Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

How Long Will I Need this Retainer?

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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.

Will My Face Really Collapse if I Get Dentures?

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I’ve had massive problems with my teeth. So much that they’re all coming out. I’m new in my career and don’t have a lot of money. Because of that, I want to get dentures. My dentist wants me to get dental implants and said because I’m in my 30s getting dentures would cause my face to collapse. Is that true or is he trying to scare me into the more expensive procedure?

Marcus

Dear Marcus,

dentures and dental implant side by side

I don’t know how your dentist explained this to you. I’m sorry you have had so much trouble with your teeth. What your dentist is calling facial collapse, is a term used to describe the shrinking of your jawbone.

This happens after your teeth are removed. Your body recognizes there are no longer teeth roots there. As a result, in an effort to be efficient, it takes the minerals from your jawbone and redistributes them elsewhere to areas it perceives they’ll be more useful. As your dentist mentioned, this has unfortunate repercussions.

How Dental Implants Prevent Facial Collapse

As you can see from the image on the top right, dental implants place a prosthetic root in your jawbone to replace the root you lost when your tooth was extracted. This signals to your body that there are still teeth there and your jawbone remains intact.

So, here’s is what I’m going to recommend to you. First, try to save all the teeth you can. Natural teeth are always worth fighting for. You can get dental implants for the ones which can’t be saved.

If you are unable to save any teeth, it would be too much money for you to do a one-to-one ratio of teeth to implants. Instead, you’d get something called implant overdentures. This places four to six dental implants and then you can anchor a denture to them.

This gives you the protection of dental implants without needing one for each tooth.

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

Orthodontics before Crowns?

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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.



Dental Implants or Implant Overdentures

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I’m a little confused. I can’t figure out the difference between dental implants and implant overdentures. Some people seem to use them interchangeably but I think they’re different. Can you help me? I need to replace a few teeth and don’t know which one to get.

Sandy M.

Dear Sandy,

Dental Implant Diagram

A dental implant is the fixture that is implanted into your jawbone to take the place of your tooth root. When the healing period is over, then it is topped with a porcelain crown to stand in for the visible part of your tooth.

Uses of Dental Implants

Dental implants can be used to replace a single tooth or multiple teeth. They’re also used to completely replace all your teeth. That’s where implant overdentures can come in handy.

Because these are the top of the line procedure for replacing your teeth and the procedure itself is very advanced and requires a great deal of post-doctoral training, it is the priciest of your options.

If you wanted to replace each and every tooth with a single dental implant, you’d end up costing yourself a fortune. Implant overdentures gives you the advantages of dental implants without having to place one at every tooth.

You can usually place four to six dental implants per arch and then anchor a set of dentures to them.

Advantages of Implant Overdentures

When your teeth are removed, your body begins to reabsorb the minerals in your jawbone to use elsewhere in your body. This has the unfortunate result of causing your jawbone to shrink.

After a number of years, there isn’t enough jawbone left to retain dentures. This is known as facial collapse. The implants protect you from this because your body interprets the implants as teeth roots and leaves your jawbone intact and secure.

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

Dentist Insisting I Get Braces

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I’m at my wit’s end. I know I’ll never be able to have a perfect smile, but I was hoping for something at least not humiliating. I have crowns on my two front teeth. They’re over 15 years old and starting to show their wear. They’re stained and starting to crack. I just wanted to replace them and maybe whiten my teeth if I still had enough money. However, my dentist is insisting I get braces on my teeth before I get my crowns re-done. I just can’t afford that. Is it truly necessary? My teeth stick out a little, but not that much. Why was the last dentist able to do crowns?

Karen

Dear Karen,

Smiling young woman with braces

This is one of those situations which truly frustrates me. Some dentists will insist on only doing the ideal no matter what type of burden that places on the patient. This is unfair. It’s obvious your crowns need replacing and he’s putting you over a barrel.

As you said, your last dentist was able to do the crowns, why isn’t this one? I think in this case you may need to see a different dentist to get the treatment you want without it costing you a fortune. You can completely do without braces, or you could just get them later if circumstances changed.

Teeth Whitening and Crowns

If you’re serious about getting your teeth whitened, it will save you a lot of money to get them whitened before you have the crowns made. It’s possible to get your teeth whitened in one appointment these days with in-office teeth whitening. That will save you time.

If you wait to whiten your teeth until after your new crowns are made, they won’t match. The whitening gel only works on natural tooth structure, which means your teeth will whiten but not your crowns, causing you to need to purchase new ones unless you want mismatched teeth. Doing the tooth bleaching first prevents that.

Althernative Orthodontics for Adults

If somewhere in your future, you decide you do want orthodontics, you should know it no longer means you have to get uncomfortable wires and metal all over your teeth. These days, Invisalign is a great alternative to traditional braces.

They use clear plastic aligners which are invisible even at a conversational distance.

One other thing to note. Because the crowns are on your front teeth, make sure whatever dentist you settle on gives you all-porcelain crowns. They’ll look much more natural.

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

Gums Over Crowns Turning Gray

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I have two crowns on my front teeth. They’ve never looked quite natural, but now I’m worried there’s something seriously wrong. The gums above the crowns have developed a dark gray line. Is there something dangerous going on?

Gina

Dear Gina,

all porcelain crowns versus metal based crowns

First, let me reassure you. There is nothing dangerous going on. What you’re dealing with is a cosmetic issue as a result of the type of crown you received. It sounds to me like you were given a porcelain-fused-to-metal crown. These metal-based crowns are more opaque than the all-porcelain crowns because they need the added opaqueness to cover the metal base. The gray line your seeing is also a result of that type of crown. It happens to all metal-based crowns.

The only solution is to replace them. I wouldn’t go to the same dentist. Truthfully, I’m surprised your dentist placed those on your front teeth. For aesthetic reasons, a responsible dentist would only place all-porcelain crowns on your front teeth. These are much more natural looking as you can see from the comparison images above.

Considerations with Your Dental Crown

Check the work of the dentist you’re considering before going through with the procedure. You want your crowns to look natural and seeing examples of work the dentist has done in the past will let you know if he or she is capable of providing that.

Once the crowns are made, the color is permanent. If you are interested in having your teeth whitened, you’ll want to do it before you replace your dental crowns. That way, when the crowns are made they will match the color you’d want them to be permanently.

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

Gum Recession During Braces

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I had a problem with gum recession during my braces. This created a black triangle at my gums. Is there a solution for this?

Dave

Dear Dave,

images of teeth with black triangles

Unfortunately, quite a few patients develop this problem with traditional braces. Many patients find it harder to keep up with their oral hygiene as well. Yes, gum recession can lead to black triangles. I’m sorry you’re dealing with this. The first thing I’d do is find out the cause of the gum recession, making sure it’s not a result of gum disease. If gum disease is the cause, that will need to be dealt with first.

There are orthodontic treatments that make it easier to brush and floss properly. For instance, with Invisalign, you simply remove your aligners then brush and floss as you normally would.

Treating Black Triangle After Orthodontics

Sometimes orthodontics can correctly repair a black triangle, but if this happened during your treatment that’s not going to happen. Instead, you’ll need a cosmetic solution.

I’ll be honest with you, not many dentists can do this repair. It’s treated with dental bonding, but because of the placement of the spaces, it requires some real expertise in cosmetics to make this look natural.

Unless your dentist is among the top cosmetic dentists in the country, I’d have him recommend someone for you.

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

Can I Use Antibiotics for a Tooth Infection?

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I have a pimple on my gums and my tooth hurts. I looked it up online and it sounds like I have a tooth infection. I don’t have dental insurance and don’t make much money. I do have some antibiotics I’d never taken for a sinus infection that went away on its own. Can I just take those for the tooth infection?

Carl

Dear Carl,

A man holding the side of his jaw like he needs an emergency dentist

Antibiotics won’t solve a tooth infection

There is a common misunderstanding about antibiotics and dentistry, which is probably why we still have people dying from tooth infections. I’m glad you wrote so you won’t risk the same fate. Think of antibiotics as an aide to instead of a cure for tooth infections.

The reason they can’t knock it out on their own is due to the structure of the tooth. Once the infection gets to the pulp of your tooth, it dies. That means no more blood flow. Without blood flow, there’s no way for the antibiotic to have any effect on the infected pulp. While antibiotics will slow down the infection on the areas it can reach, the infection will return and spread.

The only way to truly take care of it is for a dentist to get in there and physically dig out the infection. This is called a root canal treatment.

Finding an Affordable Dentist

You’re in a bit of a pickle and I understand that. Fortunately, most dentists are compassionate and got into this field with the idea of helping people. There are affordable dentists. Be careful though. There is a difference between affordable dentistry and cheap dentistry.

Cheap dentistry is when a dentist has significantly lower prices than almost all the other dentists around him or her. They are doing that to draw people in. You need to ask yourself why they are so much cheaper than everyone else. Is it because they have trouble retaining patients because of poor dental or people skills? Bear in mind, there’s also a real possibility they’re making up their profits by purchasing cheap materials which will fail on you.

Instead of a cheap dentist, you want one who works to keep their prices reasonable without cutting corners. They can be affordable in other ways, such as making low or no-interest payment plans available so you can get the treatment you need and then pay it out. They can also phase your treatment in some cases.

Do an online search for an affordable dentist, but be certain to check out their reviews to make sure you’re not getting into a disastrous dentist.

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

Will Invisalign Work for Me?

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I have two differing opinions about whether I should use Invisalign. My dentist said Invisalign will be fine for my case, but when I went to see an orthodontist about it he said traditional braces were a better option for me. I do want to fix my teeth but I’m not too keen on the whole metal mouth thing. Is my dentist or the orthodontist correct?

Mandie

Dear Mandie,

Two images: one of a woman placing her Invisalign aligner. The other, she's smling with it in.

Please bear in mind, I don’t know your specific case. I can’t give you a definitive yes or no, but I can give you some guidance.

First, the orthodontist you went to see said that traditional braces would be better. What he didn’t say was that Invisalign wouldn’t work in your case. My experience has been that orthodontists are specialists who are protecting their specialty. As such, they tend to downplay Invisalign.

I’d ask yourself if your dentist has always been honest and trustworthy in his dealings with you. Has he been the type of dentist to try to talk you into procedures to get more cases or does he just give you your options and let you decide? Have you ever doubted him? Has he ever misled you? If he’s trustworthy and he says it will work for you. Then, you may just want to believe him and go with Invisalign.

If you have any doubts, you are perfectly within your rights to get a second opinion from another Invisalign dentist. Let them know up front they won’t be doing the procedure, you just want to know if you’re really a good candidate because of conflicting opinions.

If you do get a second opinion, you can double the input by going to a dentist who does both Invisalign and traditional braces in their office.

Invisalign and Teeth Whitening

While most patients know the benefits of Invisalign, such as comfort and invisibility, they may not be aware of one that is rarely advertised.

If you turn out to be a good candidate for Invisalign, the aligners can double as teeth whitening trays. That means you can simultaneously whiten your teeth while you straighten them.

Your dentist will simply need to provide you with the gel and give you instructions as to how long to wear the gel. Instead of putting it in your whitening trays, you’ll put the gel in your aligners to the exact same effect.

Be aware that even professional teeth whitening will only whiten natural tooth structure. Therefore, if you have any dental fillings or any other dental work, those will remain the color they currently are.

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

Does an Open Bite REALLY Have to be Fixed?

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My dentist wants me to get braces. He insists my open bite needs to be fixed. There’s nothing really wrong with my teeth except for that. Is it really necessary to fix it? I suspect it’s either just for cosmetic reasons or to make my dentist a load of money. Either way, I’m not interested. So, give me a real reason.

Mike A.

Dear Mike,

Tulsa Orthodontist

An open bite actually would benefit from being fixed, and for more than cosmetic reasons. While it does have a negative impact on the appearance of your smile, it’s actually the negative impact on your jaw joints and teeth that are the real concern.

How Do Open Bites Affect Your Body?

Your upper teeth are meant to go a bit forward of your lower teeth. An open bite prevents that putting pressure in unnatural places.

TMJ PROBLEMS
The first obvious problem is your jaw joints. Your temporomandibular joints get knocked about and ground down. This will lead to TMJ disorder. TMJ can be mild to so serious that your jaw locks up and you’re unable to close it or eat. Even the mild cases generally cause migraines, which can be debilitating in they’re own right.

Tooth Damage
Your molars especially will become ground down or even chipped or cracked. In most cases, you’ll end up needing dental crowns. This is costly and an unnecessary loss of otherwise healthy teeth.

Orthodontic Solutions to an Open Bite

Invisible Orthodontics with Invisalign

The most severe open bites require surgery to repair. But, if your dentist is suggesting orthodontics then you’re not in that situation. That’s good news because it means it can be solved with orthodontics. There are two routes to choose from:

  • Traditional braces. These are the usual metal brackets and wires you likely think of when you hear the braces. These can be placed by any orthodontist and a few dentists. Dr. Noah’s practice is one of those dentists.
  • Invisalign. These days there is another option. Invisalign can be useful in solving this problem without anyone knowing you’re even wearing them. Better still is almost any dentist can place them.

Bottom line, your dentist is looking out for your best interest and isn’t just trying to make a quick buck.

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