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Invisalign and Wisdom Teeth

I was told when I was 17 if I removed my wisdom teeth I’d never need braces because there’d be plenty of room for my teeth. I did. Now I’m in my 30s and my front teeth are crowding. Have I done something or was my dentist not honest? Can this be fixed without braces? I’m a little old for a mouth full of metal, even with the cool new colored bands the kids are wearing these days.

Angie

Angie,

A woman inserting her Invisalign aligners onto her teeth

I wouldn’t say your dentist was dishonest. I think he probably meant you’d definitely have crowding if you didn’t get your wisdom teeth out, but there’d be room if you did. However, teeth move and shift throughout our lives. You asked if you did anything wrong. It’s hard to know. There are a few patient-related reasons we’ll go into in a moment.

Some Reasons for Crowding

  • You were made that way: For some, their narrow palates or smaller jaws can lead to misalignment through normal everyday biting forces.
  • Tooth Grinding: This is something that is patient related. Unfortunately, most patients don’t even realize they are grinding their teeth because it often takes place while they’re sleeping. The motion of your teeth causes them to shift and could cause the crowding you’re experiencing. Unfortunately, this type of thing often leads to TMJ Disorder.
  • Bad Dental Work: We’d like to think every dentist is as skilled as the next, but that is not always true. Sometimes there is a poorly fitted crown or another type of dental work which can throw off your bite.
  • Ignoring Dental Care: Sometimes people neglect their dental care and can develop gum disease. This can cause your teeth to shift. Without getting the care you need, your teeth will eventually become loose and you’ll lose them, requiring expensive tooth replacements.
  • Tumors: There are certain medical conditions which cause tumors that can throw off your bite. If you’re getting regular checkups your dentist will do regular examinations for things like that. So, it’s not something you should panic about if you’re diligent with your dental appointments.
  • Trauma: I’m assuming you’d know if you had an accident of some type which affected your bite. But that is another issue which can cause problems.

Invisalign Could Solve this for You

You won’t have to have a metal mouth, even a colorful one. Invisalign is a modern orthodontic system which allows adults and older teens to repair their smile without anyone having to know. The aligners, which are used instead of wires and brackets are completely invisible. Even at a conversational distance, people cannot tell you have them on.

My suggestion would be for you to see your dentist and find out the reason for your recent crowding. While Invisalign can straighten your teeth, if the problem is grinding, you’ll need a mouthguard to permanently protect them or you’ll be right back in the same position.

Additionally, if it’s something like gum disease causing the problem, Invisalign would be dangerous. You don’t want to be shifting around your teeth when they’re already loosening.

This blog is brought to you by Dr. Steve Bader.

Travelling with Sleep Apnea

I’ve recently been diagnosed with sleep apnea and my dentist gave me this CPAP machine. I usually travel a lot, especially by air. I can’t imagine they’ll let me take this on the airplane. Is it possible to travel with a CPAP when you have sleep apnea?

Carl.

Dear Carl,

an oral appliance for sleep apnea
If you have sleep apnea, there are alternatives to a CPAP.

Though sleep apnea can be a bit of a nuisance, you will find that once your treatment is going regularly and you’re getting to breathe all the way through the night, you’ll wake up much more refreshed and energetic.

You are able to travel by air with a CPAP, but it does take some preparation ahead of time. When you purchase your ticket, you’ll need to be sure they give you a seat by an outlet for your CPAP. It’s hard to get the distilled water through security because of the limitations on liquid these days. However, you can get a prescription for pharmacy grade distilled water and that will allow you to take it on board. You will also need to have some disinfectant wipes with you. The security scanners aren’t exactly what we’d call sterile, so you’ll need to wipe everything down again before you use it.

Be aware, TSA regulations change all the time. It’s in your best interest to check their site and see if they’ve made any other regulations that have hoops you need to jump through to get on the plane without a nice pat down by some stranger in a uniform.

Sleep Apnea Alternatives to CPAP

I don’t know if your dentist mentioned that there are now alternatives to a CPAP machine. These will allow you travel without all those complications. Using an oral appliance, you can breathe freely without needing a machine to help you.

Many patients fall in love with their oral appliance and find it so much more comfortable that they use it full time instead of just when they’re traveling. You may want to schedule an appointment with your dentist well ahead of your next trip and get fitted for a device. This way you can try it out at home where you have your CPAP as a backup to see if it works for you. It may change your life. You can read Dr. Bader’s Sleep Apnea Page to learn more.

This blog is brought to you by Boston Holistic Dentist Dr. Steve Bader.

Can Porcelain Veneers Cause Bleeding Gums?

I just had porcelain veneers placed about six months ago. I noticed a month or so afterward that my gums would occasionally bleed when I brushed my teeth. I invested in a water pick to make sure I was getting everything I could, but it didn’t help. I had my six-month check up this week and the hygienist said it looks like I’m developing the start of gum disease. Because this started shortly after I got my porcelain veneers, could they be the cause?

Miriam

Dear Miriam,

A dental tool holding up a porcelain veneer

It sounds like you’re doing everything right and taking good care of your smile. While I do suspect the porcelain veneers are involved in what’s going on with your teeth and gums, they are definitely not the reason.

Porcelain veneers do not cause bleeding gums. Poorly placed porcelain veneers can, though. If you went to an inexperienced cosmetic dentist, they may not even realize they’re the cause. This is just business as usual for them.

Do a Porcelain Veneer Check

I want you to find an expert cosmetic dentist in your area. Look on the mynewsmile.com website. A dentist can request to be placed on their list, but they can’t pay to be listed. Instead, they have to pass some stringent requirements. Dr. Hall, who runs the site, verifies their training, their technical skill in cosmetic procedures, as well as their artistry in creating beautiful smiles. If they don’t meet his stringent requirements, they won’t get listed. It’s that simple.

Have one of their recommended dentists check your porcelain veneers. Let them know what is going on but not who did your smile makeover. That’s just a precaution in case they’re friends with your dentist. You don’t want them to feel torn between honesty and protecting their friend’s reputation.

There are two possible causes for what I suspect is happening to you.

  • Excess cement or bonding material

If your dentist didn’t get all the bonding material away from your gums, it could be causing irritation to your gums and that would lead to bleeding.

  • Bulky Margins

In the dental industry, bulky margins simply mean the porcelain veneers aren’t sitting flush against your teeth as they should. Instead, you’ll have a ledge and uneven edges. Things can become trapped on the ledge, which breeds bacteria. That, in turn, will lead to gum disease and decay. This will need to be repaired or you’ll end up needing fillings on the edges of your veneers.

Your dentist should fix either of these issues free of charge. You may need the testimony of the other cosmetic dentist to “convince” him though.

This blog is brought to you by Dr. Steve Bader.

Holistic Dentist and Healing Cavities

I’ve read an article which said you can heal a cavity with nutrition. I must be doing something wrong. My cavity isn’t getting worse, but it’s not getting better either. Will a holistic dentist help me do it right? My regular dentist says I’m being foolish and wants to put one of those toxic fillings in it.

Regina

Dear Regina,

A woman lying down in a field of flowers

There hasn’t been any evidence from a reputable source that you can repair a cavity with nutrition. While good nutrition is certainly good for your teeth, I couldn’t in good conscience tell you it will heal a cavity.

Currently, there’s some very promising research in regrowing teeth, but that’s being done with stem cells. The data is still in the early stages. Be careful believing everything you read. It’s not just the internet where you have to use discernment anymore. News sources, print books, articles all are written by people with a bias and agenda. Even those who strive to remain neutral in their research and reporting, we’re human. We tend to get excited about data which backs up our hope or belief and ignore anything that doesn’t. These days, you have to do some research to make sure you’re getting the correct information.

A Holistic Dentist Can Help with Your Cavity

Even though a holistic dentist can’t heal your cavity with nutrition, they can help you. I know you were worried about having to put a toxic substance into your body with a filling. That’s one thing you will never have to worry about with a holistic dentist. They would never intentionally place any harmful substances into your body.

They are all mercury-free dentists. That means instead of amalgam fillings, which are loaded with mercury, they would provide you with white, composite fillings. These are mercury-free and actually help to strengthen the bond with your tooth, instead of weakening it the way their amalgam counterparts do.

Another benefit is they’re able to do a sanitary amalgam removal on any amalgam fillings you happen to have in your mouth. When amalgam fillings are removed, the patient is in danger of inhaling mercury vapors and swallowing bits of mercury. A sanitary amalgam removal uses special equipment to protect you from this, allowing you to exchange them for the safer composite fillings without any risk of ingestion.

This blog is brought to you by Dr. Steve Bader.

Dental Cosmetic Solutions for Bulimic

I’m in therapy for Bulimia. One of the things my dentist suggested is making myself feel more attractive in healthy ways. I’ve been thinking about it and I want to fix my teeth. The bulimia has done quite a number on them. What should I do?

Karen

Dear Karen,

Smiling young brunette

I think you’re onto a great idea. Not only will it make you feel more attractive, but it will significantly improve the health of your teeth, which are likely struggling right now. The last thing you need during your recovery is one more thing to worry about.

My suggestion is to have porcelain crowns done on the teeth that have sustained damage from the purging process. Then, the healthy, visible teeth can have porcelain veneers. You may be wondering why not just do crowns on all the teeth? You could, but most dentists want to be as conservative as possible when it comes to removing healthy tooth structure. Crowns require a removal of tooth structure on the entire tooth. Porcelain veneers just require a mild shaving on the front to prepare the teeth. Keep what you can is always a good motto when it comes to your teeth!

Finding the Right Cosmetic Dentist

Now for the tricky part— you need to find the right cosmetic dentist. You’ll want someone with both technical skill and artistry who can give you the stunning smile of your dreams. The problem is there isn’t a recognized specialty for cosmetic dentistry. So, any dentist can do cosmetic procedures.

You’d think that would mean opportunities abound to get a great smile, but not all of them are that skilled. In fact, two dentists can do the same smile makeover for the same person and one will turn out horrible and the other gorgeous. So, how is a patient to know who will give them a Hollywood smile and who will make them a cosmetic horror story?

Fortunately, the mynewsmile.com website has done the research for you. They examine a dentist’s cosmetic training as well as cases they’ve actually performed to ensure they’re artistic as well. What you do is go to their site. They have a “find a cosmetic dentist” link. Then you put in your zip code and how many miles you’re willing to travel for a gorgeous smile. They’ll pull up a list for you. It’s that simple. You’ll be safe with any cosmetic dentist they recommend. In fact, most of them are so good, they have a beautiful smile guarantee.

This blog is brought to you by Dr. David Newkirk.

Best Smile Makeover for My Nephew

My nephew wants to be an actor. He’s actually quite good. I think the only thing which could hold him back is his smile. It’s not quite Hollywood material. I really believe in him so I’ve offered to pay for a complete smile makeover for him, no matter the cost. I’ve been told to get him Lumineers by our dentist, but truthfully, I’ve never thought he did the most stunning work. So, I’m writing someone whose smile gallery does seem to have beautiful work but also won’t make money from me because of the distance to get a second opinion. I think his biggest problems are some crooked and stained teeth, but I want his smile to look fantastic!

Audrey

Dear Audrey,

First, let me say you are a very devoted aunt and it is wonderful that your nephew has someone who believes in him and gives him support. Acting is a tough career so knowing you’re behind him will give him confidence. I think young people should always be given a chance to live their dreams.

Secondly, I’d like to say that you’ve made the right decision not going forward with your dentist’s plan of Lumineers. This particular brand is not known for its good results. Some of that is the dentists who use the brand and some if it is the lab they require dentists to use. Either way, if you want your nephew to have a stunning smile, Lumineers is not the way to go.

I have two great options for your nephew.

A Smile Makeover with Invisalign and Teeth Whitening

before and after picture of a woman's smile who used Invisalign
An Invisalign Case

If the only thing wrong with his smile is some staining and crooked teeth, those two things can be easily repaired. He can even repair them simultaneously. Above, you’ll see before and after images of an Invisalign case done by Dr. Bader. Once her teeth were straightened with Invisalign, she couldn’t stop smiling.

Whatever dentist you choose could also use the Invisalign aligners as teeth whitening trays allowing him to do both procedures simultaneously.

This may be all he needs. They’re very easy procedures and don’t cost a fortune.

A Smile Makeover with Porcelain Veneers

before and after porcelain veneer images
Smile makever done with porcelian veneers

If you’re looking for a top of the line smile makeover, then porcelain veneers are your likely procedure. This is what most people think of when they say a “Hollywood Smile”. Veneers are able to change anything about your nephew’s smile—their shape, size, color, even their character. An expert cosmetic dentist can do miracles and create a work of art.

Finding the Right Cosmetic Dentist

What he’ll need is an expert cosmetic dentist. My suggestion would be for you to look on the mynewsmile.com website. They screen cosmetic dentists and only recommend those who meet their high standards of technical excellence and artistry. You can search by your nephew’s zip code and even place the distance you’re willing to travel.

This blog is brought to you by Dr. Steve Bader.

Why Send Me to a Dentist for Being Tired?

I’m a little frustrated. I’ve been telling my doctor I’m tired all the time for months. He did some blood work where everything turned out fine. Now he’s not taking me seriously. I persisted, but he said to see a dentist about my sleep habits. What would a dentist have to do with that?

Miriam

Dear Miriam,

man snoring keeping wife awake
One of the most common symptoms of sleep apnea is snoring

I would be willing to bet that your doctor wants you to get a sleep study done, though usually that is done through a prescription from your doctor. Your dentist can get you a sleep study too. It mostly depends on what your insurance requires.

The study can help reveal if you have sleep apnea. As the picture above states, snoring is a common symptom of sleep apnea. So is being tired. That’s especially true if you wake up tired after a full nights sleep.

How Can a Dentist Help Sleep Apnea?

If sleep apnea is the cause of your exhaustion, your dentist can custom design an orthotic which will position your jaw in a proper position so that your body receives the proper amount of oxygen while you sleep. This will allow you to wake refreshed, probably for the first time in a long time.

You’ll want to get your bite evaluated as well. Some recent research has found a link between TMJ Disorder and sleep apnea.

I haven’t examined you, so there is no way I can begin to tell you if either is an issue for you, but those would be some reasons to see your dentist.

I know it’s frustrating when your caregivers can’t seem to figure out what is going wrong with your body. Some medical practitioners go into medicine thinking we know most things and can fix people. When they bump up against something that doesn’t fit with what they know, they get frustrated as well. Some react to that by making the patient feel like it is in their head.

It might help you to see a holistic dentist. They’re a little better at working with people who’ve had trouble diagnosing what’s going on with them. That’s more because they consider the whole body’s health and not just your teeth.

This blog is brought to you by Dr. Steve Bader.

Disappointed Dentist Said No to Porcelain Veneers

I wanted to get porcelain veneers. I’ve got several chipped teeth and ugly stains. I asked my dentist to give me porcelain veneers to fix them, but he said no. When I asked him why he said because as the dentist he’d know what would work and what wouldn’t. He did say he was willing to whiten my teeth but thinks veneers would be a mistake. I think I’d be okay with his decision if he would just tell me why. What am I missing?

Caryn

Dear Caryn,

A dental tool holding up a porcelain veneer

I think the biggest thing you’re missing is a dentist who understands cosmetic dentistry. Yours obviously doesn’t and rather than admit that he tries to lord over you with the “I’m the doc and you’re not” comment. That’s a complete cop-out and unfair to you. If he’s going to tell you no, he owes it to you to tell you why.

My guess is (and this is truly just a guess) is that he doesn’t know how to do the procedure. He also didn’t suggest any alternatives for you outside of giving you teeth whitening. What about the chips on your teeth?

What if You’re Not a Porcelain Veneers Candidate?

The first thing I’m going to suggest to you is to get a second opinion. Porcelain veneers are a great procedure for the two issues you’ve described. They can give your teeth a brilliant white color while repairing the chips at the same time. In fact, they can even change the shape of your teeth if you’re interested in that. Because of that, I’d like you to find out if there truly is a reason for you not to get them.

If for some reason you are not a good candidate, all is not lost. There are options. First, go ahead with the teeth whitening. Next, for the chipped teeth. Dental bonding can fix chips very well. The reason you want to do the whitening first is so your dentist can match the bonding to the new color of your teeth. The bonding won’t whiten after it’s placed on your teeth.

Who Should Place Your Porcelain Veneers?

Let’s assume for the moment that you are a good candidate. Your dentist likely did you a favor by not agreeing to do your procedure. You wouldn’t have gotten a beautiful smile. What you need is an expert cosmetic dentist. To find one in your area, I’d check the mynewsmile.com website. They only recommend artistic, skilled cosmetic dentists. Make sure they have some form of beautiful smile guarantee.

This blog is brought to you by Dr. Steve Bader.

Can’t Find a Holistic Dentist on My Dental Insurance

I’ve just discovered I’m pregnant. I’m thrilled, but do want to go to a holistic dentist during my pregnancy. I’ve been looking through all the specialists and can’t find a holistic dentist anywhere. Are they not covered?

Serena

Dear Serena,

pregnant woman at dentist
Do Pregnant Women Need a Holistic Dentist?

Congratulations! What an exciting time. I can totally understand why you’d want to seek treatment from a holistic dentist during this time of your life. They’re extra cautious when it comes to treatment, considering not just how it affects your body but your baby’s as well.

I think the problem you’re encountering is a misunderstanding of specialties. Your insurance will list things like General Dentists, Pediatric Dentists, etc. because they’re recognized specialties by the American Dental Association. But, things like Holistic Dentistry or Cosmetic Dentistry are not yet recognized as specialties.

What that means is the patient is left trying to determine which general dentists are actually skilled at cosmetic dental work and which just call themselves cosmetic dentists but actually aren’t that great at doing it beautifully.

Similarly, you’ll just have to check a dentist’s website to see if they have a holistic philosophy.

What If I Can’t Find a Holistic Dentist?

While the number of holistic dentists is growing, not every area has one. If you’re in that position, I would take two precautions when choosing who you’ll use for dental care during your pregnancy.

This is the minimum of precaution that should be taken with a pregnant woman. You don’t want a dentist who will introduce mercury into your body, especially when you’re expecting.

  • Always Consult Your Ob/Gyn

Most General dental procedures are safe and it’s actually even more important that you keep up with your oral health care during this time. Pregnancy can be rough on your teeth and a tooth infection is bad for you and your baby. That being said, every pregnancy is different and anything outside of routine care, it’s important you consult your OB to be certain it’s okay in your particular case.

You’ll find the second trimester is the most comfortable time, so try to schedule your appointment then if possible.

This blog is brought to you by Dr. Steve Bader.

Do I Need a Cosmetic Dentist for White Fillings?

My family has been seeing the same dentist for three generations. I feel bad even saying this but I’m thinking of switching. He just seems so set in his ways. My children are beginning to need a filling or two, though right now we’re just keeping an eye on the teeth. I told him if we did get a filling, I’d like it to be those white fillings everyone gets these days. He insists they’re not as good as the old ones and says he doesn’t place them. I’m thinking of switching dentists to get them. I keep thinking my dentist is going to retire anyway so this might be the ideal time to switch. Would I need to switch to a cosmetic dentist in order to get the white fillings?

Olivia M.

Dear Olivia,

Silver amalgam fillings in teeth Composite White Fillings

What’s obvious to most people is the difference in the appearance of the white fillings compared to their amalgam counterparts. However, there are many other benefits as well. Despite what your dentist said, the old fillings are NOT better for your teeth. In fact, it’s the opposite. However, I’m glad you’re not trying to “force his hand” to placing them. The procedure is completely different and it’s rather obvious he hasn’t bothered to learn the new bonding procedures necessary to place composite fillings.

You wouldn’t necessarily have to switch to a cosmetic dentist to have white fillings placed. Many dentists place them these days. All you’ll need to look for is a mercury-free dentist. These dentists will only place white fillings.

When You Need a Cosmetic Dentist

Cosmetic Dentistry isn’t actually a specialty. It just means a general dentist who offers cosmetic procedures. As with any other artistic skill, their results vary from dentist to dentist. The only time that would matter significantly is if you were looking for a total smile makeover, such as with porcelain veneers. If that’s something you’re considering, then choose your dentist wisely.

In your place, I’d look for a dentist who has been recommended by the mynewsmile.com website. They only recommend skilled, artistic dentists on their site. A dentist cannot purchase their way on as a means of drawing in clients. Instead, they have to demonstrate their technical knowledge and skill. It’s worth some time to invest before choosing.

This blog is brought to you by Dr. Steve Bader.