Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Dentist Told Me to Go to Orthodontist Not Cosmetic Dentist

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I have a gap between my teeth I want to fix with cosmetic dentistry. I’d asked my dentist for a referral but he says that’s a waste of money and I should see an orthodontist. I’m too old for a mouth full of metal. Besides, it’s my money, if it’s more expensive but works I’ll be happy. I don’t want to be a metal mouth at 42.

Lara M.

Dear Lara,

A woman placing her Invisaliagn aligners

Orthodontics no longer mean metal braces

The only time cosmetic dentistry is a waste of money is if you go to a bad cosmetic dentist. It sounds to me like your family dentist is feeling a little salty about you asking to see a cosmetic dentist, probably because he hasn’t developed his skill set to include cosmetic work.

Cosmetic dentistry isn’t a recognized specialty with the American Dental Association (ADA). Instead, it’s general dentists who’ve invested time in learning the cosmetic procedures. Obviously, some dentists will be better than others, so you have to be careful.

Are Orthodontics the Only Solution for a Tooth Gap?

There are several solutions for a tooth gap, but let’s look at the orthodontic ones first. Obviously, you already know about the traditional metal braces. But, there have been significant advances in orthodontics since you were a child. We now have braces that you can’t even see.

If you look at the image above you see a woman placing clear aligners onto her teeth in the first picture. The second picture beneath that is her with the aligners on. As you see, there’s no way to tell she’s wearing anything on her teeth. This is Invisalign. It uses sets of clear aligners to straighten your teeth which are not visible even at a conversational distance.

But, let’s say you still don’t want orthodontics. That’s okay. The most common solution for a tooth gap is dental bonding. It uses a composite resin to fill in the gap. A good cosmetic dentist will make it blend seamlessly in with your natural tooth structure.

If there are more things about your teeth you’d like to change than just a gap, you might consider porcelain veneers. Porcelain veneers completely remake a smile. They can change the shape, size, and color of your teeth.

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

Orthodontist Said Fluorosis Means I Can’t Get Braces

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I’m very sad. I grew up in Columbia and became a citizen of the United States about ten years ago. I’ve always wanted to straighten my teeth, but needed to get financially stable first. I am and went to my first orthodontist appointment today. It was very disappointing. He said I couldn’t have braces because I have severe fluorosis. Is there no way I can fix my teeth?

Luis G.

Dear Luis,

Someone smiling with braces

I’m sorry you’ve been given the impression you can’t get your teeth straightened. You can. There are two ways to go about this, but with either option, it sounds like you’ll need a different orthodontist, one who’s more up to date with techniques and procedures.

Orthodontic Options for Patients with Severe Fluorosis

If braces are what your heart is set on, there is a way to get that. Recent studies have shown that if the orthodontist does double etching, the bond will be strong enough for your braces to remain where they should for the duration of your treatment.

Many dentists have done dental bonding procedures on fluorosis patients with great success. If it works with the bonding it should work with braces.

There is actually a better option than braces for someone in your position. Have you looked into Invisalign? It straightens your teeth without any metal wires and brackets. It’s also completely invisible, so no one will know you’re straightening your teeth.

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.

Is It Possible My Tooth Gap Will Close?

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I’m seventeen years old. My teeth are completely straight and healthy except for a small gap between my front teeth. I know that I’ve kind of lucked out in the teeth department but the small gap between the two front teeth really bugs me. My wisdom teeth still haven’t come in. Is there a possibility when they do come in it will push the gap closed? If not, is there something I can do to close it that doesn’t include a mouth full of metal?

Amanda P.

Dear Amanda,

While it is possible that the eruption of your wisdom teeth could shift your top arch and close the gap, there are also a few things that could keep that from happening.

First, the gap could be too large. That may mean that your teeth shift, but not enough to close the gap completely.

Second, there is a small piece of tissue in between your two front teeth which is known as a frenum. Most people who have a gap between their teeth, the frenum is the cause. In some patients, the frenum is so large they need to have it removed so that the gap can be closed with orthodontics.

impacted wisdom teeth

Third, not everyone’s wisdom teeth come in straight. If they do, great. But, many patients have to have their wisdom teeth removed because they end up impacted. If that’s the case with your wisdom teeth, they won’t be available to push your diastema (tooth gap) closed. The above image shows you what impacted wisdom teeth can look like.

If it happens that you aren’t able to use your wisdom teeth to shift everything, there’s still hope. And, it won’t require a mouth full of metal.

You could use Invisalign. These are invisible aligners that can close the gap for you in a more effective and comfortable way than traditional braces.

If you don’t want to use orthodontics at all, you can go the cosmetic route. The simplest procedure is to have dental bonding done by a good cosmetic dentist. It uses composite material, similar to what you’d find with white fillings to fill in the gap. You want an experienced cosmetic dentist in order to ensure they’ll be able to make it look natural.

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

Smile Club or Professional Orthodontics

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I’ve been trying to do save up for orthodontics for a long time. I’m getting close, but just read something about Smile Care Club. It’s a lot less expensive than the orthodontics. Is it okay for me to use that and then save the rest of the money for something else?

Lisa A.

Dear Lisa,

The best thing about the Smile Club is the cost savings. I just want you to think about it ahead of time. They have you send x-rays, but there are some things, such as gum disease, which is very hard to discern by x-rays alone. It usually takes a physical exam as well.

Gum disease is serious and can creep up on you silently. If you get this type of orthodontics while having gum disease, it will make the situation significantly worse. That puts you at risk of losing your teeth. In that case, instead of spending a little extra money up front, you’ll end up spending thousands to replace lost teeth.

The other thing to bear in mind is things which can go wrong during the treatment. Sometimes, as teeth are brought together, there needs to be some mild shaving to ensure they come together well. In that case you’d need to see a dentist. You’d want it to be a dentist invested in your case, but you won’t have one of those.

Smile Club keeps up with you by photos and phone. I feel one on one monitoring in person is the safest way to go, especially for the patient. This is designed to be a mail order substitute for Invisalign. You’d be better served getting actual Invisalign and the personal attention you both need and deserve during your treatment.

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

Is Orthofill a Scam?

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I was looking at the Orthofill website. They seem to have a lot of regular people saying it worked for them. It’s so much more affordable than braces. All I really need to do is close a gap in my front teeth. This seems like a much more reasonable option. However, my dad always says if something seems too good to be true, it probably is. I just want to make sure I’m not getting myself scammed when I just want to close a gap. I’m not opposed to spending money, but I don’t want ugly braces and I kind of wanted something that worked faster than braces.

Mandy P.

Dear Mandy,

I’m glad you wrote. People see their gap closing and think “Problem solved.” What they don’t see is that the gap will eventually open back up. The bands don’t actually work on your teeth the way true orthodontics would. They tip your teeth toward one another. You’d get the same results if you wrapped small rubber bands around your front teeth.

There have been horror stories with these too. Bands have wormed their way underneath people’s gums causing horrific damage to the patient. As the bands are most often worn during sleep, you wouldn’t even know it was happening.

Orthodontics aren’t the only solution for a tooth gap. There are cosmetic solutions, such as dental bonding as well. That will use a composite solution to fill in the gap on your teeth. If there are other things you’d like to change on your teeth, porcelain veneers are a great solution. They can completely remake your smile. You mentioned the only thing you were interested in is the gap, so this probably isn’t your solution. I just wanted you to know it was available.

Also, if you’d like to close the gap, not just cosmetically, but actually. There is a way to do it without bulky metal wires and brackets. Invisalign can do the same things as braces, without anyone knowing you’re wearing anything. Faster too.

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

Solutions for a Wonky Tooth

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I have a tooth slightly rotated. My dentist wants me to get braces, but that is a minimum of two years treatment. I’m a senior. I don’t want to look ugly my last year of high school and first year of college. Tell me what my options are.

Caitlin D. – Boston

Caitlin,

You have a couple of great options aside from traditional orthodontics. The first is Invisalign. If you are a candidate, which not everyone is, it can straighten your smile in about half the time as braces. The best part is it truly is invisible. No one will know you’re wearing them.

If you’re not a candidate for Invisalign, or if you have other things you’d like to change about your smile, then I’d suggest porcelain veneers. It’s a strictly cosmetic procedure that can completely remake your smile. It can change the shape, size, and color of your teeth. It’s the type of makeover celebrities get on their teeth.

Invisalign is the more affordable of the two options. I don’t know if budgeting is a factor in your decision. But, if it is you’ll want to consider the cost difference.

Also, if you’re getting porcelain veneers in order to re-make your smile, you won’t just get a veneer for the wonky tooth. You’ll get a minimum of six on your upper arch.

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

 

Can an Epileptic Get Braces?

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I’ve wanted braces for as long as I can remember. However, because I have epilepsy, my mom was always terrified and seizure would tear up my mouth. I’m an adult now and am considering it again. I was thinking about Invisalign because they’re softer. What do you think?

Anna G. – Alabama

Anna,

I don’t know if you’ve ever seen the meme about how things look to moms. There’s a toddler being gently tossed by the dad. But, what the mom sees is him skyrocketing. Your mom saw the potential for injury and that shut the option down in her mind. It’s because she loves you.

However, you can get orthodontics, even with epilepsy. Obviously, because of the risks, some precautions need to be taken. There is the risk of some soft tissue damage during a seizure, but it’s generally minor.

I’d certainly tell the dentist what medications you’re on. I’d also ask for smaller brackets than the traditional ones.  That is possible. Many epilepsy medication cause swollen and bleeding gums.  Braces can also aggravate that, so diligent oral hygiene will be a must.

You asked about Invisalign. Yes, they are softer, so you wouldn’t have to worry about tissue damage. However, I’d be concerned about the possibility of the aligners dislodging and blocking your airway.  Visit with your orthodontist. There is a way to get your teeth the way you’ve always dreamed.

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

Metal or Ceramic Braces

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I need to get braces and am having a hard time deciding between metal or ceramic braces.  Can you help? I’ve heard they’re less visible, but can have some other problems.

Dave H. – Montana

Dave,

You’re right that the ceramic brackets are less visible than the metal brackets. However, they will still have the metal wire going through them, so I’m not sure how beneficial that is. Here are some of the downsides to ceramics and you can decide what you feel has more weight to it.

  • Ceramics are stronger than the enamel on your teeth, so if you bite down and hit one of the brackets, you risk chipping a tooth.
  • Some orthodontists charge more for ceramic brackets.
  • Ceramics are harder to remove.

There is an alternative if your goal is to have less visibility on your orthodontic treatment. Have you spoken with your dentist about Invisalign? These are completely invisible, even at a conversational distance.

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

Does Invisalign hurt as much as braces?

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When my first daughter had braces they hurt her all the time. The inside of her mouth was constantly cut, no matter how much “wax” was put on the brackets. My youngest child now needs braces. I keep hearing about invisalign. Are they more comfortable than braces?

Irene F. – Nevada

Irene,

Your youngest daughter is lucky. Orthodontics have changed a lot. Invisalign is much more comfortable than traditional braces, as long if she is a good candidate. There are some things to take into consideration.

First, they are slightly more expensive than traditional braces. But, given your first child’s experience, I doubt you’d mind.

The second one is your youngest child’s responsibility level. Unlike braces, Invisalign is removable. So, if your child won’t keep them in, that could be a problem. The treatment only works if they’re kept in the prescribed amount of time.  There is an Invisalign Teen which has a few replacement aligners, but only you know your child.

I hope this helps.

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