solving a collapsed bite

I’m trying to find out what to do about my smile. I hate it. You can never see my teeth when my mouth is at rest. Actually, they’re almost impossible to see all the time. Even smiling my hardest you can barely see them. There is also almost constant jaw pain. When I wear a nightguard, it does help things feel more normal, but obviously I can’t wear that all the time. I want a smile I can be proud of. I was thinking of porcelain veneers but wanted to get all my options before deciding.


Dear Margot,

Woman covering her mouth with her hands

You don’t have to spend your life ashamed of your smile. I will say, though, I’m very glad you wrote before seeing a dentist. Too many would make things worse instead of better. It sounds like you’re dealing with a collapsed bite, along with complications from TMJ. Disorder This will take a dentist with advanced post-graduate training in a variety of skills.

Porcelain veneers aren’t the best option for you. You’ll need a procedure that will build up the teeth. This should be done with dental crowns, but it has to be done in a very specific way.

This should start with a provisional restoration. Once that is successful, the permanent restoration should be built from it. However, this isn’t easy. Successful will mean your teeth show under normal circumstances, your jaw doesn’t hurt, your speech is normal, and you love how they look.

You will need a dentist who has advanced training in restorative dentistry, neuromuscular dentistry, as well as cosmetic dentistry. That is a tall order.

See what dentists have advanced TMJ Training in your area, then check to see if they’re listed on the website. These dentists have the cosmetic training to create beautiful smiles. Combined, it will cover all the aspects you need.

This blog is brought to you by New Orleans Dentist Dr. Duane Dellaune.

Overbite and porcelain veneers

I have pretty bad tetracycline stains and wanted to get porcelain veneers to help cover them. My dentist said I am not a candidate for porcelain veneers because of my overbite. Instead, he wants to do dental crowns on my top six teeth. Is this a good alternate solution? Do I just bleach the bottom teeth?


Dear Katilyn,

A tetracycline case done by Dr. Delaune.

Please don’t let your dentist do dental crowns. This will require him to grind your healthy teeth down to nubs. He is likely saying that because he doesn’t know how to do porcelain veneers. I’ll give him credit for having a creative excuse. I’ve never heard a dentist use an overbite as an excuse. In reality, an overbite is easier with porcelain veneers.

You can see from the image above that a tetracycline case can be made to look stunning. There is a big “HOWEVER” when you’re considering this though. Smile makeovers aren’t taught in dental school. Instead, a dentist has to invest in post-doctoral training in order to truly know how to create a beautiful smile. Now, factor in tetracycline stains. These are among the most difficult type of cosmetic cases to do.

What you need is an expert cosmetic dentist. The images above show a tetracycline case done by Dr. Delaune. You want to find a dentist with his training and skills in artistry.

Finding that Expert Cosmetic Dentist

One thing I will suggest is you look on the website. This site is run by a retired dentist who is accredited in cosmetic dentistry. He screens each dentist who wants to be listed for both their technical training as well as looking to see what type of beauty they create in the cases they do.

One thing to be aware of, I”m pretty sure whichever cosmetic dentist you end up with will suggest more than six porcelain veneers. Most of our smiles are at least eight teeth wide.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

why won’t my dentist do all-on-4 dental implants?

I want to get dental implants but have lost some bone. My dentist says I need to have bone grafting done before I get the implants. I read that you can do all-on-4 without bone grafting. When I asked him about it he said that isn’t a good fit for me. Why not? Because the other way means an extra procedure and extra money for him? Should I go to another dentist who will do it?


Dear Adam,

illustration of the position for all-on-4 dental implants
All-on-Four Dental Implants

I wouldn’t necessarily assume that your dentist is opposed to the all-on-4 dental implants because he wants to make more money. There can be a few reasons.

First, all-on-four dental implants procedure requires additional training as it is done differently than traditional dental implants or implant overdentures. It may be that your dentist simply doesn’t do that procedure. Not all implant dentists do.

A second possibility he is saying no could simply be that you’re not a good candidate. While it was developed to help patients with less bone still get dental implants, it really will depend on how much bone you’ve lost. Maybe your dentist said it won’t work for you because you’ve lost too much bone for this to be a viable procedure.

The first thing I would do is simply as him why he says it won’t work for you. If you are not satisfied with the answer, then getting a second opinion would be a good idea.

Options to All-on-4 Dental Implants

Before making any decision, you should know all the facts. While there have been improvements doing all-on-4, you should be aware if one part of the procedure fails or is damaged, you’ll have to replace the whole unit.

If you are not a candidate or decide you want to go with something else, then implant overdentures will be a great option. Though, as your dentist mentioned, it will require some bone grafting. The good news is this is an outpatient procedure

Getting a Smile You’re Proud to Share

This is your chance to not just get functional teeth, but an attractive smile. The way to do that is to be certain the dentist who does your procedure is not just a trained implant dentist, but is also a skilled cosmetic dentist.

To find one, I suggest you look on the They screen dentists who wish to be listed for both their technical training as well as their artistry. Any dentist they list will be able to create a stunning smile for you.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.