They assured me that when the permanent ones were bonded on that would not be an issue. Yet, like the promise about the tooth structure, this has not proven to be the case. So far two have fallen off. They tried a different cement, but yet some structures are still falling off. Now they’re talking about ordering a special stronger cement. I’ve just lost confidence in them. While I am relieved that I haven’t swallowed any of them while I have slept, I am living in complete fear of them falling off in public. Do you have any advice for me?

Emily

Dear Emily,

I am going to be blunt in telling you that you were taken advantage of and misled by your dentist. My first clue was when he told you 360 veneers. There is no such thing. Porcelain veneers only go on the front and hug the sides a little. If the restoration for your smile makeover went 360 degrees around your tooth, then it was porcelain crowns.

tooth prep for porcelain veneers A second hint of their unethical behavior was the nubs the created of your teeth. When your teeth are prepared for porcelain veneers, only a small amount of tooth structure is removed, as pictured to the left.

You described a small nub, which is what is used to prepare teeth for porcelain crowns. That is two times they have lied to you.

Often, when dentists steer patients toward porcelain crowns instead of porcelain veneers it is because they are not comfortable with the advanced cosmetic procedures. They tend to want to convince you of the procedure they are comfortable with instead of admitting the skills they lack. In this case, your dentist can’t even do the basic crown procedures. This is distressing because it is one of the first things dentists have to learn to do. You shouldn’t even be able to graduate dental school without having the ability to successfully place dental crowns. Most dentists go their whole careers without having a crown fall out. That has not been the case for your dentist.

So, what is my recommendation? You need to find another dentist. One with post-doctoral training in cosmetic dentistry as well as artistic skill. Look at the bio on their website. Then look at their smile gallery to see what type of results they create. They may even be able to help you get a refund on your badly done work. After all, a basic expectation is that the work will actually stay in!

This blog is brought to you by Dr. David Marion, who was honored by the International College of Dentists as being one of the top dentists in the world.

Porcelain Veneers While Pregnant

Posted on by .

I just found out I am pregnant. Before I knew that, I had complete porcelain veneers placed on my teeth. My aunt told me that you can’t have dental work while you are pregnant. Did I do something that will harm the baby?

Lydia

Dear Lydia,

porcelain veneers placement

First, congratulations on becoming a mother! What wonderful news. Now, I want you to take a deep breath. Your aunt is a tad confused. In dental school, we are taught to do our best to schedule dental work for pregnant women in the second trimester. That is because in the first trimester, things are a bit riskier and in the third trimester, women are usually too large to sit comfortably in the dental chair.

That being said, getting porcelain veneers will not have caused your baby any harm. The only medication used during this procedure is Lidocaine. This particular medication has been deemed safe for use on pregnant women. It is often even used during the delivery itself. Your baby will have no ill effects from you getting your smile makeover.

Best to you and the little one.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Porcelain Veneers or Invisalign?

Posted on by .

I have been saving up for quite some time to get my smile makeover done. There’s nothing too major. I want the color whiter, there are some chips here and there, and I have one slightly crooked front tooth. It’s not crooked enough where I ever considered braces. However, my dentist is suggesting I have Invisalign done before getting the porcelain veneers. He said that way there wouldn’t be any need for tooth preparation because he’s using Lumineers. I am not too keen on the idea of adding another 9 months to my smile makeover. Is this completely necessary? I thought porcelain veneers could make a tooth look straight. Am I misunderstanding anything?

Patricia

Dear Patricia,

invisible braces

Bear in mind that I haven’t examined you, but I am skeptical of what your dentist is telling you. In almost all cases, you would either do porcelain veneers or Invisalign–not both. You had the right idea that porcelain veneers can make your teeth look straight. My guess is your dentist is trying to get you to do the Invisalign because he doesn’t know how to shape teeth with porcelain veneers.

He also suggested Lumineers for your case, which is a brand of porcelain veneers highly marketed to inexperienced cosmetic dentists as being “easy to place” because they don’t require tooth preparation. However, in most cases, Lumineers end up looking bulky without some tooth prep. Not to mention inexperienced cosmetic dentists do not generally know how to produce beautiful results. Smile makeovers aren’t taught in dental school.

At this point, you have two choices if you want to get porcelain veneers, I would get them but with a different dentist. Look at their smile galleries to make sure you like the type of results they get. You want to know that they can produce beautiful, natural-looking smiles. Also, make sure they have some type of beautiful smile guarantee.

A second option is to do get Invisalign or another brand of invisible braces to straighten your teeth and whiten your teeth simultaneously using the clear aligners as teeth whitening trays. This will be significantly less expensive than porcelain veneers, but will take longer. You mentioned a few chips on your teeth. You didn’t mention how many or how large, but in most cases, these are repaired with some dental bonding.

Truthfully, wanting all three things repaired, which is what would be necessary for a complete result, the porcelain veneers will be a better idea. I just don’t think your current dentist is the one to do it. He sounds to be in over his head but not wanting to admit it.

This blog is brought to you by Duluth, GA Dentist Dr. David P. Marion.

Porcelain Veneers and Invisalign?

Posted on by .

I want to upgrade my smile. I need them whiter and my two front teeth are a tad crooked. I was thinking of getting porcelain veneers. My dentist suggested I get Lumineers, but before that he wants me to get Invisalign to straighten those two teeth. I just want to get a sort of “second opinion” before going through all that.

Amara

Dear Amara,

invisible braces

Bear in mind when I give you an answer that I haven’t seen your case, so I’m giving generalities here based on what you’ve written. In general, you would either do Invisalign or porcelain veneers, not both. Porcelain veneers can make your teeth look straight. You mentioned it is only your two front teeth which are crooked, which shouldn’t be too complicated. It’s possible your dentist is just in over his head and he doesn’t know how to fashion porcelain veneers except under the ideal conditions.

Rather than say that, he is suggesting you use Invisalign to fix the crooked teeth and then he’ll place Lumineers. That brings me to another reason I think he is in over his head. Lumineers is a particular brand of porcelain veneers that is heavily marketed to inexperienced dentists as being easy to place. Your case is a smidge more complicated.

You haven’t mentioned anything about needing or wanting to change the size and shape of your teeth. Aside from the front teeth, you’ve only mentioned wanting to whiten their color. If that’s the case, porcelain veneers may not be necessary.

You can whiten and straighten your teeth all at once using invisible braces, saving you thousands of dollars. My suggestion is you get Invisalign to straighten your teeth. The aligners can also double as teeth whitening trays. Your dentist simply has to provide you with the whitening gel. Wear the gel while you’re straightening your teeth. When you are done, you’ll have beautifully straight, white teeth.

Additionally, these two procedures are simple enough they can be done even by inexperienced cosmetic dentists. If you were to get porcelain veneers, I would recommend you go to someone with more expertise.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

I Hate My Lumineers

Posted on by .

I had four Lumineers placed. I was pretty specific about how white I wanted my smile. Because of that, I even had my teeth whitened ahead of time. But, when my Lumineers were placed they looked darker than I anticipated. When I asked my dentist about it he told me he had a “natural” stain put on the Lumineers so they wouldn’t look fake. I don’t think they would have looked fake with the color I wanted, so I don’t understand why he did that. He told me to give it a few days and I’d probably like them. I tried but didn’t adjust in my view. I called him back so he had me come in. When I did, he sort of drilled off some of the top layer with the stain to get to the whiter color underneath. Now, they are uneven and the color seems dull. They look awful. Is there anything which can be done to fix them at this point?

Candace

Dear Candace,

woman covering her mouth

I’m sorry for what you’ve experienced with this, especially given this probably cost you a pretty penny. I do have some good news for you, but first let’s go over the reason why this happened. You told him you wanted a very white smile, yet he still put a stain on the Lumineers to make them look natural. This tells me your dentist has not invested in a great deal of training in cosmetic work. That doesn’t surprise me. Lumineers is often marketed to inexperienced cosmetic dentists as being easy to place.

In dental school, dentists are taught they know what is best for the patient. This means you wanted a white smile and he felt it needed to look natural. As the dentist, he thought he knew best. If he’d invested in cosmetic training, he’d know this is different. You are creating the smile the patient wants. Therefore, it is the patient who knows best in these situations.

Second, his drilling of the upper layer. This was the wrong thing to do as you’ve discovered. He should have just re-done the whole case, especially given he didn’t follow your instructions as to what type of smile you wanted. Instead, he takes a short cut which essentially ruins your Lumineers. The bad news is actually the good news as well. Because he damaged them so badly, you are able to get a refund and have this done by a more experienced cosmetic dentist.

If a dentist is serious about cosmetic dentistry they will have a smile gallery on their website. The one thing I would do is call and make sure the before and after images of the work they’re displaying is work they have done themselves and not stock photos. Look at their photos. Do you absolutely LOVE the results? If not, look for someone else. Don’t be surprised if whichever dentist you end up with chooses a different brand than Lumineers. There are several brands of porcelain veneers and Lumineers isn’t know for its quality in aesthetics.

This blog is brought to you by Duluth, GA Dentist Dr. David P. Marion.