Porcelain veneers are the pinnacle of modern cosmetic dentistry – they can give you the smile you have always dreamt of, but it comes with a catch.
Veneers are not “one size fits all”. Beautiful, highly functional veneers are the most customizable dental procedure available, but also the most difficult. This has led to many incredible smiles, but also many more poor fitting, poor functioning “Chiclets” smiles. What a disappointment to spend all that time and money trying to get the smile of your dreams only to end up with something sub par?
Let me summarize. If your child, partner or best friend was in an accident and had a deep laceration across their face that would require many stitches and could possibly result in a permanent life altering scar, who would you seek out to work on that laceration? I bet you would want a plastic surgeon to perform this procedure, not a general doctor, right?
Veneers are the most difficult procedure in dentistry, so why have a regular dentist “try” to give you the smile of your dreams?
You only have one smile, forever. It represents who you are, how you feel, and how others feel about you. Why would you want to gamble with all that?
I have guided my career towards becoming the best cosmetic dentist I possibly could from the beginning. I knew I wanted to be a true cosmetic dentist, becoming one of the youngest, if not the youngest, accredited cosmetic dentists in the entire world. This has given me the experience over the past 10 plus years to “walk the talk”.
At Ideal Dentistry I don’t just offer lumineers, Da Vinci Veneers, Cerinate Veneers, or any of the other names out there for veneers. I offer custom veneers designed for you and your smile. Everybody has a different idea of what a beautiful smile looks like. I focus on exceeding your expectations by listening to you and sculpting the perfect smile for you, and only you, not a “generic” veneer. That is the Ideal Dentistry difference.
So, if you are looking for a beautiful smile that perfectly matches your look and personality, then Ideal Dentistry is for you.
A beautiful smile is the window to your soul. Treasure it as it reflects who you are to everybody you meet, including yourself.
Gum Disease, the silent killer…This sad story, posted today on MSNBC, is a wake-up call for all of us. Gum Disease, and its associated bacteria, are deadly in more ways than we can imagine. This article discusses the new study that shows that the bacteria found in untreated gum disease has spread to inside the unborn baby.
Bleeding gums are a strong warning sign that something is wrong. Only your dentist is able to diagnosed and treat gum disease.
All you own in this world is your body. Take care of it and it will take care of you. Ignore it and bad things will happen.
Question: Why does my tooth hurt after it just received a new white filling? It did not hurt before!
Answer: Your tooth should obviously not hurt after the filling, especially if it did not hurt before. In this practice I do not have patients complaining of pain after white fillings are placed. If you are experiencing pain, here are some reasons why:
Polymerization Shrinkage: Composites (white fillings) shrink a little when they harden. Generally the dentist will place the material into the cavity in a liquid to pasty form and then use a strong light (LED or Halogen) to instantly harden the material. If the composite material is placed incorrectly or in bulk then the composite will shrink enough to either allow a little gap to form around the filling, or it will actually pull the tooth together. Either way the tooth will become sensitive to hot and cold.
Too Large Composite: Composite is a great material, in small fillings. Once the filling reaches a certain size (1/3 the distance between the cusps or more than 2 surfaces) then it generally is not strong enough to function correctly. Composite material is not strong enough to function exactly like tooth structure. The tooth will bend, the composite will wear or fracture, and eventually failure is inevitable. When the filling fails it will then require a much larger restoration or worse.
Fractures in Tooth: Often old silver mercury fillings, amalgams, are removed and replaced with white fillings for various reasons. These amalgams have too many issues to list here (let’s see if any ADA dentists complain), but the main one is that the expansion and contraction as well as compression over time results in tooth fractures. Removing these fillings and not recognizing the fractures (visually) will result in trouble. A fractured tooth should not receive a white composite filling!
Other Issues: The two scenarios above are fairly common. Often I see patients that have super large composite fillings (patches), and that is usually a warning sign to the quality of dentistry found in all the other teeth. Composite material is great if used correctly. It is not a cure-all. It can have bubbles in it, fail to bond correctly, not cure all the way, etc. Composite is very technique sensitive and is often placed without enough care. This is where experience becomes important!
So, to answer this persons’ question – Your tooth could hurt for many reasons, none are good. Talk to your dentist about this problem and see what they say. If the answer is “wait and it will get better”, then seek out a second opinion. Unfortunately Kentucky is not known for its quality dentistry (we are 49th and 50th in the US when it comes to number of teeth in adult mouths and oral health), so do your research and find a top dentist. I suggest you look at the AACD (American Academy Of Cosmetic Dentistry) as one of your sources. Select a member as they have gone through some of the most rigorous training in the world and must live up to their reputation.
Over the last 10 years I have been researching natural alternatives in Dentistry, continuously seeking the healthiest form of treatment for my patients. Just repairing the problems that I encountered with my patients teeth seemed futile. It is not enough to just “fix what broke.” WHY did it break in the first place? WHY are your gums bleeding?
WHY are your teeth loose? WHY do you need a root canal? These are the questions I spend most of my time on. All too often our society seeks the MAGIC PILL to fix the problem. You can get a pill for anything and everything these days. Why? Because it is instant gratification and big business. As DOCTORS we need to look beyond the pill and “FIX THE PROBLEM first”. This does not mean that you do not need any medication, it means we need to find out why you may need the medication first and try to correct it.
For 2010 IDEAL DENTISTRY is expanding its focus on what we have quietly provided all along, ORGANIC DENTISTRY.
You may ask “What is Organic Dentistry?”, and rightfully so.
Organic Dentistry (my definition): Dental Products, Procedures, and Philosophies that focus specifically on re-establishing and maintaining the most natural environment in the mouth.
What makes IDEAL DENTISTRY Different?
We’re passionate about our organic approach to dentistry. Ideal Dentistry helps patients achieve an overall feeling of well-being using safer, less intrusive practices and products. Our passion for the organic approach to improved quality of life goes beyond the dental office and is seen in everything we do, even at home.
We don’t pontificate. We innovate.
Experience and credentials you can trust.
Care of teeth and gums and YOU. At Ideal Dentistry, we whiten and repair damaged teeth, create beautiful smiles, treat the gums and provide other dentistry services but do so believing that the mouth is the gateway to the total health of your body, mind and spirit. We focus on identifying the cause of the problem before trying to blindly repair it.
An engaging and interactive approach to patient care.
One visit to Ideal Dentistry and you’ll know you’ve come to the right place. There is a reason why our office won the 2009 Health Care facility of The Year award from Contract Magazine. This national competition sought out health care facilities that delivered an environment that is environmentally green and centered around building a comfortable patient experience. We are very proud of our beautiful facility and invite you to come visit anytime.
Looks Healthy, Right?This Morning one of my staff members brought in a bottle of “Blueberry Tangerine Spring Water” from Archer Farms. She said she was trying to grab something healthier than soda! Well, I read the ingredients and tested the pH with my trusty pH meter. This is what I found:
Loaded with Preservatives
Loaded with Citric Acid
5 mg of Salt
Artificial Sweetener E955, or as you know it as, Sucralose
a pH of 3.2!
The facts above are scary. It looks just like water, has the words “Spring Water” on the bottle, but is just as bad as a soda! How deceiving.
It is very sad to see this as consumers are struggling to eat and drink healthier, but unless you know the facts it is easy to fall into visual trap. Reading the label quickly you may even think that Vitamins are in the bottle! You have to look closer and see that the sentence starts with “Not”. Very tricky.
This “Blueberry Tangerine Spring Water Beverage” is just as good at dissolving your teeth as soda.
Organic Dentistry (my definition): Dental Products, Procedures, and Philosophies that focus specifically on re-establishing and maintaining the most natural environment in the mouth.
Here is a broader description of what that means: Organic Dentistry tries to rebuild your mouth so that it functions the way nature intended it to. Organic Dentistry uses products that rebuild the natural oral flora. Organic Dentistry is minimally invasive and proactive when it comes to decay. Organic Dentistry focuses on teaching nutrition and decay prevention to patients.
What is the difference between a Cosmetic Dentist and an Accredited Cosmetic Dentist? Well, the difference is in the details.
Understanding facial aesthetics, not just teeth, is critical. The goal with every cosmetic smile makeover is to improve the whole smile, the whole face, the whole person, not just the teeth.
Here are a few cases I found online that are touted as “Smile Makeovers“. You be the judge. Are these smiles complete? What is missing? More after the pictures.
Please remember, these cases are NOT MY DENTISTRY!
Do these cases sound like “Smile Makeovers?”
A smile goes from one corner of the mouth to the other. Teeth are framed by the lips and need to follow the lip line. A “black corridor” will result if one side of the smile, or frequently both sides, are neglected. This dreaded black corridor makes the person look like they have no teeth on that side when they smile, especially in photos! Who wants that? How is that “cosmetic/aesthetic?” All these patients above spent a lot of money on their smiles, significantly more than their insurances would ever cover. Why would you not finish the case and get rid of that black corridor? Until that is done right, it is not a “smile makeover”, but simply a few veneers on some teeth.
Bulky. Teeth are not bulky, why are so many veneers bulky? They shouldn’t be. It does not look real, and it is not good for the teeth.
Shine through. Meaning, you can see the prepared tooth shine through the porcelain. Look at the last before and after. Can you see the darkness in the middle of the two front teeth? That is of course ignoring the blackness of the back lower teeth and the black corridor on the top side.
Long story short, everyone is a cosmetic dentist, but if you are going to invest in your smile, why not see someone who has the experience to give you a result that really can be called a Smile Makeover?
Most of our Smile Makeovers are Smile Redoes. Who wants to go through this whole process twice, not to mention pay twice?
That is what being an Accredited Cosmetic Dentist is all about. Having the experience to do it right the first time!
Here are some pictures of “second opinions” I have given and what my thoughts were.
When patients tell me that I am “more expensive” then another dentist in town, I can not help but imagine what type of dentistry this patient really want in their mouth. My answer, always, is to have the patient compare apples to apples, and oranges to oranges.
If you are looking for high quality dentistry that looks beautiful, is made by a top laboratory technician, and is designed and maintained to last (experience matters, but a lot of bad experience does not count!), then I am the dentist for you. On the other hand, if you want the cheapest and are not really worried about what is put into your mouth/body, how it fits or functions, or how long it will last, then I most certainly am not.
I follow the golden rule – “Treat others the way you want to be treated”. I would never put something into one of my patients mouths that I would not put into my families mouth, period. After all, all you really own in this world is your body, right?!
I am getting carried away, sorry. I just wish people knew what I know about dentistry, how it affects everything about you from soul to function. That would keep the following examples from ever happening.
Local “cosmetic” dentistry. Upon closer examination (besides the fact that the veneers are not good looking), the “real” problem this lady had was ignored. Below is the picture of the lower teeth.
Note all the gum tissue is pulling away from the teeth! That is a great way to loose teeth rather quickly. This person need to see a gum specialist as soon as possible, plus determine why the “recession” is happening.
Needless to say, this is not very good “cosmetic” dentistry. The “black triangle” is a result of tissue loss and is very difficult to remove.
This may be hard to see at first, but I will explain. The above patient has 2 premolars, or the 2 teeth to the right of the turned tooth, that are bigger than the molars, or the far right teeth. These are really big and bulky crowns! The tissue cant breathe, so it gets inflamed, bleeds easily and gum disease is the result.
When tissue bleeds, bacteria seep into the bloodstream and attack your system from the inside. This is an all too common “one size fits all” dental lab. The good news you ask? This patient saved a few bucks by going to a lower priced dentist! (Except of course now it has to be redone). This dentist did not make less money then a high quality dentist would, he/she just charged less and hired a cheap lab (possibly in China) to make the new crown. Who suffered in the end?
This picture is from the same patient above, only it is his other side. Note how “small” his own two premolars are! Don’t let that other dentist get a hold of those perfect little teeth, all they need is to have the silver mercury removed, minimally, and the tooth can be restored without cutting it down to a little stump.
This patient, I call him patch, has been to the same dentist for many years. He came to me after a recent filling “just fell out”. Well, almost every single tooth has a bunch of plastic patches on it, most surrounded by decay. A “new” bridge was placed on the lower right side of the above picture (the patients lower left). Everything else was “ok”. Really?! Well, I hate to be the messenger sometimes, but there is a significant amount of decay that should have been treated a long time ago. Of course the patient is shocked, but I need to tell the truth about what I see. Now we are “fixing” the mouth, not patching.
This is a great example of “if it does not fit into the mouth, grind a little more!”. The black spot on the big tooth is where the porcelain has been ground off to make the crown fit into the space. And even worse, the tooth to the right of the big crown has a monster patch that is fractured. That little tooth needs a crown, a buildup, and possibly a root canal. Maybe the tooth is even fractured itself and then it can not be saved. Was it worth placing a super large plastic filling where they really don’t work? And that crown, if you look closely, you will see that where the top touches the tissue the tissue is red and swollen. That is a portal for bacteria into your system, and it bleeds if you touch it. Not a very healthy situation.
Now, here is the next level of “if it does not fit, grind a little more”. The gold/black spots on the teeth above are where the porcelain crowns were ground through to the underlying metal to make them fit in the mouth. Just because the patient can’t see these areas does not mean they don’t exist! This weakens the crowns, and is just not acceptable.
Here is another final example of a mega tooth. This white blob is significantly larger than the original tooth, inhibiting everything from the flow of food to tissue health. There is just so much wrong with this tooth that I don’t know where to begin.
Moral of the story, you own your mouth/your body, nothing else. Take good care of it and it will take good care of you.
A recent article in Forbes (November 16, 2009) described the difference between dental insurance and dental discount plans. It made some great points that I would like to mention here.
According to this article, “the average individual dental insurance plan costs $554 – and that’s for a limited network of providers… Even using one of these plan’s chosen (i.e., cheapie) dentists, you’ll have a 20% copay for routine fillings and a 50% copay for crowns and bridges.” Your benefit is 2 free cleanings per year and an exam. Reading the fine print you will quickly realize that the yearly treatment cap ranges between $1000 and $1350, and implants usually are not covered. The waiting periods are usually long, some as long as 18 months prior to getting basic coverage for exams, x-rays and extractions.
Many years ago I decided that there is a better way. Why plan for failure? Dentistry is not much different that the crisis in today’s health care system. Too much emphasis is put on a magic pill that will cure all ailments. We eat too much (and mostly bad stuff), exercise too little, and then wonder why diabetes, heart disease and every other illness is on the rise. So we look to pills, plastic surgery, and any means possible to cure our “resulting” condition with very little emphasis on WHY we got there in the first place! This is a formula for disaster that we are all experiencing right now in the USA.
We are solely responsible for our body’s health. With a few exceptions such as genetic disorders there-alike, most health issues are preventable! The same goes for the mouth. I explain this to my patients as the DENTAL CYCLE. For some odd reason it was accepted that you get decay, you will need lots of fillings, then crowns, root canals, extractions, and eventually dentures. It was the natural progression of a mouth. Well, it is not.
Dental Insurance has mostly focused on the resulting mess neglect has caused. Fillings to remove cavities, crowns to fix broken teeth, and extractions for gum disease. These are but a few examples. Why did you need that filling in the first place? Why do you have gum disease? What, your insurance will only pay for 2 cleanings a year but your dentist and hygienist say you really need 3-4? Who do most patients listen to? Yes, you guessed it, the insurance company. So, don’t be surprised if in a few years of “supervised neglect” by your dentist you now have active gum disease, bone loss, and now you need “deep cleanings”. Teeth get looser, root surfaces get exposed and become sensitive, tissue recedes and reveals “longer teeth” with black spaces between them. Now you wonder how you got there? All along you had the “cavities” fixed, right?! Wrong. It is not about fixing the resulting issues but fixing the reason behind the issues. And that happened years ago now when your dentist said you needed to be seen 3-4 times a year but your insurance only paid for.
2. Follow me?
For this reason I do not allow insurance companies to run my practice or tell me what to do. I work for my patients, nobody else. My sole goal as a dentist is to inform you about your personal oral health, why you are where you are and how you can improve your situation and hopefully keep your teeth and gums healthy for the rest of your life. Period. Many years ago I fired the insurance companies and decided that to be able to provide Ideal Dentistry I need to focus on providing the best dental care system, not just fill and bill.
At Ideal Dentistry we do very few root canals, have very few emergencies, and do even fewer extractions, yet we are a highly successful practice with a great pool of patients that is growing daily. Why do you think that is? Simple, I focus on your individual situation and help you step out of the dental cycle as soon as possible!
So, now to answer the question that started this thread, Is Dental Insurance Worth The Premium? Not in my opinion, especially if you are young and have well taken care of teeth. All you really should need on a yearly basis is 2-4 cleanings and an exam with x-rays. That alone is significantly less than most premiums, even at the best dental practice. So what if you have an accident and break your 4 front teeth off? Won’t insurance pay for that? Nope, they protect themselves from paying by having a ridiculously low yearly max towards treatment. You would still end up paying most of it out of pocket.
For years you paid into this insurance, padded their pockets, and then when you need them most they say sorry. What if you had seen a dentist that helped you avoid gum disease, cavities and tooth wear and put all that money that you would have given to insurance companies into a savings account? Yes, you would have plenty saved up for emergencies as well as maybe a nice vacation. Furthermore, you would have healthy teeth and a resulting healthier body since you learned how important it is to avoid gum disease and decay in the first place. You would probably have many less fillings and saved many hours in dental office visits.
What this country needs is a class on prevention of disease, bad habits, and quick fixes. I for one have chosen a different approach to dentistry that I feel has benefited my patients significantly.
If you want to step out of the dental cycle, feel free to contact me with questions or just come in and experience the difference yourself!
So you want Beautiful White Teeth but you dread the idea of having your teeth ground down to little stubs. I feel the same way about my teeth and would most certainly want the most minimally invasive approach. The problem is that these “stick on veneers” like lumineers can look fat, opaque and bulky, not exactly what I call cosmetic dentistry.
Here is an example of a zero preperation veneer case I did 3 weeks ago.
I feel this is a great solution and if done correctly can result in a beautiful smile without cutting teeth!
BEFORE
After Smile
What a great way to improve your smile without loosing tooth structure!
I feel it is critical to address this question that I hear all the time:
“I want to wait on treatment for that tooth. I understand it has a little decay in it, but IT DOES NOT HURT. Let’s watch it and see how it feels next time.”
If I had a quarter for everytime I hear this…Anyhow, here is “my” philosophy on dental decay. Do as you please, but realize what you are doing and what the consequences are!
DECAY: Decay is decay. It starts out small, then continuous to grow until it eventually encompasses the entire tooth. There is no such thing as “a little decay”. Decay is decay. The tooth is rotten and will continue to get worse.
IT DOES NOT HURT: This is a good sign, most of the time. Once a tooth hurts you are looking at extensive and expensive treatment to try to save the tooth! The chances of success are directly proportional to the extend of the decay. Once it hurts you probably need a root canal treatment, rebuilding of the core of the tooth and a crown. Expensive and not very good for you or your tooth.
LETS WATCH IT: Ok, let’s watch it get worse. If you had large, spreading infection on your leg and your doctor told you that it is spreading, would you watch it spread? Probably not. Watching decay get worse without recommending treatment is what I call supervised neglect. Dentists exist to help you have a healthy mouth and consequent healthy body. Our only purpose is to watch out for you, remove decay and bacteria from your mouth and make your smile pretty. Watching is decline and get worse is not part of the job description.
I understand the restrictions of life, including finances. I am human as well. For that reason I am extremely proactive with my approach towards dental decay. It is a thousand times easier and cheaper to treat a small area of decay than wait for it to “hurt”. I aggressively treat to causes of decay such as poor oral hygiene. I do whatever I can in my power to avoid root canals, extractions and dental infections in general. Every patient is treated the same way I treat my family:
1. Treat Dental Infections: Infections affect your whole body health, which comes first. So, cleaning your teeth, removing infections in the bone as well as infected teeth, should come first. Once this is completed, move to number 2.
2. Treat Dental Decay: Decay only affects the tooth until it results in an infection of the bone. So, decay comes second. Treat decay at its earliest onset! This will be better for you, your tooth, and your wallet. Decay will grow into a full blown body infection eventually. I check teeth very thoroughly for incipient or early decay. This can often be treated painlessly without shots! We call it minimally invasive dentistry.
3. Elective/Aesthetic Dentistry: Once the foundation is sound, let’s make your smile beautiful! This is the last step, not the first. Too often I see new patients that had aesthetic dentistry done but the foundation is poor. Kind of like building a house on house on swamp land.
To summarize: Decay does not hurt until it gets pretty large. On x-rays decay can be 50% larger than what we see, which means that we are missing a lot of decay that is present but does not yet show up on x-rays. The dental “pick” instrument has been shown to be 25% accurate, which means that once again, decay needs to be pretty large to respond to the pick. I prefer to treat decay before any of these traditional methods detect the “large” lesions. I use 4.5 times magnification loops and a laser to help me find early decay. This decay can be removed with much greater ease and comfort, avoiding the “pain” from decay! Why would you want to wait until it hurts? That would result in more aggressive, expensive and uncomfortable procedures.
