Best Dentist Archives - Dr. Duane Delaune's Blog

Am I at Risk of Nerve Damage with Tooth Removal?

Posted on December 31, 2023 by AllSmiles.

My dentist removed four teeth before Invisalign treatment and left one tooth root behind by mistake. He says a premolar tooth root touches a nerve, and an oral surgeon must remove it. The surgeon explained the risks for numbness that can be brief, last for months, or permanent paralysis. Can I skip this surgery? I’ve already delayed Invisalign treatment for the first surgery. Thank you. Chase from NH

Chase,

You need a second opinion with another oral surgeon to examine your X-rays and determine what you might expect with surgery.

Is it Necessary to Remove Tooth Roots Left After Extraction?

Sometimes, tooth roots left after extraction are harmless. However, if you are in Invisalign treatment and the tooth is a lower molar, the root can affect the movement of other teeth.

Oral surgeons must protect themselves from lawsuits and explain the most extreme results of surgery. The risk of nerve damage with wisdom teeth is higher than with premolars. Still, if a tooth root touches a nerve, the roots may affect the mental foramen nerve that travels along the lower lip and chin. You might have some temporary numbness or complete loss of sensation but not paralysis.

An oral surgeon can see the nerve on an X-ray and, with good technique, avoid damaging it during surgery.

Get a Second Opinion

If you want to feel confident about your decision to accept or decline surgery, schedule a second opinion with another oral surgeon. They will examine your X-rays and explain your options. The surgeon will also explain what you can expect if you do or don’t have surgery to remove the tooth root.

Dr. Duane Delaune of Metairie, Louisiana, sponsors this post. Read why Dr. Delaune’s patients consider him one of the best dentists in town.

My Daughter’s Dental Crowns are Ugly

Posted on July 10, 2021 by writeradmin.

Years ago, when my college-aged daughter, was a middle-schooler she had a fall that caused some tooth trauma. Two teeth were crowned and one of them even needed a root canal treatment. One of the crowns has turned gray over the years, so we were looking for a solution. We went to this dentist who provided two porcelain veneers for us. Whle they are more attractive than what she had, we’re still not too thrilled. The biggest thing is that one tooth is still darker than the other. The second is that one of the teeth are thicker, which he said was due to the fact that he was trying to cut down on some of the grayness of that tooth. He also said that we have unrealistic expectations. Do we? I feel like after $5,000 she should feel confident about her smile. Am I being overly critical?

Morgan

Dear Morgan,

I will say up front you are not being overly critical to want two front teeth to match in color and size, especially when you are paying a cosmetic dentist to do it. That being said, I want to clear one thing up before we get into the solution to this. You said he was giving you porcelain veneers, but that previously she had crowns. Once you have crowns, they can only be replaced with other crowns. Unless of course, your dentist was planning on placing porcelain veneers on top of her dental crowns. However, that would be a dumb thing to do because they are less secure and an equal amount of work for the dentist. My suspicion is that he gave her porcelain crowns and called them porcelain veneers. Crowns go all the way around her teeth, which means the tooth structure is ground down quite a bit.

For now, I’m going to go on the assumption she actually has crowns, but the principles I’m about to share are the same either way. While getting a single porcelain crown to match a front tooth is extraordinarily hard and takes the top 1% of cosmetic dentists, getting two crowns to match should not be that hard. This dentist is not the best dentist for you. I believe your dentist is in over his head. While I can tell you the procedure to help, your best bet would be to find a dentist who does not need to be taught.

The first thing I want you to do is ask for a full refund from this dentist. Then, look on the mynewsmile.com website. They have a find a cosmetic dentist link. You input your zipcode along with the distance you are willing to travel and they will bring up a list of skilled cosmetic dentists in that area. Everyone they will recommend has been prescreened for both their technical training and skill as well as their artistry. They’ll be able to give your daughter a smile she will be proud to share.

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

My Dental Bonding Looks Awful

Posted on May 9, 2020 by writeradmin.

I had some discoloration on my teeth after getting braces. I really regret not getting Invisalign now, but hindsight is 20/20. I had discoloration on several teeth after my procedure was done. I asked her what we could do about it. At first, we tried teeth whitening, but that only made it worse. So, she told me she needed to do some research. She called me back and said the consensus is dental bonding is the right solution. I felt confident going in because this time she researched the solution. Honestly, though, my two front teeth now look like she just glued pieces of chicklet gum to them. They are way too thick and the color looks flat and chalky. I could tell even she wasn’t thrilled with them but she was trying to not make me feel self-conscious about them. Is there anything I can do to fix these at this point or is it too late?

Sheena

Dear Sheena,

It sounds like your dentist cares about her patients but is just in over her head when it comes to the cosmetic end of things. That isn’t terribly surprising. Dentists are in a bit of a pickle when it comes to cosmetic work. It’s not really taught in dental school, nor is it a recognized specialty. If a dentist wants to learn about cosmetic dentistry they have to invest in post-doctoral training to learn more about it. Especially for dentists just starting out, that’s a tough one.

I can tell your dentist had not invested in that training right off that bat with her suggestion about teeth whitening. Two basic tenets about teeth whitening that every dentist should know are: 1. It whitens your teeth evenly. As a result, when there is discoloration whitening your teeth actually makes that more obvious, not less. 2. It will only whiten natural tooth structure. If someone had discolored dental work bleaching them won’t work.

When that failed, she did what she should have to begin with, and did some research. She was right about the solution. Dental bonding is the correct way to fix this problem. What she didn’t realize is that it is an advanced cosmetic procedure that takes a while to learn, especially because it has to be done freehand.

Another common repair that uses dental bonding is for broken and chipped teeth. if you look at the image above, you can see a repair done by Dr. Delaune. Notice that it blends in seamlessly in both color and texture. This is what you should expect with a dental bonding case.

Getting Bad Dental Bonding Fixed

The only real fix for this is to have it done over. Based on what you’ve said, I honestly don’t think your dentist has the skills yet to give you a beautiful natural-looking result. Your first step is to get your money back, so you can get this done properly. She likely knows it didn’t turn out beautifully and should be willing to give you a refund.

You’ll want an expert cosmetic dentist to do this repair. It is hard for patients to know who has the training and who doesn’t because there isn’t an “official” specialty. One retired cosmetic dentist realized this and started a website to help patients like you. I would go to the mynewsmile.com website. They screen dentists, who want to be listed, for both their technical knowledge and skill, as well as their artistry. Only the best cosmetic dentists are included. They cannot simply pay to have a listing there. Any one of them can give you the repair you were hoping for to begin with.

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