Archives for April 2024

Why Can’t I Floss Between My Porcelain Veneers?

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My dentist seems unconcerned that I cannot floss between my porcelain veneers. Is this common? Why can’t I floss? Thanks. Alec from Pittsburgh, PA

Alec,

The inability to floss between porcelain veneers is unusual and unhealthy. You have good reason to be concerned.

What Can Prevent Floss from Gliding Between Porcelain Veneers?

If floss cannot guide between your porcelain veneers, there may be a problem with the bonding. Correct bonding technique usually includes the following steps.

  • Use etching and bonding agents to prime the tooth
  • Place bonding on the back of each porcelain veneer before pressing it onto the tooth
  • Remove excess bonding material around the veneer
  • Harden the bonding only on the center of the composite with an ultra-small light
  • Remove excess composite by flossing
  • Smooth the surfaces of the veneers
  • Use a larger curing tip to ensure solid attachment
  • Smooth teeth with fine polishing strips

What Are the Results of Inability to Floss Between Veneers?

Plaque buildup can lead to gum disease if you cannot floss between porcelain veneers. According to the American Academy of Periodontology, flossing is essential to preventing dental plaque and inflammation. Advanced gum disease is linked to an increased risk of systemic diseases, including diabetes and heart disease.

We recommend asking your dentist to ensure you can floss between your veneers. Consult an advanced cosmetic dentist if your dentist cannot resolve your concerns.

Dr. Steven Brooksher, a Baton Rouge accredited cosmetic dentist, sponsors this post.

 

Can I Get Dental Implants If I Take Actonel?

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Can I get dental implants if I’m on Actonel for osteoporosis? My upper left front tooth and incisor behind have been missing for 14 years. I had my first consultation with a dentist last week. She is not pressuring me to get dental implants but presented them as an option. I haven’t disclosed my medical history to the dentist yet. However, she said implants need healthy bone, which made me think of the medication. Would Actonel prevent me from getting dental implants? Thanks. Craig from NH

Craig,

Model of a dental implant with the crown, abutment, and root form labeled

Each patient’s case is unique, so you must find an experienced implant dentist or oral surgeon to determine whether you are a candidate for dental implants. However, we will provide general information on whether a person taking Actonel® or other bisphosphonates can get dental implants.

Can You Get Dental Implants While Taking Actonel or Other Bisphosphonates?

If you take Actonel or other bisphosphonates, you may still be a candidate for dental implants. Actonel is a bisphosphonate that treats osteoporosis by slowing down the cells that break down bone tissue. However, an implant dentist, oral surgeon, or periodontist (gum and bone specialist) will take a CT scan of your oral anatomy and review your medical and dental histories to determine if you are a candidate for dental implants.

How Do Bisphosphonates Affect Dental Implants?

Bisphosphonates increase the risk of developing jaw osteonecrosis, which can weaken bone tissue. However, if you are a candidate for dental implants, an implant dentist or specialist may recommend the following:

  • Stop taking bisphosphonates four to six months before dental implant surgery.
  • Avoid the medication while dental implants fuse with your jawbone.
  • Resume the medication when the risk of compromising your dental implants is low.

What Does Research Show for Bisphosphonates and Dental Implants?

The October 2023 issue of Cureus published an article on bisphosphonate-treated patients and dental implants. Researchers recommend careful consideration, management, and bone monitoring for dental implant patients taking bisphosphonates.

A September 2023 Materials (Basel, Switzerland) article cautions that patients taking bisphosphonates have higher dental implant failure risks than patients not taking the medication.

Schedule Dental Implants Consultations

Schedule consultations with implant dentists, periodontists (implant specialists), or oral surgeons if you want dental implants. Tell the doctor that you take Actonel for osteoporosis. Take notes and compare your treatment options from the consultations. However, avoid insisting on dental implants if they are not recommended. If you are not a candidate for dental implants, a skilled cosmetic dentist can give you natural-looking results with alternatives.

 

Dr. Steven Brooksher, a Baton Rouge-accredited cosmetic dentist and a fellow of the International Congress of Oral Implantologists, sponsors this post.

 

Should My Dentist Have Put a Veneer Instead of a Crown on My Front Tooth?

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After getting a root canal on my left front tooth in 2021, started turning dark. My dentist at the time wanted to put a veneer over the tooth, but I declined. I’m beginning to regret it. My new dentist filed down the tooth for a crown last month. The crown looks okay, but I’m still concerned about how little of the tooth is left. Did I make the wrong decision? Did my dentist trick me into getting a crown when a veneer would have worked better? Thanks. Dominique

Dominique,

Dental school teaches students to protect a tooth with a crown after root canal treatment. Your dentist did what she was taught and offered a crown, which requires grinding down your tooth in preparation. It’s unfair to say she tricked you into getting a crown when you could have a porcelain veneer for your front tooth.

Photo of the tip of dental forceps holding a single porcelain veneer; from the Baton Rouge office of accredited cosmetic dentist Dr. Steven Brooksher.

A porcelain veneer covers the front of a tooth and requires minimal tooth preparation

Your description sounds as if your tooth didn’t have extensive decay or breakage. However, root canal therapy weakens teeth, and a crown protects them from fracture.

Back teeth absorb more pressure from chewing than front teeth. Without a dental crown, a back root canal tooth would break.

Stress on front teeth is lateral mainly because they do not have chewing surfaces. A front tooth is most likely to break at the gumline. After root canal treatment, preparing the tooth for a dental crown further weakens it. A veneer would have left your front tooth stronger.

Tooth discoloration after root canal treatment is caused by the dental filler material. A skilled cosmetic dentist would remove the material, place a flexible fiberglass post in the tooth, and fill it with tooth-colored composite. However, you have a dental crown instead of a veneer now. Keep your dental cleaning, exam appointments, and yearly X-rays to help your dentist monitor your front tooth and ensure it remains healthy.

Dr. Steven Brooksher, a Baton Rouge fellow of implant dentistry, sponsors this post. Request a consultation with Dr. Brooksher today.