Hope Restorative & Cosmetic Dentistry

Category: Best Dentist in Tulsa

What’s the Best Treatment for a Cracked Tooth?

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Woman holding the side of her face and portraying pain from a cracked toothWhat’s the best treatment for a cracked tooth? I was planning to start Invisalign next month, but my hygienist noticed two cracks in my upper first molar, so Invisalign has to wait.

After my appointment with an endodontist who recommended a crown, my dentist used bonding on the tooth as a more conservative approach. Now the tooth is sensitive and chewing on it hurts. I want this resolved so I can get Invisalign. Should I ask for a crown or an onlay? Thank you. Sonja from Douglasville, GA

Sonja,

Thank you for your question. Dr. Tostado would need to examine and ex-ray your tooth to determine its condition. You may still feel discomfort and sensitivity in the tooth if it is not fully repaired. An accurate diagnosis depends on these factors:

  • The crack’s location
  • The crack’s length and depth
  • Whether the damage is horizontal or vertical

Will a Dentist Recommend a Crown or an Onlay?

A dentist’s recommendation for a crown or an onlay depends on the tooth’s condition and position. Also, not all dentists use onlays. Although an onlay or a crown can restore a tooth, we explain the differences.

Onlay

An onlay is a custom-made restoration that replaces only the damaged portion of your tooth. An onlay covers one or more cusps or peaks of a tooth. An onlay can be gold, ceramic, or porcelain. A porcelain onlay is not strong enough to restore a cracked tooth. A dentist may recommend a gold onlay or a dental crown.

Dental crown

A dental crown is a dental restoration that covers the entire tooth from the gumline up. An extensive crack may require a dental crown. Or, if you already had a crown on a tooth, you could only receive another crown.

Repeated attempts to restore the tooth will further weaken it. Speak with your dentist again to ask about the condition of your tooth and treatment recommendations. Afterward, you may get a second opinion from an advanced cosmetic dentist to compare your options.

Dr. Jerome Cha, a Tulsa, Oklahoma, cosmetic dentist, sponsors this post. Read about what Dr. Cha does to provide his patients with some of the best dental care in Tulsa.

 

 

Will the Pain from a Broken Second Molar Go Away?

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Brunette pain portraying pain from a broken second molar and wondering how to find the best dentist to save the toothThe right side of my face is swollen and tight because I broke my second molar tooth two weeks ago. The tooth was weak from a deep silver filling over 15 years old. Last weekend, I heard and felt the tooth crack while eating dinner. Eventually, it broke off in my mouth. I saved the broken piece after I mistakenly bit it. The tooth left a foul taste in my mouth, but I rinsed my mouth with Listerine. I have not thought about replacing the tooth, but it is sore. Will the pain eventually go away? Thank you, Milton, from Columbus, OH

Milton,

Thank you for your question. Dr. Cha would need to examine and x-ray your tooth to evaluate its condition. Still, we will generally explain what to expect with a broken tooth.

Will the Pain from a Broken Tooth Go Away?

Infection often causes pain in a broken tooth, which will not go away until the pulp (the living tissue and nerves) inside the tooth die. Without intervention, the infection causing tightness and facial swelling will continue to spread. A dentist may be able to preserve your tooth with root canal treatment to prevent further damage.

How Will a Dentist Treat Your Broken Tooth?

Treatment for a broken tooth depends on the location and extent of the damage. If the tooth is savable, a dentist or endodontist (root canal specialist) will perform root canal therapy. You can expect these steps:

  • Prescribe an antibiotic to ensure the infection does not return
  • Remove the infection with root canal treatment and fill the tooth with a dental filler material
  • Prepare the tooth for a crown, which may require building up the tooth with dental composite to ensure a crown will stay in place

If the tooth is not savable, a dentist will recommend removal and a dental implant.

If you have dental anxiety, talk to a dentist about it and ask about your options for sedation to help you relax. If you do not have a current dentist, look best results, look for one with advanced root canal therapy and cosmetic dentistry training.

Tulsa, Oklahoma, cosmetic dentist Dr. Jerome Cha sponsors this post.

Is It Too Late to Switch Dentists?

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I got a new Maryland Bridge in early May and have had it replaced three times. I need more dental work but am afraid that this family dentist will be unable to correct the bridge or complete the other work I need. Is it too late to switch dentists in the middle of my bridge work? – Thank you. Frank P. from Dix Hills, NY

Frank,

We understand your concerns about your dentist’s inability to give you a stable dental bridge. Problems can occur when a dentist lacks training and experience in cosmetic dentistry. It is wise to switch dentists.

What Is a Maryland Bridge?

Model of a Maryland dental bridge

Dental Maryland bridge

A Maryland bridge is a tooth replacement option with replacement teeth suspended between two wing-shaped anchors. A dentist bonds the anchors to the backs of each tooth on either side of the missing one(s).

What Causes a Maryland Bridge to Fail?

When a Maryland bridge fails, possible causes include:

  • Flawed design – Inadequate tooth impressions or faulty construction can cause the bridge to fail. Sometimes, the dental lab can re-etch the metal and correct the flaws.
  • Poor bonding techniques – If your dentist’s bonding techniques are flawed, the wing-shaped anchors will not adhere to the backs of your teeth.

When you tell your dentist you want to switch to another dentist, they have an ethical obligation to send your dental history and records to your new dentist. Your new dentist may decide to take x-rays to ensure your anchor teeth are stable. If your new dentist recommends treatment other than a dental bridge, such as dental implants, please consider the reasons and decide what is best for your long-term oral health.

How Can You Find a New Dentist?

Look for a dentist with post-graduate training in cosmetic dentistry. A combination of experience and training will help the dentist determine why your Maryland bridge failed repeatedly and whether the bridge is the ideal solution for your missing teeth. Schedule a consultation with at least two dentists before you commit to becoming a patient.

 

Dr. Jerome Cha, a Tulsa, Oklahoma, cosmetic dentist, sponsors this post.

My Tooth Is Sensitive to Cold

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Man holding his face portraying tooth sensitivity to coldMy upper left molar tooth is sensitive to cold and air. The tooth has a large filling. Two days ago, I went to the dentist, and she used a tool to blow air on the tooth in different areas. She asked if the air made the tooth hurt or sensitive (it did). Afterward, my dentist put a desensitizing agent on the tooth and said the sensitivity should decrease. Is that it? Did I get an accurate diagnosis in five minutes, or was my dentist brushing me off? What has been causing the sensitivity? Dylan from NH

 

Dylan,

Sometimes sensitivity in a tooth is easy to diagnose. At other times, it is more complicated. But your dentist performed a standard test to determine the source of discomfort. Dr. Cha would need to examine your tooth and filling for an accurate diagnosis.

Air Test for Tooth Sensitivity

A dentist might blow air on a tooth to determine if any portion of it is unprotected and sensitive. A desensitizing bonding agent will coat and protect the tooth.

What Causes a Tooth to Be Sensitive to Cold?

The cause of cold sensitivity in a tooth depends on the pain you are feeling and the tooth’s condition. In many cases, a tooth might be sensitive to cold and heat.

Type of pain

  1. Pain that goes away quickly – The tooth pulp (the living tissue inside the tooth) or nerves are irritated, but they could heal.
  2. Lingering pain – When an air test provokes lingering pain, tooth pulp or nerve irritation will not heal by itself. Your dentist can perform a root canal treatment to remove the pulp and nerves.
  3. Established filling – Any space between filling edges and your tooth allows bacteria to leak in. Tooth decay beneath the filling will cause pain and sensitivity to cold.

Tooth condition

  1. New filling – Sensitivity immediately after getting a new silver or composite filling is normal. But if sensitivity begins later, it usually means that bacteria from the previously decayed tooth infected the pulp (the living tissue inside the tooth). You may need root canal treatment to resolve it.
  2. Wisdom tooth extraction – Although it rarely occurs, sometimes during wisdom tooth extraction, the adjacent tooth’s root is exposed and becomes sensitive. Toothpaste for sensitive teeth often resolves the issue. According to the American Dental Association, it takes several applications before desensitizing toothpaste relieves your symptoms. If not, your dentist can apply a desensitizing agent to the tooth.
  3. Tooth decay – Decay or infection can irritate tooth pulp and make your teeth sensitive to cold or heat.
  4. Fracture – A fracture can irritate tooth nerves and increase sensitivity to cold. If you leave the tooth untreated, pulp damage can become irreversible and require root canal treatment and a dental crown.
  5. Gum recession – If your gums are receding—or pulling away from your teeth—exposed tooth roots can be sensitive to cold or heat. Desensitizing toothpaste may help, or your dentist may recommend a gum grafting procedure to cover the exposed roots and reduce sensitivity.
  6. Worn tooth enamel – When tooth enamel wears down, dentin (the layer beneath the enamel) is exposed. Without protection from tooth enamel, heat and cold can enter the dentin and stimulate tooth nerves. Dentin contains small tubes that lead to tooth nerves.

 

Dr. Jerome Cha, a Tulsa, Oklahoma cosmetic dentist, sponsors this post. Read what Dr. Cha does to provide patients with some of the best dental care in Tulsa.

Is a Peroxide Mouthwash Protection Against COVID?

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Young woman portraying uncertainty about peroxide mouthwash for COVID if you have porcelain veneersI read online that hydrogen peroxide can disinfect against coronavirus. So, I looked further and found a do-it-yourself mouth rinse recipe that includes hydrogen peroxide. My only concern about rinsing my mouth with it is that I have six porcelain veneers. I know alcohol-based mouthwash can loosen the bonding on veneers, but what about peroxide? Thank you. Cassie from KY

Cassie,

Thank you for your question.

You are right. Alcohol-based mouthwash can weaken the bonding behind porcelain veneers and cause stains. But weakening porcelain veneers’ bonding is not the only concern when choosing a mouthwash.

A Rutger’s School of Dental Medicine study published results on mouthwash and its effect on coronavirus. Additionally, the Environmental Protection Agency lists hydrogen peroxide as a disinfectant for COVID-19.

Still, if you have porcelain veneers, you must be cautious about which toothpaste and mouthwash you use. But even if you do not have porcelain veneers, regularly using hydrogen peroxide as a mouthwash can cause other problems.

Is a  Peroxide Mouthwash Protection Against COVID?

According to the Rutger’s study on mouthwash, peroxide can provide some protection against COVID. But hydrogen peroxide mouthwash goes beyond killing harmful bacterial. The effects include:

  • It kills many harmful microorganisms
  • Long-term use kills healthy bacteria, too
  • Long-term use causes yeast (candida albicans) to thrive

Regular use of peroxide as a mouthwash can result in an oral yeast infection. Your oral tissue will turn white, peel, turn red, and be painful.

How Is Oral Yeast Infection Treated?

If you get an oral yeast infection, your dentist will recommend taking oral antifungal tablets or lozenges or using a liquid for seven to fourteen days to get rid of the infection. You must complete treatment to prevent the infection from recurring.

Speak with your dentist before choosing a mouthwash.

Dr. Jerome Cha, a Tulsa, OK accredited cosmetic dentist, sponsors this post. Read about what Dr. Cha does to provide some of the best dental care in Tulsa.

My Dentist Nicked My Maryland Bridge and Left a Silver Line Showing

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My Maryland bridge is 15 years old, but until recently, it was intact. I agreed with my dentist to replace two crowns on the top left side of my mouth. I grind my teeth, so the crowns were worn and looked rugged. I got new crowns three weeks ago, and when I got home, I noticed a silver line showing through the bridge tooth. My dentist covered the silver line with composite and said that I should probably get the bridge replaced. He did agree that he might have nicked the bridge tooth while adjusting my bite, but he also said that my teeth grinding more likely caused the streak. How could teeth grinding cause a line? Today, I see the silver line again on the bridge tooth. So, I probably will get it replaced. What’s the point of having two new crowns with another damaged tooth flashing a silver streak? I’m wondering if my dentist should pay for this, though. Should I ask? Thank you. Wesley from Andover, MD

 

Maryland Bridge replacing two lower teeth - info from Tulsa, OK dentist Jerome Cha, DDS

Dental Maryland Bridge

For our readers: A Maryland bridge is a type of tooth replacement. Replacement teeth are in the center, and wings, or extensions, on each end of the bridge attach to the back of adjacent teeth. See the photo on this page.

Wesley,

Thank you for choosing our office for your question.

Dr. Cha would need to examine your Maryland bridge to see its condition. But you realize that your bridge tooth did not have a silver line before your dentist replaced your crowns and adjusted your bite. So yes, you should ask your dentist to restore or replace the bridge tooth at no charge.

Asking Your Dentist to Pay for Your Damaged Crown

You can ask your dentist to pay for the bridge tooth directly, but you may want to prepare an explanation. We suggest finding an experienced cosmetic dentist to examine your Maryland bridge. The dentist who examines it can do the following:

  • Tell if teeth grinding caused the streak on the bridge tooth
  • Determine if a dental instrument scratched the surface
  • Give you documentation on the cause of damage to the surface

You can return to your dentist with the second opinion document and ask for a refund or if he will pay for getting your bridge restored or replaced.

Restoring a Crown without Replacing the Maryland Bridge

Perhaps a highly skilled cosmetic dentist can conceal the damage to the tooth of the bridge without replacing the entire bridge. One method includes these steps:

  • Grind some of the metal to make room for dental bonding cement
  • Etch the metal with a micro-etcher
  • Prime the metal with a thin layer of opaque cement that bonds to metal
  • Cure the cement
  • Place composite over the cement
  • Shape and polish the composite

Patient cases differ, so an advanced cosmetic dentist will need to examine your bridge and determine if they can save it.

Schedule an appointment with an accredited cosmetic dentist or one with extensive post-graduate training in cosmetic dentistry.

Dr. Jerome Cha, a Tulsa, OK accredited cosmetic dentist, sponsors this post.

 

My Two Front Crowns Don’t Match

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I have some metal allergies so I went to a dentist who offered zirconia crowns. I had damage to two front teeth that both needed crowns. The first time they came back, they looked really opaque and I asked him to re-do them. He didn’t seem thrilled but he agreed. When the permanent ones came back, I expected he would again let me see them first, but instead of putting them in with temporary paste, he just bonded them on. They are several shades darker than my natural teeth and are shorter than I would have expected. Normally, my front teeth are a little longer than my other teeth. He insists this is the color I told him I wanted. It isn’t. First, I didn’t pick a specific shade just that I wanted them as white has my natural teeth. I don’t know what to do. He said the only way he’ll change them out now is for the other ones I’d already rejected. I didn’t think I’d need a cosmetic dentist for two simple dental crowns. I thought that was something every dentist did.

Morgan

Dear Morgan,

Woman Covering her mouth

I am sorry you are going through this and will definitely file it in my cosmetic dentistry horror story file. Though, technically, you are correct that every dentist should be able to do a dental crown, that doesn’t mean they understand both function and form. Front teeth are tricky because they are so visible when you smile.

You have likely already figured this out, but this guy isn’t the best cosmetic dentist. He isn’t even the best dentist because he doesn’t seem to care how his patients feel about the quality of his work or their smile.

The one good thing you have going for you is that this dentist did not let you approve them before permanently bonding them on. Because he used a temporary try-in paste last time, you had a reasonable expectation that you would get to approve them this time. Therefore, bonding them on without your permission was wrong and unethical. Instead of having him re-do them..again, which I doubt will get you any better results, I suggest you just ask for a refund on the basis that you didn’t approve him bonding them on.

Once that is secured, you can find a great cosmetic dentist to do these. Those at the top of the cosmetic field are AACD accredited. They’ll give you two gorgeous crowns.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.

Save Yourself from a Cosmetic Dentistry Disaster

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I had four porcelain fused to metal crowns done on my front teeth years ago. I wanted to update my smile. I went to see one cosmetic dentist who was voted as one of the best cosmetic dentists in our area, but he was out of my budget. Plus, he wanted to do four crowns and four porcelain veneers covering eight teeth and I really only need the four crowns done. I went to my family dentist who assured me I’d get a smile I’d love. This hasn’t turned out to be the case. The crowns he made are too short and you can’t even see my teeth, which makes me look ancient. I also think the color looks greenish, which he said, “Is the color I picked.” I’ve been back several times trying to get this right. The last time they actually said to me, “You’re expecting perfect teeth, which is unrealistic.” Well… duh. That is why someone does cosmetic dentistry. I don’t know what to do at this point.

Pam

Dear Pam,

Woman giving a thumbs up in a dental chair

You are running up against a philosophy taught in dental school but corrected in post-doctoral institutions that teach cosmetic dentistry. In dental school, we’re taught the dentist always knows best and you don’t want cosmetic work to look perfect. Those dentists who invest in serious cosmetic dental studies know it is about how the patient wants their smile to look.

Another problem you are running up against is that doing smile makeovers isn’t taught in dental school. A dentist has to invest in that post-doctoral training in order to know how to do it well. My guess is your family dentist hasn’t done that. I also don’t think you’re going to get anywhere with him on making this the way you want it. That isn’t just because of the attitude. It’s also an issue of his ability.

You can ask him for a refund. He did assure you that you’d get a smile you love and he hasn’t been able to provide that. What you’ll need to do from there is find a true cosmetic dentist. It isn’t a recognized specialty so it is hard for patients to know who has invested in the training and who hasn’t. The best cosmetic dentists are accredited by the American Academy of Cosmetic Dentistry. That is different than just being a member. To get AACD accredited, the dentists have to not only pass stringent exams, but demonstrate their artistry with visual evidence of a large number of cases they’ve done.

As to the other dentist who is suggesting you also get four porcelain veneers, he is probably doing that so your smile will match. Most smiles are much wider than just four teeth. One other way to accomplish that is to whiten your teeth, which is recommended anyway so your bottom arch will blend well. See if he’ll let you do that instead of getting veneers and crowns.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.

Help Picking the Right Dentist

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I need some advice on picking a new dentist. I haven’t been happy with the last few I’ve tried. Then, every time I want to try another one it means more x-rays and a whole new charge for a visit. I’m just not having much success in finding a practice where I’m happy. Do you have any tips for me?

Elana

Dear Elana,

A woman smiling with her dentist behind her also smiling

Each person has a different dentist who is the best one for them.

There are some hacks to picking the best dentist for your particular needs. First, decide if you need any special type of treatments. For instance, needing a dentist with expertise in cosmetic work is very different than looking for a general dentist. The same is true if you prefer dental sedation because of any level of dental anxiety or have other needs such as TMJ Disorder.

When it comes to a general dentist, the first thing I’d like you to do is check their reviews. You can get a good idea about a dentist from reading about those who’ve already visited the office. That alone can help you eliminate some duds right off the bat saving you both time and money.

Some good review sites are:

  • Google Reviews
  • Yelp!
  • Facebook

The second thing you can do is ask for a complimentary visit. This is where you get to go in and meet the staff and possibly even sit with the dentist for a few minutes and ask some questions. This should give you some idea of whether or not they have the services you need. Not every practice will accommodate you on a complimentary visit, but they’re likely not a practice you’d want anyway.

If You’re Looking for the Best Cosmetic Dentist

This is a little different. Doing a smile makeover isn’t taught in general dental school. Dentists have to invest in time and training post-doctorally. Then, you’d also need to know if this particular dentist has an artistic eye. Two dentists can do the exact same smile makeover and the cases will turn out completely differently.

Fortunately, there is an easy button in these cases. The American Academy of Cosmetic Dentistry has an accreditation program to test both the technical knowledge and artistry of cosmetic dentists. They have to pass stringent oral and written exams. If they pass those, they’ll then have to provide visual evidence of a large number of cases they’ve performed to show they have the artistic skill required to reach accreditation.

Any AACD accredited dentist can give you a stunning smile. Check out their website (aacd.com)and they have a link for you to find a cosmetic dentist. Just make sure you check the box for accredited.

This blog is brought to you by Tulsa Dentist Dr. Jerome Cha.

Cosmetic Dentistry Malpractice

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I need help. I’ve spent over $25,000 to get my smile makeover. I had teeth which had composite bonding on them but they were old and needed to be replaced. I was told the best thing to do would be crowns on the top teeth, with whitening on the bottom. I was nervous about this because I had healthy teeth and wasn’t keen on grinding them down to nubs only to have a smile I don’t like. They assured me over and over they wouldn’t be bonded on unless I liked them. That’s not what happened.

We went over extensively the smile design I wanted along with the color. When the temporary crowns were ready they were okay. When the permanent ones came in, I wasn’t too happy. They were too dark. I said that before they put them in, but they insisted once I saw them in, I’d like them. They were still too dark. I still told them I didn’t like them but they insisted they were exactly what I requested and bonded them in.

Not only are they ugly, but uncomfortable. I am not getting anywhere with this practice. Even when I told them they hurt they suggested I give it a couple of weeks first. What do I do? I’m out quite a bit of money and am worse off than I was before agreeing to this debacle.

Katherine

Dear Katherine,

A Woman Giving a Thumbs up in the dental chair
The Best Dentists Listen to their Patients

First, you did not agree to this debacle. You agreed to get a beautiful smile makeover. They didn’t do that. In fact, you have a good case for malpractice. One of the tenents of dentistry is informed consent.

Though they promised you’d love your smile or it wouldn’t be bonded, they seemed to have had no intention of keeping their word. They bonded those crowns on without your approval.

Another thing I will bring up, though there is nothing that can be done about this particular bit, is they shouldn’t have used crowns for a smile makeover on healthy teeth. Smile makeovers are most often done with porcelain veneers which don’t require the teeth be ground down.

If you want to get your money back, you are going to have to get tough. This doesn’t sound like the kind of practice that cares about what their patient thinks. They likely won’t just give you a refund, though do ask.

If they say no, tell them you are willing to go to a lawyer and follow through. You may also show him this post as well. That should get them moving a bit.

They may offer to just do the case over for you. That’s up to you. Personally, I wouldn’t let them near my teeth. Instead, I’d like you to have your dentist pay for a better cosmetic dentist to re-do the smile makeover properly.

Finding the Best Cosmetic Dentist

What you’ll want to do is get the best cosmetic dentist in your area to do this. It will even be worth it if you have to drive to a nearby city. With true cosmetic dentists, your smile will be stunning.

In your place, I would look for an AACD accredited dentist to re-do your crowns. They are the top cosmetic dentists in the country. In fact, I don’t think you’d find one of them who’d be satisfied if you weren’t. Most of them have a beautiful smile guarantee. You can find them by doing a search on aacd.com. Just be certain you check that you’re looking for an accredited dentist. That makes all the difference.

This blog is brought to you by Tulsa Dentist Dr. Jerome Cha.

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