Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

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.

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How Long Does Emergency Bonding Last?

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I had quite the fight with a flight of stairs and my teeth lost. Two of them were badly chipped. I went to see an emergency dentist and he put some kind of emergency bonding on them and told me to follow up with my regular dentist. The bonding he did seems to be holding up, even though it is a few days later.  How soon will I need to see my dentist before it wears out?

Caryn – MIchigan

Caryn,

I’m assuming  the emergency dentist used a composite bonding on your chipped teeth. It’s used in emergencies, but not soley. It’s a common treatment for chipped teeth and will last several years. He didn’t want you to follow up because it needed replacing right away.

Instead, it is to double check the tooth itself. When a tooth is traumatized, it doesn’t always give  symptoms right away. If the blood flow was cut off to the tooth it wouldn’t show up on x-rays. If this is the case, the tooth could be dead or dying, and it will eventually need a root canal. Unfortunately, the first sign this has happened is often pain or an abscess, though sometimes the person notices discoloration as well. Anytime you see an emergency dentist, he’ll refer you back to your regular office for a follow-up.

I hope this helps you. Do make sure you follow up.  It could save you a great deal of time and money, as well as unnecessary treatment.

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Dentist Refuses to do any treatment except implants

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I need to replace several teeth, but my dentist says he only does dental implants. I can’t afford that procedure. Please tell me there are other viable options. And also tell me they’re more affordable.

Humphrey A.  – Maine

Humphrey,

While it is his practice, I will admit to getting a little frustrated when dentists are so inflexible, especially when there are other viable options.

There are affordable ways to get your teeth replaced. Just some of the options are removable partial dentures or a dental bridge.

You can even get certain types of more affordable implants, such as mini implants or implant supported dentures.

Another option, would be to find a dentist who is willing to work with you on payments for dental implants or another replacement option.

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Can I use old invisalign aligners for teeth whitening trays?

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I was cleaning out my dresser and found an old pair of invisalign aligners. Can I use those as whitneing trays and just order the whitening gel? It would save me a ton of money?

Jillian K. – Ohio

Jillian,

Well, do you know which pair of aligners this is? If it’s anything but the last pair, you could shift your teeth and do your bite serious harm. Plus, they’re old, but how old? There’s a lot of information I don’t have here.

While some people whiten their teeth with invisalign aligners, that is always done during their Invisalign treatment, not consecutively.

If I were in your position, I would just talk to my dentist about it.  Let him look at the aligners and make sure they’re the right pair AND in suitable condition. It’s possible, but I wouldn’t do it without checking it with your dentist first.

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Orthodontist vs. General Dentist: Who’s Right?

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I’m having trouble figuring out what’s going on with my son’s teeth. We have a great orthodontist and what I thought was a good dentist, but now I’m not so sure. My son is missing a tooth on the upper right, near the front. We planned to have an implant done for him when he’s older, so the orthodontist straightened everything out and left a space for the implant. He said we could either get a retainer to keep everything in place or have the family dentist make something else. Well, that something else wound up being a “Maryland bridge,” to put a false tooth in place for the next few years. On the first round, the dentist created something with clasps and it fell out right away. He said it was the cement, so he put it back in with something stronger. It fell out again within a few days. Now he wants to have the whole thing remade with metal clasps and I’m a little worried that the same thing will happen. I mentioned it to the orthodontist and he said he wasn’t sure why the family dentist was going this route and suggested we get a flipper instead. I’m really torn. Was the orthodontist saying the dentist did something wrong? Should we switch gears and get a flipper? Do we need a new dentist?

Thanks,

Jocelyn

Dear Jocelyn,

The problem probably wasn’t the cement. It was the way that the teeth were prepared. The adjacent teeth needed notches cut in them to hold the bridge in place, but in an effort to be conservative, the dentist probably made them too shallow. For this reason, the replacement bridge will probably do the exact same thing. The only real fix is to make those grooves deeper, but that will permanently alter the structure of those teeth. Since they’re healthy, that would not be the best form of treatment.

It’s unclear why your dentist chose this route over a flipper to begin with, unless it’s because you passed on the retainer and they’re similar in build. Your best bet is to request the flipper, instead of going forward with a new bridge. This is something that your family dentist should be able to create for you, but if you have trouble, you may want to find out who the orthodontist prefers for general dentistry and get an opinion from that office.

I hope this helps you make a decision.

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I Need Dental Implants and Braces

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Can you advise me? I need some dental implants on two teeth I lost in an accident. I also wanted to get my teeth straightened. which procedure is it important to do first?

Jeannie L. – Portland

Jeannie,

You’ll need to have your teeth straightened before you get your dental implants. Dental Implants are surgically implanted directly into your jawbone. They don’t have the ligaments that allow them to be moved, like your natural teeth can.

One exception would be if you need the implants in your molar. In some cases those need to be placed first.

Either way, I would meet with your orthodontist and your implant dentist and make sure they’re communicating.

If you have a dentist who does both orthodontics and dental implants, that would be ideal.

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Can I Self Medicate with Marijuana Before Going to the Dentist?

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I take marijuana for anxiety. And I can assure you a dentist causes me anxiety. I have a serious toothache and likely need to see a dentist. Will they treat me while having marijuana in my system if I have a prescription for it?

Mark L. – Arizona

Mark,

Honestly, it will depend on the dentist. I suspect from your question that you don’t have a dentist of your own. That’s OK. My suggestion would be to call around and ask some emergency dentists. There are two very important aspects to this though.

  1. You need to be seen. You likely have a tooth infection. Infections spread, so you’ll want to get the infection removed.
  2. You need to tell the dentist that you’ve got marijuana in your system. It could save your life. Here’s why.

Many dentists use a local anesthetic that contains epinephrine, which isn’t a great mix with marijuana. It can cause an abnormal hearthbeat or peripheral vasodilation. Either of those combined with your anxiety can cause serious harm to you. As long as the dentist knows what you have in your system, he can avoid any contraindications.

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Thought I was saving money until my tooth fell out

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I needed to replace my tooth. I called around to find the cheapest dentist to do it. I was so excited when I found a dentist who was several thousand dollars cheaper. I got the procedure done. Then the new tooth just fell completely out. I went back and he’s saying it’s my fault. I went to a different dentist and he told me that first one botched the job. Now I have to spend a lot more money to get it fixed and need and additional procedure. I’m devastated. It’s going to cost me double than if I had just gone to a different dentist to begin with.  Can I get my money back?

Stella B. – Denver, CO

Stella,

What a horrible experience. I think you’ve learned there is a very big difference between an affordable dentist and a cheap dentist. This cheap dentist has cost you a small fortune.

As far as getting a refund, there is no guarantee. It helps that you have a second dentist saying that the procedure was botched. Your first dentist will likely care about his professional opinion. You could get at least a partial refund just by that reason alone.

The fact that it fell out works in your favor too, because it didn’t meet the minimum standard of care, which is it needs to be functional.

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Can I Switch Invisalign Dentists?

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I’m not too crazy about the dentist who’s doing my invisalign. I’m happy with the product, but can’t stand the dentist. He’s always talking politics and of course he hates my candidate, so I spend the whole appointment hearing him tell me everything that’s wrong with him. I can’t go back every two weeks until the election. I just can’t. Is it too late to switch?

Vivian K. – Massachusetts

Vivian,

Politics should be left out of the operatory unless the patient brings it up. Sorry, there’s not thing more unbearable that won’t stop talking about politics.

You can switch at any point in any dental treatment and your dentist is ethically bound to share all the treatment information with the new dentist.

I’m glad you’re happy with the Invisalign treatment itself. It has a very high patient satisfaction rate.

There are lots of good dentists that are certified to place them. Most of them politics free….

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Will braces really cost more if I leave my son’s baby teeth alone?

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My son has teeth erupting behind his baby teeth. My dentist thinks I need to have his baby teeth extracted. He says if I don’t it will make the braces harder and more expensive later. To be frank, I think he’s being melodramatic in order to get some more money out of me. I mean, if he’s going to need braces, he’s going to need braces. Why would it be harder if the adult teeth stayed where they are? They’re there now anyway.

Lisa – Delaware

Lisa,

I don’t think your dentist is trying to squeeze extra money out of you. The fact of the matter is, the longer your child’s adult teeth are in the wrong position, the harder it is to move them into the correct position with orthodontics. The more difficult the orthodontic case, the more expensive it is.

If the baby teeth are loose and about to come out, then sure, you may let nature takes its course. But, if they’re holding firm, then I would agree with your dentist. The teeth need to be extracted.

I hope this helps put your mind at ease.

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