dental crowns Archives - Marie Moeckel, DDS

Can a Sedation Dentist Do All My Work at Once?

Posted on July 8, 2022 by writeradmin.

I am ready to take charge of my smile. I need a significant amount of dental work done. According to my dentist, I need three root canal treatments. One of those is on a back tooth and the rest are in front, if that makes a difference. All three will need dental crowns. I also need about six fillings. My dentist told me that if I had teeth whitening done first he would be able to match the dental work to the new color. I really like that idea. The thing that concerns me is that the way he divided the work up it would take dozens of dental appointments. Someone told me that if I saw a sedation dentist I would be able to get a lot more done each appointment. Is there a chance I can get it all done at once?

Susan

Dear Susan,

Sleep dentistry changes lives

Your friend is correct that a sedation dentist can get much more done in each sitting. This will save you time and get you on the road to that great smile you want much more quickly. One thing you will not need a sedation dentist for, however, is the teeth whitening. This is a painless procedure. You’ll want a couple of weeks between the whitening and the remainder of your dental work anyway in order for the color to settle. Even after your whitening is “done” the teeth will continue to whiten just a bit for between one to two weeks.

As for how much the dentist will do, that depends on the dentist. Some do one quadrant in a sitting; some do one arch; some just have a set period of time they think is reasonable for the patient. I would speak to some sedation dentists and see what they recommend. Don’t just go by the one with the shortest time. You’ll want to make sure they do solid and beautiful work as well.

If any of your crowns are being placed on front teeth, you will want a sedation dentist who also does excellent cosmetic work. The best cosmetic dentists have reached accreditation with the American Academy of Cosmetic Dentistry (AACD). If you can find a sedation dentist who is also AACD accredited, you will have hit the jackpot.

This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan.

Dentist Said I Can’t Get My Crowns as White as I Want

Posted on March 5, 2022 by writeradmin.

Years ago, I had a bunch of crowns placed on my teeth. I wanted them whiter than they gave me. Now that it is time to replace them I thought it would be my chance to get them the color I wanted, but my dentist said that is not possible. I want a BL1. He said because there are posts in some of my crowns that it is not possible to do anything whiter than the B1 or the posts will show through. This is darker than I want. Is there any way I can get away with an M4 or a BL4? I do want white teeth but don’t want them fake looking.

Pilar

Dear Pilar,

I am not certain this is the best dentist for you. He does not appear to have the skills you need to get the smile you really want. One reason I say this is your dentist is confusing color with transparency. You don’t make a crown more translucent if you make it whiter. If your posts are not showing through on a B1, they won’t show through on a BL1.

However, let us give him the benefit of the doubt… for now. One thing I think you should do is tell HIM what type of smile you want. Tell him the shape, the color, and any other details you want in your dental crowns. In cosmetic work, it is the patient who gets to dictate what they want. Then, when your crowns come in, make sure he only places them using a temporary try in paste. You should get a good look at them in a variety of lights. If you’re not pleased with them, he should send them back to the lab to make the changes you want.

If he is either unwilling to agree to that or unable to make your smile the way you desire, then it is time to switch dentists. If it comes to that, you will be safest with an AACD accredited dentist. These are the best cosmetic dentists in the country.

This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan.

This Dentist isn’t Serving Her Best Interest

Posted on September 30, 2020 by writeradmin.

I had a dental crown done on a tooth that was fractured. They never told me when they treated the tooth that it may end up needing a root canal treatment or I would have pulled it. The crown never felt right and I complained multiple times that I couldn’t chew on the side of my mouth where the crown had been placed. They ignored that by telling me that it is normal for a tooth to have sensitivity after a crown and to give it time. I did. But it still kept hurting. Then I had another tooth develop a problem and they needed to place another crown. I asked them to deal with the first crown before placing the second but they totally ignored me and I left still in pain with the first crown. I insisted on coming back a week later and they now tell me that the tooth has a periapical abscess and I need a root canal treatment. Can’t I just extract it at this point?

Phyllis

Dear Phyllis,

I am sorry you are facing this. It doesn’t sound to me like your current dentist has your best interest in mind. You are complaining about pain with a dental crown. They blow you off saying it was normal. The type of pain you described is not normal. In fact, when a crown is done properly you don’t feel it at all because it blends in with the remainder of your bite. Can there be sensitivity with a new crown? Yes, but that is sensitivity to temperature, not chewing.

Not only do they not listen carefully to your complaint, but they are more interested in picking up a fee for a second crown than they are in fixing the first. The best dentists want their patients out of pain and completely happy with their treatment.

There are two reasons a crown would hurt when chewing. One is that the crown is seated too high and therefore you are biting down on that first before occluding with your other teeth. The second is that there is a lingering infection there. As you have an abscess that may have been the problem.

You are asking why get the root canal treatment instead of extracting it? In this case, they are actually right. With the abscess you have, all tissue inside the tooth is dead, which means they could drill in there with no pain to you. If you extracted it, on the other hand, you will have a two-fold problem.

An extraction will be much more painful, especially because that type of abscess will make it much harder to get the surrounding area numb where they will be pulling the tooth.

In addition to that, you will have the additional expense of needing to replace the tooth. If you don’t, the other teeth will shift or tip into the open space. This can lead to painful TMJ Disorder later on, which you want to avoid if at all possible.

This blog is brought to you by La Jolla Dentist Dr. Stephen Doan.

Her Dentist Destroyed Her Teeth

Posted on December 30, 2019 by writeradmin.

I need some advice. I’ve been crying for over an hour and I need to stop and figure out my next step. I had dental bonding for two chipped teeth on my top arch. They’ve gotten old and I thought I could just replace them. Unfortunately, the dentist who did the case originally has retired. I went to his replacement but he said the dental bonding can’t be redone and I will need to have crowns placed on those teeth. He also said the only way to get the teeth uniform would be to crown the front four teeth. Now I have four dental crowns on healthy teeth but the two front teeth look a gray color compared to the rest of them. Now my smile looks worse than if I’d left the old bonding on. What do you recommend?

Beverly

Dear Beverly,

When a true cosmetic dentist does the work, you’re not ashamed to smile.

This is an absolute disaster, through zero fault of your own. First, your dentist either doesn’t understand dental bonding or outright lied to you. Neither one speaks to his credit as a cosmetic dentist. Your dental bonding could have been re-done. Now, instead of just mild work on your teeth, your healthy teeth have been ground down to nubs. Not only did he do that to the teeth which needed the bonding replaced, but to their adjacent teeth as well simply because he wasn’t skilled enough to color match.

Unfortunately, the only way to fix this is to have the two front teeth which are too gray replaced. My hope is the dentist cares enough about his work to redo the crowns which don’t match the rest of your teeth. And, he should do it free of charge. However, if he does agree to re-do it, make sure he uses a temporary try-in paste so you can see the crowns compared to the adjacent teeth before he bonds them in permanently.

It’s possible because he isn’t a serious cosmetic dentist he doesn’t stock a try-in paste. If that is the case, clear glycerin or clear water-soluble gel should be fine. It must be clear or you won’t get a true reading on the color.

If he won’t cooperate, your only other option is to get them replaced by another dentist. If it comes to that, please make certain it’s an AACD accredited dentist. These dentists have done extensive post-doctoral cosmetic training and have the artistry to create a beautiful smile for you, whether it is porcelain veneers or porcelain crowns.

This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan.

Repairing Teeth after Years with Bulemia

Posted on October 31, 2019 by writeradmin.

I struggled with bulimia for years. I’m finally recovered and haven’t had a single relapse in two years. The problem I’m facing now is the state of my teeth. They’re paper thin from constant damage. They’ve got spaces between them. To make matter worse, my bite seems to be completely off on the left side which is pushing my jaw forward when I chew. I don’t know if this is connected but every time I eat and when I wake up in the morning I have a massive headache. I’m thinking I need a cosmetic dentist to fix this because my family dentist doesn’t seem to think much can be done. But, I want a smile I’m proud of now that I’ve worked so hard to be healthy.

Maggie

Dear Maggie,

The key ingredient to a gorgeous smile makeover is the right cosmetic dentist

First, I’m going to say how fantastic it is you were able to overcome bulimia. I know several friends who still struggle so what you’ve done is incredible and you should be proud of yourself. Second, it is great that you are looking for a cosmetic dentist because that is the type of dentist you will need to take care of this.

Because of the damage to your teeth, you will likely need almost every tooth crowned. It will require special bonding technology. You will need an expert cosmetic dentist as a result. Not only will they have the technical skill necessary to do the job properly, but they also have the artistry to create a stunning smile you’ll be proud of for many years to come.

Dealing with Your Bite

I do think the headache issues you’ve been facing are TMJ related. You’ll want to make sure whichever cosmetic dentist you choose is also trained in treating TMJ disorder. He or she will do a full-mouth reconstruction. The treatment for that will also be crowning every tooth. So, nothing different there.

I’d start by looking for a dentist who has been accredited with the American Academy of Cosmetic Dentistry. Fortunately, those who’ve reached accreditation usually also invested a significant about of training in TMJ as well, so you can knock out two birds with one stone.

Best of luck to you.
This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan.

Should my new smile cause so much pain?

Posted on August 8, 2017 by smiles4u.

I know the old saying goes, “No pain, no gain.” So, when I decided on some cosmetic dental work, I figured that a small amount of short-term pain would be worth the benefits of new, beautiful smile. Boy, was I wrong!

I went to Mexico to have lower crowns place as well as veneers on the front upper teeth. It was twelve crowns total and six veneers. While they look great, the problem is I am in so much pain. I’m not talking sore gums or tenderness, but rather extreme pain that radiates through my entire jaw. Plus, there’s one particular tooth that hurts so bad I can’t even bite down or chew soft foods like bread. My dentist chalked it up to having so much work done at one time and basically said to take ibuprofen for a few weeks. As for the tooth, he said it may have high contact or need a root canal. I’ve been taking 800mg of ibuprofen around the clock, but I can’t keep doing it forever. Is this pain normal and if so, how much longer should it last? — Mark

Mark,

Sorry to hear you’re dealing with so much pain. It’s definitely not normal! Most people can expect a day or two of tenderness and soreness after crowns and veneers, but if you’re having the pain you describe, there’s definitely something wrong.

Taking so much ibuprofen (3200 to 4000 mg per day) for an extended period of time can be damaging to your liver or your kidneys. If you check the maximum recommended dose, you’ll see that you are greatly exceeding it.

Here’s what you need to do first – find an American dentist and have them examine you immediately. Hopefully they can figure out what went wrong so you can get off of the ibuprofen. And if you do need that root canal, have it done here – not in Mexico – no matter how much money it could save you.

While most dentists in the U.S. are competent general dentists, only about half have the skills and capability to do a beautiful smile makeover. In Mexico, you are putting yourself at risk even with basic general dental procedures, and if you’re lucky, you may find a small handful of dentists who can do good (not great) cosmetic procedures. Here’s to making some gains – without any more pain!

This blog is sponsored by AACD Accredited dentist, Dr. Stephen Doan. Find out more about the services he provides by visiting his La Jolla cosmetic dental website.

I’m being sued for payment when it’s the dentist’s botched work!

Posted on June 10, 2017 by smiles4u.

I was a thumb-sucker as a child and it messed up one of my front teeth to the point it was severely crooked. It didn’t bother me so much growing up, but once I became an adult, it really started to affect my self-confidence. So I decided to have it fixed. I went to my dentist and he suggested a crown.

A few weeks after getting the crown, I started noticing a lot of sensitivity to hot and cold. When I called about it, they said not to worry because that was normal for the first few months. Several more weeks later, it was hurting so bad one day that I ended up going to the ER! From there, my face swelled up and I missed work for a week because I was in so much pain. I ended up getting a second opinion and I was told the tooth was infected and a root canal and new crown would be the only option to fix it. I couldn’t believe it. Evidently the crown was placed improperly and there was an “open margin.” I saw the x-ray and it is blatantly obvious that it was done wrong and the margin is huge.

To make matters worse, I called my original dentist and explained what was going on and asked about getting a refund since the crown was obviously placed wrong. I was told by the office staff that they had no liability in the situation once the crown was placed. I continued to ask why I should have to pay for a crown that failed due to his error and they wouldn’t budge. Having only paid for half of the procedure, I told her they would not get any more money from me. Today I got a notice saying they are taking me to court, so I filed a counter suit. My dentist’s lawyer basically told me if I drop the counter suit, they will relieve me of the debt I still owe. I refuse to do it because I believe my dentist is in the wrong.

How can he not stand behind his work? I missed work, endured days of horrible pain and have had at least ten appointments between the dentist, ER and doctor. AND I had to pay for a root canal and new crown! Am I out of line to expect a refund? — Frank

Frank,
So sorry you have been through such an ordeal! Based on your information, it would be safe to say that your old dentist is liable because he violated the standard of care. I sounds like he neglected to check the margins for a good fit after seating the crown. An x-ray isn’t typically done, but all it takes is running the explorer around the margins to check for any opening. It’s good that you have the x-ray from your new dentist for documentation.

Unfortunately, in a situation like this, involving lawyers and even going to trial ends up costing more than the money you want back in a refund. It’s just not practical or cost-effective. However, there are some things you can do to pressure your dentist into refunding your money:

Threaten to go to the dental board with your complaint. It’s not like a malpractice suit, but most dentists want to avoid that.
Have your new dentist call and talk “dentist to dentist” and verify that there was a problem with the crown. You will need the expert opinion of a dentist – even better if it’s a cosmetic dentist — to back up any claim of negligence if you do go to trial.
Have a lawyer write a threatening letter. Rather than pay for an entire malpractice case, just having a letter from an attorney can get the dentist to take your complaint more seriously.

Good luck! Hopefully you can put all of this behind you very soon.

This blog is sponsored by AACD Accredited dentist, Dr. Stephen Doan. Find out more about the services he provides by visiting his La Jolla cosmetic dental website.

My TMJ pain has worsened after getting a crown

Posted on July 29, 2016 by Paula Sprunger.

TMJ pain has been a problem I have struggled with for a few years now. It is mostly in the mornings when soreness is noticeable. I know. . A night guard could help minimize the problem. I have yet to take my dentists advice to have one made. The immediate problem I’m having is the crown I had placed a few weeks ago. From the very start, something felt “off.” I went back to my dentist, and he adjusted the crown a bit, but it still feels as though it is hitting the opposing tooth wrong. My dentist says that further adjustments really aren’t possible. He says I will get accustomed to this new feel; but I’m in more pain now than ever in terms of my TMJ. Could it be because of this issue with my new crown?

Thanks,

Molly

Dear Molly,

It is absolutely necessary for teeth to come together properly. Otherwise, the muscles and joints have to work harder. This could exacerbate TMJ, or even be the underlying cause for this condition. In order for a dentist to achieve the right fit, he or she must be very familiar with the complex nature of the anatomy of the jaw, not just of teeth.

Unfortunately, relatively few dentists realize the importance of a perfected bite, and so there aren’t many who attain the additional training needed to get the job done right. Often, patients go back to their dentist for ongoing adjustments in order to address the complaint. The repeated adjustments to existing crowns can result in such extensive reduction that the crowned tooth no longer meets the opposing tooth at all when you chew!

Ultimately, you really need a night guard. Until your bruxism, or tooth-grinding, is under control, your TMJ will get worse. That being said, you will not get used to a bad crown; it needs to be adjusted. The only way that your mouth will adapt to this crown will be to move differently so teeth come together comfortably. This will stress your joints and muscles. Go back to your dentist until the issue is resolved. If you are not getting the results you need, we suggest that you consult with a dentist who has obtained specific training in the treatment of TMJ disorder and occlusion issues. Dr. Doan is a La Jolla TMJ dentist who has trained at the Dawson Academy as well as under the tutelage of Dr. Mark Piper.

This blog is sponsored Dr. Stephen Doan.

Dealing with Your Bite

Introducing Dr. Marie Moeckel