Expert Answers

Would Invisalign or Lingual braces be able to remedy the state of my teeth?

Q.
Hello Dr. Lerner and Dr. Lemongello! I’m in my mid teenage years and need to have something done to my teeth; but, I do not want metal braces which is what my orthodontist insists on. Because I feel its an awkwardly late time to get braces, I’m hoping you could enlighten me with a different solution? I had my two canine teeth pulled in July (they’ve finally grown back in… smiling with missing teeth was imaginably not fun, especially when you’re not 7 years old). Since, my teeth have become more crooked. I have a minor open bite (compared to google image results its not bad) on the left side of my mouth. I love the idea of Invisalign and/or lingual. Invisalign corrects cross bites, but, does it also correct open bites?? I visited an orthodontist who said lingual would be too complicated because my teeth weren’t straight enough. Am I nuts for thinking that I should just get invisalign, straighten out my teeth, and if my open bite remains get lingual braces? Again, the idea of having metal braces at college interviews is a scary one that I’d very much like to never become a reality!!! Thank you so much for your time and advice, I REALLY appreciate it!
A.
Open bite is one of the more difficult type of cases to treat with Invisalign. Lingual braces can be very challenging for this situation as well. If you feel that Invisalign is your first choice seek out Orthodontic specialists in your area and consult with a few of them to see if Invisalgn is right for you. If after multiple opinions traditional braces are best, than you will have to make a choice to treat your teeth now or face further challenges in the future. Dr. Lemongello
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Dr Lerner & Dr Lemongello

Lerner & Lemongello
5602 PGA Blvd, Suite 201, Palm Beach Gardens, Florida FL 33418
Web: www.lernerlemongello.com Tel: (561) 627 9000

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After a filling replacement I can’t open my mouth fully and am experiencing jaw pain. What is the reason?

Q.
I had a filling replaced 3 weeks ago. 1 week after this was done I can’t open my mouth wide enough to eat food like a sandwich, etc. without having terrible jaw pain.
While the work was being done, I had very bad jaw pain while trying to keep my mouth open, but it stopped once he was done.
I’ve had this jaw pain now for almost 2 weeks. I can eat food as long as I don’t open my mouth wide. It doesn’t hurt to touch my jaw inside or out, I just can’t open very wide to eat without pain.
My dentist thinks that my jaw is sprained and I have inflammation. He gave my Tylenol #3 to take for a few days. I just want it to get better.

Thank you,

A.
It sounds as if you have strained the muscles and injured the cartilage in your jaw joint. Usually over time this will resolve on its own. Just avoid opening too wide, stay on a soft diet, use moist heat on the area (washcloth in hot water on the side of your face in the evening. I would recommend an anti-inflammatory medication like Ibuprofen instead of Tylenol. Dr. Lemongello
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Dr Lerner & Dr Lemongello

Lerner & Lemongello
5602 PGA Blvd, Suite 201, Palm Beach Gardens, Florida FL 33418
Web: www.lernerlemongello.com Tel: (561) 627 9000

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I have been told it wouldn’t be a good idea to get implants as an abscess could occur. Can you advise?

Q.
Hello Drs Lerner and Lemengello. Can you help me – I have four crowns which are front central and in the upper set of teeth. I have had 3 operations as regularly have abscesses that flair up and the gum has been cut open every time. I have been told it wouldn’t be a good idea to have implants because an abscess can occur anytime and the implants will need to be removed. I am very extremely worried and embarrassed about my implants and that they can move and fall out at any time. I am just wondering if you could give some advice? Many thanks 
A.
Hello and thank you for your question. I have to say that it is very difficult to give you advise about your teeth on this occasion. I would consequently recommend that you consult with and implant specialist in your area. Once your teeth are removed and the bone and infection are allowed to heal you should then be a suitable candidate for dental implants. Dr. Lemongello
dr lerner & dr lemongello

Dr Lerner & Dr Lemongello

Lerner & Lemongello
5602 PGA Blvd, Suite 201, Palm Beach Gardens, Florida FL 33418
Web: www.lernerlemongello.com Tel: (561) 627 9000

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Maryland bridge has darkened adjacent teeth. What are my options?

Q.
Dear Drs Lerner and Lemengello. My daughter just had a Maryland bridge placed in last wk. The adjacent teeth have darkened after its placement due to the metal wings . Is there anything that can be done about it?. How difficult and painful is it to take the bridge off should I decide Im not comfortable with the way it looks?. Thank you. Are there any other alternatives to it? Thanks! and i hope you have a good day.
A.
Hello. Thank you for your question. Unfortunately this is a disadvantage of a Maryland bridge. They can be difficult to remove when bonded properly but it can be done. Beware that removal at this stage could damage the teeth. There are alternatives depending on her age. Perhaps implants, or a bridge with ceramic “wings” rather than metal. Discuss these options plus the advantages and disadvantages of each with the dentist. Dr. Lemongello
dr lerner & dr lemongello

Dr Lerner & Dr Lemongello

Lerner & Lemongello
5602 PGA Blvd, Suite 201, Palm Beach Gardens, Florida FL 33418
Web: www.lernerlemongello.com Tel: (561) 627 9000

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What sedation is used during dental implant procedure?

Q.
i am asking about dental implants. the sedation used for this procedure what effect does it take? will i be put to sleep or just out of it?
A.

Depending on your needs you can choose your level of anesthesia.  You can be put to sleep, moderately sedated so you do not recall the experience or mildly sedated where you are awake but very relaxed.  Consult your dentist regarding your needs.  Dr. lemongello

dr lerner & dr lemongello

Dr Lerner & Dr Lemongello

Lerner & Lemongello
5602 PGA Blvd, Suite 201, Palm Beach Gardens, Florida FL 33418
Web: www.lernerlemongello.com Tel: (561) 627 9000

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What can be done for loose denture?

Q.
I have had my denture for around four years now and have had no problems before. Obviously it took time to get used to it but ever since then… Now it feels slightly loose and I am worried that it may fall out and break when I laugh or talk too enthusiastically. Is there anything that can be done to stop this?
A.
Relining a denture will likely help this situation.  Also, the use of adhesives can temporarily give you the confidence of a secure fit.
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Dr George Kirtley

Smiles By George
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What treatment is available for gingivitis?

Q.
what treatment is given by dentists for gingivitis and how long into the diagnosis should the treatment start
A.
Gingivitis is inflammation of the gums and can have many causes. The main treatment is your good oral hygiene. Treatment should start immediately and treatment can vary greatly frim deep cleanings to topical medication, rinses and treatment of systemic factors like Diabetes.
Dr. Lemongello
dr lerner & dr lemongello

Dr Lerner & Dr Lemongello

Lerner & Lemongello
5602 PGA Blvd, Suite 201, Palm Beach Gardens, Florida FL 33418
Web: www.lernerlemongello.com Tel: (561) 627 9000

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What would be a good level of oral hygiene?

Q.
I know there are a lot of dental products on the market but is it not enough to just brush my teeth twice a day. Flossing seems like a lot of effort but I suppose mouthwash would not be too much hastle to add to my routine. Do I need to do more?
A.
Those three things are ususally very adequate.
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Dr George Kirtley

Smiles By George
7465 East 82nd Street, Indianapolis IN 46256
Web: www.smilesbygeorge.com Tel: 317-841-1111

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Can teeth be whitened if have a dental crown?

Q.
I have a crown which I have now had for a few years but I have noticed that the rest of my teeth are getting relatively discoloured. Teeth whitening is something I have heard bits and bobs about but I am not exactly sure what this would involve. Would I be able to get it done if I have a crown?
A.
Yes, you can whiten your natural teeth if a crown is involved. The crown will not change color but the rest of your natural teeth should whiten. The whitening process is a simple use of whitening trays and whitening gel worn over time to whiten teeth.
Dr. Lemongello
dr lerner & dr lemongello

Dr Lerner & Dr Lemongello

Lerner & Lemongello
5602 PGA Blvd, Suite 201, Palm Beach Gardens, Florida FL 33418
Web: www.lernerlemongello.com Tel: (561) 627 9000

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What affect does smoking have on teeth?

Q.
In your opinion would you say smoking about four times every two weeks could have a bad effect on teeth? This is quite minimal and I do clean my teeth morning and night so I hope not???
A.
The teeth would not be my biggest concern.  What smoking does to the inside of the mouth is alter the cell lining of the gum tissue around the teeth and the cheeks.  The danger is oral cancer….not a good thing to risk.  Smoke stains on teeth can be removed through dental cleaning.
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Dr George Kirtley

Smiles By George
7465 East 82nd Street, Indianapolis IN 46256
Web: www.smilesbygeorge.com Tel: 317-841-1111

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