Archives for June 2021

Is This Dentist Pulling Our Leg?

Posted on June 29, 2021 by writeradmin.

My wife has been doing splint therapy for TMJ Disorder. Our dentist said that would help her migraines. It hasn’t and now he’s suggesting Botox. Is this dentist just pulling solutions out of thin air? I thought Botox was for wrinkles. I half suspect she’s paid him under the table to suggest this treatment. I think she’s always wanted to try it.

Carl

Dear Carl,

I can almost guarantee your wife did not slide a briefcase filled with a bribe under the dental tray. TMJ Disorder is very complicated, with a vast array of causes. While migraines can be a symptom of the disorder, sometimes it is not enough to simply do splint therapy. You are correct that Botox is used to deal with wrinkles. However, the same treatment can also relax muscles and help alleviate the excruciating pain that accompanies a migraine.

It has been approved by the FDA for use in the treatment of migraines under certain conditions. First, the patient must be over 18 years of age. Secondly, the patient must have a minimum of 15 migraines per month. In some cases, it is even covered by insurance.

If your wife suffers from migraines and splint therapy has not worked, then I would definitely do the Botox treatment. I don’t know if you’ve ever had a migraine, but they can be debilitating. This will give her some relief. Make sure she understands that it often takes a few treatments before there are more permanent results, but she will see results.

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

Why Did Three of My Dental Implants Fall Out?

Posted on June 13, 2021 by writeradmin.

I had six dental implants placed a few weeks ago and I’ve already had three fall out. I’ve paid 3/4 of the fee already. Should I get a partial refund? Is it possible for me to get them again because they were supposed to secure a denture to them.

Leigh

Dear Leigh,

You absolutely should have a refund, and not just on the ones that have already fallen out. I think you need a complete refund. I don’t know what your dentist did without examining you, but you need to get to a different dentist as soon as possible for an evaluation. Most experienced implant dentists will have around a 95% success rate. Those that do fail, won’t often do so until much later down the line. Your dentist has a 50% success rate and the failure was in just a few weeks.

There are a few reasons that dental implants can fail and we need to nail down what was the cause of your implant failure. This will give you an idea of how to proceed. If you are in good general health, you can most likely still get dental implants. Though, because of the failed implants, you will need a bone grafting procedure.

Here are some reasons that dental implants can fail:

Infection. I don’t think this is your issue. It is often accompanied by pain and/or fever.
Diagnostic shortcuts. This means the dentist did not take adequate diagnostic x-rays to determine whether or not you had sufficient bone support to retain your dental implants.
Cheap implant fixtures. Some dentists, in an effort to increase profits, will purchase their implant fixtures from outside the United States, where standards might not be as high.
Incorrect placement of the implant. This can occur because the dentist is unskilled or careless, but it can also occur if the dentist did not get the right x-rays done.
Premature Crown Placement. A dental implant has to integrate with the surrounding bone tissue in order to securely retain the implant.

As I mentioned before you need to find out what went wrong. Dental implants are not adequately taught in dental school. In order to really develop the skills necessary, a dentist must invest in post-doctoral training specifically in the implant procedure. Before going to get your second opinion, make sure the dentist you see has that training.

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

Why Did I Need Root Canal Treatments After Porcelain Veneers

Posted on June 4, 2021 by writeradmin.

I had ten veneers placed on my upper teeth and the same number placed on my bottom. During the diagnostic stage, I was told everything was fine and there were no real risks involved. Since the procedure, I’ve had a lot of pain. My dentist made a few height adjustments, but that did not seem to help. Then, two of the teeth developed an abscess and, when he did the x-rays, it showed my nerves have died, even though they were fine before. Now I have had to have root canal treatments. I’m still in pain and worried more of my nerves will die. My dentist said he’s never had this happen with veneer crowns. What is going on?

Jayla

Dear Jayla,

The first thing I am wondering about is whether you actually received dental crowns instead of porcelain veneers. There are a couple of things that make me things this. First, you called them veneer crowns. That is not a thing. Either you have porcelain veneers or you have dental crowns. There is not a combination. A second inconsistency here is the height adjustments that were made. That is something done with dental crowns. Finally, it is the damage to the nerves.

The Difference in Preparation between Crowns and Veneers

Tooth preparation for porcelain veneers

When a tooth is prepared for porcelain veneers, there is hardly any of the tooth structure removed. Here is an example in the image above. Notice only the surface is affected. Now contrast this with the image below.

Preparation for a Dental Crown

Notice with this tooth, much of the tooth structure had to be removed. It is a much more aggressive preparation and your nerves are at a greater risk as a result. I think this is the treatment you received.

One way to tell is by how far around the tooth your restoration is. With porcelain veneers, it just covers the very front of your teeth and will hug the sides slightly. But, with porcelain crowns, the restoration goes around your entire tooth, including the back.

If your dentist told you that you were getting porcelain veneers, but then gave you porcelain crowns, that is unethical. Plus, if the only reason for the restorations was a smile makeover, porcelain veneers are what you would do— not dental crowns. To be honest, I would tell your dentist he needs to cover the cost of the root canal treatments. I’m sorry this happened to you.

This blog is brought to you by New Orleans Cosmetic Dentist Dr. Duane Delaune.
Click here to learn about our free virtual smile makeover consult.

Dental Bonding Doesn’t Match and Falls Off

Posted on June 1, 2021 by writeradmin.

I have tetracycline stains and my dentist said dental bonding would take care of it. It has not worked out at all like I wanted. First, the color doesn’t match and it is pretty obvious. Plus, you can still see some of the tetracycline stains through it. As if that weren’t bad enough, the bonding fell off after just three days. I went back for him to repair it. At the time, I told him about the color problem so he made them thicker, which looks weird in its own way. Now they have fallen off again just a few days later. I called him back and he said they’re not meant to be permanent so I should not have high expectations. However, I was told they’d last up to five years, this is like just a few days. What should I do?

Calorie

Dear Calorie,

As you can see from the image above dental bonding can blend in quite naturally with your teeth. I think the biggest problem you are facing is the skill and technical knowledge of your dentist. Both dental bonding and tetracycline stains are some of the most advanced procedures in cosmetic dentistry. You should be aware that cosmetic dentistry is not a recognized specialty. Any general dentist can call themselves a cosmetic dentist regardless of the amount of training they have invested (or not invested) in.

I think your dentist is in way over his head. Dental bonding should not fall off, especially after just a few days. As for the color, if he is an inexperienced cosmetic dentist, he probably doesn’t even have the colors and other materials necessary to make things blend well. An additional problem in dealing with tetracycline stains is making the teeth opaque enough to cover the stains, while translucent enough to look natural. That is not an easy accomplishment, even for a skilled cosmetic dentist.

Honestly, the better treatment for you would be porcelain veneers and not bonding. It is more permanent, decades rather than years. Plus, it is more stain-resistant. I don’t think your dentist is the one to do it. Here is my advice. Do not let him “fix” this. instead, ask for a refund. Then, we’re going to get you to a highly skilled cosmetic dentist.

Finding an Expert Cosmetic Dentist

Because there is not a recognized specialty in cosmetic dentistry it is hard for patients to know who has the skills and who doesn’t. There is a website that strives to help patients in your position. A retired cosmetic dentist runs the mynewsmile.com website. He prescreens all dentists that want to be listed on his site. They cannot purchase their way on. Instead, they have to show their training credentials, in addition to proving their artistry and skill on cases they’ve completed. Any dentist he lists can provide you with a stunning smile.

This blog is brought to you by New Orleans Cosmetic Dentist Dr. Duane Delaune.
Click here to learn about our free virtual smile makeover consult.