Archives for December 2020

My new dental crown feels weird and loose

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I’m frustrated because I had to relocate and switch dentists in the middle of Invisalign treatment. After examining my teeth, my new dentist recommended a crown for my bottom right first molar. She attached the crown but didn’t spend a lot of time checking my bite. She seemed in a hurry. My crown feels wobbly and doesn’t fit right. I can really feel it when I chew on the right side of my mouth. What should I tell my dentist to do to correct it? I’m worried that if she can’t get the crown right, I will have to switch dentists again and prolong my Invisalign treatment. Thank you. Autumn from Kansas

Autumn,

We understand your concerns about your dental crown and the frustration it is causing during Invisalign treatment. Dr. Brooksher would need to examine your crown to determine the cause of looseness and how to resolve it. But we are concerned because dentists dedicated to providing quality work will check a crown thoroughly before cementing it to your tooth.

When a dentist places a new crown, it should feel like a natural tooth. You shouldn’t notice the crown at all. If your crown is loose on the tooth, it will eventually fall off.

Reasons for a Loose New Dental Crown

If your new dental crown is loose, there are two possible causes—not enough tooth structure or a problem with cementing it.

  • Not enough tooth structure – If you don’t have enough healthy tooth structure to support a crown or if your dentist aggressively prepares your tooth, a crown can feel loose. The more a dentist tapers your tooth, the less likely it is to stay on. It takes a lot of precision for a dentist to prepare a tooth for a crown minimally.

    If your tooth is too small for a crown to adhere to it, a skilled dentist can build up the tooth for a secure bond.
  • Crown cement isn’t strong enough – It is possible that the cement was contaminated during the bonding process. Or something might have gone wrong during the bonding process. But in most cases, if a dentist prepares a tooth properly, even the weakest cement will hold.
Invisalign upper and lower aligners

Find a dentist with Invisalign experienced and advanced cosmetic dentistry training

Schedule an appointment for your dentist to check the crown. If she doesn’t have a satisfactory answer, schedule a second opinion with an experienced cosmetic dentist. Look for a dentist with advanced training in dental aesthetics and experience with Invisalign. If a dentist has experience in both areas, it can eliminate the need to find yet another dentist to resume your Invisalign treatment.

 

Steven Brooksher, DDS, of Baton Rouge, LA, sponsors this post.

 

Why do my veneers make my teeth look thick and bulky?

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One of my best friends and I both received porcelain veneers about six to eight months apart. But my veneers make my teeth look thick and bulky. We went to the same dentist, and he used the same veneers on both of us. My friend got veneers to make her teeth look larger, but I wanted veneers because my teeth were inconsistently shaped and uneven at the edges. My friend’s smile looks beautiful, which is why I used her dentist. She received no-prep veneers, so I asked for the same type.

I’m disappointed with the results from my smile (eight upper veneers) because my teeth look thick and bulky. The dentist explained that sometimes that happens with no-prep veneers. But if the dentist knew the results, why wouldn’t he tell me how they would look? And yes, I did try on temporary veneers, but I let the dentist convince me that I would get used to my “fuller” smile. Why did I get such drastically different results? Will I have to start over with veneers? Thank you.  Kennedy from Memphis, TN

Kennedy,

From your description, it seems that your friend’s case was successful because her teeth were small, and she wanted to enlarge them. The results of no-prep veneers vary with each patient. And not every patient is a candidate for no-prep veneers.

Thick and Bulky Porcelain Veneers

Your porcelain veneers can make your teeth look thick and bulky if you have average-sized or large teeth and your dentist doesn’t prepare them first. Even ultrathin veneers—as thin as 0.3 mm—add thickness to your teeth and slightly extend their length. Cosmetic dentists with advanced training in aesthetics use several brands of veneers and select one to match your case and your smile goals. And they work with master ceramists to ensure give you beautiful results.

Although Dr. Brooksher would need to examine your teeth, minimal preparation is probably the solution to helping your veneers fit well and look natural.

Correcting Thick or Bulky Veneers

If you want to correct the look of thick or bulky porcelain veneers, we recommend that you schedule a consultation with an advanced cosmetic dentist. You can ask your dentist to redo your veneers, but based on your experience, you will probably be disappointed with the results again.

  • Look for a dentist with accreditation from the American Academy of Cosmetic Dentistry (AACD) or the American Academy of Esthetic Dentistry (AAED).
  • Read the dentist’s patient reviews about porcelain veneers and the results.
  • Ask to see the before-and-after photos of the dentist’s patients who had cases like yours.

Before and after cosmetic dentistry photos from Steven Brooksher, DDS of Baton Rouge

Dr. Brooksher used cosmetic dentistry to even this patient’s smile


A cosmetic dentist will explain your treatment options. And unlike your current dentist, they won’t try to convince you that you will eventually like your smile. Skilled cosmetic dentists don’t bond veneers to your teeth unless you are confident that your smile is exactly as you want it.

Best wishes for a beautiful smile.

Steven Brooksher, DDS, an accredited cosmetic dentist in Baton Rouge, sponsors this post.

My zirconia crowns don’t match after a second try

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In September, my dentist placed four new zirconia crowns on my upper front teeth. The crowns don’t match the shape of my natural teeth. They look like they would not match the shape of anyone’s natural teeth. My mistake was to ask my dentist to do the work. He said he could do it for $600 – $800 less than other dentists because I am an existing patient.  Thank you, Ada

Ada,

My dentist agrees that my teeth do not look natural, so he referred me to a prosthodontist to correct the issue. Now the shape of my teeth is okay, but the color is off. I made the mistake of asking for sedation before I saw the crowns. The prosthodontist cemented the crowns without me getting a non-sedated look at them. I am angry and frustrated. He said he will change the color if I pay for it. Why should I pay for teeth that look gray? Isn’t a prosthodontist a specialist?

It’s unfortunate to know you’ve had two bad experiences with dentists who can’t give you natural-looking results with crowns.

Your dentist should take responsibility to correct your smile in the best way possible instead of referring you to a prosthodontist. Although prosthodontists have two to three years of training in restoring teeth, few are artists in cosmetic dentistry. They can get the technical details and function correctly, but the aesthetics are often lacking. But an excellent cosmetic dentist is concerned about the details that make your smile look natural. And they don’t bond the work to your teeth unless you love the way it looks.

Zirconia crowns for front teeth

Although a dentist can give you zirconia crowns on your front teeth, it takes advanced cosmetic dentistry training to make the crowns look natural.

  • Zirconia crowns are made from a block – A dental lab tech makes zirconia crowns from blocks and mills them into shape to fit over your tooth. But a zirconia block has one color throughout it. Your natural teeth have variations in color and translucence.
  • Porcelain layers can make zirconia look natural – A zirconia crown cannot recreate the look of your tooth unless a ceramist bakes porcelain onto the surface and manipulates the color.

Sedation for dental crowns

Face of a woman relaxed during dental treatment for information on sedation dentistry from Dr. Brooksher of Baton Rouge

Try on temporary crowns before receiving sedation dentistry

If you need sedation when your crowns are cemented, your dentist can create temporary crowns first. If you like the temporary crowns, a dental ceramist can duplicate them when making your permanent restorations. Before you are sedated for the final crowns, at least you know you approved them.

What’s Next?

Our recommendations are below:

  • Discontinue treatment – Don’t let the prosthodontist do any more work on your teeth. He isn’t interested in giving you crowns that you love.
  • Ask for a refund – Depending on the extent of color mismatch in your crowns, you may only receive a partial refund.
  • Look for an advanced cosmetic dentist – Don’t rely on a referral. Look for a dentist with credentials (accreditation, at least) from the American Academy of Cosmetic Dentistry or the American Academy of Dental Aesthetics.

 

Steven Brooksher, DDS, is a cosmetic and implant dentist in Baton Rouge, LA. Read about his credentials and visit his smile gallery.