All my front teeth are significantly chipped. I consulted with my cosmetic dentist and she said the only option was to extract the teeth and replace them with a bridge. This scares me! Quite frankly, I’d rather live with chipped teeth than have them extracted. I know that you’d have to see me to give your professional opinion – but I am curious to know if there is at least a sliver of hope for another option?

Answer: 

Something is wrong with this picture – is there perhaps something that you are not telling me?  Are the teeth abscessed or have they lost a lot of bone surrounding the teeth? 

There is not another reason that I can think of that would justify extracting teeth that are only chipped. 

I would not extract them at this time and would go to another dentist for a second opinion.  If both dentists have the same opinion after looking at your x-rays and doing an examination, then chances are that extractions my be the best choice.  It is just hard to believe with the information that you have provided.

Dr. Sam, I am 63 and my teeth are so bad that it seems I have no option but to have them extracted and live with dentures. I hate the idea! Both my parents had dentures which always seemed to have a life of their own as the wobbled around in their mouths. Can rotten teeth be saved?

Answer:

Rotten teeth can be saved depending on the degree of rotten! In many cases, patient can only see the tops of their teeth and they appear rotten but the roots are quite solid. Solid roots or long roots can support new teeth very well and a complete bite and a great smile can be reconstructed if the roots are good.

Dr. Sam Muslin Specializes in Mouth Reconstruction and Extreme and Complex Dental Care

Sometimes, some of the teeth have to be extracted and some of the teeth can be saved. The creative and engineering skills of the dentist can completely rebuild the bite with a mouth reconstruction that can be surprisingly successful and look totally natural. Some people can have a combination of dental implants and natural teeth that work very well producing a solid bite that lasts for many years. The technology is very good and highly predictable.

Lastly, if all of the teeth have to be extracted and dentures need to be worn, again the technology of dental implants have improved dramatically. The dentures can be build over the dental implants with snaps so the dentures are more stable. The patient can remove them and clean them and has fairly good chewing power. In other instances, many dental implants can be placed and the patient can have all new, completely fixed or permanent crowns cemented or screwed to the dental implants. It is just like having a whole new set of teeth again. The results are natural looking and natural feeling teeth.

In short, it doesn’t matter if your teeth can be saved because there are solutions for almost any situation of tooth loss that works far better than just a set of dentures worn by your parents. The don’t have to wobble anymore.

My dentist told me that most porcelain veneers are made by the same labs and that talk of different quality is just sales talk. Is this true? Are there labs that are better than other labs?

Answer:

You dentist is so wrong that it is scary. Probably 99% of all cosmetic dentists send their work to a dental lab and never see the porcelain veneers until they are finished and delivered into their office. The problem is the porcelain veneers are made without any customization by the dentist therefore all decisions that could make a world of difference for the patient are made by the lab. The dental lab has never seen the patient and has no idea. The porcelain veneers made without dentist supervision tend to be fake looking, thick, lack surface texture, are poorly proportioned, lack translucency or have too much translucency for the color of the teeth. All of this is normal for most cosmetic dentists as they totally rely on the lab to produce porcelain veneers without any customized guidance by the dentist. The result by the dental lab is limited if the knowledge and skill of the cosmetic dentist is limited.

My opinion is there is a huge difference between dental labs and an even bigger difference between dentists.

I have found over the last 30 years that the dentist must personally work on each porcelain veneer personally in order to maintain quality. I have developed a system of photography that includes over 40 images and diagnostic model measuring that helps me develop customization and create individualized quality that is unsurpassed from multiple facial angles. I personally work on every patient’s porcelain veneers before the final glaze is fired which permits me to insure the best shape, surface texture, size proportioning, veneer angling, surface contour, color and overall quality that is ideal for my patients. Over the years, I have worked with multiple dental labs that are the biggest and best in the industry and still personally work on every single case before the lab finishes their work. The ability of the lab is limited if the cosmetic dentist’s ability is limited. Every patient has different needs and there are so many ways the porcelain veneers could be better if the cosmetic dentist could only recognize it when he or she is looking at the patient.

How to Pick a Cosmetic Dentist?

I am honored that such a large number of my patients have signed model release forms (without payment) that gave me permission to show their entire face on the Hightech Dentistry Gallery. It is the ultimate testimonial. I highly recommend that you compare before and after photos of potential cosmetic dentists work and make sure the expressions and smiles are matched. Also, look at the close-up photos too. Find the best cosmetic dentist possible and make sure they have the photos to prove they are competent.