Six Upper Teeth Left After Gum Disease. What Are My Options?

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I had a two-year battle with gum disease that left me with six upper teeth remaining. The teeth are unevenly spaced from tooth loss and disease. My dentist recommends dental implants, but implants are expensive, and they do not resolve the spacing issue. I am not against implants, but the thought of going into debt for them makes me anxious. Maybe I need to take more time to find affordable implants and dentures. I already wear an uncomfortable dental flipper and understand I can get a partial denture or another flipper. I have a lot of teeth to replace, but at 62 years old, with longevity in my family, I must do something about my missing teeth. My thoughts are scattered. What are your suggestions? Are dental implants my only option? – Antoinette from Austin, TX

Antoinette

Thank you for contacting Dr. Brooksher’s office. Dr. Brooksher would need to examine your teeth and gums and take a 3-D T scan to determine your treatment options. Still, we can advise you on how to find a dentist to manage your case and give you a healthy, attractive smile.

Are Dental Implants Your Only Option?

It is unlikely that dental implants are your only option. Still, your treatment options depend on several factors, including:

  • Your oral health
  • The condition of your remaining teeth
  • Your jawbone volume and quality
  • The sizes of your remaining teeth
  • The extent of spacing between your teeth

Schedule a Consultation with a Cosmetic and Implant Dentist

We recommend searching for a dentist concerned about the function and appearance of your teeth and smile. You will benefit from a highly sympathetic dentist with advanced training in these areas:

  • Cosmetic dentistry
  • Dental implants
  • Occlusion and bite
Diagram of snap-on dentures. Dental implants are in the lower jawbone, and a denture with attachments in the base is hovering above the gumline.

A snap-on denture is an affordable option for dental implants

Although saving natural teeth is a dentist’s priority, affordable implant dentures can restore your smile if your remaining teeth do not support your long-term oral health. The dentist will explain options for natural-looking teeth replacement that complement your facial features and personality. An implant bridge may be an option for you.

Dr. Steven Brooksher, a Baton Rouge accredited cosmetic dentist and Fellow of implantology, sponsors this post.

My Porcelain Veneers Don’t Look New Anymore

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My porcelain veneers are only two years old, but they are not as bright as new. My smile makeover does not look fresh anymore. I am disappointed because I thought veneers were colorfast. Although I drink coffee every morning, I never drink more than two cups. The dentist who placed the veneers asked if I smoke or am a heavy coffee drinker. I have an appointment with the dentist in two weeks, but I do not want my dentist to blame me for the discoloration of my veneers. Is there anything I can do to make them look better, or is this something only a dentist can do? – Thank you. Marcello from ATL

Marcello,

Thank you for your question. You are wise to ask how to improve your smile makeover before using products such as abrasive whitening toothpaste that will scratch the surface of your veneers.

Do Porcelain Veneers Stain?

Porcelain veneers are colorfast and covered with a glaze that helps them resist staining. But if the glaze is damaged, it can increase the risk of stains.

Factors that may damage the glaze on porcelain veneers:

  • Abrasives – Abrasive whitening toothpaste can create tiny scratches in the glaze that attract stains.
  • Dental cleaning or polishing techniques – Power polishing equipment, pumice pace, air-powered cleaners, or acidulated fluoride can etch porcelain veneer glaze and cause stains.
  • Tobacco use – Regular tobacco use can cause surface stains on veneers.
  • Heavy coffee drinking – If you are a heavy coffee drinker, it may leave surface stains on your veneers.

What Can You Do to Brighten Porcelain Veneers?

Although whitening toothpaste or bleaching gels will not whiten porcelain veneers, either of these methods will help when your veneers do not look new anymore:

  • Use toothpaste that will not harm restorative dentistry – Supersmile is non-abrasive toothpaste that removes surface stains on cosmetic dentistry work. But it will not remove deep stains.
  • See an expert cosmetic dentist – A skilled cosmetic dentist can polish porcelain veneers, restore their original shine, and refresh your smile makeover. Polishing will increase stain resistance. If the glaze on your veneers is damaged, polishing will not remove the damage, but it will improve discoloration.
Before and after porcelain veneers photos from Baton Rouge cosmetic dentist Dr. Steven Brooksher

Before and After Porcelain Veneers from Dr. Brooksher

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

What’s the Cheapest Fix for a Tooth Broken at the Gumline?

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My front left tooth broke below the gumline. I am looking for a cheap, fast way to fix it. I don’t know if there is anything like an affordable implant. Will a mini-implant work? If not, I am interested in something that is not expensive. I suppose there are not many options, but what is the least expensive? Thanks. Bart from WVA

Bart,

Cheap options do not last. You can ask a dentist to bond the tooth back with composite as an inexpensive fix, but it will not look good, nor will it last. Two treatment options can restore your tooth, but neither is cheap or fast.

Restoring a Tooth that Broke at the Gumline

Depending on the severity of the break, a dentist can restore a tooth that breaks at the gumline a dental crown or a dental implant.

Dental crown

If you do not have a strong bite or deep overbite, a dental crown might be able to restore your tooth. Treatment steps include:

  • Root canal treatment
  • Inserting two strong, flexible post in the tooth to absorb stress on the crown and prevent tooth root fracture
  • Building up the tooth and post with composite
  • Bonding the crown to your tooth

Dental implant

Dental implant components, including root form, abutment, and crown

If you need a dental implant, it will mimic a natural tooth.

If your tooth broke at the gumline, weak and you have a strong bite, a dental implant is the only solution. You will need a standard dental implant—not a mini-implant. Although mini-implants are more affordable, they are not durable enough for front teeth, molar teeth, and most teeth. A mini-implant might support a small upper or lower incisor. And some dentists use mini-implants to secure a denture.

An implant and crown cost about twice as much as a root canal, two posts, and a crown, and it takes longer to heal. But a dental implant will last longer because the implant fixture fuses with your jawbone like a natural tooth root.

You can choose to get a dental crown, but understand the risk of failure if you have a strong bite or underbite. It is usually best to get the most effective option and avoid spending more time and money in the long-term.

We recommend scheduling an appointment with a dentist who has advanced cosmetic and implant dentistry training to discuss your options.

Dr. Steven Brooksher, an accredited cosmetic dentist in Baton Rouge, sponsors this post. Dr. Brooksher is a Fellow of the International Congress of Oral Implantologists.

Tooth fillings near my gumline keep popping out

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Woman covering her mouth, perhaps due to tooth fillings popping outOver the years, I’ve had problems with notching at my gumline, and my dentist covered them with bonding to prevent any more cavities. The issue affected five teeth. That was 15 years ago.

Last summer, my new dentist replaced the bonding because it was old and discolored. Since that time, the fillings on three of the five teeth popped out twice. I have slight anxiety over dental appointments, but this episode is making me nervous. I asked my dentist to find a permanent solution because the fillings popping out is increasing stress.

I have an autistic child and a stressful job, so I do not need repeated dental visits. My dentist seemed unphased by my concern and said he could use sedation whenever I needed new fillings. He doesn’t get it. Why are the fillings popping out? Also, I’ve never had sedation. Is it safe enough for me to keep getting it whenever I need new fillings? – Thank you. Katia from GA

Katia,

Thank you for your questions.

What Causes Notches on Teeth at the Gumline?

Clenching and grinding put pressure on your teeth and cause them to flex. Research shows that clenching or grinding your teeth causes notches on then near your gumline. The notches are called abfraction lesions.

How Can You Prevent Fillings from Popping Out?

Your dentist can prevent fillings near the gumline from popping out by using flexible dental composite. Silux Plus and Renamel are two brands of flexible composite. They will blend with your teeth and stay in place for years if your dentist properly bonds them. Newer dental composites are often hybrids that do not stay in long. And your dentist might be using a newer composite.

How Safe Is Sedation Dentistry?

Sedation dentistry is safe enough to use on every dental visit. Relaxing at the dental office might require the lowest level of sedation—nitrous oxide, or laughing gas. Otherwise, your dentist might prescribe an anti-anxiety for you to take before your appointment. In the United States, training requirements for dentists to administer sedation vary in each state. According to the American Dental Association, millions of dentists safely treat dental anxiety each year.

But in your case, the issue is using a dental bonding that will stay in your teeth and not pop out. If your dentist lacks the tools or materials to keep your fillings in place, we recommend that you schedule an appointment with an advanced cosmetic dentist.

We hope the information will help you make an informed decision about what to do next.

 

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

Is my electric toothbrush damaging my porcelain veneers?

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Two of my porcelain veneers loosed three times within the past five months. My dentist rebounded them. But during my last visit, my dentist asked me what kind of toothbrush I use. I use an ultrasonic toothbrush and Supersmile toothpaste. My dentist blames my toothbrush on the loose veneers, but I know better. And if a toothbrush could cause loose veneers, I asked my dentist why he didn’t tell me that before I got veneers. Please tell me that I am right, and my toothbrush is not causing loose veneers. Thank you. Max from TX

Max,

Although ultrasonic cleaning devices in a dental office can damage dental bonding or veneers, an ultrasonic or sonic toothbrush will not harm them. Let us explain the difference.

Is Your Toothbrush Damaging Your Porcelain Veneers?

Your toothbrush is not damaging your porcelain veneers. And there is a difference between ultrasonic dental tools and your toothbrush.

Ultrasonic dental tools

Ultrasonic dental tools have metal tips that can damage bonding or veneers. The devices can crack the glaze on porcelain veneers. And professional ultrasonic speeds are much higher than your toothbrush.

Ultrasonic toothbrush

An ultrasonic toothbrush has soft bristles that will neither nick bonding or veneers. Instead, they polish your veneers and clean them. And toothbrushes are usually sonic—not ultrasonic—which means their vibration speed is slower and more gentle than dental equipment.

What Is Causing Loose Porcelain Veneers?

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

Porcelain veneers do not loosen if a dentist bonds them properly

Loose porcelain veneers result from failure of your dentist’s bonding technique, aggressive preparation of your natural teeth, or both.

  • Aggressive tooth preparation – Often, a dentist who lacks advanced cosmetic dentistry training removes too much tooth enamel when preparing teeth for porcelain veneers. As a dentist removes more enamel, it becomes difficult for the bonding to adhere to your teeth. And if a dentist grinds your teeth down to the dentin (the layer beneath the enamel), it increases the risk of veneers falling off.
  • Bonding technique – Dentists who take advanced cosmetic dentistry training after dental school learn techniques to bond porcelain veneers securely to your teeth. And they know the importance of removing excess bonding material to avoid irritation and inflammation.

Get a Cosmetic Dentist’s Opinion

Although your dentist is blaming your toothbrush for loose porcelain veneers, that is not the problem. We recommend that you schedule a consultation with a skilled cosmetic dentist to examine your teeth and veneers to identify the issue. A cosmetic dentist will explain the treatment options to keep your veneers intact.

 

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

My dentist placed four gray crowns on my front teeth

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I’ve had composite bonding on four front teeth since 2002. Last September, one of the teeth chipped. My new dentist of 2 years suggested replacing the composite with crowns for all four teeth to prevent them from chipping again. Unfortunately, I did not know much about crowns, so I agreed to the procedure. I have four ceramic crowns that look gray in pictures. My center front teeth and the ones immediately next to them are the teeth with crowns. And the crowns do not match my other teeth. So my smile is gray and white. I have no trust in my dentist. This episode has made me so nervous about trusting any dentist. My anxiety level is high even with teeth cleaning, so the hygienist gives me nitrous oxide first. I hate to think about what is involved in removing my gray crowns. What are my options? – Thank you. Louis from OK

 

Louis,

We are sorry to hear about your horrible experience with crowns. Although your dentist offered aggressive treatment to correct dental bonding, your only option now is to find a dentist to replace your four crowns.

Replacing New Gray Dental Crowns

If a dentist gives you new dental crowns that are the wrong color, only new crowns will correct the issue. Dental ceramic is colorfast, and the color will not change. But look for an experienced cosmetic dentist to replace your crowns. A dentist who is concerned about aesthetics—the appearance of your smile—will not bond crowns to your teeth unless they fit well and match your natural teeth.

What to expect from your new cosmetic dentist

  • Discussion about your crown color – A cosmetic dentist will ensure you like the color of your natural teeth. If you want whiter teeth, the dentist will recommend teeth whitening first. And then, a lab will make your new crowns to match your brighter smile.
  • Temporary crowns – You will wear temporary crowns to ensure they look good and feel comfortable. But your final crowns will look even better.
  • Try on your new crowns – Your cosmetic dentist should use a clear paste to put your crowns on your teeth so you can see the color, shape, and how they feel. A skilled dentist will do this before bonding or cementing crowns to your teeth.

 

Request a Consultation

A closed eye - for information on sedation dentisry in Baton Rouge

Speak with your dentist about sedation options

Find a few accredited cosmetic dentists in your area. Look at their website smile gallery for cases like yours. And schedule a consultation with a cosmetic dentist to discuss your options. Also, speak with the dentist about your anxiety and discuss which form of sedation you may need while the dentist completes your crowns.

 

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

Her Porcelain Veneers Are the Wrong Color – Again?

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In October, I went to my dentist to get a second set of six porcelain veneers on my front teeth because he can’t get the color right. The first set of porcelain veneers looked horrible. On this new set, my dentist allowed me to speak with the lab tech. I chose a specific white shade that is whiter than what my dentist likes, but it still looked natural. When I went to get the veneers bonded on, they were darker than what I requested. I complained, and my dentist said that he asked the lab tech to add color.

I’ve read too many horror stories online about porcelain veneers, so I didn’t let my dentist bond them to my teeth. I asked him to hold while I am thinking about what to do next. Is there a way to lighten the veneers? Or will I need another new set to get the color corrected? Thank you! Carlie from S. Carolina

 

Carlie,

We are sorry that you’ve already had two bad experiences with porcelain veneers. Unfortunately, your dentist puts his preferences above yours. Dr. Brooksher would need to examine your veneers to explain accurate treatment options, but we will discuss the possibilities.

Can Porcelain Veneers Be Lightened?

It is impossible to lighten porcelain veneers if a dark shade is within the porcelain. But if a stain was applied over veneers to add color, an advanced cosmetic dentist might be able to remove it. Over-the-counter products will not lighten porcelain veneers.

  • Over-the-counter products – Neither teeth bleaching gel nor whitening toothpaste will whiten porcelain veneers. Abrasive toothpaste might scratch the surface.
  • Cosmetic dentistry polishing – If the lab technician applied stain to your veneers to add color, an expert cosmetic dentist might be about to polish or grind out the color. Afterward, the cosmetic dentist can polish the veneers to improve their appearance. After examining your veneers, a cosmetic dentist will let you know if this is an option. But don’t ask your dentist to complete the work. It seems that he has limited skill in aesthetics.

Replacing Your Porcelain Veneers

You have a right to ask for new porcelain veneers. Although the process might be inconvenient and take up more of your time, you didn’t receive what you paid for and requested.

We recommend asking for a refund from your dentist and finding a dental artist to complete your smile makeover. Dentists who receive post-graduate training in cosmetic dentistry are concerned about creating a smile to match your preferences—not theirs. And cosmetic dentists are concerned with function and beauty. You will get porcelain veneers in the color you want.

How to Ask for a Refund from Your Dentist

Speak with your dentist respectfully and explain your concerns:

  • You’re unhappy with your veneers because they are not the shade you requested.
  • You believe that your dentist violated your right to be informed of the color change.
  • You did not receive what you paid for and requested.

Explaining it in a way that helps your dentist see his negligence should influence him to give you a refund. Dental law classes emphasize that it is essential to get a patient’s consent before providing treatment.

If the color of your porcelain veneers is the only thing you dislike about them, consider these options:

  • You can ask your dentist for a refund.
  • If you want your dentist to replace your veneers, insist on a third set of porcelain veneers in the color of your choice.
    • Remind your dentist that you want clear, tint-free bonding resin that will not alter the shade of your veneers.
    • Bring a friend or family member with you to look at your porcelain veneers after your dentist places them on your teeth with a try-in paste—before the dentist bonds them to your teeth.
  • Whether you receive veneers from your dentist or an advanced cosmetic dentist, please do not allow the dentist to bond them to your teeth unless they match your request. Don’t compromise.

How Can You Find a Cosmetic Dentist?

Before and after porcelain veneers photos from Baton Rouge cosmetic dentist Dr. Steven Brooksher

Before and After Porcelain Veneers from Dr. Brooksher

Look at dentists’ websites and read their biographies to see if they have advanced cosmetic dentistry or dental aesthetics training. Most dentists with membership or credentials in cosmetic dentistry organizations, such as the American Academy of Cosmetic Dentistry or the American Academy of Esthetic Dentistry, are concerned about the beauty of your smile, not just the function.

Steven Brooksher, DDS, a Baton Rouge cosmetic dentist and accredited member of the American Academy of Cosmetic Dentistry, sponsors this post.

What if you have an issue with just one veneer? Read our post about replacing a single porcelain veneer.