Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Are Orthodontics Required to Replace Crowns?

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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.

One Orthodontist Thousands Less

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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.

The Aftermath of Thumb Sucking

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Can you help me? I have a teenager who is still sucking her thumb and now her teeth are protruding quite a bit. She’s starting high school soon and I want her to feel beautiful. But, they’re not just an overbite. They’re also kind of curved. What will fix this AND is there anything which can help her with this habit?

Tracy

Dear Tracy,

Smiling young woman with braces

I agree it is important for a young woman to feel confident and attractive. In fact, confidence is attractive. Because of the issues facing your daughter’s teeth, I’d suggest you see an orthodontist. She will need braces. These will fix both the problems of inclination and position simultaneously.

As for aiding her in giving up the thumb sucking, the first thing to do is not use punishments or shaming. You want her to grow up confident, not worried there’s something wrong with her. However, the thumbsucking has to stop or her teeth will continue to go out of alignment.

The easiest way is to use a product called Thum. It’s an unpleasant tasting liquid you can paint on her thumb. It should help her break the habit.

It’s important she’s careful about brushing her teeth during braces. Let her know ahead of time it’s harder. She’ll have to really work to get in there. It would help her to have a water pick too, which helps with getting food trapped around the bits of metal.

Too often we see white spots on teeth after braces. This is decalcification, which is the precursor to decay.

After Orthodontics

When her braces are done, she’ll be given a retainer to wear. It’s important she wears that or her teeth won’t stay in the proper position. You won’t be starting over, but you will have to do some repairs after shifting without that retainer.

With healthy teeth, there usually isn’t much a teenager needs to do cosmetically. However, some prefer to have their teeth whitened after they finally get their braces off, giving them a fresh look along with the straighter teeth.

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

Do Braces Cause Spots on Teeth?

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My mom wants me to get braces. I want to get Invisalign. She says I’d have to give her a good reason to pay the extra for Invisalign. My friend Sydney got braces and when they came off her teeth were spotted white were the braces were and have stayed that way. Is that caused by the braces?

Kaleigh

Dear Kaleigh,

Someone smiling with braces

While those spots wouldn’t have appeared like that without her braces, the braces weren’t the actual cause of the spots. The spots are caused by food being trapped in the braces and not adequately cleaned. After a time the bacteria will start eating away at the enamel on your teeth. When the braces are removed, those spots look whiter or sometimes brown. Often, there is decay underneath the spots which seriously needs to be dealt with.

Benefits for Using Invisalign Orthodontics

Here is what you can tell your mother. Invisalign is superior to braces in the following ways:

  • Invisalign makes it much easier to clean your teeth. You simply remove the aligners, brush, and floss, then put the aligners back in. There is a lot less risk of the problem listed above, which will cost your mother additional money in digging out the decay, then finding a skilled cosmetic dentist to do the cosmetic bonding on top of the spots.
  • She can cook whatever she wants because there are no limitations on what you can eat. Nothing gets stuck in the aligners because you remove them to eat.
  • They’re much more comfortable than braces because there are no metal wires and brackets.
  • They tend to work faster than braces.
  • Students have more confidence wearing them because they truly are like having invisible braces.

What You Need to be Aware of

There are three things you need to be aware of going into this so you’re prepared. First, not everyone is a candidate for Invisalign. It’s always possible your mom could agree to get you Invisalign but when you go to see a dentist or orthodontist, it turns out your case is too advanced for Invisalign and you have to do traditional braces.

Second, it will cost your mother additional money if you misplace your aligners, which has been a problem with teenagers using the procedure.

Third, you must wear the aligners the prescribed time or it won’t work. This is a great treatment, but it’s a treatment which requires patient compliance requiring maturity. Be honest with yourself about your abilities to take this seriously.

Best of luck convincing your mother!
This blog is brought to you by Tulsa dentist Dr. Ryan Noah.

DIY Braces

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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.

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.

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.

Can an Orthodontic Disaster Be Fixed?

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My mom had me see an orthodontist while I was younger and the orthodontist had two of my teeth pulled because I didn’t have much space. I’m not quite sure why, but he went with the two nearest my two front teeth, which means that my pointier teeth are closer to the front than they should be, if that makes any sense. I’m 26 now and my teeth have shifted some, so now there’s a big gap between those teeth and my front teeth too. It looks so bad. I’ve been considering going in and seeing if an orthodontist will give me braces again to close the gap, but that’s not really what I want. If possible, I’d like the pointier teeth shaved down or moved or something instead. After all these years, is it still possible to correct what the first orthodontist did?

Thank you,

Tammy

Dear Tammy,

It sounds like you had your lateral incisors removed, which isn’t very common because people wind up with the problem you currently have- it never looks quite right. Plus, the canines play a crucial role in the side to side motion of chewing, protecting the back teeth from undue stress, so those are not usually moved much. With that said, what’s done is done and now you want to see about fixing it.

You’re probably right about not just having the gap closed again. Even if you see a really good cosmetic dentist, it would be difficult for him to make your canines look like lateral incisors. The teeth are built so differently. If there isn’t enough space to replace the lateral incisors that were taken, you may have to go that route anyway, though. If you do have a considerable amount of space, you may be able to go through another round of orthodontics to straighten things up and shift the gap, so you could have something like dental implants, a bridge, or partial denture made.

The bottom line with this one is you’ll want to see an orthodontist and a dentist who specializes in cosmetic dentistry to do an exam and x-rays. Every case is a little different and it’s difficult to know how much space you have to work with. With something this extensive, you’ll probably want to get a couple of opinions, so you can get a good feeling for what’s best and you’ll want to see someone who has preferably handled a case similar to yours before. You can fix it and make it look better than it did before, but it’ll never be quite the same as it would have if those teeth weren’t extracted.

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

Why Do I Need a Retainer?

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I just spent four years wearing braces. Do I really need a retainer?

Beth – Kansas City, MO

Beth,

There’s an important reason for retainers after braces. They’re designed to keep your teeth in their new position. If you don’t wear it, your teeth will shift quickly. Retainers are even more important if you’re still growing into adulthood because your growth causes your teeth to shift even more.

Another reason a retainer is necessary is because your new bite needs to stabilize and it may take some time for all of the tissues and the bone to reorganize. Shifting of the teeth occurs naturally so retainers are needed to help keep them in place. Relapse of the teeth is very high the first month after the removal of braces and it usually takes about one year for teeth to stabilize completely after orthodontic treatment. If you had spaces in between your teeth before braces then it takes longer to keep the dentition stable. The rule of thumb is you wear your retainers as long as you wore your braces. So if you wore braces for four years then you wear your retainer for four years.

The good news is not all orthodontic patients need to wear their retainers 24/7. Your orthodontist will recommend what retention plan is best for you. Patients with removable retainers are recommended to wear their retainers on a constant basis for at least the first six months and then usually just at night while they sleep for a few years. Yet some orthodontic patients need only wear their retainers for the first week on a constant basis then after that just at night. A lot of orthodontists apply fixed retainers that are cemented in place to stabilize the teeth which are usually worn for at least five years. This is commonly used for adolescents because it’s common for teenagers not to wear their appliance, plus there’s the possibility of wisdom teeth causing shifting of the teeth while trying to erupt.

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