Solution for a Large Tooth Gap

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I had planned to fix my smile with that snap on smile appliance, but it turned out that it didn’t work for me. I have a large tooth gap I want to fix. It’s about 10 mm. I’m way too old for braces. Because the snap on smile didn’t work, my dentist said he is willing to get certified in Lumineers. He’d been considering it anyway and this is giving him the push to go ahead with it. Do you think this is a better solution for me? I want to get another opinion before telling him to get certified because it is a lot more money.

Brooke

Dear Brooke,

I am very glad you wrote. This could have ended up a disaster. A 10 mm gap is large enough to fit another tooth. It would take one of the top cosmetic dentists in the country to make this look right. You should know that Lumineers are highly marketed to inexperienced cosmetic dentists as being easy to place. Getting “certified” in Lumineers simply means that they will attend a seminar. It does nothing to develop their skill in cosmetic work, which would take years of training.

Invisalign aligner

Invisalign Aligner

If you had a small tooth gap, I would recommend having dental bonding done. However, that would also take an expert cosmetic dentist as it has to be done freehand. But, your gap is too large for that. Instead, I am going to suggest you get the gap closed using Invisalign. Unlike traditional metal braces, no one will even know you are getting your teeth straightened. Invisalign uses clear aligners. This will close your gap and it does not require the years of training that cosmetic work will.

Invisalign also has a hidden benefit of being able to whiten your teeth at the same time as straightening them. This is because the aligners can also double as teeth whitening trays. All you would need is for your dentist to provide you with the whitening gel. This would give you a mini smile makeover for a fraction of the cost you would otherwise have to spend.

This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan, an AACD Accredited Dentist.

Cosmetic Solutions for Potruded Teeth

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I have protruded teeth. I’m looking for options to help me fix this and get a smile I will not be ashamed of. It would also help if I knew about how much money this would cost so I can make a good decision.

Jennie

Dear Jennie,

I’m glad you wrote. Please understand, without having examined or even seen your bite, I can only make some generalizations. With protruded teeth, you have three options that can work well for you. These are in no particular order of preference.

Option One: Braces

Conventional braces have been tried and true for even the most difficult orthodontic cases. They can and will straighten your teeth in about two to three years. The cost is around $4000 unless you have an unusually complicated case that requires some type of surgery. These usually have to be done by an orthodontist, though some dentists have braces training.

Option Two: Invisalign

Invisalign aligner

Invisalign Aligner

These are sometimes called invisible braces because they use clear aligners to straighten teeth instead of metal wires and brackets. In most cases, Invisalign works in less time than braces and costs about $5000. Whether they work for you will depend on how protruded your teeth are. These can double as teeth whitening trays allowing you to whiten and straighten your teeth at the same time. Any dentist trained in Invisalign can do these. Orthodontists tend to shy away from them because it is not what they went to school to do.

Option Three: Porcelain Veneers

porcelain veneers being placed

This would, again, depend on how protruded your teeth are. While they will not actually straighten your teeth, in the hands of an expert cosmetic dentist, they can make them look straight and further back. I would expect to pay about $1500 per tooth for this, depending on the location and skill of the dentist. Most smiles are 8-10 teeth wide. Though, you can do fewer if you have teeth whitening done to help the teeth blend in. While any general dentist is technically allowed to do these, to do them right, especially in an advanced case like yours, requires some expertise. I would only allow an AACD accredited dentist to do this procedure for you. Porcelain veneers are what celebrities use to get that Hollywood smile.

This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan.

 

 

Do I Need Invisalign AND Porcelain Veneers

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I planned on getting porcelain veneers. He is suggesting for it to go well, I will also need to get teeth whitening and Invisalign. Is that normal? The only thing I can think of that might need braces is one tooth that overlaps the front just a little. It isn’t anything major. I was under the impression that porcelain veneers could make that look straight. For that matter, they’re supposed to take care of the color of the teeth too. Am I mistaken about this? Is it necessary to do all of them?

Margie

Dear Margie,

Invisalign aligner

Invisalign Aligner

I am glad you wrote. So some of your dentist’s advice makes sense. The teeth whitening for instance. While porcelain veneers will change the color of your teeth, they will only change the color of the teeth they are bonded to. For instance, unless you are also placing veneers on your bottom arch as well, you will want to whiten them so that they can match the upper arch. Another reason for the teeth whitening could be on the top arch. Most smiles are eight to ten teeth wide. If you don’t cover each of the visible teeth when you smile you’ll want to whiten those as well so they blend with the made over parts of your smile.

The Invisalign is another matter altogether. You are also correct that porcelain veneers can make your teeth look straight. If I understand your description, this would be easily done with porcelain veneers by a skilled cosmetic dentist. Because your dentist is saying you need orthodontics to straighten them, it tells me that he doesn’t feel qualified to manipulate the porcelain veneers the way you actually need. I would take that as a warning sign.

Believe it or not, cosmetic dentistry is not a recognized specialty, neither are smile makeovers. If you want a smile makeover done well, you need a dentist who invested in post-doctoral training in the art of smile makeovers. If you’re going to invest in a smile makeover, you will want the best cosmetic dentist possible so that you end up with a smile you are proud of and not a cosmetic dentistry horror story.

I will say one thing. Smile makeovers are for big changes, not just color and straightening. Usually, you’ll want to change the size and character of the teeth too. If you are only wanting to straighten that one front tooth as well as whiten them, you would be better off just doing Invisalign. The aligners can double as teeth whitening trays. This will allow you to straighten and whiten your teeth simultaneously at a fraction of the cost of porcelain veneers, plus any dentist can do those. If it is a true smile makeover that you want, then you will want a qualified cosmetic dentist. I would look for someone who is an AACD accredited dentist.

This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan.

Solutions for a Tooth Gap

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I have been embarrassed by the gap in my smile for several years. My dentist knows I have been bothered by it for some time. He has recently learned how to do Lumineers and has just gotten his certification. He said they could close the gap for me. I was excited about that until I saw the price tag. Are there other solutions? I know I could get braces, but I am not exactly keen on the idea. I’m rather past the age where I’d look cute with a mouth full of metal.

Presley

Dear Presley,

I am glad you wrote. This could have ended up a disaster. I am certain your dentist has good intentions and he is only trying to solve your problem with using a new skill, but it is a massive overtreatment for a tooth gap. There are better, less expensive, and less invasive treatments.

Solution One:  Dental Bonding

before and after dental bonding

The quickest solution is to close the gap with dental bonding. The image above is an example of dental bonding repairing a chipped tooth.  To do this a dentist will sculpt composite bonding onto your teeth. Because it is sculpted freehand, this is an advanced procedure. I don’t think your dentist is qualified to do this for reasons I’ll go over in a moment.

Option Two: Invisalign

Invisalign aligner

Invisalign Aligner

I don’t know if your dentist ever mentioned this, but you no longer have to wear metal wires and brackets in order to straighten your teeth. Now you can use Invisalign, which uses clear aligners. These are removable, which makes it simple to brush and floss your teeth every day. It also has a hidden benefit. The aligners can double as teeth whitening trays. If you want, you can ask for some whitening gel from your dentist and you will be able to straighten and whiten your teeth at the same time.

While your dentist can do the Invisalign if he has invested in that training, as I mentioned before, you won’t want him to do the bonding. He suggested Lumineers to you, this is a brand of porcelain veneers, which is highly marketed to inexperienced cosmetic dentists. The training they receive is just attending a seminar. It doesn’t give him any practical training and it takes years to develop the artistry necessary to do a good job on porcelain veneers. Bonding is even more challenging. If you choose to go with dental bonding instead of Invisalign, I recommend you find an AACD accredited dentist. These are the top cosmetic dentists in the country.

This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan.

How Long Between Invisalign Aligners

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I live way out in the boonies and, while I love country living, I have to drive over two hours one way to get to a dentist who does Invisalign. I’m very excited about the prospect of getting my teeth straight after all these years, I’m just wondering how often I have to go to the dentist for the aligners. I read that you switch them out every two weeks. That will be a bit of a hardship for me. If that is the case, would it hurt my treatment to go longer between aligners?

Melody

Dear Melody,

Invisalign aligner

As long as you kept your Invisalign aligners in for the prescribed amount of time and kept it that way until you received your new aligners, it would not mess up your treatment per se. However, it would drastically slow down the results. The good news is I don’t believe that will be necessary for you. While you do change your aligners every two weeks. You generally only have to see your dentist once a month. They’ll check on your case and make sure everything is on track, then provide you with two sets of aligners. One you will wear starting then. The other you will start two weeks later.

Additionally, as long as your case doesn’t have any extenuating complications, you may even be able to go longer between visits. I would talk to the dentist who is providing your Invisalign for you and ask what his or her recommendation will be.

A Bonus Benefit with Invisalign

I don’t know if you have ever even wanted to do teeth whitening, but if you have you can save a lot of money doing it during your Invisalign treatment. The aligners can double as teeth whitening trays. Then, all the dentist would need to provide for you is the whitening gel. You would wear the gel in your aligners anywhere from 20 minutes a day up to overnight. It’s completely up to you.

Obviously, the more you wear the gel, the faster your teeth will whiten, but some people have more sensitive teeth than others. Don’t go beyond your tolerance. Your teeth will continue to whiten.

By the end of your Invisalign treatment, you will not only have a straight smile, but a bright, younger-looking, white one as well.

This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan.

Switching Dentists During Invisalign

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Let’s say that I absolutely hate my Invisalign dentist and want to switch, is that possible? I’m only halfway through my treatment. I don’t have a problem with Invisalign itself and love, love the results I’m seeing, but I’m finding my dentist intolerable. She is always discussing politics and I just can’t. It’s hard enough going to the dentist without having to worry about controversial issues. Will going to a new dentist mean I have to start over?

Annette

Dear Annette,

Invisalign aligner

When you switch dentists, which is always a patient’s prerogative to do, your dentist is under an ethical obligation to provide all the information to the new dentist that would be needed to continue your care. This would include all the diagnostics and follow-up done on your case.

Even if your dentist didn’t provide those things, you would still just start from where you are, though the new dentist would have to develop the treatment plan. I don’t think you’ll have much trouble with getting the diagnostics though. Dentists are fairly good at following up with one another.

I am glad to hear you are happy with your Invisalign results thus far. It probably would not surprise you to know that it has a very high patient satisfaction rate.

You may have already tried this, but one thing to consider before you completely switch dentists is to simply talk to your dentist about the fact that you are uncomfortable discussing politics. You can even blame it on your anxiety in the dental chair, which is an issue every dentist is familiar with.

I’ve often found when people share their passions with you so openly, it is usually because they have a high regard for you and feel comfortable around you. Simply telling her you’re too nervous as it is may solve the issue.  If you’ve already tried that or are uncomfortable trying, then yes, switch dentists for your own sanity.

I don’t know if you are aware of this, but Invisalign aligners can also double as teeth whitening trays, so if you wanted to you could simultaneously straighten and whiten your teeth at the same time, giving yourself a mini smile makeover.

This blog is brought to you by La Jolla Dentist Dr. Stephen Doan.

I Have Beaver Teeth

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Can you help me? I have two front teeth that are huge. I honestly feel like I look like a beaver. My dentist suggested Lumineers, but wouldn’t that make my teeth look bigger? I’d be putting something on top of my already huge teeth. I’m to the point of wondering if I should just take them out and get dental implants in their place. Do you have a better idea?

Andrea

Dear Andrea,

Invisalign aligner

Please don’t take out your front teeth. That is a horrible idea!  Even though dental implants mimic the structure and function of your natural teeth, it is still far better to save your natural teeth whenever it is feasible. I am glad you recognized the false solution Lumineers would provide for you.

The first thing you need to do is find an excellent cosmetic dentist and let them examine you. I have a solution, but please bear in mind that I haven’t examined you.  When the dentist examines you, he may see something I am unaware of.  I think some careful trimming will help, using diamond burs and diamond strips. Based on what you described they could trim some from the sides and from the incisal edges.

Once they are trimmed in size, your teeth can be moved into place with something like Invisalign. These are sometimes called invisible braces, though they are not braces in the traditional sense. Instead, they use clear aligners. No one will know you are even wearing them.

If the trimming is extensive, then your dentist can place porcelain veneers on any exposed dentin. Both the trimming and the porcelain veneers do require real expertise. Cosmetic dentistry is not a recognized specialty. Unfortunately, neither is it taught in dental school.

Not only does this mean that any general dentist can call themselves a cosmetic dentist, but it is also up to them how much training they invest in. So, how is a patient to recognize who has the skills and who doesn’t?  The American Academy of Cosmetic Dentistry (AACD) recognized this problem. So, they started an accreditation program. While any dentist can become a member of the AACD, only those dentists who pass stringent exams and demonstrate real artistry in their cosmetic work can be accredited.

In your place, I would only go to an AACD accredited dentist to have your teeth worked on. This will guarantee you a beautiful result.

Missing Teeth and Invisalign

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What do I do if I have crooked teeth, still have baby teeth, have two missing teeth, and am 41 years old? I feel I am too old for traditional braces. However, I’ve been told by my dentist that Invisalign doesn’t work with missing teeth. So, what do I do?

Kyra

Dear Kyra,

Invisalign aligner

Actually, Invisalign can work with missing teeth. My guess is your dentist doesn’t have a high comfort level with Invisalign in general. You’ll just need to find an Invisalign dentist who is willing to work with you. The baby teeth will need to be dealt with. I’m guessing, at your age, the baby teeth have congenitally missing teeth. In that case, those (along with your other missing teeth) will need to be replaced.

My suggestion is to use temporary tooth replacements, like a dental flipper. Then, when all your teeth are in their correct alignment you can get a permanent replacement. The best tooth replacements are dental implants. They are the most like having healthy, natural teeth in your mouth.

However, if you are going to straighten your teeth you might as well take advantage of this opportunity to give yourself a mini smile makeover at a fraction of the cost.

Your Invisalign aligners can double as teeth whitening trays. All your dentist will have to provide you with is the whitening gel, which doesn’t cost much. This means you can straighten and whiten your teeth simultaneously.

One other thing. If your missing teeth are visible when you smile, make sure it is a skilled cosmetic dentist so that the implant crown will look natural.

This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan. An AACD accredited dentist.

Lumineers and Invisalign

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I wanted to get ten porcelain veneers in order to make my teeth look pretty. My front two teeth cross in front of each other a bit and they are old and stained. My dentist suggested I do Invisalign to straighten the front teeth and then Lumineers which won’t cause any grinding on my teeth. I’m not sure I can do both procedures, not without selling some things. Is it necessary to do both? I don’t know much about Lumineers, but I thought porcelain veneers could make teeth look straight. Did I misunderstand that in my excitement?

Miranda

Dear Miranda,

Invisalign aligner

Bear in mind that I haven’t examined your teeth. It could be that you have something unusual going on with your bite. However, without that exception, you are correct. Porcelain veneers can make teeth appear straight when you have a skilled cosmetic dentist working with them. The problem I think you are facing is you don’t have a skilled cosmetic dentist.

One of the things that makes me think that is his suggestion of Lumineers. While they are simply a brand of porcelain veneers, this brand is typically suggested by inexperienced cosmetic dentists. That is because they are highly marketed to them as being easy to place, as they may not need any tooth preparation. However, in many cases, they tend to end up looking bulky like that. Some patients have even described it as having horse teeth. He certainly couldn’t do it without any tooth prep with your front teeth being a bit crooked. This is probably why he suggested you get them straightened first.

I’d like to clear up a misconception. Your dentist used vernacular that hinted porcelain veneers would require your teeth to be ground down. In reality, there is very little tooth structure removed. The only thing that requires grinding of your teeth would be a dental crown.

If you still want porcelain veneers, I suggest you get a second opinion from a proven cosmetic dentist. Look for someone who is either accredited with the American Academy of Cosmetic Dentistry or who is recommended on the mynewsmile.com website.

However, if the only thing wrong with your teeth is the crooked front teeth and the color, then you can save a lot of money by doing the Invisalign, to straighten your teeth, and teeth whitening. An added benefit is the Invisalign aligners can double as teeth whitening trays. All you’ll need is the professional strength gel to wear inside it. Your dentist can provide you with that. This method allows you to straighten and whiten your teeth at a fraction of the cost.

This blog is brought to you by La Jolla Dentist Dr. Stephen Doan.

Will a Dental Flipper Make My Teeth Look Straight?

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I have crooked teeth but feel too old for braces. I wish I had gotten them when I was younger, but my parents couldn’t afford it. I’ve heard there is a dental flipper that snaps on to your teeth that will make your teeth look straight. Will this be useful for people like me?

Sandy

Dear Sandy,

dental flipper A dental flipper is used as a temporary tooth replacement. It doesn’t fit over your teeth, instead, it fills in the empty space from a missing tooth. This isn’t going to help you.

You may be thinking of Snap-on Smile. This is made of acrylic and snaps over your teeth. It looks okay. Not great. Because it snaps over your teeth, it can also make them look bulky. You do have other options though.

Straight Teeth with a Total Smile Makeover

If you get porcelain veneers, this will not only make your teeth look straight, it can completely remake your smile. These tiny porcelain magicians can change the shape, color, and size of your teeth. It is what Hollywood celebrities and wannabe celebrities go to in order to get those stunning smiles you see on the big screen. Mind you, this is your most expensive option. It’s an investment in your smile. Those who get porcelain veneers done by a skilled, preferably AACD accredited, cosmetic dentist find their confidence skyrockets.

Straight Teeth with Orthodontics

Invisalign aligner

I know what you are thinking when you read this heading. “I said no braces!” Yes. I know that. It isn’t what I am going to suggest. I totally get not wanting a mouth full of metal as an adult. Has anyone mentioned to you about Invisalign? Instead of metal, this uses clear aligners. It will allow you to straighten your teeth without anyone even noticing. Generally, it does it in half the time of traditional braces as well.

In addition, it has a hidden benefit. The aligners used, are custom fit to your bite using a sophisticated software program. That also enables them to double as teeth whitening trays. All you will need then is to ask your dentist to provide you with professional teeth whitening gel and you can straighten and whiten your teeth at the same time. This gives you a mini smile makeover at a fraction of the cost.

I hope this helps.
This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan.