Please Tell Me I Don’t Have to Remove All My Teeth

I need some advice. I have avoided the dentist for years. It’s a long story, but my fear started when I was a child after a horrible experience. I started having a toothache which was pretty bad and decided I had to go in. It was equally horrible. He told me all my teeth are bad and I need to remove them and get dentures. He tried to insist I do it then saying I’d die if I didn’t. I started to cry and he essentially said I’m being a baby and did this to myself. Then said if I’m not going to do what’s necessary, I need to leave. I left devastated thinking even if I HAD to do this I didn’t want to do it with someone so insensitive. I’d rather give my money to someone else. But, I’m only 32 years old. Are dentures really my only option? I don’t want to look like my grandma. But, I also don’t want to die.
Stacey A.

Dear Stacey,

Dental implant
Dental Implant

I’m sorry you’ve had such a disastrous experience for a second time. I want to assure you that not all dentists are like this. The behaviour of this dentist makes me question his diagnosis. First, most dentists try to save as many teeth as possible. If it’s not possible to save any teeth, the next best option is dental implants. I don’t know any dentists who would suggest full dentures. They’re a last resort kind of option because of all the drawbacks.

What I’d like you to do is get a second opinion. I’m optimistic at least some of your teeth can be saved. You only mentioned the one toothache. I don’t know if you had any symptoms of gum disease. Some ways to recognize that is gum tenderness and even bleeding when brushing your teeth. If it progresses too far, without treatment, it can cause you to lose your teeth.

As far as threatening death, a tooth infection left untreated can spread to the brain or heart, which will lead to death. Only the severely infected tooth would need to be removed, not all of them.

Whatever teeth you do end up losing, you are better suited having replaced with dental implants. That gives you a prosthetic tooth root which will protect you from losing jawbone. That shrunken look your grandmother has is from that loss of jawbone. It’s called facial collapse and is a side effect of dentures. You won’t have to worry about that from dental implants.

I also wanted to address your dental fear. Most patients with dental anxiety developed it in childhood just like you, due to a negative experience. I’ve found that many patients with dental anxiety do much better with dental sedation. The chance to have pain-free dental experiences generally changes their whole outlook on dentistry. Eventually, many don’t even need the dental sedation anymore.

It’s worth looking into, especially if you end up needing more than that one tooth worked on. It can allow you to get a significant amount of more work done than you normally could in one sitting, all without pain or stress.

This blog is brought to you by Dr. Jerome Cha.

My Porcelain Veneer Is Turning Dark at the Top

I need some advice. I had a large chip that my dentist repaired with a porcelain veneer. It always looked okay, but for some reason it’s turning dark at the top near the gumline. I don’t know why. I’ve only had it for two years. The dark line is really visible and is making me feel awkward about smiling. Do you know if this is normal? My dentist never mentioned this as a possibility.

Serena A.

Dear Serena,

I can think of a couple of possibilities for what is happening. If you truly have a porcelain veneer (and I’ll explain why I’m not positive that’s what you have in a moment), then it means it’s not bonded on properly. A porcelain veneer should sit flush against your gums so that nothing can become trapped there. If it’s not properly placed there can be a ledge. This will attract food and bacteria. If it’s not dealt with it will lead to decay. Poor bonding can also leave a space between the veneer and your tooth which will allow things to seep between them. Not only will this also lead to decay, but your veneer will turn dark from the things gathering beneath it.

However, if you had a very large chip it’s possible you were given a dental crown instead. Porcelain veneers are used for smile makeovers and only cover the front of your teeth. Dental crowns are used to cover the whole tooth when there are large chips or decay over a majority of the tooth.

If you were given a porcelain-fused-to-metal crown, it would explain the dark line as well. These will begin to show the metal at the top of your gums eventually. However, it generally takes more than two years for that to happen. There are a couple exceptions to that time rule. One is if you have gum disease. Another is if you brush hard. That can cause your gums to recede.

Either way, the only way to fix this is to have either the crown or the veneer re-done. If it is a crown, be sure to have them give you an all-porcelain crown this time, so you don’t have to worry about a dark line eventually showing up. However, if there is gum disease you’ll want to address that as well. If it’s a veneer, the problem resulted in an error on the dentist’s part. They should repair it for free.

I hope this helps.
This blog is brought to you by Dr. Jerome Cha.