Dental Veneers Questions and Answers Archive

Feb
2002

Q&A: How do I get rid of tetracycline stains on my teeth?

Question:

I have a slight tetracycline stain across the top of my teeth. What are the odds of either the tray whitening system or the light activated in office system reducing this stain? Is one system more likely to work than the other? Thanks, Lisa

Answer:

 Debra Gray King, DDS - LocateADoc.com

Although tetracycline stained teeth present one of the biggest whitening challenges, many people can experience a significant improvement through whitening -- whether the in-office systems or take-home. Probably the best approach is a combination of in-office and take home sytems (like the new Discus Dental ZOOM! system). Usually though, getting to the optimal level of whiteness for someone with tetracycline stains can only be achieved through porcelain veneers.

-- Debra Gray King, DDS
Atlanta, Georgia



Dec
2001

Q&A: Should I have my wisdom teeth extracted because my teeth are overlapping after I had braces years ago?

Question:

I've had braces before, about 14 years ago, but my teeth have started to overlap and are getting worse as time goes by. My dentist said I need to get one of my wisdom teeth taken out but I really want to get braces again. Should I have my wisdom tooth removed first or can I have that done later?

- Andrea

Answer:

Debra Gray King, DDS - LocateADoc.com

Without the benefit of examining you, I cannot tell you what sequence of treatment you should follow. It may very well be that your wisdom teeth are forcing your other teeth together. Here is something else to think about --A lot of adults that do not want to undergo braces have opted for veneers, which give the appearance of perfectly straight teeth and what some call, "instant orthodontics." This is just one option that you may want to discuss with an accredited cosmetic dentist to see if it is a viable alternative for you. If you have unanswered questions, ask your current dentist or seek a second opinion from a qualified dentist that can examine you.

--Debra Gray King, DDS
Atlanta, Georgia



Dec
2001

Q&A: I was wondering, because I have an over bite and then my teeth are crooked, that would I be able to get this fixed with cosmetic dentistry or do I need to get braces?

Question:

I was wondering, because I have an over bite and then my teeth are crooked, that would I be able to get this fixed with cosmetic dentistry or do I need to get braces?

- Jeremy

Answer:

Debra Gray King, DDS - LocateADoc.com

Thanks for your question. The condition you have described with your overbite is usually correctable. Without the benefit of seeing you, I cannot tell you which treatment options would be best for you. Situations similar to yours are corrected all the time either through restorative dentistry, orthodontics, or a combination of both. We often correct these deep overbites with what we call an "open bite" treatment plan. This consists of reducing your overbite by placing porcelain veneers and onlys on your teeth. I hope this helps and good luck in getting a better smile!

--Debra Gray King, DDS
Atlanta, Georgia



Nov
2001

Q&A: Was my application of veneers abnormal because I had a lot of pain and still have sensitivity to hot & cold?

Question:

I just had a gum lift and 8 porcelain veneers applied to my teeth. I'm curious about a few things. I heard that the preparation and application of veneers is painless and sometimes unnessesary for anasthetic to be used. This is definitely not how my proceedure was. I was subjected to a lot of novacane and a lot of pain. I'm not sure why my case was any different. Although I couldn't see what the doctor was doing, it seemed as if he ground my natural teeth down drastically. Is this normal? My gums are extremely sore and swollen, and I'm very sensitive to hot and cold. I had my veneers applied just last week, but I'm still confused as to why this was such a painful proceedure. I also had to undergo 3 root canals for the proceedure. Previously, I had a very gummy smile, so I needed the gum lift. Subsequently, the doctor had to "shorten" my teeth. But it felt as though he ground them down to little points and then applied the veneers. I was very choosy when picking my doctor. He is very well know in the Midwest. The veneers look beautiful, but I'm a little nervous about what was done to my natural teeth. Also, will this sensitivity to hot and cold ever go away? Thanks

Answer:

Debra Gray King, DDS - LocateADoc.com

Sometimes veneers can be placed with little to no tooth reduction. Other times, a lot of tooth reduction is required. This is particularly the case when the natural teeth jut out, are twisted, or are rotated. Cases like this are sometimes called "instant orthodontics" because the end result looks like the teeth have been moved (but the illusion is due to porcelain veneers). In short, the more reduction that is required -- the more risk that it will be a painful experience and there will be root canals involved. That also provides part of the explaination why one person may have a virtually pain-free experience and another person may have a very different one. Some people just have a higher pain threshold than others. There are a variety of pain reduction devices (e.g., computer controlled anesthetic delivery devices) and techniques that are helping to minimize pain. At this point, however, pain is still a risk when teeth structure is reduced. Ususally, the pain subsides fairly quickly and the residual sensitivity to temperature goes away spontaneously. You should keep in touch with your dentist and have him check it out if the pain continues. You'll probably just be left with a beautiful smile and feel like it was well worth it.

--Debra Gray King, DDS
Atlanta, Georgia



Dec
2001

Q&A: Can I have bonding put on my teeth to cover enamel loss and staining even if I will have braces put on?

Question:

I have had braces for 4 yrs---about 1 and a half yrs over treatment time because i missed so many appointments for a period of time. I have moved to another state and just started with a new orthodontist again. He took braces off - brackets had moved and stuff, and I needed some periodontal surgery. The braces will be put back on in a few weeks- for only about 4 more months. the problem is, that I have had enamal loss in the top half of my two front teeth, so they are pitted and very stained. I am wondering if I can have them bonded before I get braces put back on---even if I have to get them bonded again after the braces are taken off. They just look so horrible that I won't be able to tolerate it for 4 more months. Thank you!

- danielle

Answer:

Debra Gray King, DDS - LocateADoc.com

You have indicated that some of the enamel is lost on your front teeth. The first step is to check with your orthodontist to make sure that the addition of bonding material will not affect his treatment. Generally speaking (and I say this without the benefit of having seen you), I see no reason why you should not be able to have some bonding placed on these teeth for protection and aesthetics. You will probably need to have the bonding replaced, perhaps with porcelain veneers after braces. So you should plan for this as well. Hope this helps.

--Debra Gray King, DDS
Atlanta, Georgia



Oct
2001

Q&A: is it possible to push back my top teeth and push out my bottom teeth?

Question:

hi, i have i believe whats called a over bite?..my top teeth goes down close to my lower gums on my bottom teeth, my teeth are otherwise very straight,but i'm bothered my by bite because when i smile all you see is my top teeth, can you tell me if it's possible to push back my top teeth and push out my bottom teeth to meet correctly to have a better smile..thanx

- rachel

Answer:

Debra Gray King, DDS - LocateADoc.com

Thanks for your question. The condition you have described with your overbite is usually correctable. Without the benefit of seeing you, I cannot tell you which treatment options would be best for you. Situations similar to yours are corrected all the time either through restorative dentistry, orthodontics, or a combination of both. We often correct these deep overbites with what we call an "open bite" treatment plan. This consists of reducing your overbite by placing porcelain veneers and onlys on your teeth. I hope this helps and good luck in getting a better smile!

--Debra Gray King, DDS
Atlanta, Georgia



Aug
2001

Q&A: I have braces, take an anti-convulsant which makes my gums swell, and some gum was surgically removed for the braces. What can I do?

Question:

I am an adult with braces. I also am taking an anticonvulsant medication that causes gum swelling, which is especially severe after each orthodontic treatment. I was told by my orthodontist before putting the braces on that my medications would not be a problem in the treatment. Obviously, he was wrong. The braces have so aggravated the gum swelling that I have already had to have part of my gum removed to reduce the swelling caused by the braces/medications. I have not had the braces tightened in over five months because of the severe swelling that always happens afterwards. My orthodontist's solution to this problem is for me to either find a new anticonvulsant medication or keep having my gum cut out. However, I cannot switch medications now because of the two year restriction of driving priviledges that would be necessary in order to make sure the new medication works. I cannot keep having part of my gum cut out because I cannot afford numerous periodontist bills in addition to the orthodontist bills. My orthodontist will not remove the braces until his entire fee is paid, which I cannot afford up front. I am on a payment plan, and it will not be completely paid off for quite some time. Meanwhile, I am stuck with braces that are not able to be tightened or removed. I am considering retaining legal counsel in this matter since the orthodontist obviously was in error about my medications, but I fear that it will be cheaper to just pay the orthodontist his entire bill so he will remove the braces. I am also hoping to be ale to find another orthodontist that will remove the braces for me, but I suspect that a different one will not "step in" on this matter. So,what exactly should I do now?

- Danyse

Answer:

Debra Gray King, DDS - LocateADoc.com

The Internet can do a lot, but it is difficult, if not impossible, to properly diagnose your condition without seeing you. Therefore, my general comments should not be considered a substitute for second opinions from appropriate dental and medical doctors who have the benefit of your case history and a thorough in-person examination. Having said that, let me share with you that I am very sorry to hear of your problems. As you are aware, certain anti convulsant drugs may cause swelling of the gum tissues in certain patients. It is extremely difficult to predict how and to what extent a person's gums will swell due to a medication. This is because side effects from a medication can and do vary from person to person. Also, as discussed below, there are a number of other factors in play beyond the medication that may be contributing to your gum swelling. Therefore, I do not think that the orthodontist can be held responsible for your present situation. Patients who notice a change in their gums while taking a medication should consult with their physician and their dentist to get a diagnosis and to see whether they can or should change medications. Swollen gums make it easier for bacteria to accumulate on the teeth, invade gum tissue and spread to a tooth's bony support. If too much bone is lost, teeth can fall out. When dealing with gum enlargement, the patient must be especially vigilant about oral hygiene while they are on the medications causing it. This is because it can become a vicious cycle. The initial gum swelling caused by the medication can make it harder for patients to properly brush or floss away bacterial plaque from teeth. That can increase the risk of plaque, infection, etc., etc. Many times, however, if the swelling is caught early enough, it is easier to treat and bring under control. At this point, it seems like you should have your teeth professionally cleaned every 2 - 4 weeks. You should also maintain a vigorous home care program such as brushing and flossing at least 3 times a day and rinsing each time with something like Peridex. Follow this regimine until you see some improvement in your gums, then re-evaluate with your dentist. Hopefully, this therapy will allow your braces to be tightened on schedule. I would also recommend that your physician consider switching you to another medication. I understand that this may impact your life in connection with driving privileges, etc. but your health is of the utmost concern. Here are a couple of more things to explore. A removable orthodontic device like Invisalign may be an option for you. Also, an alternative to braces in many cases is porcelain veneers. You may want to look into them in lieu of braces. Go to the American Academy of Cosmetic Dentistry (www.AACD.com) to find an accredited cosmetic dentist to discuss this option. Good luck. I hope this helps.

--Debra Gray King, DDS
Atlanta, Georgia



Jul
2001

Q&A: Is it possible to get a crown that matches my veneers in color and finish?

Question:

I have three veneers and a crown in the top,front of my mouth. When I had this work completed, all four teeth matched. Since that time, the crown lost the finish and I had to have it replaced. I spent four months with a temporary in my mouth while the crown was returned several times because it was not correct. I am very upset with the finished product. My crown looks fake and you can see metal through the top of it.I am embarrassed to open my mouth. Is it possible to get a crown to match the veneers? I have consulted another dentist but I am scared that the next crown might be worse.Is it possible to get a crown with the same finish as the veneers? How do I locate a good cosmetic dentist? Thank you for your help!

- Cindy

Answer:

Debra Gray King, DDS - LocateADoc.com

The problem that you are having was caused in part by the type of crown that was placed. The crown you have described is called a porcelain fused to metal (or PFM) crown. Sometimes PFM crowns are fabricated where the metal margin shows at the gum line and this can give an unsightly aesthetic result. They also frequently lack the translucency and coloring of a natural tooth. If at all possible, an all-porcelain crown would be preferable from an aesthetic standpoint. An all-porcelain crown has the same type of material as was used in the veneers (porcelain) and therefore stands a greater liklihood of matching the veneers. Another problem that arisies in your case is that it presents more of a challenge to the cosmetic dentist and lab to match a single tooth color that is placed after the other restorations are already in place. To the extent that the lab, dentist, batch of porcelain, etc. are different, color and texture matching is made more difficult. Finding a good cosmetic dentist may appear difficult. This is partly because cosmetic dentistry is not presently recognized as a specialty branch of dentistry and many general dentists perform some types of cosmetic dental procedures. But, choosing one with the right education and experience that compliment your needs and wants is critical to achieving the most successful outcome. The best way to find an accredited cosmetic dentist is go to www.aacd.com, which is the website of the American Academy of Cosmetic Dentistry. The AACD is the leading organization for cosmetic dentistry and it has a rigorous accreditation process whereby dentists must demonstrate their excellance in the art and science of cosmetic dentistry to a panel of judges. Good luck on getting a gorgeous smile!

--Debra Gray King, DDS
Atlanta, Georgia



Jun
2001

Q&A: Is there a surgery to fix an underbite?

Question:

As an adolescent I had braces to correct an underbite. The braces did their initial job. However, my bite has since slipped back a little. I am in my mid 20's and do not want to go through the ordeal of braces again. Is there a surgical procedure that can fix this once and for all? If so what is involved and how long is the approximate recovery time? Thanks in advance for you assistance.

- Kathleen

Answer:

Debra Gray King, DDS - LocateADoc.com

Generally speaking, a slight underbite in many people can potentially be addressed in a few different ways. First, there is traditionaly orthodontic treatment. As you indicated that braces were not something you wanted to deal with again, you may want to consider the Invisalign system. It is a a system that uses a clear splint to move your teeth into position. You may also get the results you are looking for from porcelain veneers. They are thin shells of porcelain that are bonded to your teeth to give the effect of perfectly straight teeth. These can usually be applied over the course of a few weeks. If you are interested in this procedure, I would go to www.aacd.com, which is the website of the American Academy of Cosmetic Dentistry, to obtain the name of an accredited cosmetic dentist in your area. Good luck!

--Debra Gray King, DDS
Atlanta, Georgia



May
2001

Q&A: Will I need braces and for how long if I have an overbite and gaps between my teeth?

Question:

I have an overbit and and some gaps,do you think that I would need braces if I do need braces do you know how long I would need them for.

- Shani

Answer:

Debra Gray King, DDS - LocateADoc.com

The Internet is great in many respects, but it would be virtually impossible to accurately diagnose your condition and develop a treatment plan without having seen you or appropriate photos of your mouth. Braces may be appropriate, but you would need to be evaluated by an appropriate orthodontist to determine whether you are a suitable candidate, and to discuss the proper type of braces and the estimated length of your treatment. You may want to also consult an accredited cosmetic dentist about the possiblility of porcelain veneers. Sometimes this procedure is called "instant ortho" because it can have the effect on many people of transforming teeth with gaps into a beautifully straight smile in only a couple of weeks. Good luck!

--Debra Gray King, DDS
Atlanta, Georgia



May
2001

Q&A: I would like to get some other opinions and pricing. Are the xrays mine to take to other doctors or do I have to pay for additional xrays each time?

Question:

I am 55 an looking to have my lower front teeth straighten. I have just gone to one doctor and had some xrays and was given a price for either reguler braces or the new invisaline. I would like to get some other opinions and pricing . Are the xrays mine to take to other doctors or do I have to pay for additional xrays each time?

- DAVID

Answer:

Debra Gray King, DDS - LocateADoc.com

As to the x-ray portion of your question, my informal survey of the regulations of many states call for the dentist to provide copies of the x-rays to the patient upon request. In my experience, most dentists will gladly do this regardless whether there is a legal requirement to do so. So, I would suggest that you simply ask your dentist for a copy. As for additional options for getting a great looking smile, I would also consider porcelain veneers. Sometimes the procedure is called "instant ortho" because it has the effect of giving many people with twisted and rotated teeth a beautiful straight smile in only a couple of weeks. Good luck!

--Debra Gray King, DDS
Atlanta, Georgia