Annmarie Worthington

Should I Save My Last Two Upper Teeth?

November 30, 2023 by writeradmin

I’m in a bit of a pickle, that I completely caused. I have never been a fan of the dentist. Rather than sucking it up, I avoided you guys as best I could and only went when I had a dental emergency. Now I am left with only my two front teeth on the top. My bottom level has most of the teeth. At the moment, I am wearing two partial dentures up top. They are very uncomfortable. My dentist suggestted I just take those last teeth out and get dentures, but I read it is important to keep teeth because of facial collapse. Is there another option for me?

Keith

Dear Keith,

You are in a unique situation. I’m going to start by helping you keep those lower teeth. Those are essential for reasons I’ll go over shortly. Even with your dental anxiety, you will not have to “suck it up.” My suggestion is that you see a dentist who offers dental sedation options. If you have mild anxiety, then nitrous oxide is enough. If you have severe anxiety, you will want a dentist who offers oral conscious sedation.

This is administered by a pill and will allow you to sleep through your dental procedure if you want to. Be aware, however, that it is so strong that you will need someone to drive you to and from your appointment as well as stay with you for a few hours after your procedure is completed. You will want to be lucid and steady on your feet before being left alone.

You will want to do everything possible to save your lower teeth. These are the teeth that will impact you when it comes to facial collapse. While your upper dentures will be held in my suction, it is the ridge of your lower jawbone that holds in your lower dentures. When your teeth are removed, your body recognizes that and begins to resorb the minerals in your jawbone in order to use your body’s resources as efficiently as possible. This has the unfortunate side effect of shrinking your jawbone as the minerals leave. After ten years or so, you will not have enough of the ridge left to retain your dentures. Keeping those teeth are essential.

Because you are dealing with just your upper teeth, you can go ahead and extract those last two. You will be much more comfortable with a full upper denture than you are with the two partials.

This blog is brought to you by Auburn, AL Dentist Dr. Alan Yount.

Fixing Enamel Hypoplasia

November 15, 2023 by writeradmin

I have enamel hypoplasia, which has led to me becoming uncomfortable in social situations. I recently heard there are cosmetic solutions for this. Do you have any recommendations for me?

Dudley

Dear Dudley,

I’m glad you wrote. I am going to start by explaining what enamel hypoplasia is for those who may be reading but are not aware of this condition. This is a physical defect where tooth enamel is not completely formed. It can happen because of a genetic condition or because of serious illness that occurs during the same time the teeth are still forming. Teeth are generally forming between birth to twelve years of age.

Now for the solution. The treatment you get will depend on the severity of the hypoplasia. In the image above, I’ve shown both mild and severe hypoplasia. With mild hypoplasia, you can have dental bonding done in order to even out the color on the teeth. If you want your teeth whiter, you will need to have teeth whitening done. Just make sure you have the teeth whitening done before you have the dental bonding done. This is because the whitening will not affect your bonding. So, get your teeth the color you want them and then your cosmetic dentist can match the bonding to that color.

If you have more severe hypoplasia, then dental bonding will not be a good solution for you. In that case, you would need to have porcelain veneers done. These are tiny wafers of porcelain that will completely cover the fronts of your teeth as well as hug the sides. These can do more than cover the stains. They can change just about anything about your teeth, including the shape, size, and color. This is the Hollywood type of smile makeover you see celebrities get.

This blog is brought to you by Auburn, AL Dentist Dr. Alan D. Yount.

Is a Cracked Crown a Dental Emergency?

October 31, 2023 by writeradmin

I have four dental crowns on my front teeth for a bit over twenty years. One of them has always had a minor defect. I was told that was fairly common. I could never see it but if I ran my tongue over it I could feel a tiny dip. However, now something has changed. There is a horizontal crack on it. I can both see and feel it. Is this a dental emergency that I need to take care of right away or is it something that I can put off for a bit? What I don’t want is for it to break when I am in public. I am not opposed to replacing it. I just need to know how fast I need to do it.

Stacey

Dear Stacey,

As your dentist told you, minor defects, called craze lines, are usually not that big of a deal, but yours has changed significantly. While I would not call it a dental emergency, I do think this needs to be replaced. It is going to break at some point. I would talk to your dentist and make arrangements at a time that is convenient for you. This way you have more control.

Your dental crowns have lasted you quite some time, which says a lot about the dentist who placed them. I would have your dentist give you an idea of the condition of the other three at the same time you schedule the other crown’s replacement. It may be better to change them out all at the same time if they are showing signs of failure. In that case, changing them all at once will save you time from having to go back and forth to the dentist every time each one of them fails. However, if they’re in good condition, there is no reason for you to change the others.

I hope this helps.

This blog is brought to you by Auburn, AL Dentist Dr. Alan Yount.

The Danger of Yelp! for Smile Makeovers

October 18, 2023 by writeradmin

I am working on my smile makeover. I am thinking of the BL2 or BL3 color. I’m almost 60 with medium blond hair, blue eyes, and a fair skin tone. I don’t want an over-white smile because of my age. I’ve going with dental bonding because it is less expensive than the porcelain veneers. I’ve looked on Yelp! and have picked the dentist they listed as number one for cosmetic dentists. Quick question, though. Should I have him start with the canines so I can see that I’m getting the right color?

Beverly

Dear Beverly,

I am very glad you wrote. I think I can save you from a disaster here. Let’s start with the choice of your cosmetic dentist. While I use Yelp! myself, you have to be careful which services you use it for. For example, it is a fine way to find a good plumber or hair dresser. However, if you are looking at cosmetic work, you have to be more careful. The reason for that is Yelp! does not distinguish between what the ratings are for. A dentist could be getting lots of five stars for being friendly when patients receive their dental cleanings. Yet, he may have no training in cosmetic dentistry.

As an example, I went to Yelp!, picked a random city, and asked for the best cosmetic dentist in that city. I went to the websites of the top five results. The first did not show any links for cosmetic work, not even teeth whitening, which tells me he doesn’t do any cosmetic work. The second through fifth did have cosmetic work on their site, but only two of them had a smile gallery. If a “cosmetic dentist” does not have a smile gallery, that tells me they have zero results that they are proud to display. Any serious cosmetic dentist will have a smile gallery. Of the two that did have a smile gallery, only one of those had any post-doctoral training in cosmetic dentistry.

In order to find the best cosmetic dentist, the first thing you’ll need to do is really make certain the dentist you have in mind has post-doctoral training, but also that their smile gallery shows they achieve beautiful results. If you get a skilled cosmetic dentist, they can help you with the color issue, as well as many other considerations, such as shape and size that will need to be addressed.

As for the choice of dental bonding, I think you may want to reconsider and go for the porcelain veneers. When well cared for the porcelain veneers will last your lifetime. Dental bonding will only give you a few years before you have to replace them. Plus, dental bonding is done free hand, which means there is no testing out the results.

With porcelain veneers, they can place them with a temporary try-in paste. This allows you to look at the comlpleted results and make certain that you really love them before they are permanently bonded on.

This blog is brought to you by Auburn, Al Dentists Drs. Alan Yount and Steve Murphree.

Dental Implants Fell Out in Just a Few Days

September 30, 2023 by writeradmin

I planned on getting eight dental implants in total. Six on the top and two more on the bottom. The top was done first and I have already paid for these. The plan was after these healed to get the remainder done. I’m a bit worried, though. Three of the six on top have have already fallen out. Here are my questions:
1. Should I get the money back on the ones that fell out?
2. Should I be worried about the remaining three?
3. Should I move forward with the last two?

Carl

Dear Carl,

Wow! What a disaster. That is a 50% failure rate. Most dentists have a 5% failure rate. Even then, they don’t fall out the first week! First, you should not have to pay for the dental implants that have fallen out. A basic tenant of dental care is that the work stays in your mouth. This is an easy one. He owes you a refund.

Now for your second question. I would be very concerned about the remaining three. My very strong suggestion is that you see another dentist, one who has post-doctoral training in dental implants. Look for someone who has trained with the Dawson Academy or the Las Vegas institute of Advanced Dental Studies. Have them look at the three of your dental implants which are left and give you a prognosis on the likelihood of their survival. I will be honest, I would not hold out much hope. In fact, I would not hold out any hope.

Before you move forward with the other two, I would like you to find out why these three failed. There are a few possibililties for dental implant failure.

Inadequate bone support. This would only have been an issue for you if your dentist did not do the proper diagnostics. These should be done to not only check for bone support, but also to plan the proper placement.
Incorrect placement of the implants. As mentioned above, placing these are quite tricky. If he didn’t do the right diagnostics, then it is very possible the implants themselves were not placed properly.
Infection. This is one of the leading causes of implant failure. However, it is often accompanied by a fever and/or pain. You have not mentioned either of these, so I don’t think this is an issue.
Substandard implant fixtures. Some dentists try to save money by purchasing implant fixtures from overseas. While they can save several hundred dollars per fixture, the patient’s outcome is put at risk.
Premature loading of the implant crown. This is if the dentist did not wait long enough for the bone to integrate with your dental implants before placing the dental crowns or a denture on your implants.

Your dentist should have been on top of this and offered a refund the moment your implants failed. I think you are going to be better served elsewhere. My suggestion is you just ask for a full refund and start over somewhere else. Bear in mind that starting over will require you have some bone grafting done, in order to build back the bone you’ve lost in this whole process.

This blog is brought to you by Auburn, AL Dentist Dr. Alan Yount.

Can Supersmile Remove Stains on Dental Bonding?

September 15, 2023 by writeradmin

I have dental bonding and they are beginning to stain. I know they don’t last as long as porcelain veneers, but I thought they would last longer than six and a half months. Will Supersmile toothpaste help them to whiten up again?

Paula

Dear Paula,

Whether or not Supersmile can help in your situation will depend on a few things. The first is whether the stains are internal or external. Nothing works on internal stains except for professional teeth whitening. Even then, it will only work on natural tooth structure and not on cosmetic work, such as your dental bonding.

If the stains are external, Supersmile could be a great option for you as long as the bonding still has its polish on it. Supersmile is one of the best things you can use for your teeth, especially when you have dental work. Most over-the-counter toothpastes are too abrasive. Supersmile works differently. It uses an enzyme known as Calprox that breaks down the protein pellicle. The stains bind to this pellicle and are removed safely.

If your dental bonding has lost its polish, then nothing will help except replacing the dental bonding. The timing of your staining makes me a bit suspicious. Is it possible you recently went in for a check up and cleaning? If so, did the hygienist use anything like a power prophy jet or acidulated fluoride? If so, that would have taken the polish right off of them.

Your question also makes me wonder about the surface area of your treatment. Dental bonding is better for smaller areas, such as a gap or chip in a tooth. If you are talking about the entire front of the tooth, you are much better off with porcelain veneers. They last years longer and are much more stain resistant. In fact, they are even more stain resistant that your natural teeth.

This blog is brought to you by Auburn, AL Dentist Dr. Alan Yount.

Does My Dentist Owe Me A Refund for Not Finishing My Dentures When Promised?

August 31, 2023 by writeradmin

I was moving in two and a half months. I told my dentist this when I went to him about needing to replace the overdenture for my four mini implants. I asked him how long it would take him to make a new one because I was trying to decide if I needed to wait until I was in my new state to take care of it or if I could knock this out before moving. He told me three weeks so I agreed to move forward. Nine weeks later, the thing finally arrives and doesn’t fit. The dentist forces it on and sends me on my way. By the next day, I was in so much pain that I couldn’t even eat a bowl of noodles. I call the office and they squeeze me in but with a different dentist because mine is tied up. He diagnosed a two-fold problem. First, the holes were not drilled out properly. Second, the overdenture was slanted. They said they can order new gaskets which should fix some of this. I’m out of time and have little confidence in this office or their follow through. Is it unreasonable for me to just ask for a refund and get this taken care of after I move?

Drew

Dear Drew,

You are not being unreasonable. Your dentist made a legal agreement with you that the dentures would be ready in three weeks. Three weeks is the standard for turnaround on dentures. He took nine. That alone would be enough but most patients are just happy they got them and move on. However, your situation is different. Even after they came in they were not up to any standard of acceptability. Your dentist should not have forced them on, but instead examined them to see what the issue was.

Here is what I recommend you do. Start out by asking for a refund. Hopefully, he has the wisdom and integrity to realize he blew it here and just give you the refund. If he refuses, you have some leverage here.

Options You Have When a Dentist Refuses a Refund

Tell him you’ll be writing a review warning other potential patients of his lack of follow through, skill, and ethics. Research shows that about 65% of potential patients looking for a new dentist check online reviews.
Go to the dental board. This definitely did not meet the standard of care and you even have one of his colleagues in the same office saying that.
Call your dental insurance, if you have any, and tell them what happened.
Threaten to take him to court. This can be expensive and time consuming so I only recommend this when there is the potential for a payout that makes it worth it. I do not believe your case has a payout that makes it worth your time.

When you get to your new state, make sure the dentist you go to has post-doctoral training in dental implants so you don’t end up in a similar predicament.

This blog is brought to you by Auburn, AL Dentist Dr. Alan Yount.

Sonic Toothbrushes and Porcelain Veneers

August 19, 2023 by writeradmin

My roommate just got porcelain veneers. Tonight she was using a sonic toothbrush. I remember when my aunt got porcelain veneers and her dental hygienist ruined them with some kind of sonic tool. I told my roommate about that, but she said her dentist told her it was fine. How could the sonic thing ruin my aunt’s veneers but be fine for my roommate? I like her, but she’s sort of rich and spoiled and I don’t think she always values the awesome things she has. Yes, her parents can afford to get her new ones if these are damaged, but I’d hate to see all that money go to waste. Are her veneers in danger?

Myka

Dear Myka,

It is lovely that you are looking after your roommate. While there are some sonic things that are dangerous for dental work, such as porcelain veneers or dental bonding, a sonic toothbrush is safe.

I am guessing what happened to your aunt was that her dental hygienist used something like a power prophy jet on her veneers during her cleaning. This will destroy the glaze on her veneers, which is what both gives it its shine as well as protects it from staining. Your aunt’s veneers would have begun picking up stains within a few days.

A sonic toothbrush does not have that same strength and capability. If you want to help your roommate, you can tell her about the power prophy jet for when she goes to see her dentist for a cleaning. She should also make sure her hygienist does not use acidulated fluoride which can etch the glazing.

One other tip is that the best toothpaste she can use is Supersmile Whitening Toothpaste. It was specifically developed for cosmetic work. Unlike over the counter whitening toothpastes, Supersmile does not use abrasives. It will safely keep her teeth, as well as her porcelain veneers white.

I can tell you are a caring friend. It’s great that you are looking out for others.

This blog is brought to you by Auburn, AL Dentist Dr. Alan Yount.
Auburn, AL College Dentist

I Want My Husband to Switch His Dental Implants

July 31, 2023 by writeradmin

I have a sensitivity to chemicals and am having a reaction to my husband’s dental implants. I believe it is because he has the metal implants. I want him to get the zirconia ones. Whenever he gets close to me, all I can smell is rubber. Right now he has the post screws and temporary acrylic dentures. The porcelain dentures are in the process of being made. I think his body is reacting to the metal, which is causing the smell. This cannot be good for either of us. My husband is not keen on the idea of switching them out and when I spoke to his dentist about it, he blew off my concerns. Is there anything you can tell me that can convince them to switch these?

Deanna

Dear Deanna,

I am sure you are smelling something, however, I do not think it is from the dental implants. Here is why. The metal in traditional dental implants is titanium. This is a very inert metal that would not even have a smell out in the open. With the implants, they are buried into his bone, so it is even less likely that you would be able to smell anything.

If there is a bad smell the culprit is more likely to be that your husband is having trouble getting the acrylic dentures clean. If food or debris are getting caught in his dentures then it would create a rather unpleasant odor. He could try using something like a WaterPik to help clean out all the debris.

Why You Don’t Want to Unnecessarily Switch Out Dental Implants

When dental implants are removed, bone structure comes with it. This means that he will need to have new bone placed in order to retain any further implants. After the bone grafting has time to heal, then there will need to be ANOTHER surgery to place the zirconia implants. That adds up to three additional surgeries that are not necessary, all of which have a risk of failing. Right now, he has a successful implant case. It is not worth risking unless something is wrong.

This blog is brought to you by Auburn, AL Dentist Dr. Alan Yount.

Tooth Infection and No Money

July 17, 2023 by writeradmin

I am a college student with no dental insurance and no money. I had a tooth I neglected because of finances which had a cavity. Now, I think it is infected. At least that is what my roommate says. I am in a lot of pain. Now, my cheek is swollen. It is almost the size of a golf ball. How do I get this fixed, bearing in mind I am broke?

Maddy

Dear Maddy,

I am sorry for the pain, as well as the predicament you are in. Being a college student is not easy, even when you don’t have medical or dental expenses to think about. What you do not want to do is to try to treat this with antibiotics alone. While these are helpful in holding the infection at bay for a short time, once your antibiotics are finished, your infection will return, raging. Then, it is possible that the antibiotic will no longer work if the infection develops a resistance to that particular medication.

The only way to truly “heal” a dental infection is to remove the infected pulp. There are two ways to do this. The first is with a root canal treatment. This is the preferred option because it will save the natural tooth. If the infection is too far gone and the tooth cannot be saved, then you would extract the tooth. When that happens you will also need to replace the tooth.

Because you are in a financial bind, I would start by calling your local dental society and see if there are any programs in your area that help low income residents with dental emergencies. This is a dental emergency that you do not want to ignore. The tooth infection will continue to spread. Your jaw is close to both your throat and your brain. You don’t want a brain infection, nor do you want it to reach your throat. if that happens, your windpipe could swell up and then you would not be able to breathe.

If there are not any programs in your area for people in your situation, then I recommend that you just start calling some local dentists and explain your situation. Most dentists are compassionate and went into their profession in order to help people. I feel confident someone will give you the treatment you need and then allow you to pay out the bill a little at a time.

This blog is brought to you by Auburn, AL Dentist Dr. Alan Yount.
An Auburn, AL College Dentist.