Archive for January, 2010

What to do in place of my Maryland bridge?

Wednesday, January 20th, 2010

I am wanting to replace a Maryland bridge I have had since I was 18 years old (I am 42 now). It replaces my tooth #10. The replacement front tooth is too dark or yellowed and I am wanting to have my teeth bleached. I am also unhappy with the gray that shows thru on #9 and #11. My general dentist suggested a conventional bridge to replace the Maryland bridge and possibly a lumineer on #8 so it would look more symmetrical. Does this sound like a good idea to you?
- Lori from Missouri

Lori,
So you have an existing Maryland bridge replacing one of your lateral incisors. As is typical with a Maryland bridge, the metal framework that holds in the false tooth darkens a little bit the natural teeth that it is attached to.

If you want something nicer, in my opinion you have two options. One would be to have a conventional bridge, which would involve crowning the two adjacent teeth and suspending the false tooth between them. The other would be to have a single dental implant replacing this tooth. To read about the advantages and disadvantages of these two treatments, you can read my implant vs bridge page on my implant dentistry website.

It worries me that your dentist wants to put a Lumineer on your front tooth just for the purpose of matching the bridge. I’m worried that this indicates that your dentist doesn’t have confidence in his ability to match the porcelain to your natural tooth. Porcelain can be tinted and shaped to match a natural tooth, and my opinion is that this would be the way to go, if you choose the bridge.

But if he or she can’t match the bridge to your natural tooth, then I wonder how your dentist plans to match the Lumineer to the bridge. That is just as hard, maybe harder. Unless there’s something particular about your case that I don’t know, on the surface this seems like unnecessary treatment.

Other links:
Check our Los Angeles gentle dentistry page.
Read about Los Angeles white fillings.

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How should I have my tooth gaps fixed?

Monday, January 4th, 2010

I’d like to know if bonding can be as effective or look as appealing as Lumineers. I just got my braces off after nearly 4 years and have some spaces that wouldn’t close all the way.

My orthodontist recommended bonding to close the spaces. I had an appointment with the dentist this past Monday and she is saying that the bonding won’t look right and that it won’t match enough to appear natural and that there is too much space and that she recommends lumineers.

I have no intention of getting lumineers as if that was the solution then I would not have gone through the time with braces. Suffice it to say, I don’t think she has an extensive enough cosmetic background and/or she’s just trying to sell something else. I need to know if bonding is still a good option for me. It is the only option I am willing to consider at this point. The orthodontist left spacing across the front on the top specifically for bonding.

Thanks!
- Cornelia from Texas

Cornelia,
Do the dental bonding, not Lumineers. Let me explain why I believe this dentist is trying to steer you toward Lumineers.

Dental bonding has to be done freehand, so it requires artistic ability. Dentists tend to be technicians but not artists. So I’m sure what is going on is that this dentist is feeling very uncomfortable with doing direct bonding. And in many dental schools, they are very emphatic in their training that the dentist always needs to present a confident front to the patient, so she doesn’t dare say, “I’m just not very good at bonding.” So she says that it won’t look natural, etc. She also may be coming from the perspective that IN HER HANDS, the result would not look very natural, and she may not be able to match the color very well. Lumineers, on the other hand, are sold to the dentist as not requiring much at all from the dentist – the lab does it all – so she feels that would be a better way to go in her office.

When you just have gaps between your teeth, Lumineers are not only overkill, but they could result in your teeth looking funny. If done the way the Lumineers people recommend, they would make your teeth longer and bulkier. Dental bonding is very conservative, and is what we recommend for a tooth gap. Lumineers or porcelain veneers would have to cover your entire tooth. Bonding just adds the composite material to the sides of the teeth where it is needed to make your teeth wider.

Posted in Dental Bonding, Lumineers | Comments Off