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writeradmin writes blog posts on behalf of Dr. Kevin Peck
Lumineers

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.

Teeth Whitening

How Long Should Free Teeth Whitening Last?

I went to a new dentist partly because I wasn’t happy with my old one and partly because this new one was offering free teeth whitening to new patients. I thought it would be the higher quality teeth whitening because they made the custom trays for me.

At first, I was quite pleased with how it was going and my teeth were much brighter. The gel lasted me about two weeks. Now, only a few months later, they are starting to stain again. I find it curious that they are staining right when it is time for me to go to a new appointment. Did they give me lesser quality whitening gel in order to keep my coming back?

Miranda

Dear Miranda,

Teeth whitening trays
Teeth Whitening Trays

While it is true that dentists want you to come back both for their benefit and yours, it is unlikely that the gel was anything but professional strength. You saw good results after just two weeks which tells me it was the right gel.

Teeth whitening isn’t permanent and how long the teeth stay stain free depends a lot on the habits of the patient. This doesn’t just mean whether you brush regularly, which is important, but also the foods and beverages you consume.

For instance, certain beverages, such as coffee, tea, or certain wines will stain your teeth each time you consume them. If you are a smoker, that will also add to the staining. Even sauces, such as soy and curry will quickly stain your teeth. A good rule of thumb is if it will stain a white shirt, it will stain your teeth.

Keeping Them Pearly White

There are some things you can do. First, drink more water. While the water won’t whiten your teeth, it is better for both you and your teeth than coffee, tea, or alcohol. The more water you consume the better.

When you do eat or drink something that can stain your teeth, such as a delicious curry, brush your teeth afterward. Be careful though if you eat or drink anything acidic. You don’t want to brush those acids into the teeth. Neutralize those acids first by taking a quick swig of water around your mouth and then you will be fine with brushing.

Keep up your regular appointments and your dentist will very likely give you some more gel for touch ups, so keep those custom made trays. They’ll be good for years.

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

Affordable Dentist

Affordable Options for Securing a Lower Denture

Hi, I’ve got problems and I’d love answers. I’ve had dentures for over five years, and my lower one drives me up a wall! It floats around, clacks whenever I eat or talk, and never feels tight or stays put. I have to use adhesive every single day to be able to bear it. The upper one is fine, and I like the way they look, but I just can’t stand the looseness of the lower one any longer.

I can’t afford implants, but I was told by a friend that there may be other, more affordable methods of securing my lower denture, she said her dentist was talking about them. So is this true? What are my options?

Help,
Dennis

Dear Dennis,

Mini Implant compared with a traditional dental implant

Sorry to hear your lower denture is giving you such a difficult time! It sounds frustrating. Glad your upper plate is doing well. While conventional implants can be costly, your friend may have been correct: you likely have other more affordable dental options.

Why Don’t Lower Complete Dentures Fit As Well As Uppers?

Many patients wonder why their lower complete denture is looser than or doesn’t seem to fit as well as their upper. This is common and is due to your bone levels. When teeth are extracted, a ridge of alveolar bone is left behind. That’s what your dentures are fit to. This ridge acts as retention for your denture. The upper denture is fabricated to fit over this ridge, around the arch, and across most of the roof of the mouth. This extra span against the palate gives the upper denture “suction”, which holds it tightly in place.

The lower denture does not have this extra coverage and relies completely on the bone. Plus, the longer you are in dentures, the more bone you lose on your lower jaw through resorption. Depending upon the anatomy of the patient’s ridge, mandibular dentures may tend to be looser and may lift, “float”, or move around in the patient’s mouth.

What Can Be Done?

Mini-Implants
As you no doubt know, conventional endosteal implants can be cost-prohibitive for some. Many people don’t realize there are options such as what are known as “mini-implants”: small, pin-shaped implants that are easily placed and do not need to be inserted as far into the bone as the former. These are generally a bit more reasonable economically, as well. These small implants are placed into the lower ridge, allowed to heal, and the denture is re-lined to fit (or “snap”) down over them. This holds the denture firmly in place, and many people love them. You can have snap-on dentures with as few as two mini implants.

Reline
Barring this, you may want to look into having the denture relined. Being as it’s been over five years since you’ve received it, your bone and soft tissues have surely changed and shifted in this time. Asking your dentist for either an in-office or lab-fabricated reline may be the answer: a current, custom fit might just bring about the retention you need. Best of luck to you in your journey toward a better fit!

Just bear in mind, the longer you are in complete dentures, the more bone you lose, so you may want to save up for one of the better treatment options for several years down the line.

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

Root Canal Treatment

Pregnant with a Horrible Toothache

I am twenty-two weeks pregnant. My OBGYN suggested that I go to see my dentist for a check up during my second trimester because healthy teeth and gums are important for a healthy baby during pregnancy. I’m not exactly a fan of dentists but did what my doc said in order to protect my baby. At the appointment, my dentist found a couple of cavities and filled them right there. That was a few weeks ago and I am now in excruciating pain. Nothing helps it except Tylenol, which I am trying to avoid because I am pregnant. Why am I having all this pain? I didn’t have any before the visit. Is there anything I can do about it while I am pregnant?

Marla

Dear Marla,

Pregnant woman at the dentist

Congratulations on your baby!! I can tell you are going to be a good mother because you are already doing things that scare you for the sake of your baby.

It is not uncommon for a tooth to ache after getting filled. However, you are describing significantly more pain than I would have expected. There are a couple of possibilities that spring to mind.

First, it could be that your filling is sitting too high. If that is the case, your dentist can adjust it in order to make it more comfortable.

A second possibility is the depth of the cavity. I don’t know if your dentist mentioned that you had a deep cavity. If that is the case, then it would be close to a nerve. She may have put a buffer there in the hope that you would not need a root canal treatment.

My suggestion is you get a follow up visit including an x-ray to get this looked at. If you are worried about the x-ray, be assured that most dentists use digital x-rays these days. This gives you no more radiation than you are exposed to just going outside. Even with the low radiation, they will provide you with a special lead lined robe as an additional precaution.

Your dentist is correct that healthy teeth and gums are important for your baby. Gum disease has been linked to low birth weight in children, which puts them at a greater risk of illness. Infections can be passed on to the baby as well, so treatment is recommended.

You’re at the perfect stage of your pregnancy for any dental work needed and your dentist should be well-versed in what is safe for the baby. You don’t want to put this off and have it blow up into a dental emergency. If you are concerned, you can get some extra advice from your OBGYN about medications.

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

Are Lumineers Bad For Your Teeth?

I’ve been looking into my smile makeover options and was excited about the prospect of Lumineers because my dentist told me they don’t require any grinding down of your teeth. However, as I’ve looked online, I see a lot of mixed information about them. Some love them and some say that they destroyed their smile. Should I be concerned?

Alexis

Dear Alexis,

An advertisement for Lumineers

Lumineers won’t destroy your smile on their own. That is why there are mixed reviews. If you have a dentist who is skilled in cosmetic dentistry, then you have a better chance at a successful outcome than if you have a dentist who hasn’t invested a lot of time and training in learning cosmetic work.

That being said, there are two big problems with Lumineers. The first is that they are heavily marketed to inexperienced cosmetic dentists as being easy to place because they are ultra thin, which Lumineers says makes them no-prep.

While an occasional smile can get away with a no-prep makeover, most need at least some tooth preparation or else the smile ends up looking bulky. Some have even described it as having horse teeth.

Your dentist was mistaken in saying that your teeth will need to be ground down with another brand. That is simply not the case. The only procedure that would require your teeth to be ground down is with dental crowns. For porcelain veneers, you only need about the depth of a fingernail gently shaved to make room for the porcelain veneers.

Your dentist’s claim gives me pause to think he is not experienced enough in cosmetic dentistry to give you a beautiful result.

The second issue with Lumineers is their lab. The company that owns them forces dentists to use their lab, which is not known for producing beautiful results.

In your place, I would not worry about the brand as much as the dentist. Ask to see some before and after pictures of porcelain veneer procedures they’ve done. If you like their results, you should be fine. Then, let them pick the brand that will give you the look you want.

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

Affordable Dentist

Can I Refuse

Is there a way to whittle down unnecessary services that your dentist insists on? I’ve had the same dentist for years and he recently retired. The staff stayed on and I know them quite well and enjoy them. However, the new dentist is tacking on services that raised my appointment cost by over $200. She’s added things like full panoramic x-rays and fluoride treatments. Are these really necessary? Can I refuse them or should I just switch to a more affordable dentist?

Joseph

Dear Joseph,

Dollar sign hatching out of an egg

It is hard to make ends meet these days, especially with inflation the way it is, so I understand your desire to cut back some expenses on your dental bill.

The first thing I would do is have a conversation with your dentist about the reasoning behind the additional services. Most dentists will to a panoramic x-ray every three to five years. You didn’t mention when your last one was. If it has been a while then it might just be time.

While fluoride is most often used in childhood appointments there are still instances when doing it in adulthood is useful. One is if you are undergoing any treatments such as radiation that will be hard on your teeth. Other reasons include frequent decay or sensitive teeth.

If your dentist is doing these additional treatments for one of those reasons, it may be in your best interest to go with them, though you can certainly explain the hardship the cost is for you and see if she is willing to allow you to pay them out in installments.

If she just does them as a matter of course, you can ask if she is willing to make an exception for you. If not, it may be time to seek out a more affordable dentist.

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

Affordable Dentist

Dentist Keeps Adding Things I “Need”

I am starting to get a bit frustrated with my dentist. Every time I go in, he keeps pushing new suggestions on me. This checkup it was a mouthguard because he said that I grind my teeth. Is this typical practice for dentists or is mine just greedy?

Brooke

Dear Brooke,

Dollar sign hatching from an egg
There is a difference between affordable and cheap denitstry

I would like more information before I want to pronounce your dentist as greedy. Could you give me some more examples of things he’s pushed on you? The reason I asked you that is the suggestion for a mouthguard is not only appropriate but important if you grind your teeth.

Without that protection for your teeth, then you will end up with your teeth ground down to nubs. The only way to fix that is with a full-mouth reconstruction, which entails placing a dental crown on every tooth. That will cost you upwards of $30,000. Getting a mouthguard can literally save you a small fortune.

If affording it is the problem you are facing, then you have a couple of options. First, you can ask your dentist if he’d be willing to allow you to pay it out. If he is not, there are dentists who would be.

In that case, I would look for someone who advertises as an affordable dentist. They are much more willing to allow you to pay things out financially.

If that doesn’t work for you, there is a second option but it is not as good. The mouthguard a dentist would make you will be custom fitted to your bite. If that is not possible, you could, alternatively, purchase an over the counter mouthguard. They pretty much come in a one-sized fits all so they will not be comfortable. But, they will be cheap.

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

Pediatric Dentistry

Baby Teeth Didn’t Come Out

Can you help me? I am 16 years old and most of my adult teeth have come in behind my baby teeth. This makes me look hideous. Is there any way to fix this? I’m tired of everyone’s comments and want to be able to smile without feeling like a freak.

Tara

Dear Tara,

teenager smiling with braces

I am sorry this happened to you. I’m a little frustrated on your behalf that your pediatric dentist never took care of this. Maybe you haven’t gotten to go to a dentist? That’s the only legitimate reason I can think of for this type of neglect on the part of a dentist. The good news is that this can be fixed.

First, if you have all your permanent teeth, the baby teeth will need to be removed. Don’t try to do this yourself. It needs to be done by a dentist. Then, the adult teeth can be moved into their proper place with orthodontics.

Whenever an adult tooth is erupting and the baby tooth is still in place, it is always best to remove the baby tooth as quickly as possible. This way you can minimize any misalignment. It doesn’t guarantee the teeth will come in properly aligned but does greatly increase the chances.

Sometimes a baby tooth doesn’t come out because of congenitally missing teeth, which simply means the adult teeth didn’t form and all you have is the baby tooth. In that case, you try to keep the baby tooth as healthy as possible and then, when all your teeth have erupted, you can have the baby tooth removed, open up the space for a replacement tooth and you are ready for a prosthetic tooth.

I hope this helps. You can get the smile you want.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck, an affordable Scottsdale Dentist.

Lumineers

Lumineers Disaster. What Should She Do?

I have a situation. I spent a ton of money getting Lumineers on my top six teeth. When I first went in, I told this dentist that I have had two dental bonding procedures done on my teeth that has made them look a bit bulky and I’d like that to be corrected with my Lumineers. The dentist assured me the Lumineers people knew exactly what they were doing. They did provide an image of what my smile would look like when they were completed and I was really excited about that. However, the result turned out nothing like expected. The closest I can explain it is saying I now have horse teeth. They are bulky and I have a huge overbite. My top teeth actually come out to the middle of my lower lip. They told me my muscles would adjust. I’ve been in tears since they bonded it. Is there any way to get my money back?

Catherine

Dear Catherine,

Lumineers Advertisement

I cringed when I read your dentist’s comment that the Lumineers people will know exactly what to do. There are two things wrong with that statement. First, it is the dentist who is supposed to know exactly what to do and give the laboratory specific instructions. Think about it like a doctor writing a prescription and the pharmacy filling that prescription. If the doctor writes the wrong prescription, there is no way for the pharmacist to know that. They can only do what they’ve been told. Second, the laboratory that does Lumineers’ work is not known for its beautiful results.

Getting a refund, however, could be tricky. Because cosmetic dentistry is not a recognized specialty, which means it is judged by the standards of general dentistry. That means to get a refund, it doesn’t matter what the results look like, but rather whether or not the smile is functional. If it is, all you can do is appeal to your dentist’s sense of pride in his or her work. If that doesn’t matter to them, I would tell them you’ll be posting a review about how they don’t care whether their “smile makeovers” are attractive or even feel comfortable in or mouth.

I’m sorry for what you went through.
This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Affordable Dentist

My Dentist Keeps Trying to Upsell Me

I am starting to get a bit frustrated with my dentist. Every time I go in, he keeps pushing new suggestions on me. This checkup it was a mouthguard because he said that I grind my teeth. Is this typical practice for dentists or is mine just greedy?

Brooke

Dear Brooke,

A dollar sign hatching out of an egg

I would like more information before I want to pronounce your dentist as greedy. Could you give me some more examples of things he’s pushed on you? The reason I asked you that is the suggestion for a mouthguard is not only appropriate but important if you don’t get some protection for your teeth in this case, then you will end up with your teeth ground down to nubs. The only way to fix that is with a full-mouth reconstruction, which entails placing a dental crown on every tooth. That will cost you upwards of $30,000. Getting a mouth guard can literally save you a small fortune.

If affording it is the problem you are facing, then you have a couple of options. First, you can ask your dentist if he’d be willing to allow you to pay it out. If he is not, there are dentists who would be. In that case, I would look for someone who advertises as an affordable dentist. They are much more willing to allow you to pay things out financially.

If that doesn’t work for you, there is a second option but it is not as good. The mouthguard your dentist would make you would be custom fitted to your bite. You could, alternatively, purchase an over the counter mouthguard. They pretty much come in a one-sized fits all so they will not be comfortable. But, they will be cheap.

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