Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Are My Daughter’s Teeth Ruined from This Cheap Braces Scam?

by

I am so worried my daughter ruined her teeth. We’d talked about orthodontics and I know she needs them, but I’m a single parent and the cost was just more than I could do at the time. Apparently, she got these “invisible braces” from the internet. I can’t believe they were treating a 14 year old without her parent’s permission. She had been hiding it from me by only wearing them at school. I only noticed when she got really sick and had to stay home for a few days. My boss let me work remotely so I could care for her. Something I am grateful for on two counts now. I found her wearing them and I’m really worried about her teeth. Is there a way to know how much damage these have done to her teeth? I feel like the worst parent ever.

Kelly

Dear Kelly,

Upper Invisalign Aligner

Please don’t beat yourself up over this. You would not believe the things dentists see young people trying because of the internet. For a while, there was a YouTube video going around about how teens could straighten their teeth with rubber bands that caused damage to a lot of teeth. In this case, she was using invisible braces, which I’m guessing look a bit like the clear aligners pictured above. If that is the case, the situation may not be as dire as you think. Some warning signs would be if she is in pain or if any of her teeth are loose.

There are legitimate clear braces, such as Invisalign, but they are accessed through a dentist who monitors the case throughout the procedure. One thing I do worry about in a situation like your daughter’s is the bone density. Sometimes young people don’t realize to wear their aligners for the full time period and skip ahead to try to straighten their teeth more rapidly. This can cause the bone not to have time to integrate with the tooth roots. Take her to your dentist to have her bit e evaluated.

It Is Possible to Get Affordable Braces

While you are there, I would also talk to your dentist about your financial situation. I know there are affordable dentists who would be willing to work with you to get your daughter the treatment she needs without making you pay for all of it up front. If your dentist is not, there are dentists who will. Communication is key.

On a separate note, I would contact your state’s attorney general about this company treating a minor without parental consent. You are probably not the only family this has happened to.

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.

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.

Are Orthodontics Required to Replace Crowns?

by

I have had two crowns on my front teeth for a while. They are starting to show their age and really need to be replaced. For some reasons, my dentist is insisting that I do orthodontics first before he’ll replace my dental crowns. It’s not that I don’t want straight teeth, but I just can’t afford them. Is this just a preference thing or will I face this with every dentist?

Miranda

Dear Miranda,

A dentist and patient
It is unfair to patients when a dentist insists on the ideal treatment, regardless of circumstances

I have to admit that it annoys me when dentists behave this way. Yes, having straight teeth is the ideal, but if you cannot afford orthodontic work, then you can’t afford it.

Obviously, you can have dental crowns placed when your teeth aren’t straight or you wouldn’t have any now. This is a preference issue on the part of your dentist.

In all honesty, I’m going to suggest you find another dentist. Look for one who is willing to work within the budget of his patients. You could do an internet search for an “affordable dentist” in your area.

Benefits of an Affordable Dentist

If you find an affordable dentist, they’ll be willing to work within your budget. They’re also willing to stage treatments, so you don’t have to do everything at once. Additionally, they will often have payment plans. Some of them have in-house plans and some of them work through Care Credit.

Getting a Crown on Your Front Teeth

One thing you want to be careful of, regardless of where you go to get your crowns done, is that they only give you all-porcelain crowns on your front teeth.

A metal-based crown will not look right on front teeth. They will be too opaque. They will also develop a gray line on the gumline.

If You Ever Decide to Get Orthodontics

When you do decide you are able to get orthodontics (and that should be completely up to you) you no longer have to get metal wires and brackets. These days, you have the option of “invisible braces”.

Invisalign is the most popular brand which utilizes clear aligners. These gently guide your teeth into their correct position.

I hope this helps you. This blog is brought to you by Tulsa 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.



One Orthodontist Thousands Less

by

I don’t know how it is possible for one orthodontist to cost so much less than another. It’s appealing, but I don’t want to make a mistake about this. I’m out of college and in my first PR job. My appearance is important which is why I want to straighten my teeth. However, I’m still paying off student loans, and will be for a while, so I don’t want to spend a fortune. The first dentist suggested Invisalign. The next one suggested Six-Month Smiles. The second one seems to work faster and is thousands of dollars cheaper. How is that possible?

Karyn

Dear Karyn,

A woman placing her Invisaliagn aligners

Do you remember in Algebra when they said you can’t add x’s and y’s? Well, this is sort of like that. Invisalign is a complete orthodontic treatment It will shift your bite into proper position, changing aligners every two weeks.

Six-Month Smiles is a completely different orthodontic option which doesn’t correct your complete bite, but just straightens the front visible teeth. This is also why it takes less time and doesn’t cost as much.

This means the second orthodontist isn’t charging less but offering a completely different treatment option.

Which Option is Best?

Which one you choose really depends on your goals for your smile. Do you just want it to appear straight and beautiful and saving money is the higher priority or are you wanting your bite fixed, while looking straight and beautiful?

There’s not a right or wrong answer unless you’ve had jaw pain or persistent headaches. If you have had those, fixing your bite would likely alleviate both of those. Not fixing it could lead to TMJ problems. I don’t say that to scare you. Headaches don’t necessarily mean TMJ, it is just a symptom.

Combining Procedures

One thing you can do with Invisalign which you can’t do with the Six-Month Smiles clear braces is whiten your teeth at the same time. The aligners can double as teeth whitening trays. Then, by the time your treatment is finished you’ll have both straight teeth and a white smile.

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

Dentist Insisting I Get Braces

by

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.

Will a Dental Flipper Make My Teeth Look Straight?

by

I really don’t want braces. They take forever, hurt, and look horrible. Would a dental flipper work to just make them look straight?

Ben

Dear Ben,

A woman placing her Invisaliagn aligners

Orthodontics no longer has to mean metal braces

I like how you like to think out of the box. That shows a creative mind open to new ideas. Unfortunately, the dental flipper won’t be a viable solution for you. It’s meant as a temporary tooth replacement option. However, I do have two great solutions for you.

The first will do what you were hoping a dental flipper would accomplish. Snap-on Smile will fit snap over your teeth and make them appear straight. However, because they fit over your teeth they tend to make your smile look bulky. You also need to understand their limitations. These aren’t going to be a beautiful smile makeover like porcelain veneers. They’ll look okay. They can even look attractive. But, they won’t be stunning.

Invisalign—The Modern Alternative to Braces

You no longer have to wear traditional braces with their ugly, uncomfortable wires and brackets. Invisalign uses clear, comfortable aligners. You wear them in two-week intervals and switch them out for the next set. They’re nicknamed invisible braces because no one can tell you’re wearing them, even at a conversational distance.

Because they’re removable, you can eat whatever you want. Additionally, it makes it easier to brush and floss. You simply remove your aligners and brush and floss as you normally would.

A little-known side benefit of Invisalign is the aligners can double as teeth whitening trays. This allows you to get two procedures knocked out in one go. It’s like getting a mini smile makeover. You’ll look and feel great. You’ll also be surprised how much more confidence a nice smile brings you.

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

Gum Recession During Braces

by

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

DIY Braces

by

I’ve got a group of girls in my elementary school class who are doing DIY braces with rubber bands. I know this has to be dangerous, but when I told them that they said that “I didn’t know because I’m not a dentist and this was on YouTube with lots of people who’ve done it.” As you’re a dentist. Can you let these girls know what they’re getting themselves into?

Miss Ketchum

Dear Miss Ketchum,

Someone smiling with braces

You sound like a compassionate teacher. I’m glad you’re looking out for these girls. I’m sure their parents will be too. The first thing I’d do, though, is let their parents know what they’re doing at school. It’s very likely they’re hiding this from their folks and this will give them a heads up so they’ll know to keep an eye out for it.

Now, onto what you should show the gals. I’m sure you’ve told them this many times, but you cannot believe everything you see on the internet. I’ve seen the video they’re talking about. There are actually several of them and, for a while, they were very trendy. In this case, listening to whoever uploaded these to YouTube could actually cost them their teeth.

When you get braces from a dentist, it’s a carefully planned treatment. First, the teeth are gently edged into a new position. Then some time is given for the bone to reform around the roots of their teeth. With the rubber bands, their teeth are being tipped inward. While it will bring their teeth closer together, it doesn’t do it properly. However, the way it does do it does not allow the bone to reform properly around them. The danger of that is your teeth don’t have any support. They will become loose. If you continue on with the bands, they will eventually fall out.

There have even been a few cases where some young people slept in their bands and they ended up with the rubber bands worming their way under their gums. The only way keep them from developing a severe infection was to have surgery to dig them out.

Alternatives to DIY Orthodontics

They don’t have to shift their teeth themselves. There are lots of fun options in orthodontics.

  • Traditional Braces

Getting traditional braces can give you an opportunity to express your personality. You can get them different colors or even a mixture of colors. You can even switch your colors at some appointments, so you get the opportunity to mix it up a bit.

  • Invisible Braces

Maybe you’re the type who doesn’t want anyone to know you need braces. In that case, Invisalign is your better option. Instead of the flash of colored braces, you can have invisible ones. Seriously. No one can tell you’re wearing them even at a conversational distance.

These have an added benefit of allowing you to whiten your teeth at the same time you’re straightening them. So, if you gals happen to be big coffee drinkers (shame on you!) then you can get rid of those unsightly coffee stains.

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