New Orleans Dentist Archives - Dr. Duane Delaune's Blog

Dental implants with metal allergies

Posted on July 13, 2019 by writeradmin.

I have a severe allergy to cobalt, nickel, and mercury. I’m in need of one filling and one dental implant. Is there a way to do this with my allergies?

Cassie

Dear Cassie,

a woman smiling from the dentist chair with her dentist smiling beside her — The key to a good outcome with your dentist is communication

Mercury-Free Dental Fillings

You will be able to treat both of these situations. We’ll start with the fillings because that is easy. You simply need to see a mercury-free dentist. They will provide you with white composite fillings and you’ll never have to worry about any mercury content.

Metal-Free Dental Implants

As for the dental implant, the metal allergies you mentioned shouldn’t affect you. Traditional dental implants are made from titanium which is extremely biocompatible. They’re used in many body replacements, including for hips.

If you are still concerned you might have an allergy to it, you can ask your doctor to run an allergy test. That is fairly simple. If it turns out you are allergic, there is still a way for you to get a dental implant.

They now make zirconia implants. These are metal free. The zirconia is just as strong as the titanium and is nicknamed ceramic steel. The reason dentists typically use the titanium is it has been in use longer and has a proven track record.

Most dentists are good at working around a patient’s limitations. For instance, there are anxious patients who need either extra patience and explanations or what’s happening or their anxiety is so strong they need some form of dental sedation.

If your dentist isn’t willing to work with you, I’d suggest finding a better caregiver.

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

whitening teeth with white spots

Posted on July 6, 2019 by writeradmin.

I have one tooth which has had two white spots on it my entire life, or at least for as long as I can remember. I like the white parts and want to get all my teeth to look that way. My dentist is suggesting I get Zoom Whitening but my sister says that won’t work that the spots will still be whiter than the rest. Who’s right?

Brianne

Dear Brianne,

Patient using Zoom Whitening light — Zoom Whitening Light

Your sister is correct. It worries me that you’re getting better advice from your sister than you are your dentist. He is supposed to be the professional.

Teeth whitening whitens teeth uniformly. This means that all the natural tooth structure will whiten, including the white spots. That doesn’t mean there isn’t a solution.

You can go ahead with the Zoom Whitening. This will get your teeth as white as possible in just one appointment. You’ll still have those two spots, but they can be fixed with either dental bonding or a porcelain veneer. Dental bonding costs less, but will have to be replaced a little more often.

Either procedure will require an expert cosmetic dentist. In your place, I’d look on the mynewsmile.com website. They pre-screen cosmetic dentists who want to be listed on their site for both their technical skill and artistry. Anyone on the list will do a beautiful job for you.

White Spots on Teeth

Sometimes there are white spots on teeth which are just the pigment. This seems to be your case because you’ve had it for as long as you can remember.

Other times, however, white spots are more serious. Usually, these are signs of decalcification and an early sign of decay. We see them most often with teenagers who’ve recently had their braces removed. These metal wires and brackets are hard to clean around. This is one of the reasons some parents prefer Invisalign for their teenagers.

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

dental implant perforated my sinus cavity

Posted on June 22, 2019 by writeradmin.

I’m a little concerned about some things. I was several months into my “healing period” from my dental implant being placed when the dentist removed it. He said it wasn’t integrating with the bone and the implant perforated my sinus by a few millimeters. He gave me flonase and instructions not to blow my nose, etc. Then we’ll try again after a while. Is this okay or will the same thing happen again?

Miranda

Dear Miranda,

I’m a little concerned by some things I’m hearing. While it may seem a matter of semantics, the dental implant didn’t perforate your sinus cavity, your dentist did. Plus, he did it by several millimeters which by dental standards is quite a bit.

When your dentist was doing the diagnostics for this procedure, did he take any three-dimentional x-rays, such as a CT scan? This is a necessary step to prevent sinus perforation.

Additionally, the implant didn’t integrate with the bone. This is a nother cause of concern. Yes, it should have been removed, but before you go forward, I’d like to know what your current dentist will do to prevent this from happening again before moving forward.

When a Dental Implant Fails

In order to move forward, you are going to need to make sure the sinus cavity is properly healed. After that, you’ll need some bone grafting done. Without that, there is not enough bone there to inegrate with your implant.

I’d like you to get a second opinion on this situation to see what another implant dentist says.

From there, you can either go with the other dentist to replace this or you can get assurances from the second dentist with specifics as to how he’ll take steps to prevent another perforation.

If he was planning on replacing the implant without any bone grafting, I suggest you find another dentist completely. Make sure the new dentist has specific training in dental implants. Dental school isn’t enough. It needs to be post-doctoral work.

Cosmetic Consideration with Dental Implants

Whatever color the implant crown is made will be permanent. If you are happy with the color of your smile, then you are good to go. However, if you have contemplated whitening your teeth, you’ll want to get the teeth whitening done before having the porcelain crown made.

This will save you money while allowing your smile to match from the beginning. The other option is to whiten your teeth later, but then you will have to redo the crown to match the newer, white color of your teeth.

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

does tmj mean surgery?

Posted on June 6, 2019 by writeradmin.

I’m 27 years old and have been dealing with a significant amount of jaw pain. I did some research online and it sounds like I may have TMJ. Everything I read says the treatments for this are jaw reconstruction or having all your teeth re-made. That sounds terrifying to me. In fact, I’m a little too scared to see a dentist about it in case they say that is what I need. Are there any other options? What happens if I just don’t treat it and just deal with the pain with medications?

Morgan

Dear Morgan,

close up of temporomadibular joint — TMJ disorder has various causes and solutions

Before you panic, let me assure you there are many causes and solutions for TMJ Disorder. As you can see from the image above, your TMJ joint is similar to your knee joint. It has movable parts and a disc which serves as a buffer. There are also lots of muscles that help with the various movements requisite to good jaw function. This is known as the temporomandibular joint (hence the TMJ).

Treatments like full-mouth reconstruction or jaw surgery are for the most severe cases, usually after years of going without treatment or a tragic accident. It doesn’t sound like that is what you’re dealing with.

The first step to any treatment is a diagnosis of what is causing the problem in the first place.

Two Causes for TMJ Disorder

One common cause for this is pressure you’ve put on the jaw joint. This is done through clenching your jaw or grinding your teeth. This often happens without a patient even realizing it because they do it in their sleep.

If you get treatment for this early on, before too much damage is done, there is no invasive treatment. It can often be handled simply by wearing a night guard to protect your teeth and add some cushion to assist with the pressure on your jaw.

Another cause is misalignment of your bite. Our teeth shift over time. It could be that yours have shifted in a way that has caused pressure on your jaw.

In some cases, this can be fixed with orthodontics such as Invisalign. Other, more severe cases, will require a full-mouth reconstruction. This latter treatment can also happen if you don’t get teeth grinding under control and your teeth get worn down to nubs.

Full-Mouth Reconstruction

With this procedure a dentist has to crown all of your teeth. This is either because they are too worn down from grinding or your bite is so far out of alignment this is necessary to repair it.

This is quite an advanced procedure and would require a dentist with significant training in TMJ Disorders as well as cosmetic dentistry.

Look for a dentist who trained at one of the following:

Dawson Academy
J.D Pankey Institute
The Las Vegas Institute of Advanced Dental Studies

This will take care of their TMJ qualifications. To find out if they’re also a great cosmetic dentist, go to the mynewsmile.com website to see if they’re recommended . They pre-screen cosmetic dentists for both their technical skill and artistry.

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

luster premium home whitening

Posted on June 2, 2019 by writeradmin.

I’m considering whitening my teeth. I know a lot of dentists tout the Zoom Whitening because it has the light that speeds up results. I noticed that the Luster Premium Home Whitening kit has the same light. It’s significantly less money than my dentist charges for Zoom. Do you know if they get similar results?

Cath

Dear Cath,

I’ll address the light first. Yes, with Zoom Whitening the light activates the gel and allows you to meet your maximum whiteness in just one appointment.

The light from the Luster Premium kit is too weak to have any effect. My guess it is there to associate it with Zoom and help patients feel like it is making a difference.

The main whitening ingredient in this kit is also less than legitimate. This is a pigment in their SuperWhitener, Zinc Oxide. What it does is stick to the teeth to make them appear whiter. Unfortunately, that effect is temporary and will fade away.

Sadly, the consumer won’t realize that. They’ll see the whiter teeth in the beginning and feel like it is working. Then, continue purchasing the product thinking they “re-stained” their teeth.

Best Ways to Whiten Your Teeth

If you are after whitening your teeth quickly, than Zoom is the standard. It works. However, it is pricier than other options. If the price tag is what’s bothering you, then it is more affordable to do traditional teeth whitening through your dentist.

He’ll custom design trays for your teeth and provide you with professional strength whitening gel. You’ll place the gel in the trays and wear them for a minimum period of time every day at your convenience at home.

These can also help you achieve your maximum whitening potential. It will just take a few weeks rather than one appointment. Though it does have the benefit of you getting to control the level of whitening. With Zoom, you get the maximum. Period. With at-home whitening, once you achieve the level you want, you simply stop wearing the trays and gel.

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

teeth darkening under porcelain veneers

Posted on May 25, 2019 by writeradmin.

I’m really worried something is seriously wrong with my teeth. I had porcelain veneers placed about six years ago. I moved shortly after that. Two of the veneers fell off. A dentist placed them back for a small fee, that after a receiving a letter on an attorney’s letterhead my original dentist finally reimbursed me for. Now it looks like the teeth under the veneers are darker. So much so that the porcelain veneers are no longer white. Even my friends with natural teeth have a whiter color now. What do I do?

Mark

Dear Mark,

A woman getting a porcelain veneer placed on her teeth

I’m afraid neither of your dentists have done you a great service. I’m sure it is obvious to you the first dentist wasn’t a skilled cosmetic dentist by the fact they would just fall off.

The problem you are facing is they weren’t bonded on correctly to begin with and things are getting underneath them, including bacteria. This can lead to serous decay.

It sounds like the second dentist didn’t have enough expertise to recognize the problem or to rebond them on. Truthfully, very few dentists know how to properly re-bond.

Re-Bonding Porcelain Veneers

One of the problems you will run into is very few dentists have the skill and equipment to do this properly. Using sand-blasting equipment, the old bonding material would first need to be completely cleaned off. After that, they’d have to etch the inside surface of the porcelain with hydrofluoric acid. The final step is to prime the porcelain veneer. Only then could it be bonded on again.

Now, if your porcelain veneers can be removed without them breaking, you can likely find an expert cosmetic dentist to do this properly.

Unfortunately, I’m worried the second dentist bonded them on strongly, without fixing the problem. This may mean they’ll break when the dentist tries to get them off.

If that happens, you will have to have them completely re-done. You may be able to get a refund as your porcelain veneers weren’t placed on properly and have put your teeth in danger.

Finding an Expert Cosmetic Dentist

To find a cosmetic dentist skilled enough to do either of these correctly, I recommend you go to the mynewsmile.com website. They have a link to help readers find a cosmetic dentist.

The biggest benefit to this website’s list is they prescreen every cosmetic dentist who wishes to be listed. They have to prove both their technical knowledge as well as their artistry to ensure that anyone they recommend has the expertise and artistic eye to give patients a stunning smile.

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

Is My Dentist Too Old School?

Posted on May 11, 2019 by writeradmin.

I’ve been going to my dentist for over 15 years. I really like him, but I’m wondering if he’s losing his touch. I don’t think he always keeps up with his field anymore. I asked him to remove one of my dental fillings because of the amalgam content and he said it’s not safe to do that and I should just leave it in. Can you please explain to me if it is not safe to remove because I’ll ingest some mercury, why it is supposedly safe to have it in my mouth at all?

Carrie

Dear Carrie,

Image left of silver amalgam fillings loaded with mercury. Image right: mercury-free composite fillings

Mercury-Free Dentists Know How to Do Sanitary Amalgam Removals

You asked a great question. Why should a patient feel safe having mercury in their filling if it is considered unsafe to remove it? Your dentist should be asking the same question. The truth is, you can have this filling removed safely if that is what you want. However, you’ll have to go to a different dentist to have it done.

You’ll want a dentist who knows how to do a sanitary amalgam removal. You could do an internet search for a “mercury-free dentist” online. They’ll know the proper method for preventing you from inhaling any mercury vapors or swallowing any bits. You shouldn’t have much trouble finding one unless you live in a very isolated area.

That leads me to the other issue you brought up. Your dentist not keeping up with the advancements in his field. This is actually a big issue. While most states have a minimum amount of continuing education dentists must take every year, some dentists do just that—the bare minimum.

You want a dentist who is passionate about his work. Science changes all the time. That’s because we learn more as we go along. I once looked at an old magazine which had an advertisement promoting the superiority of lead paint. Now we know it is toxic. This is why you want a medical professional to keep up. It’s a lot of work doing that, which is why a passion for your field makes it easier to keep up. It’s likely time for you to find a dentist who still has that passion.

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

why didn’t zoom whitening help?

Posted on May 7, 2019 by writeradmin.

My daughter had braces. When they were removed, there was an uneven color on her teeth. Some of the teeth had white spots. We talked to our dentist about it and he suggested we use Zoom Whitening. We did. Although her teeth are whiter they are still quite uneven. What went wrong?

Natasha

Dear Natasha,

The biggest thing which went wrong is your dentist doesn’t know anything about cosmetic dentistry. while Zoom Whitening is an extraordinarily effective treatment for whitening stained teeth, it is not the correct treatment for uneven teeth.

When it comes to white spots, any type of teeth whitening procedure will actually make the situation worse.

Dealing with White Spots After Braces

When a patient has white spots after braces, it is usually caused by decalcification. Cleaning your teeth with braces on is very challenging. It takes a lot of effort to get in all the nooks and crannies. That’s one reason many dentists are recommending Invisalign for orthodontics whenever possible. It makes it much easier to clean your teeth.

Tooth Mousse is a product designed for this type of situation. It helps to remineralize the decalcified spots.

Another option is to have dental bonding placed in order to cover the uneven spots on your teeth. Don’t go to your family dentist for this. It requires a great cosmetic dentist to do this well.

How to Find a Great Cosmetic Dentist

I’m going to suggest you go to the mynewsmile.com website. They pre-screen cosmetic dentists for both technical skill and artistry. Anyone listed on their site will give your daughter a beautiful smile.

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

lumineers for white spots

Posted on May 1, 2019 by writeradmin.

I just finished my braces and my teeth have white spots on them. It’s pretty embarrassing and my friends have pointed it out to me, so I know it is noticeable. Getting braces was pretty expensive. I want to cover the white spots, but I don’t want to ask my mom about it if it is going to be way too expensive for her. She’s a single mom and works super hard but we don’t have a lot of money.

Becky

Dear Becky,

Advertisement with Lumineers including a woman smiling and a single veneer being held by a tool — Lumineers are just one brand of porcelain veneers

First, I just want to tell you how proud I am of how you are handling this. You aren’t running to your mom demanding anything. Instead, you are doing research to see if this is even a possibility.

You should know up front, that Lumineers are just one brand of porcelain veneers. Many of the best cosmetic dentists actually prefer to use a different brand, so don’t be surprised if you go to a dentist and they suggest another type.

As far as the cost, that often depends on the quality, skill, and philisopy of the dentist you’re going to, but I would expect it to cost between $800 to $1,600 per tooth.

This may be out of the budget of your mother if finances are a struggle. That doesn’t mean you can’t have a beautiful smile though.

White Spots After Braces

When your braces are removed and there are white spots, it is a sign that food and bacteria became caught around your braces while you were wearing them. The white spots are the pre-cursors to decay, so you’ll want to see your dentist fairly soon to shore up and weak spots before they become full blown cavities.

Repairing the white spots cosmetically can be done with dental bonding. A dentist could hand sculpt the composite bonding onto your teeth and it will cover the white spots perfectly.

In your place, instead of suggesting a procedure to your mother, I would just let her know what’s going on and ask if the two of you can talk to the dentist about affordable solutions.

Best of luck to you!

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

Can I bleach my non-veneered teeth?

Posted on April 27, 2019 by writeradmin.

I had four porcelain veneers done several years ago. They look fine, but the teeth next to them have stained a bit and it looks weird having white teeth and not white teeth when I smile. I was thinking of getting Crest Whitestrips but don’t want to hurt the veneers. Would it be safe?

Mia

Dear Mia,

Crest Whitestrips are safe for your teeth and they will whiten them some, but very slowly. They only cover a few teeth so to get the teeth you need whitened, you’ll need to cut them and try to fit them on those teeth.

I wouldn’t use other over-the-counter products. They’re not as safe. Some have citric acid and some have things which will etch the teeth to make the look whiter. Unfortunately, they also cause micro scratches on your teeth which will cause them to pick up stains.

Consider Professional Teeth Whitening

If you want to whiten them faster, you may want to consider professional teeth whitening with a dentist. They can get all the teeth you want without any damage to your porcelain veneers.

Another option would be to add porcelain veneers to the teeth which are exposed when you smile. This way you wouldn’t have to constantly worry about the discrepancy in color.

In fact, originally, your cosmetic dentist should have suggested to cover all your teeth visible when you smile. For most smiles, that would mean 6-8 veneers. Some wide smiles require up to ten.

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