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Using Invisalign as a Retainer

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I am finishing up my Invisalign treatment. I have two sets of aligners left. I have to move rather quickly to another state and will be quite busy once I arrive. My sister and her young son were just diagnosed with cancer, though they have two different cancers. I was coming to help anyway, but now her husband was in a car accident and he is in a wheelchair and will be for several months. I need to leave immediately. My boss has given me permission to work remotely. The only thing I don’t have worked out is how to do the Invisalign. I will have no time to find a new dentist. Do you have any recommendations?

Kathy

Dear Kathy,

Invisalign Aligner

Invisalign Aligner

First, let me express how sorry I am for all that you and your family are enduring at the moment, as well as how grateful I am that you are doing all you can to help them. I am sure it brings them some peace of mind. The first thing I would do is call your dentist and ask him to provide you with your last two sets of your Invisalign aligners. Assuming your case has had nothing unusual and everything is going according to plan, he should not have any problem with that at all.

That is the easy part. the tricky part comes after you are done with your treatment. You will need to wear a retainer, unless you want your teeth to go right back to the way they were before their treatment. The good news is, there is a way to do this without you having to take time out to see a dentist. Your final pair of aligners can double as a retainer if you follow these directions and take good care of them.

Using Invisalign as a Retainer

The first step will be to wear them all the time for a month. Once the month has passed, then start backing off. You can wear them nights only for a month or two. After that, try every other night. Directly after the first time you were without them for two days, I’d like you to do a little test. When you put the aligners back in, if they are a little harder to put on I suggest you go back to wearing them every night for a couple more weeks, then try again.

Once they remain in place, you can wear them every other night for a month then retest to see how that is going. If they are fine, you can go to wearing them once a week. Always repeat the test mentioned above before any change, backing off a little more after each stable pass. Eventually, you won’t need them at all.

I would still keep the aligners even after you are done with them for two reasons. First, you can periodically check to see that no shifting has happened. Second, they are great for doubling as teeth whitening trays. When you do get to a new dentist, he can provide you with whitening gel. This will allow you to keep your teeth youthful and bright at a fraction of the cost.

Best of everything to you and your family.
This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

Smile Makeover Disaster

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I need some serious advice. I went to my dentist with the intent of having my cleaning done and then getting a recommendation for an orthodontist. My four upper front teeth are crooked. He said he could make them straight with cosmetic dentistry and I would not have to worry about the inconvenience of braces. That sounded great to me so I agreed. He told me that two porcelain veneers and dental bonding would make my smile look completely straight. I was excited about the possibility of having a beautiful smile. When the makeover was “completed”, it wasn’t anything like he promised. The teeth are still uneven, the porcelain veneer is too small and you can see a gap between the veneer and my gums. He also charged me for reshaping my lower teeth which was never even discussed. I was quite upset and told him this wasn’t the outcome I expected. Then, he proceeded to tell me the only way to get the outcome I want is with four dental crowns. Of course, that will be an additional fee. Is this allowed? Can he get away with it?

Fanny

Dear Fanny,

porcelain veneer being placed on a tooth

No. Your dentist cannot get away with this. I would go back to him and ask for a refund. If he says no, remind him that he was the one who told you what this outcome would be and he didn’t deliver on his promise. On top of that, the porcelain veneer he provided for you has an open margin (what dentists call that gap you described). Open margins put your teeth at risk because it allows food and other bacteria to get caught between your teeth and the veneers, leading to decay. A second issue that can get him in big trouble is reshaping your bottom teeth without your permission. It sounds like this dentist was using you for practice. Let him know you will be taking this issue to the dental board and I think he will provide your refund.

Once you have secured your refund, you will want to get the smile makeover you wanted. Believe it or not, it is probably still possible to do with porcelain veneers. You just need a skilled cosmetic dentist to do the work. I would look for a dentist who is recommended on the mynewsmile.com website. Dentists cannot pay to be listed on this site. Instead, they are screened for both their technical skill as well as their artistry. Any dentist recommended on there will give you a stunning smile.

I will say, if you are planning on just getting four porcelain veneers (and it is okay if you are) then I suggest you have teeth whitening done first. Most patients smiles are six to ten teeth wide. Getting your teeth whitened allows you to have your non-veneered teeth blend in better than if you left them their current tone.

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

The Secret to Very White Teeth

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I have been using whitening toothpastes for years and never seem to get very white teeth. I’ve about given up and am now looking at getting Lumineers at the suggestion of my dentist. It looks like it can give me very white teeth, but I wanted to make sure I am on the right track with this before investing that much money. Any advice?

Melissa

Dear Melissa,

Zoom Whitening

You have a few good options. Before we get into that, I’d like to discuss why your whitening toothpaste hasn’t worked.  These don’t actually whiten our teeth as much as scraping them clean. Whitening toothpaste uses an abrasive on your teeth, which removes the stains. However, it also will scratch the surface of your teeth. This has the unfortunate effect of damaging the surface of your teeth, in turn making them pick up stains more.

I’m a bit concerned that your dentist jumped from whitening toothpaste straight to Lumineers. It is massively more expensive than some of your other options. Lumineers are one brand of porcelain veneers. It’s a highly marketed brand. Unfortunately, it is mostly marketed to inexperienced cosmetic dentists. This rarely goes well for the patient. Plus, porcelain veneers are not intended for simply whitening your teeth. Instead, they are for total smile makeovers. If that is what you want, then great. Get porcelain veneers. They can be made as white as you’d like. They can also change the shape and size of your teeth. It’s important you choose an excellent cosmetic dentist to do that procedure.  If you decide to go that route, I suggest you look for a dentist that is listed on the mynewsmile.com website. These dentists are pre-screened for their training, technical knowledge, and artistry. They cannot just pay to get listed.

If you are not looking for anything quite that expensive, then you can get your teeth very white by doing professional teeth whitening. Doing bleaching trays can get them very white and you can do it at your convenience. If you want them white super fast, then you can go with Zoom Whitneining which will whiten your teeth in just one appointment. Unlike with porcelain veneers, you won’t need an exceptional cosmetic dentist for either teeth whitening procedure. Pretty much any dentist who offers the services can do them without any problem.

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

Should She Finish This Full-Mouth Reconstruction?

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I went for years grinding my teeth without any intervention or knowledge that it was happening. I moved to a new city, which meant a new dentist. He was the one who told me about the grinding. I would explain why my jaw always hurt. I am wearing a night guard now, but he also suggested a full-mouth reconstruction. I was a bit nervous about that because I have a very sensitive mouth. I once had Zoom Whitening done and it was absolute agony. I did (and do) trust this dentist so I went ahead with the reconstruction. He’s finished the first half, which is the bottom arch. While it does make that part of my smile look much better, it almost looks too perfect. I liked the quirky look of my old smile. Plus, like the Zoom, the procedure was agony for me.  I’m no longer hurting, since he did the first half and I’m wondering now if it is necessary to finish. There is a color difference wtih my bottom teeth being whiter. If Zoom weren’t such a painful experience for me I’d just do that.  Do you have an opinion?

Katherine

Dear Katherine,

a woman smiling from the dentist chair with her dentist smiling beside her

You’ll need to bear in mind that I haven’t examined you, nor have I seen any x-rays. I can give you some generalities. I am not usually one to recommend half of a full-mouth reconstruction. In general, restorative material is harder on your teeth than natural tooth structure. That could cause a problem with your upper teeth, including increased sensitivity–something you definitely don’t need.

If not having the quirkiness bothers you, there is an easy solution for that. Most cosmetic patients want the perfect smile look. My feeling is your dentist and his ceramist would LOVE the opportunity to be more creative and add some quirkiness. You mentioned having some pain with the reconstruction. If the numbing medication isn’t working it is likely because with your sensitive teeth you have had enough bad experiences to give you dental anxiety. There is something about how the anxeity affects your body chemistry that causes it to interfere with the effectiveness of your medication. Oten, doing something as simple as using nitrous oxide before the procedure starts will relax you enough to enable the numbing medication to do its job.

All of that being said, if you feel the first half of your reconstruction has served the purpose you needed and all you truly want at this point is the whitening, you don’t have to use Zoom Whitening, which can be a tad strong for people with sensitive teeth. Instead, you can do home whitening trays. You will wear the gel at your convenience for as long as you can comfortably tolerate. You may find that a better solution for you. There are a variety of teeth whitening options.

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

Crooked Porcelain Veneer

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I had a chipped tooth that had dental bonding done. It was getting old and ended up breaking. I wanted to just replace it but because the chip is 1/5 of my tooth they said it was not possible to replace the bonding. My dentist wanted to repair it using a dental crown but I didn’t want to lose any more tooth structure, so I suggested a porcelain veneer, which doesn’t take away as much. When the veneer came in, the size and shape looked fine. The color was whiter than my other teeth, but I anticipated that because we knew I would be whitening my teeth later. I saw it before they bonded it on and everything seemed great. After they bonded it they told me it was gorgeous and sent me on my way. It wasn’t until I got home that I realized it was a tad crooked and the bottom was too long compared to the other tooth. Plus it sticks out a bit almost like they put on too much glue, which also puts a small gap behind the bottom of the tooth. I called them about it when I got home. They said there isn’t anything that can be done about the length but they can fill in the gap. To me that doesn’t sound like it will make the tooth stick out any less. Is there anything I can do about this?

Morgan

Dear Morgan,

a porcelain veneer being placed on a tooth

These type of stories are so frustrating to hear. This is one of the big problems with cosmetic dentistry not being a recognized specialty. Any general dentist can do it regardless of the amount of training or skill they have. There are quite a few things wrong with your case. First, the dental bonding. That could have been replaced. My guess is she doesn’t know how to do dental bonding so she steered you toward a procedure she is familiar with, dental crowns.

You were wise not to get that. Not only would it have severely ground down your healthy tooth structure, but it is rather tricky to match a dental crown to a front tooth. With your dentist’s cosmetic skills I don’t think it would have looked very natural. A porcelain veneer should have been fine.

As for it being whiter in anticipation of whitening your teeth, your dentist should have had you do the teeth whitening beforehand, when it would make more sense. You can exactly match a porcelain veneer to the tooth color, but it is almost impossible to exactly match teeth whitening to a porcelain veneer. Plus, whitening the underlying tooth structure is always helpful.

Now to your current problem. I find it curious they let you look at it before but not after they bonded it on. My suspicion is they knew something was off. Even when you get your hair cut they have you look at the result before you get up. It’s interesting to me that they told you nothing could be done about the length. This is just more evidence to me that she doesn’t know what she’s doing with cosmetic work. The length on the porcelain veneers can be trimmed.

However, your situation is more complicated and more serious. If it is crooked, not only will it look weird but there are going to be areas where there will be gaps that can harbor bacteria. This leads to decay under your veneers. The only way to solve your case is to get a refund from this dentist and have the case re-done by a cosmetic dentist with more expertise. My suggestion is you use one of the dentists listed on the mynewsmile.com website. Each of them are prescreened for their technical expertise as well as their artistry.

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

Getting Super White Teeth

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I want super, super white teeth. My dentist said I won’t be happy with that because it won’t look natural. I don’t feel like I am going to get all my options from him. He’s a super nice guy and your basic bread and butter dentist, but for this I may need someone else. Can you tell me what my options are so I can start doing some research on dentists who do those procedures?

Missy

Dear Missy,

Blonde woman with a beautiful white smile

First, I will say you are wise to discern that you may need to see someone else for the types of procedure you are looking for. Too many patients think any dentist can do any procedure and that just isn’t true. You can have a great family dentist, but he or she could still be clueless as to cosmetic work. That’s not taught in dental school, nor is it a recognized specialty. That means it is totally up to the dentist how much post-doctoral training he invests in, if any. There are countless cosmetic dentist horror stories from patients who pressured an unqualified dentist. Fortunately, this should not happen to you.

You have a few options here.

Go the Whole Hog with a Total Smile Makeover

If you are looking to do more than just whiten your teeth, such as changing other aspects of your teeth, then you may want to look into porcelain veneers. This is what celebrities turn to for that Hollywood smile. It can remake everything about your smile. The shape, the size, the color, and even the character of your smile. However, this will need to be done by an expert cosmetic dentist. I would look on the mynewsmile.com website to choose the dentist to do this procedure. They have all been previously vetted and found to have both technical skill as well as artistry. They will create a stunning smile for you. In fact, most of them have a beautiful smile guarantee.

One Appointment Teeth Whitening

If you are just wanting to whiten your teeth but want to do it quickly, Zoom Whitening is a good option. It will get your teeth extremely white in just one appointment. You won’t have to find a dentist with special skills for this the way you would for porcelain veneers, but you will need a dentist who has the Zoom whitening machine.

At-home Teeth Whitening

If you are persistent enough, you can use at-home teeth whitening with bleaching trays. Any dentist can do this. You will wear the trays for a minimum of 20 minutes a day. The longer you wear them, the faster they will whiten. Many people choose to sleep in them. You can get them massively white by just sticking with this method.

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

Dental Bonding Doesn’t Match

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I chipped a tooth after a fall. My dentist wanted to put a crown on the tooth, but I did some research and saw the best solution was dental bonding so I asked him to do that. He agreed, but the results aren’t that great. The colors don’t match so you can really tell it is a repair. Is it okay to have this dentist do it again? Should I have to pay for it to match?

Olivia

Dear Olivia,

before and after dental bonding for a chipped tooth

When dental bonding is done correctly, it can match perfectly with the rest of the natural tooth. However, it isn’t easy to do. Not only is it done freehand, but many dentists don’t carry enough of a selection of shades and textures to do this right. When a dentist suggests something like a dental crown for a chipped or gapped tooth, which is a massive overtreatment, it is an indication they are uncomfortable with cosmetic dentistry.

You have two options: The first is to give your dentist another chance to get this right. Explain to him that the repair is obvious and doesn’t match the rest of your tooth. If he cares about the quality of his work, he should be willing to do it again. And, no, you shouldn’t have to pay for it.

I would give your dentist another opportunity to get this right. You shouldn’t have to pay for the color to match. That is part of what you paid for in the beginning. Don’t be surprised if he still struggles, but it is fair to give him another chance.  If after the second go he still can’t get it to match, then I would suggest your next step is to ask for a refund, then find an experienced cosmetic dentist.

Who Should Do Your Cosmetic Bonding?

In your place, if it doesn’t work out with your original dentist, then I am going to suggest you look at the mynewsmile.com website. The man who runs this site has retired from cosmetic dentistry but wanted to offer patients a service to help them know who has the skills to do beautiful cosmetic work. Most patients don’t realize that there isn’t a recognized specialty in cosmetic dentistry. That means any general dentist can call themselves a cosmetic dentist regardless of the level of skill they have.

To make matters worse, most of the skills they need for well done cosmetic work isn’t even taught in dental school. For a dentist to develop the necessary skills they will have to invest in post-doctoral training. It’s nearly impossible for patients to know which dentists have done that. The mynewsmile site, pre-screens dentists for their technical training as well as the artistry of their work. Only those who pass his rigorous standards can be listed. Any dentist on that site can give you a beautiful, natural-looking result.

Should You Whiten First

I don’t know if your dentist mentioned this, but the color that is created for your dental bonding is permanent. If you were to whiten your teeth at a later date, your natural tooth structure would whiten, but not the bonding. Therefore, most cosmetic dentists will warn their patients if they are even considering getting their teeth whitened, it will save them money to do it before they have the bonding done. This will save them money by not having to replace the bonding after they whiten.

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

Contouring Teeth

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Ever since I had my braces, off the jagged edges of some of my teeth have bothered me. Can this be fixed? If so, would it be done by my regular dentist or is it something the orthodontist would do? I like how straight they are now, but would like smooth edges.

Misty

Dear Misty,

Congratulations on getting your braces off and having lovely straight teeth. The repair for the jagged edges on your teeth is called tooth contouring or cosmetic contouring. You would only want this done minimally on just the enamel of your teeth. Often orthodontists will do this for minor issues at the end of your case. However, if yours didn’t, I wonder if has some complicated issues to it. In that case, I would be very careful who you had do the contouring for you. In choosing a cosmetic dentist to do it, I would likely aim for someone who has real expertise in dental cosmetics. The mynewsmile.com website has a “find a cosmetic dentist” link. They prescreen anyone who wishes to be listed and only the best cosmetic dentists will make the cut. You can’t just purchase your way to a listing.

An Example of Dental Contouring

before and after dental contouring and dental bonding

In the case above, there was some tooth contouring done to smooth out the appearance of the teeth. Then, the dentist added some composite bonding to the sides of the teeth to create a beautiful, aesthetic result. You want to find a dentist who can give you this type of results. Whether or not you are in need of the additional work of dental bonding.

If You Add Bonding

I don’t know your goals for your smile. You may be perfectly content with the contouring work and nothing else. That is fine. If you do decide there are spaces you’d like to close with bonding, it will save you money if you think long-term. When you get bonding done, the color made is permanent. If you will be doing teeth whitening anytime in the next few years, do it before you get the bonding done. This way, you can have the bonding color made with the new brighter, white color.

You don’t have to. If you decide to wait and whiten later, just bear in mind that only natural tooth structure will when. The bonding will stay the same original color. The only way to get them to match at that point is to replace the bonding.

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

Need to Whiten FAST!

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I’ve kind of let my whole routine go during this quarantine and I’m ashamed to admit I haven’t even taken care of my hygiene that well. The only thing I did do is work non-stop from home remotely.  I live alone so I just plopped on the couch, put on some background noise, ate snacks, and worked non-stop on my computer. The home office noticed my work and I’m getting a promotion and an award, that is going to be streamed to the rest of the company.  My teeth are YELLOW! Like noticeably.  How can I get them whitened fast?  I have a week and a half?

Jim

Dear Jim,

Zoom Whitening

First, let me congratulate you on your win and your promotion! That is excellent.  Don’t be too hard on yourself about letting some things go. It seems like every person working from home I know are growing beards and relaxing on some normally fastidious habits. Plus, it sounds like you were productive in other ways.

The fastest way to whiten your teeth is with Zoom Whitening. This is an in-office whitening procedure that can whiten you thoroughly in just one appointment.  However, it is most effective if you’ve recently had your teeth cleaned. Otherwise, the results could be splotchy.  The first thing I’d do is schedule an appointment with your dentist to get your teeth cleaned immediately if you haven’t done that recently.  When you schedule that appointment, explain about the award and see if they offer Zoom Whitening. If not, I would just call around and see who does.

They may want you to get your cleaning done there and some even offer discounts when you do both at their office.  Many offices will also provide custom-fitted teeth whitening trays for you to take home with you after you are done with your appointment. Keep those in a safe place and then once every couple of years you can ask for some teeth whitening gel and give yourself an inexpensive touch-up.

Best of luck with your ceremony.

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

Making Teeth Beautiful Fast without Spending a Fortune

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A man I knew way back in high school is flying into town for a business meeting and wants to have dinner and catch up. This is going to sound a bit childish, but I used to have a crush on him and want to make a good impression. Sort of show him I’ve “aged well”.  I’d like to improve my smile but he gets here in a month. I looked at porcelain veneers but they are way out of my budget. Is there another way to improve my smile that quickly without spending a small fortune?

Emily

Hi Emily,

Zoom Whitening

One of the least expensive ways to make a dramatic improvement on your smile is to have professional teeth whitening done. That simple procedure alone will take years off your smile’s appearance. You have two options to get this done.

Teeth Whitening Option One:  Take Home

Photo of teeth whitening trays in a blue case.

Teeth whitening trays

The least expensive option is to use take-home trays. Your dentist will custom fit them to your smile so the whitening gel stays in place while still reaching the whole tooth for even whitening. You’d want to wear them for a minimum of 30 minutes a day at your convenience. Obviously, the longer you wear them, the whiter they will get.  Depending on how much staining your teeth have and how white you want to get them, this can take around six weeks. Of course, the length of time you wear them each day will be a factor as well.

 

Teeth Whitening Option Two:  Zoom Whitening

Patient using Zoom Whitening light

Zoom Whitening Light

You can also have your teeth whitened in just one appointment using Zoom Whitening.  This is an in-office procedure and not all dentists have the equipment, so you may have to call around to see who in your area does.  This uses a special light that activates the whitening gel.  Your teeth will be their whitest in just three 20-minute sessions all done in one appointment.

I hope this helps.  Best of luck with your reunion!

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