Orthodontist Archives

Will I Need to Wear a Retainer 24/7 If I Had Braces Before?

Posted on April 4, 2023 by AllSmiles.

I just finished orthodontic treatment for the 2^nd time in my life. I am now 47 years old. I knew I would have to wear a retainer, but my dentist told me I had to wear one all day, every day, for a year. Is this really necessary, or can I wear them overnight? Thanks, Kevin

Kevin – Thank you for contacting Dental Loft.

After you finish orthodontic treatment, your teeth can still shift toward their original position. A retainer ensures that your teeth stay in the correct place.

How Long Do You Need to Wear a Retainer?

Invisalign upper and low aligners; for information on Dallas, TX orthodontic treatment

Your orthodontist will explain when to wear a retainer.

You must wear a retainer to keep your teeth straight for the rest of your life. How frequently and long you wear the retainer daily depends on your case. Your dentist has considered your case and determined that you must wear it 24 hours daily for the first year. After the first year, you may need to wear the retainer less.

In some cases, after the first 18 months, the teeth are less inclined to make dramatic shifts, but you still need a retainer. Otherwise, your teeth can gradually shift without you noticing it. Too much shifting can create a need to repeat some orthodontic treatment.

Wearing a retainer, as recommended, protects your investment in your smile and ensures that it stays aligned this time. Today’s aligners, such as Invisalign, are comfortable to wear during the day or overnight.

Speak with your dentist about options for a comfortable retainer.

Dr. Claudia Vargas, a Dallas, Texas dentist, sponsors this post.

Why Is My New Crown Wobbly?

Posted on September 30, 2022 by AllSmiles.

I moved from Los Angeles to Atlanta and switched dentists in the middle of Invisalign treatment. I had a toothache, and my new dentist said I needed a new crown on my lower left first molar. She took my impression quickly. The crown does not fit well, and my tooth hurts when I chew. I don’t think this dentist knows how to adjust my bite, and I am concerned that this episode will prolong my Invisalign treatment. Is there something I can tell her to do to fix this wobbly crown? Thank you. Genesis from Atlanta

Genesis,

Thank you for your question. We understand your concerns and frustration. Dr. Vargas would need to examine your tooth and crown to determine why the crown is wobbly and how to resolve it. Skilled cosmetic dentists understand the risks of rushing impressions of your teeth and ensure your temporary crown fits well before having a lab craft the final one.

A dental crown should feel as comfortable and stable as a natural tooth. You should not notice that you have a crown.

Why Is Your Dental Crown Loose or Wobbly?

If your new dental crown is loose or wobbly, the cause may be a lack of tooth structure or faulty bonding.

Lack of tooth structure

When you have little tooth structure left for a crown or if a dentist aggressively prepares your tooth for the crown, even the strongest cement will not secure it. Aggressively tapering your tooth makes it impossible to securely bond your crown.

Get a second opinion from a dentist with orthodontic and cosmetic dentistry training to minimize the impact of a wobbly crown

A dentist with advanced training understands that minimal preparation is healthy for your tooth and keeps a dental crown secure. If you lack enough tooth structure for a crown to stay in place a cosmetic dentist can use dental composite to build up the tooth structure.

A weak bond

Contamination of the dental cement during the bonding process can weaken the bonding. Or your dentist may have made a mistake in her technique.

Ask your dentist to check your crown. Schedule a second opinion with an advanced cosmetic dentist if she cannot resolve the issue. We recommend a dentist with orthodontic and cosmetic dentistry training if you need to switch dentists.

Dr. Claudia Vargas, a Dallas, Texas dentist, sponsors this post.

How Can I Close a Gap Between My Front Teeth Without Braces?

Posted on July 29, 2022 by AllSmiles.

I want to get rid of a gap between my two front teeth. I’ve had people tell me that it’s not that noticeable or that it’s cute. I prefer an attractive smile, not a cute one. I don’t want braces because my other teeth look okay. What are my options? Thanks – Carson, Elk Grove, CA

Carson,

Thank you for your question.

What Are the Ways to Close a Tooth Gap?

A cosmetic dentist may recommend closing your tooth gap with dental bonding, porcelain veneers, or braces. We will explain the differences.

Dental bonding

Before-and-after photos of cosmetic contouring

Dental bonding can reshape teeth and fill in spaces

If a tooth gap is small, composite bonding is the best way to repair it. Cosmetic dentists apply bonding by hand. It requires advanced training and artistic technique to blend the bonding with your teeth perfectly. A cosmetic dentist will roughen the tooth’s surface on either side of the gap. The next steps include:

Select a dental composite that perfectly matches your tooth shade
Apply and layer the composite to match the translucence of your teeth
Sculpt and harden the composite
Further shape and polish the bonding to a natural gloss

Porcelain veneers

Veneers are thin wafers of porcelain that a dentist bonds to the fronts of your teeth. A cosmetic dentist will prepare your teeth for veneers by lightly shaving them to ensure the veneers fit well and look natural. When a tooth gap is large, porcelain veneers can conceal it. Depending on the gap size, your cosmetic dental treatment may affect the teeth on either side of your center front teeth to harmonize tooth shape and size.

Orthodontic treatment

If you do not like the look and feel of traditional braces, Invisalign invisible braces are an alternative for closing the gap between your teeth. Invisalign uses a series of clear, custom-made BPA-free aligners to straighten your teeth in half the time of traditional braces. Unlike dental bonding or porcelain veneers, you will not need cosmetic dentistry materials on your teeth to correct your gap. If you continue to wear a retainer after Invisalign treatment, your gap will stay closed.

We recommend consulting a cosmetic dentist who provides Invisalign to examine your teeth and discuss your treatment options.

Dallas, Texas, dentist Dr. Claudia Vargas sponsors this post.

Do I Need Wisdom Teeth Removed Before Getting Invisalign?

Posted on May 19, 2022 by AllSmiles.

If you want to comfortably straighten your teeth without people noticing your braces, Invisalign might be the solution you want. But what if you still have your wisdom teeth? Will an oral surgeon need to remove them before you begin orthodontic treatment?

Do You Need Wisdom Teeth Removed Before Getting Invisalign?

You may need wisdom teeth removed before getting Invisalign if your wisdom teeth are impacted and put your oral health at risk. After taking x-rays, your dentist can see the position of your wisdom teeth and whether problems with them will interfere with or interrupt Invisalign treatment. Healthy wisdom teeth that develop and emerge correctly do not require removal.

When Might You Need Wisdom Teeth Removed?

A dentist or orthodontist may recommend wisdom teeth removal before braces in these cases:

Partially erupted – Partially erupted wisdom teeth are challenging to floss around, brush, and keep clean. Bacteria can settle in or around the teeth and cause infection. An infection can affect other teeth or your bone and interrupt Invisalign treatment. Your dentist may recommend wisdom teeth removal to prevent future problems.
Infected – If your wisdom teeth hurt or your gums are swollen around them, it is best to clear the infection before Invisalign treatment. Removing the teeth will keep your mouth healthy and increase the comfort of your orthodontic care.
Developed cysts – Sometimes cysts develop near the roots of wisdom teeth or on your jawbone. If x-rays show cysts from wisdom teeth, your dentist will recommend removing the teeth instead of interrupting Invisalign treatment later for oral surgery.
Crowded teeth – An orthodontist or Invisalign dentist may see that your teeth are already crowded, and erupting wisdom teeth may further complicate crowding.

What Happens If You Don’t Get Wisdom Teeth Removed?

If you do not get your wisdom teeth removed before Invisalign treatment, your Invisalign dentist or orthodontist will monitor your treatment to ensure all your teeth are healthy. If any condition threatens your oral health or tooth alignment, your doctor will explain your options.

Also, your dentist and hygienist will monitor your teeth and gum health during your regular cleanings and exams. Whether you keep your wisdom teeth or not, studies show that teeth drift as we age regardless of whether we have wisdom teeth. Wearing a retainer after Invisalign treatment is vital to keeping your teeth aligned.

Dallas, Texas, dentist and Invisalign Platinum Provider Dr. Rekha Reddy sponsors this post.

Is My Dentist Making Excuses?

Posted on November 19, 2021 by AllSmiles.

It seems that every time I get ready to see an orthodontist for braces that my dentist finds something wrong with my teeth. I am beginning to think that he doesn’t want me to see an orthodontist for braces. I have another delay now because an old root canal tooth is bothering me. I thought I just had some sensitivity in the tooth because my gums are receding, but my dentist did an x-ray and said I needed a repeat root canal. I never heard of a repeat root canal. Is this an actual procedure, or is my dentist making excuses again? – Thank you. Karin from OK

Karin,

A dentist can repeat root canal treatment more than twice. But repeating it is not always the best option for the patients. When a dentist completes the procedure correctly, root canal treatment has a five to fifteen percent failure rate.

Why May a Root Canal Treatment Fail?

Root canal treatment may fail because of branches in the tooth roots that a dentist cannot fully clean and seal. A molar tooth has three canals, one for each tooth root. But some teeth have a fourth canal. Or some of the canals can split off at right angles. Although fourth canals and right angles are rare, they can be the source of root canal failure.

Although a dentist uses tiny, flexible files to clean out the diseased tooth pulp, a file cannot access a side branch at a ring angle. Retreatment can resolve fifty to seventy-five percent of cases.

An Alternative to Repeat Root Canal Treatment

Root canal surgery is an alternative to root canal treatment. A root canal specialist (endodontist) with these steps:

Access the tooth roots by making an opening in the bone
Cutting off the infected root tip
Sealing the end of the tooth with a small filling

Still, some tooth roots are not surgically accessible or risky because they are near a nerve that travels through the jaw and lower lip. In that case, extraction is another option.

Get a Second Opinion

If you think your dentist is unnecessarily delaying your orthodontic treatment, we suggest that you schedule a second opinion. Look for a dentist with advanced training and experience in root canal treatment. And if you have recent x-rays, ask your dentist for them, and take them with you for a second opinion.

Rekha Reddy, DDS, of Dallas, TX, sponsors this post.

Will a tooth root left over from extraction interfere with Invisalign?

Posted on September 30, 2021 by AllSmiles.

My dentist removed four teeth before Invisalign treatment and left one tooth root behind by mistake. Now he says that a premolar tooth root is touching a nerve, and an oral surgeon must remove it. The surgeon explained the risks for numbness that can be brief, last for months, or permanent paralysis. Can I skip this surgery? Thank you. Xander from Kansas

Xander,

Thank you for choosing our office for your question.

Dr. Reddy would need to examine your x-rays to determine which tooth is in question and what you might expect with surgery.

Is it Necessary to Remove Tooth Roots Left After Extraction?

Removing tooth roots left behind after extraction depends on the location of the roots and which teeth are affected. Sometimes tooth roots left after extraction are harmless. But if you are in Invisalign treatment and the tooth is a lower molar, the root can affect the movement of other teeth.

Oral surgeons must protect themselves from lawsuits and explain the most extreme results of surgery. The risk of nerve damage with wisdom teeth is higher than with premolars. Still, if a tooth root is touching a nerve, the roots may affect the mental foramen nerve that travels along the lower lip and chin. You might have some temporary numbness or complete loss of sensation but not paralysis.

Still, an oral surgeon can see the nerve on an x-ray and avoid damaging it during surgery with good technique.

Get a Second Opinion

Invisalign clear aligners straighten your teeth

If you want to feel confident about your decision to accept or decline surgery, schedule a second opinion with another oral surgeon. They will examine your x-rays and explain your options. The surgeon will also explain what you can expect if you do or don’t have surgery to remove the tooth root.

You can also get a second opinion from another Invisalign dentist on how the tooth root will affect your treatment plan.

Rekha Reddy, DDS of Dallas, TX, sponsors this post.

Crooked front teeth, and I don’t want braces

Posted on July 30, 2021 by AllSmiles.

options to correct them, but I prefer not to get braces. Is it easier to extract the teeth and replace them with dental implants? Other than that, what else can a dentist do to straighten my teeth? Thank you. Grayson from VA

Grayson,

Thank you for your question.

When your teeth are crooked, you have two options for correcting them. Please do not consider extractions and dental implants as your options. Either braces or porcelain veneers can straighten your teeth.

Correcting Crooked Front Teeth with Orthodontics

Invisalign clear aligners instead of ceramic or metal braces

Orthodontic treatment is the least invasive way to straighten crooked front teeth. Although you mentioned that you don’t want braces, a dentist or orthodontist can offer you several options, including:

Metal braces – You can get low profile braces to correct your teeth
Ceramic braces – Less noticeable than metal, ceramic braces are more comfortable and will align your teeth
Invisalign – Most people will not notice that you are wearing Invisalign. Clear, plastic aligners fit snugly over your teeth and straighten them.

Porcelain Veneers for Crooked Front Teeth

An advanced cosmetic dentist can use porcelain veneers to correct crooked front teeth. Veneers are thin porcelain shells bonded to the fronts of your teeth. Depending on the condition and position of your teeth, a cosmetic dentist may recommend veneers for teeth nearby the crooked ones.

In general, the porcelain veneers process includes these steps:

Removing a small amount of tooth enamel for the teeth that require veneers
Making a mock-up of your smile with veneers
Letting you try on temporary veneers
Working with a dental ceramist to make your porcelain veneers
Bonding the veneers to the fronts of your teeth

We suggest scheduling a consultation with an advanced cosmetic dentist experienced with porcelain veneers and orthodontic treatment. The dentist will examine your teeth, explain your treatment options, and describe the results you can expect.

Rekha Reddy, DDS of Dallas, TX, sponsors this post.

My teeth edges are zigzagged after Invisalign

Posted on May 30, 2021 by AllSmiles.

I am concerned about how my teeth edges will look when I’m finished with Invisalign. Although it isn’t noticeable with the Invisalign trays on, my teeth edges are zigzagged when I remove them. It is so apparent that it detracts from my smile. I asked my husband and my best friend, and they both agree that the uneven edges look weird. Funny that it didn’t bother me before. My orthodontist says she can fix them, but this seems like cosmetic work to me. How do I know if I can trust her? Thank you. Luz from Kansas

Luz,

Whether or not your orthodontist can smooth your jagged tooth edges depends on the extent of the issue and your dentist’s skill. You can ask her to show you before-and-after pictures of her patients with the same issue.

What is Cosmetic Contouring?

Cosmetic contouring (or enameloplasty) is the process of reshaping your teeth. A cosmetic dentist or orthodontist will limit the reshaping to your tooth enamel. The dentist or specialist will polish your teeth after the procedure.

Cosmetic Dentist vs. Orthodontist for Cosmetic Contouring

The dentist you choose for cosmetic contouring should depend on the extent of your uneven tooth edges.

Minor adjustments – Many orthodontists regularly complete contouring for their patients.
Extensive adjustment – An advanced cosmetic dentist—not your family dentist—is trained in cosmetic procedures and can adjust your tooth edges with skill. Look for a dentist with advanced cosmetic dentistry training or accreditation.

Although cosmetic contouring may seem simple, it is challenging. For example, if your front teeth are of different lengths, your bite can change and cause your teeth to move. However, experienced cosmetic dentists understand how to even tooth edges without compromising your bite.

Dental Bonding with Cosmetic Contouring

Cosmetic contouring on teeth sided and edges

If reshaping your teeth leaves unevenness that can affect your bite, a skilled cosmetic dentist may use dental composite to add length or to finish the sides of teeth. In the photo on this page, a dentist who understands orthodontics and cosmetic dentistry used contouring and dental bonding to finish this patient’s teeth.

Best wishes for finishing your Invisalign treatment and enhancing your smile.

Rekha Reddy, DDS of Dallas, TX, sponsors this post.

Should I go with crowns or Invisalign for overbite?

Posted on March 30, 2021 by AllSmiles.

My dentist offered to refer me to an orthodontist for overbite correction with Invisalign. She says that she cannot do porcelain veneers as I asked because my top teeth almost completely overlap my bottom teeth. She said that the only other option is to do porcelain crowns on my six front teeth instead of veneers. I do not want my teeth ground down for crowns. And the other issue is tetracycline stains on my teeth. I am not sure how the stains would get resolved with just orthodontics. Are there options other than what my dentist knows about? Thank you. Todd from GA

Todd,
You are wise to decline crowns on your front upper teeth. A skilled cosmetic dentist can place veneers and confine the work to the fronts of your teeth to decrease your overbite and conceal tetracycline stains. Your dentist’s options of orthodontic treatment with Invisalign or all crowns imply that she is not comfortable using porcelain veneers for your case. Skilled cosmetic dentists do not decline to do veneers because of overbite.

Will Invisalign Correct Overbite?

Invisalign will correct an overbite. If you prefer orthodontics to straighten your teeth, an experienced Invisalign provider or orthodontist can do it.

Dental Crowns for Six Front Teeth

Getting dental crowns for only six front teeth has some disadvantages.

Grinds away healthy tooth structure – Your dentist will grind away tooth structure to place crowns over them. And if your dentist is trying to correct overbite with crowns, a significant amount is tooth structure will be gone.
Does not complete your smile – Eight to twelve teeth show when you smile, so crowns for only six teeth will still leave teeth on either side dark from tetracycline stains.

Concealing Tetracycline Stains

A skilled cosmetic dentist and his or her ceramist can craft porcelain veneers to conceal tetracycline stains. But this requires advanced training and knowledge of how to manipulate color and translucence without making the veneers look pasty.

Many experienced cosmetic dentists have success in treating tetracycline stains with the Kör Whitening system. It may be possible to improve your tooth color with bleaching and correct your overbite with Invisalign, but stay away from a dentist who wants to grind down your teeth for crowns.

Get a Second Opinion

Invisalign treats overbite, but discuss your options with a cosmetic dentist

We recommend that you schedule a consultation with an expert cosmetic dentist with experience using Invisalign. After examining your teeth, the dentist will discuss your options. Although you may benefit from treating your overbite with Invisalign, a cosmetic dentist will respect your treatment preferences while clearly explaining the results you can expect.

Best wishes on restoring your smile.

Rekha Reddy, DDS of Dallas, TX, sponsors this post.

Should I get a root canal or extraction and snap-on smile?

Posted on March 5, 2021 by AllSmiles.

My right bottom first molar is severely infected and decayed. I need a root canal or extraction. But my second molar on that same side is missing. Will a snap-on smile be less expensive while hiding the missing tooth if I get an extraction? – Thank you. Sachi

Sachi,

Thank you for your inquiry. We will discuss the pros and cons of possible treatment options.

Snap-On Smile After Tooth Extraction?

A Snap-on Smile is the worst option for concealing a missing tooth after extraction. Its purpose is to make your smile look a little better for a special occasion, but it does not look good. And it is not strong enough to function as a tooth replacement for a molar. If you wear a Snap-On Smile daily, it will wear out quickly.

Effects of Extracting a First Molar When the Second Is Missing

Missing tooth cause other teeth to shift and require orthodontic treatment

You mention that you already lost your second molar. If your dentist extracts the first molar, you will have no molars on the right side.

Chewing – How will you chew without molar teeth unless you stick to a soft diet?
Unstable oral appliance – Without a tooth behind your first molar, even a partial denture will not be stable because it needs to clasp to adjacent teeth for stability. It’s like a table with legs only in the middle and one end. The weight of the table will make it fall toward the end that has no support. An oral appliance will add twisting force to the supporting teeth and weaken them.
Tooth loss – Early tooth loss will cause your teeth to shift. And although orthodontic treatment would realign your teeth, you would also need dental implants with so many missing teeth.

Root Canal Treatment to Save a First Molar

Root canal treatment saves your natural tooth, avoids an uncomfortable oral appliance that will not have enough support, and saves the expense of extraction and a dental implant.

Ultimately, a dentist will examine and x-ray your teeth before explaining your treatment options. But if saving your natural tooth is an option, we recommend that you go for it.

Rekha Reddy, DDS, of Dallas, TX, sponsors this post.