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writeradmin writes blog posts on behalf of Dr. Kevin Peck

Lumineers for Discolored Fillings?

I had a couple of dental fillings on my upper teeth that just do not match my teeth. I’ve tried bleach, which had no affect of them, Additionally, brushing makes no difference, though I will do it anyway for hygienic reasons. I really like my smile, except for that one issue. My dentist is suggesting Lumineers. While they are expensive, if that is what will make my smile the same color I am willing to pay it.

Cassie


Dear Cassie,

Image of a Lumineers advertisement

I would not allow your dentist to place Lumineers. These should be reserved for a complete smile makeover. Additionally, they are just one brand of porcelain veneers.

While Lumineers can be done well, most cosmetic dentists prefer a different brand of porcelain veneers. This is because the Lumineers lab is not always known for their artistic results.

Also, you mentioned you loved your smile with the exception of the difference in color. Therefore, porcelain veneers, no matter which brand, would be a massive overtreatment.

Plus, your dentist struggled to match the fillings. This tells me he does not have much expertise in cosmetic work. You would likely be disappointed in his results.

The solution for discolored dental fillings is to replace the fillings. The truth is the composite bonding used for fillings can be made to match any color if the dentist knows what they are doing and has the materials.

You will save yourself a lot of money and grief just going to a dentist who can match your dental fillings to your natural teeth.

If you want your teeth any whiter than they currently are, just make sure you whiten your teeth before having the dental fillings replaced. As you learned in your efforts to match the current ones to your teeth, teeth whitening does not have any impact on dental work. It will only whiten natural tooth structure.

I hope this helps.
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How Do I Get My Money Back If the Dentist Never Did the Work?

I went to an “affordable” dentist. He had a service for payment plans through something called Care Credit. I am now wondering if it is a scam. I have already paid off Care Credit. The dentist, however, did a different procedure than was paid for. The procedure was less expensive. When I mentioned the difference in cost, he said he’d give me office credit for the rest. But, I don’t want office credit. I have bills to pay and want my own money back. Do you have recommendations on how to get it?

Fleur


Dear Fleur,

An image of a Care Credit card.

I’ll start with Care Credit. It is a legitimate business and would likely not approve of the ethics your dentist used. In fact, they pay the dentist in full up front and take all the risk of you paying them back.

What your dentist did was unethical and you should get a refund of the difference between what you paid for and what service he provided you immediately. I’m also a bit concerned that, based on how it was worded above, you had to point out the price difference to your dentist. If this is true, then I highly recommend that you find a new dentist.

You can have both an affordable dentist as well as an ethical dentist. However, let’s focus on your refund. I would start by confronting him. If that doesn’t work, let him know that you will be contacting the dental board.

Those on the dental board can completely derail his career so that should perk his ears up. An additional step to take would be to write some online reviews on Yelp! and Google Reviews. About two-thirds of patients who are looking for a new dentist will check online reviews before deciding.

I’m sorry this happened to you.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

I Just THOUGHT Dental Implants Were Too Expensive

About 20 years ago, I ended up getting dentures. My dentist mentioned dental implants but they were so expensive I just went ahead and got the dentures. I’ve been miserable with these dentures ever since. It’s hard to eat and, even when I do eat, the food gets underneath everything. Then, it got to the point where they would not even stay in my mouth. I went back to the dentist and he told me that I don’t have a lower ridge in my jawbone any more and my denture won’t stay in unless I have a special surgery to fix that and then have a new denture made. Here’s what I’m wondering. What happened to my lower ridge? Is this typical? Should I have been warned about it? Is it too late for me to get dental implants?

Carol


Dear Carol,

before and after facial collapse
Before and after facial collapse

I am sorry this is happening to you. What happened to your lower ridge is known in dental circles as facial collapse. When your teeth were removed, your body recognizes that and resorbs the minerals in your jawbone that are no longer needed to help retain your teeth. Unfortunately, while efficient, this does shrink your jawbone.

This is something that will happen to everyone who wears completely removable dentures. In that sense it is typical. And, yes, you should have been warned about this.

The good news is that it is not too late for you to get dental implants. You will still need the bone grafting surgery because dental implants need bone to support the prosthetic roots. After that, however, you will be good to get your dental implants.

Affordable dentistry is a tricky thing. While you can find a dentist with more afforadble prices, be careful you are not just going to a cheap dentist. If they’re way lower than every other dentist there is usually a reason, such as they are cutting corners, which puts the patient at risk, or they are just so bad at their job they need to have super low prices in order to attract new patients.

The same balance is true in regular oral health care. For example, it is initially cheaper to not get a filling when the decay is small, but as the cavity grows it becomes more expensive. If it gets beyond a certain size, then you need an expensive dental crown or an infection sets in and you need both a root canal treatment and a dental crown. Many compassionate dentists are willing to work with patients on payment plans when they can’t afford care they need.

I’m sorry this has happened to you.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Can Teething Cause a Fever?

My baby is a little over 8 months old. She keeps getting fevers. The doctor never finds anything wrong with her and I’m spending a fortune that I can’t afford to spend. Her gums are swollen, too. I was asking a friend about it who has two children and she said that teething can cause a fever and I should slit my baby’s gums so the teeth can come in more easily. Is this accurate? I’m not sure how to slit the gums? Does a dentist do this?

Kathleen

Dear Kathleen,

I’m glad you wrote. Being a mom can be stressful. You want to make sure you are doing the best for your child. Suddenly, you’re expected to be an expert on so many things.

The first thing I would say, emphatically, is to NOT slit your child’s gums. Your baby’s body has a very natural way of dealing with teething. The teeth will break through as they develop. If you ease the way for them, you will find the teeth can come in prematurely which will mean the roots do not have time to fully form.

This is especially important when it comes to your daughter’s back teeth. They have to stay in place until she is around twelve year’s old. With malformed roots, it will difficult for that to happen.

As for your question about whether teething can cause a fever, the answer would be yes. However, it would only be a mild fever. In addition to the fever, you may also notice more drooling than normal, general fussiness, pulling on the ears, and a diminished appetite.

If your daughter is having a hard time with it, there are over-the-counter medications that can be used to ease the discomfort she is in.

After she is able to sit up well for an extended period of time, you should look into getting her established with a pediatric dentist. One of the most common issues I see with young children is that parents tend to wait until there is an urgent dental issue to take them to the dentist. This almost always leads to some dental fear in the children that impacts their view of the dentist for years, sometimes for a lifetime. Getting them to the dentist before there is a problem gives them a positive feeling with the dentist and helps prevent anxiety.

This blog is brought to you by Phoenix Dentist Dr. HIllary Peck.

I Hate My Smile but Have No Money to Fix It

I never got to go to the dentist growing up. My teeth are mostly healthy, though there is one cavity I haven’t taken care of yet. My bigger problem is how my smile looks. These days, everyone is expected to have a celebrity smile and I feel like some kind of imp that needs to hide in a cave.

I priced porcelain veneers, which is what everyone says is the procedure for smile makeovers. The cost is astronomical. If I owned a house, I’d have to sell it. Is there any affordable way to get a pretty smile?

Amanda

Dear Amanda,

Teeth whitening trays
Teeth Whitening Trays

While porcelain veneers are a fantastic way to improve the appearance of your smile. One of the best and most affordable things you can do to improve your smile is with teeth whitening. It can make you look decades younger (though I do not know your age). It generally only costs a few hundred dollars as opposed to the thousands of dollars needed for porcelain veneers.

It is also one of those procedures that does not require any special post-doctoral training. Pretty much any dentist can do it. That also means you can shop around and find the most affordable dentist in your area to do it. Just be sure to do it right after having a check up and cleaning. Otherwise the results will be splotchy. Most dentists require a cleaning for that reason.

I want to also address the cavity you mentioned. If you are trying to save money, taking care of this cavity right away with a dental filling is the best way to do that. Filling a cavity costs significantly less than letting it grow and need a dental crown. If it gets beyond the need for a crown, then you have to extract the tooth and pay for a tooth replacement. The most affordable dentistry is preventive dentistry.

The last thing you want is for this to turn into a dental emergency.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

The Best Way to Fix My Nephews Smile?

I am gifting my nephew some braces for his graduation. However, his dentist told him that would take three years and if he just got Lumineers he could have a a smile makeover in two appointments. However, for eighteen teeth, it will cost about $18,000. He told him it would last for 20 years. I’m worried my nephew is being used for his dentist’s profit. What should I tell him?

Meghan

Dear Meghan,

I share your concern. Even if he did get Lumineers, and we’ll talk about why that makes me leery in a moment, his dentist is talking about doing both arches. Generally, that is overkill. The general procedure is teeth whitening and then to put Lumineers on the upper eight to ten teeth. The remainder of your teeth aren’t as visible, even when you smile so teeth whitening blends them to the designed teeth.

My other concern is the Lumineers. This is a brand of porcelain veneers that are typically marketed to inexperienced cosmetic dentists as being easy to place. That does not mean they are easy to make attractive. I would want to see what type of results he gets on cases he’s actually done. There are many brands of porcelain veneers experienced cosmetic dentists prefer.

The twenty years longevity on them completely depends on how well they are cared for and whether adequate upkeep is done. If it isn’t, they can lose their attractiveness in as few as 5-7 years.

My suggestion, especially as you had only planned on doing orthodontics is for you to look at Invisalign. They can straighten his teeth in 6 to 12 months and he can whiten his teeth at the same time as Invisalign is being done.

If you decide to go with porcelain veneers, please check that the dentist knows how to do them beautifully.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

My Son is Sick; What Do I Do About His Toothbrush?

I am a new mom and I never realized how much I did not know until my son was born. He’s got his first real illness and needed a prescription for antibiotics. I’m not sure what to do about his toothbrush. It’s probably got the infection on it. But, he’s still sick so buying a new one might reinfect him, right? Help! What do I do?

Fanny

Dear Fanny,

I can tell you are a great mother. Some of the best moms are constantly trying to learn more to do everything they can for their precious child. You are caring and attentive to your son. Take a deep breath. You are doing much better than you think.

You will often see toothbrush companies promoting the idea that any time you are sick you need to replace your toothbrush or you will reinfect yourself. There is actually no real scientific evidence for this. In fact, the only study on the topic I was able to locate actually said the opposite. It was a 2013 study at the University of Texas that was published by the American Academy of Pediatrics. The results showed that transmission of strep throat via toothbrush did not happen.

The fact of the matter is that, even if you caught a cold just after another cold, it would not be the same cold. It would be a new strain. This is because your body develops antibodies to the strain you had.

If you are still worried, you can clean his tooth brush head with some ordinary household bleach. This will kill any germs and then you will rinse it off thoroughly and it will be fresh as the day you bought it.

One of the best things you can do for your son is start him off with a good pediatric dentist at a young age. It is important he goes to the dentist before there is a an actual problem. This way he associates the dentist with pleasant, fun experiences. Too many parents wait until there is a problem. However, then their first experience is a scary, painful one which will taint his view for years to come. You don’t want to introduce him to the dentist through a dental emergency.

I am sure you are going to do just fine as a mother. You’ve got this.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Is this how Lumineers Should Go?

I have a question about the Lumineers process because I am afraid that I am being ripped off. I paid up front and it was a LOT. The dentist did the impressions after the tooth preparation was done. Then, we were told it would take two weeks for the Lumineers to come in.

Here is what has me worried. At the two week mark, the dentist called and told me that the lab had contacted her. They said that there was a problem with the impressions and they have to be redone, which means coming back in and starting over.

Is this normal or should I be concerned?

Katie

Dear Katie,

I am glad you wrote because this is not normal and I am a bit concerned. I don’t think your dentist is necessarily trying to rip you off. I just think that she is in over her head. I doubt you will be happy with the results.

While it is not uncommon for a dentist to have a bad set of impressions from time to time, here is what is bothersome.

First, your dentist did not recognize that the impressions were bad. The lab should not have needed to tell her that. She should have recognized it and been proactive. Now maybe she thought, “Well, they’re not great but they may be good enough.” Here is the problem with that. Do you want a dentist who is doing your smile makeover, which you paid a fortune for, to think “good enough” is what you want? People who come in for smile makeovers want something gorgeous.

Second, for the lab to call her and tell her that the impressions need to be redone means that they were unusable. That should have been easily recognizable by her.

Third, why wait the full two weeks? Was it a matter of she kept telling the lab to try to work with them when they first called early on because she was too prideful to call you? This is not a good sign either.

Lumineers, which are just one brand of porcelain veneers, are routinely and heavily marketed to inexperienced cosmetic dentists as being easy to place. Believe me, nothing is easy about porcelain veneers.

My recommendation is that you tell your dentist you want a full refund and then find a dentist who has more expertise in cosmetic work. Make sure you ask to see before and after pictures of work they’ve done.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Are There Soft Dentures?

Does anyone make soft dentures? It is more important for me on the upper denture. That hard plate is very uncomfortable and half the time I feel like I am choking.

Kelsey

Dear Kelsey,

I am sorry you are having trouble with your dentures. To be honest, there are quite a few miserable denture patients out there. To answer your question, while there is not a soft denture, there is a soft liner. However, this is mostly to help ease the pain from a bumpy lower ridge. It would not be much help to your situation.

The upper dentures generally have to have that firm plate in order to keep it secure for you to chew. As you can imagine (or maybe you do not have to imagine), those with a strong gag reflex find dentures miserable.

The best option you have is to switch from completely removable dentures to implant supported dentures. Not only will it take away the need for the upper plate altogether, but it will also protect you from the bone loss that will occur in your jawbone.

Without that, eventually, you will lose so much jawbone that you won’t be able to retain your dentures. This is known as facial collapse. Having dental implants placed in your lower jaw will preserve the jawbone.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Don’t Be Fooled By 360 Veneers

I asked my dentist to provide me with Lumineers for my smile makeover. I’d been saving up for it for quite some time. At the appointment, he told me I would be a better candidate for 360 wrap veneers and not only would I really like the results, but they’d be more secure because they wrap around the whole tooth. My one concern (other than that they look good) is the amount of tooth structure that would have to be removed. It’s one of the reasons I wanted Lumineers. I asked about how much structure they’d need to remove and they said, “Hardly any.” Fast forward and while the smile looks okay, the veneers keep falling off. I was shocked to see my teeth were little nubs underneath them the first time it happened. My problem is it is happening too frequently. I wasn’t aware this would be an issue. While my dentist always puts them back on free of charge, I always get a lecture about what I’m eating. I assure you that I have tried to be very careful with them. Sometimes they just fall off while I’m doing nothing. I’m too nervous to go anywhere. Is there anything that can be done to keep these in? Is there a special extra hardy cement out there?

Evelyn

Dear Evelyn,

I’m going to tell you right up front that your dentist has misled you on two fronts. Not only that, he appears to be incompetent in his job. Before getting into why these are falling off, I want to begin with the lies you were told. To say that he or she is ethically challenged would be a bit generous.

Let’s start with the obvious one. You asked how much tooth structure would need to be removed and they said hardly any. You discovered their lie the first time one fell off. If your teeth are now little nubs, that is not “hardly any.”

This feeds us right into another deception. He told you that you were a better candidate for 360 wrap veneers. I hate telling you this, but that does not exist. ANY brand of porcelain veneers, including the Lumineers you originally asked for, will just cover the front and hug the sides just a bit.

I believe what he gave you are dental crowns. These do wrap completely around the tooth. Above, I have an image of the type of teeth preparation needed for dental crowns versus porcelain veneers. I bet yours look a lot like the crown tooth preparation.

Unfortunately, now that he has removed the tooth structure, there is no getting it back and you will have to have dental crowns for the remainder of your life.

Can This Be Fixed?

The short answer is yes. However, you are not going to be able to do this through your dentist. Besides, how could you trust him? One of the first things dentists learn to do in dental school is a dental crown.

It sounds like your dentist struggles with even basic dentistry. Most dentists will go their entire careers without having a dental crown fall out. Yours cannot seem to keep them in.

My recommendation is you ask him for a complete refund on the procedure. If he complains or argues about that, tell him that you will be suing him for malpractice and taking the issue to the dental board as well, if he prefers. That should sober him up.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.