Q.
Hi Dr. Kirtley, my 4/5 and 12/13 teeth have a strange alignment where they are pointed in different directions which puts them sitting almost next to each other on the roof of my mouth. It doesn’t look too weird or anything but it makes cleaning between the teeth difficult and an unnoticed cavity between 4 and 5 broke my #4 tooth earlier this year. I had a
root canal done on the tooth and a filling put in which was supposed to be temporary. Now I have a cavity on the opposite side developing. My dentist recommended pulling one of the two teeth and that I talk to an orthodontist about braces. I would like to avoid braces if possible, so does it seem logical to pull the inward teeth and not having to deal with braces, but have two teeth with fillings – or to pull the damaged outward teeth and use braces to slide the inward teeth into their correct places. Additionally, if I absolutely needed braces are lingual braces an option for this situation? I know it is difficult to diagnose without xrays and what not but I would just like a second opinion. Thanks so much for your time.
A.
You should always opt for braces to correct your alignment. Bad alignment can create all sorts of problems….decay, periodontal disease, tooth loss…
Q.
Hello Doctor,
I have recently had a dental implant placed at the side of my mouth and am slightly worried about its condition. I have an appointment with my dentist in a weeks time but would really appreciate any information I could receive now. Basically there has been some mild bleeding from the site and it does feel tender to touch (which i dont continually do, just when i brush it with my tongue) and I wonder does this, in your experience, sound like a rejected implant? If it is, would I be able to try again at some point or would that be too dangerous?
Thank you very much for your time
A.
Hello there and thank you for your question. It is likely not rejecting…success rate with implants is quite high. Just see the dentist who placed it and have it evaluated. If it is rejecting it will become loose. Hope this helps and good luck with your implants
Q.
I have extremely weak teeth, despite constant flossing, mouthwashes, various dental treatments my teeth will not stop decaying! I don’t drink any drinks with sugar on (just water and unsugared tea) and rarely drink alcohol. I have started avoiding fruit, although do eat it after a meal sometimes. I have had years of braces etc and have had to have 4 root canals. I am starting to get quite obsessed with teeth and terrified about what is going to happen when I get older or get pregnant as i am only 24 and they are already appalling! Is there anything I am missing? Everytime I go to the dentist they think I am lying about flossing etc (although I always get 8/8 for ‘appearance’) because the decay won’t stop. Please help – I am quite distraught!
A.
It is difficult to determine why you continue to get decay. You mentioned you had years of braces. The decay could be related to “scaring” of the teeth and decalcification where the braces were. If this is the case the enamel is compromised in these areas. Eventually, even with good care, these areas can decay. Continue to have these areas repaired for now. Once they are all repaired you may not see decay re-appear as long as you continue with good dietary habits. No soda, not sticky chewy candy or cookies, no chips. Use fluoride or MI paste, brush and floss. Dr. Lemongello
Q.
Hi there
is it a better idea to have lumineers over veneers if your teeth only have a little staining? That is my only problem and teeth whitening hasn’t work, i don’t have crooked teeth or cracks or anything like that but i just hate the colour of my teeth. I’ve heard that lumineers are thinner than veneers and don;t require as much tooth shaving. is this true and in your opinion are they the best option for me?
thank you
A.
What is best for your situation is “prepless” veneers. “Prepless or minimal prep veneers” are veneers that can be placed over teeth with minimal or no shaving of the tooth. This type of veneer is the best type for you. Lumineers is a brand of prepless veneers. However, there are more natural porcelain materials that can be used with an outcome that is more beautiful and lifelike. Visit our website www.lernerlemongello.com for examples of minimal or no prep veneers. They are generally the cases where the teeth look pretty good before but much more natural and beautiful after. Dr. Lemongello
Q.
hello doctors
what would you recommend for a person with both big teeth and big gums. When i smile there is just too much gum showing and my lip just shows everything off and my smile is just very ugly because of it. I would like something done, but i am unsure what i should be asking for. What would you recommend doctors?
thank you very much for your time and help
A.
A gummy smile can be caused by a number of things. There are a number of treatments available depending on your situation and what you want to achieve. You may need braces, gum re-contouring, veneers or a combination of three. I recommend you consult with and orthodontist as well as a dentist who specializes in cosmetic dentistry. You may need multiple opinions. Visit our website at www.lernerlemongello.com to see examples of cases we treated to improve a gummy smile. Dr. Lemongello
Q.
Will a dentist recommend veneers over lumineers due to the cost or vice versa or should they? I want to be sure I get what is best for me and most cost efficient as my insurance will not cover any of it. Thank you for your time and any help and advice you can give doctors
A.
A dentist should recommend to you what will give you the best result for your situation regardless of the cost. If you want the best for yourself you should ask for it. If cost is a factor than you will be faced with the choice of what is best for you based on what you can afford. I would find a dentist who doesn’t treat with only one type of veneer such as Lumineers. Lumineers are not the best veneers available but can be more economical. Visit our website at www.lernerlemongello.com to see examples of traditional porcelain veneers. Lumineers will not give you the same result. Dr. Lemongello
Q.
I was at the dentist on October 3, 2011 for a filling. During the appointment my dentist was pressing hard down on my teeth, I assume to fit the metal bands around the tooth. I felt quite a bit of pressure at the time but no pain as things were frozen. After the freezing wore off, i noticed my jaw was “achy” . The following week my jaw was still feeling achy and sore but I just thought it would resolve itself. On Sunday October 9th, while eating dinner my jaw felt weird and wouldn’t open properly. The next day my jaw locked on the left side of my face. I went to my chiropractor who gently released the lock and told me to ice the area. I don’t have a lot of acute pain, rather my facial muscles below my cheek bones are very, very achy. I cannot protrude my lower jaw out and it does deviate to the left when I open. At first I was not able to move my jaw side to side but I am on day 9 now and starting to feel a very tiny bit of movement. Can you help me understand what is going on with my jaw? Is it sprained and what is the long term time frame for wellness as the jaw ache is wearing on me and giving me compounding headaches? Btw, I am not a tooth grinder or clencher. thank you!
A.
It sounds as if you do have a muscle sprain. At this point use medication like Advil to help relieve inflammation in the muscle. Instead of ice, use warm heat to help the muscle heal and stretch. Watch your diet and try not to overuse your jaw or open wide. Over time the muscle will heal. Be aware you may be prone to sprain in the future. Dr. Lemongello
Q.
hello doctors,
I wondered if you answer a question about the general health of my teeth. I use an electric toothbrush, floss and use mouthwash daily, but i am becoming increasingly worried about the condition of my two front teeth. I have notice for a while that the top of the teeth are slightly rough and if you look very closely you can notice lines running across them, near the top of the tooth. However, i have recently noticed on one of them that there is a ‘dint’ or patch of tooth that is missing, more so that before. There is no sensitivity and the patch isn’t deep, but i am just very worried about what this might mean. Could you tell me what you think it is and if i should undergo any treatment to protect the tooth if it needs it?
thank you very much for your time
A.
It’s difficult to advise you on what may be occuring. This could be wear from abrasive tooth paste and over brushing. It could be some form of erosion from acid in your diet such as Coke or citrus juice. Or may be related to stress in your bite or other habit. I would consult with a dentist to see what treatment if any is needed. Dr. Lemongello
Q.
I really want to have straight teeth for once and have been looking at the different options available. I am however finding it difficult to choose between invisalign treatment and veneers and just wondered what your opinion on them for teeth straightening was. I would like my two crossed front teeth straightened as soon as possible, but i also want them to be healthy and everything, just need to extra advice i guess
Thank you for your help doctors
A.
Invisalign and porcelain veneers are very different treatments. The advantage of Invisalign is that you are preserving your natural teeth. If you are happy with the shape and color of your teeth, than moving them into the proper position is the most conservative, least invasive treatment. The disadvantage is time and the need to wear a retainer or the teeth will move back. If you are unhappy with the shape and color than veneering them is a good option. The advantages of veneers is treatment can usually be accomplished in a few weeks and improve the color and shape of the teeth. The disadvantage is that veneers requires some permanent reshaping of the teeth. Discuss with your dentist which option is best for you. Dr. Lemongello
Q.
5 Months ago I had my Braces removed. The result was very good. I was then fitted with a clear set of Essex retainers. ( although I wanted a permanent retainer).
After six or so weeks my teeth have moved into a position that is causing me pain in my lower teeth and a particular tooth is now crooked and sitting against the other tooth. This same tooth’s gum has began to recede. My retainer then broke within 4 months of use.
I have been back to the Ortho and he then took a mould of my already crooked teeth to fit a Hawley retainer.
Should there generally be some duty of care once teeth have moved to correct back to a satisfactory level of straightness?
The deterioration of my teeth is as a result of the retainer not being satisfactory.
Any input is appreciated.
A.
There is always some amount of settling and relapse at the completeion of Orthodontic treatment. It’s not clear if a permanent retainer would have prevented some of the relapse. This result may be the best that can be achieved even if a permanet retainer and Hawley were placed. If you are not satisfied with what has occured discuss this candadly with the dentist with the goal of finding a solution that satisfies you understanding the limitations that may exist. Dr. Lemongello
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