Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Can a Teenager Use Invisalign?

by

My daughter needs braces. She told me that all of her friends that got their teeth straightened used Invisalign and no one can even see they’re wearing them. I asked my dentist about it and he said it’s for adults and not teenagers and that I’m better off taking her to an orthodontist. He recommended someone. They have the same last name, which could be a coincidence, but I’m suspicious because her friends are definitely using Invisalign.

Gina

Dear Gina,

Upper Invisalign Aligner

Out of curiosity, does your dentist typically offer Invisalign? Though I cannot be certain, my suspicion is that he does not. The reason I say this is because teenagers can definitely use Invisalign. My guess is that he was steering you toward orthodontics because that won’t send you to another dentist but a different specialty. If he sent you to a dentist who did do Invisalign, you might not return to him. The similar last name could be coincidence, but given his lack of honesty with the treatment scope, I am suspicious.

I would simply look up Invisalign dentists in your area and take her there for treatment. Some things to be aware of. You know your daughter better than anyone else, so only you can answer these questions. Unlike braces, Invisalign is removable. That means it requires patient compliance. If you think she will be responsible and wear them the amount of time each day that the treatment requires, you should be fine to go with that procedure.

It has a high patient satisfaction rate and is both more comfortable and faster than traditional braces.

I hope this helps.
This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Fixing Protruding Teeth

by

I finally have some money to fix my teeth. Mostly I am dealing with some front teeth that stick out. I’m not opposed to braces, but I am 53 and wondering if there is something better for someone my age? I know I’m a little late to the game in getting my teeth straightened. I just want a pretty smile for once.

Sylvia

Dear Sylvia,

Upper Invisalign Aligner

There is no late to the game when it comes to a beautiful smile. You get there when you can. I know a woman who is straightening her teeth in her 80s. Looking at it that way, you’re ahead of the game. You have a couple of options. The first is traditional braces, which you have already mentioned.

However, I would like to recommend you look into Invisalign (pictured above). This uses clear aligners to straighten your teeth. No one will know you are even using orthodontics. They are invisible even at a conversational distance. They are more comfortable than traditional braces and work in half the time.

There is an additional benefit to using Invisalign instead of traditional braces. The clear aligners can double as teeth whitening trays. This way you can straighten and whiten your teeth at the same time for a fraction of the cost. Your dentist will just have to provide you with the whitening gel, which you can wear in the aligners at your convenience.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Teeth Whitening and Tooth Mousse for White Spots

by

I have some white spots on my teeth ever since I had my braces off. I was a bit late getting my teeth straightened as I didn’t have the money until recently. My dentist is suggesting I do tooth mousse for a couple of months and then follow it up with teeth whitening. Is this the right plan for me? I don’t have any reason not to trust the dentist, it is more I have an off feeling about things and have learned to trust my gut. So, I’m seeking another opinion before moving forward.

Avery

Dear Avery,

Teeth whitening trays in a blue case

I am glad you wrote. Your gut serves you well. White spots, especially after braces are signs of decalcification. This takes place because your braces made it a bit tricky to really get in there and brush. Bacteria got trapped and decalcified those spots. These are precursors to decay and can do some serious damage to your teeth.

While your dentist is giving it the “old college try”, I would say that he is about 50% correct in how he is handling this. Tooth mousse is designed to help remineralize teeth, but does not always work. It would not hurt to try this.

As for teeth whitening, in this case he is completely wrong. While teeth whitening does wonderful things for making your teeth look whiter, brighter, and even younger, it will whiten your teeth evenly. This means that your white spots will get whiter along with the remainder of your teeth. That is not the solution you are looking for.

The best way to deal with white spots is with microabrasion and dental bonding. However, this will require an expert cosmetic dentist. If you want whiter teeth, go ahead and do that, but afterward you’ll need to have the dental bonding done. Do not do the bonding first, because it will not whiten along with your teeth.

I hope this helps.
This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Dentist Damaged Daughter’s Tooth Removing Her Retainer

by

My daughter had her retainer removed several weeks ago. In the process, her dentist damaged one of her teeth. It is now gray in color and receded from the rest of her teeth. He did an x-ray and said he could not tell anything for certain but then did a cold test that she failed. He believes the tooth may need a root canal treatment and is sending us to an endodontist. I have a couple of concerns. First, is there any way this will heal without a root canal treatment? Two, the endodontist he recommended does not use the Gentle Wave technology and I would prefer that if a root canal is necessary that is used. Am I within my rights to request a different endodontist who does use the technology?

Camryn

Dear Camryn,

Mother and Daughter

I am a bit concerned about the diagnostic skills of your dentist. Either a tooth needs a root canal treatment or it doesn’t. There really is not a “may” need a root canal treatment. That kind of wording leaves patients (or their parents, like you) in a quandary, wondering if they would be undergoing an unnecessary procedure.

The fact that the tooth underwent trauma, is turning grey, and has sensitivity to cold is enough to diagnose this tooth as dead or dying. In that case, it will need a root canal treatment.

I’m not sure how he managed to damage her tooth while removing her retainer. I am assuming this was some type of permanent bonded retainer that was bonded. Either way, he should have been able to remove the retainer without damaging the tooth if he knew even a minimal amount about orthodontics and bonding procedures. Obviously, he messed up and, in my opinion, is liable for the cost of the repair. Additionally, you do not have to stick with the endodontist he chose. You have the right to choose any endodontist you want, even segregating them by whether or not they use the GentleWave technology. GentleWave is getting good peer reviews in the dental literature. I think it is a good choice to use for your daughter.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.
Click her to learn about how to straighten your teeth Invisalign, which means no metal wires or brackets.

Braces Causing Enamel Damage To My Teeth!

by

I am 13 years old and just got my braces off. Right after they were removed I am seeing chalky white spots on my front eight teeth. I had my teeth cleaned four times a year, and my orthodontist never mentioned this possibility for tooth destruction to me. My dentist wants to do porcelain veneers; is this what you would recommend? Also, I am a teeth grinder, if that makes a difference.

-Ashley in Texas

Ashley,

I wouldn’t recommend porcelain veneers for someone your age for your 8 front teeth. The problem with doing veneers at your age is that your teeth could erupt a little further as you get older, which will reveal the margin of the veneers instead of keeping that margin at the gumline. Plus, the fact that your dentist is suggesting that at your age makes me worry that he or she isn’t expert in placing porcelain veneers. There is a more conservative option for you, which would be direct dental bonding, and I would go to an expert cosmetic dentist for that.

The white spots are decalcification. What happens when you have braces is that the braces catch food every time you eat anything. If you don’t brush it off right away, it sits there and bacteria grow in the food debris and put out acid that attacks your teeth. I’m disappointed that your orthodontist didn’t talk to you about that. When you have braces, you need to be very careful about eating, and your orthodontist should tell you how to avoid this problem. One thing is that when you’re wearing braces you should avoid snacking. Just confine yourself mostly to eating at meals with only occasional snacks, and that will greatly reduce the damage. And then, after you eat, you need to brush right away. When I had my braces, I carried a toothbrush with me so I could do that, and after lunch or a snack I would excuse myself to the bathroom and take care of this. If you’re not able to brush, at least swish vigorously with water to get as much of that food debris off your teeth. Not only does it decalcify your teeth, but it smells bad.

Getting your teeth cleaned four times a year is okay, but it’s no substitute for getting the food out from around your brackets right away.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Invisalign Didn’t Work For Me!

by

I’m hoping you can help me!

My dentist recommended Invisalign to fix my midline and make room to put veneers on my lateral teeth. The agreed-upon price that I paid was $4,675.00. Initially, I was supposed to do a period of 9 months, but after the 9 months and my first set of trays, my midline was still not straight.

My dentist ordered a new set of trays and recommended that I do it for another 9 months. I have spent a year and a half working with my dentist and trying Invisalign to correct my midline, with no success.

I am extremely frustrated having spent so much time and money without any results. I decided to speak with other dentists that work with Invisalign and traditional braces. They all recommended traditional braces, stating that Invisalign would not give me the results that I was looking for.

I’m wondering how I should go about getting a refund from my dentist so that I can afford braces?

Thank you for your time and advice.

-Jennifer

Jennifer,

First, the doctors you are now seeing that recommend traditional braces are most likely right that Invisalign wasn’t the best option in this case. However, many orthodontists tend not to give Invisalign enough credit. Many believe that traditional braces are the only way to correct crooked teeth.

two people smiling. One with traditional braces and one with invisalign

Traditional braces are typically the most recommended option, but Invisalign can also be very successful. I believe that many orthodontist specialists feel that because you don’t need to be an orthodontist specialist to use Invisalign, that they are protecting their status as specialists by using traditional braces.

It can be challenging moving a midline and keeping it straight, so seeing an orthodontist specialist is a good choice.

Every dentist handles refunds differently. Some dentists will, without hesitation, give you a refund if you aren’t satisfied with their work. While others will not be so willing. The first step is to simply request a refund, and if that doesn’t work, then you will need to increase the pressure by:

  1. Politely request a refund from your dentist.
  2. Ask your new dentist to call and ask for a refund.
  3. Threaten that you will make a complaint to the state dental board. Make sure to follow through if they still don’t refund you.
  4. If everything else failed, get a lawyer.

Make sure you stay polite and calm but also firm to show them you are serious.

I hope this helps.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Can Teeth Whitening Trays Double as a Retainer?

by

I’ve worn out my normal retainer. My teeth haven’t budged but I know I’m supposed to still wear them. I’ve been whitening my teeth and those trays are pretty snug. My dentist will charge me over $300 for another retainer. I don’t have that kind of money at the moment. Is it possible to use my whitening trays as a retainer for now? I only wear the retainer at night. I can just use the whitening gel at the same time and sleep with it. Is that safe or do I need to suck it up and get a new retainer?

Andie

Dear Andie,

Teeth whitening trays in a blue case

Teeth Whitening Trays Can Double as a Retainer

I think that it would be fine for you to wear your teeth whitening trays as a retainer in the short term. However, I say that with a precaution. If you notice even the slightest change in your teeth, then it will be time for you to get a true, customized retainer.

For the benefit of others who may be reading this, I’m saying this because these teeth whitening trays are recent. That means they fit her teeth in the new position. If her teeth whitening trays were from before the time she had her teeth straightened, this would not work at all.

As for the cost, I have to say I am a bit surprised at the price tag they quoted you for a retainer. It is a fairly simple thing for them to do. The process is simply a matter of your dentist making a good impression of your teeth, then pouring a model of that impression they will send that to a dental laboratory.

If it turns out the teeth whitening trays aren’t adequate to keep your teeth in place, I suggest shopping around to other dentists or orthodontists and see how much they’d charge you to make a retainer. I’m pretty sure you’d end up saving a good amount of money. There are some procedures where you are perfectly safe by price shopping. This is one of them.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Fixing a Black Triangle

by

I’ve just finished my braces and am starting my retainer. My orthodontist ended up shaving off about 2mm of space on the teeth. This ended up creating a black triangle at the gums. Will this go away or will I need to have another procedure done? Would grafting gum tissue to the space fix it?

Emma

Dear Emma,

example of black triangles at bottom teeth

Black Triangles

My guess would be your orthodontist is planning on fixing this by closing the space and just has it this way at the start of your retainer treatment. The first thing I would do is talk to him about it. If he doesn’t plan on doing anything about it and the gums don’t adjust when you’re done wearing a retainer, then you’ll need to take steps.

Gum grafting won’t be a useful procedure for you in this case. Your gums position themselves based on both the positions and shapes of your teeth. Even if you grafted gum tissue there, it would shift to a position based on the teeth in the area.

If your dentist doesn’t close this space and it bothers you, the procedure to fix it would be dental bonding. However, you don’t want to have just any dentist do this. It’s a tricky procedure to get right. You’ll need an expert cosmetic dentist to work on this.

One thing to be aware of with braces is to make sure you’re really getting in there when you brush your teeth. The areas surrounding the brackets gather bacteria. If you aren’t super careful, you’ll end up with white spots on your teeth. You haven’t mentioned this as an issue for you. I’m only bringing it up for the benefit of others who may still be wearing braces.

The Modern Alternative to Braces

These days, there are been tremendous advancements in orthodontics. The best of these advancements is Invisalign. These are sometimes called invisible braces because they use clear aligners to straighten your teeth instead of metal wires and brackets. They are completely invisible even at a conversational distance.

They have another, mostly unknown, benefit as well. The aligners can also double as teeth whitening trays. This will allow you to straighten and whiten your teeth at the same time.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

How Long Will I Need this Retainer?

by

I had braces in my teens. My teeth have done fine in past years but then started to shift again. I went to see a new orthodontist as an adult. He said I had a couple of options. I could re-do braces or wear my retainer again for a while and see if that helps. I opted for the retainer. It does move my teeth back into position. He suggested six months of wearing it full-time, then switching to nighttime wear for an equal amount of time. I followed through on that, but when I “graduated” from the retainer, I noticed that by the next day two of the teeth had shifted again. I’ll put the retainer back in and the cycle repeats. Is there anything I can do about this?

Morgan

Dear Morgan,

While this isn’t considered “normal” it does happen. For some reason, your teeth aren’t ready to stay in place on their own yet. I have a couple of suggestions for you.

When Teeth Won’t Stay in Place After Braces

You will need to wear a retainer full time for an indefinite period of time. One thing you can do in this case is have a lingual retainer made. This is a retainer which will be bonded to the back of your teeth. This is invisible to everyone else. The downside to this procedure is it is very difficult to get the teeth clean. You will need a floss threader to get in there.

Teeth whitening trays in a blue case
Teeth Whitening Trays Can Double as a Retainer

Another option is to use teeth bleaching trays as retainers. These are completely clear so no one will know you are wearing them. They do have the additional benefit of allowing you to whiten your teeth at the same time. Giving you both a straight and white smile simultaneously.

While many cosmetic procedures do require some expertise and post-doctoral training, teeth whitening does not. Any family dentist can do this for you.

My advice is to speak with your orthodontist and discuss these options in depth and decide which you think is best for your situation. It would also be good for him to investigate what is going on with the shifting.

This blog is brought to you by Glenpool Dentist Dr. Ryan Noah.

Orthodontics before Crowns?

by


I’m hoping you can help me. I have had two crowns on my front teeth for a long time. They’ve always looked a little pastier than my other teeth, but now they have this unsightly gray line and they are discolored. I need to get them replaced, but my dentist is insisting I get braces first. I really can’t afford that. Isn’t there any way they can do the crowns without my teeth being perfectly straight?

Martha

Dear Martha,

Tulsa braces for othodontic dental treatment

What your dentist is doing is unfair to you. He is insisting on the ideal treatment. Well, not everyone can afford the ideal. He should be able to do these crowns regardless of whether or not you have orthodontics done. How else would they have been placed on your teeth originally? I’m assuming the needed orthodontics isn’t a new thing.

You may have to see another dentist to work within your budget, but that’s okay. there are affordable dentists who take into consideration that sometimes a patient can’t get everything done at once. This is called phased treatment.

You can either get the crowns done now and put off the ortho until later. You can even skip braces altogether. It is completely up to you.

Orthodontics for Adults

If you decide later on you do want to straighten your teeth, you no longer have to get a mouth full of metal wires and brackets. There are better options for adults these days. Most prefer a brand of invisible braces called Invisalign.

These use clear aligners which allow you to straighten your teeth without anyone even knowing. They truly are invisible, even at a conversational distance.

Crowns for Front Teeth

There was a reason your dental crowns looked pasty when you first had them placed. Your dentist placed porcelain fused to metal crowns. While these are perfectly fine for back teeth, they are way too opaque looking for front teeth.

Plus, as you’ve experienced, they also eventually develop a gray line at the gumline. For front teeth, we recommend all-porcelain crowns. These look much more natural and will never develop that unsightly gray line.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.