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June 2010

How can I fix my really crooked smile ?

By Dental Implants

I am 35 years old and I have been living with a complicated situation on the upper right section of my smile for almost 20 years now. I have a decaying infant canine which never came out because of the adult canine growing in. The adult grew in the wrong place and never displaced the babyone.

My adult canine #11 grew in over the top of bicuspids #12. Also, I’m told that  #13  is too far away from where it belongs and is too complicated in its root structure to be moved with traditional braces.  # 11 is partially obscuring the two bicuspids behind it and creating a triangular inner area which is difficult to keep clean. It also happens to  be very unattractive.  My general dentist isn’t even sure what kind of decay might be going on up in there, but so far it doesn’t hurt or have an odor so I’m keeping my fingers crossed.

The whole area needs some serious work, but I’m not sure what the best option is. Do I extract the canines and get braces to widen the space where the baby was, so that a full-sized canine implant can be put in?   Or do I extract the canines and get a bridge?   Or… can something else be done with a smaller implant + veneers, or something to create the illusion of normal teeth ?   Please send me some input…I want to start figuring out which road I need to go down to try and fix this finally.

– Rhonda in Pebble Beach

Rhonda,

#12 (your first bicuspid) can be made to look like a canine from the front, so if your canine can’t be moved, I’d consider that option, too, after having the permanent and baby canines extracted. Or one dental implant could work – replacing the baby canine with a permanent canine implant. I wouldn’t do the bridge to replace the canine because your bone will shrink in that position over time if you do that and it will be hard to keep it looking natural. But it’s really tough for me to say without seeing you, seeing the x-rays, and doing a clinical examination. You sound like you have a very interesting case–I’d love to have had you come in my door and be given the opportunity to solve it. 

But if you don’t choose my services,  keep in mind that I recommend that you not ask a  general dentist to do this.  My recommendation – find an excellent cosmetic dentist and trust his or her judgment. 

 

Dr. Lavacca 

 

 

How can I treat damage from bulimia ?

By Cosmetic Procedures

I suffered from bulimia for almost ten years. Through counseling and treatment, I finally overcame the illness, but my teeth have been damaged severely. They are half of their original size, and in the front they no longer touch. Also, where my teeth do still touch, they don’t fit well.

And now, the left side of my jaw sticks out nearly an inch every time I open my mouth to bite or chew, which causes headaches.

Is there any hope for me and these issues with my teeth ? I’d like to see a cosmetic dentist to improve my smile and the functionality of my bite.
– Mary in Pittsburgh

Mary,
It’s a wise decision to think of a cosmetic dentist to help you with these problems. Bulimia is an appearance issue as far as your teeth are concerned. When there is little tooth structure left, you need to have bonding technology used to restore your smile because conventional cementation techniques may not be strong enough to hold crowns on your teeth.

And yes, your headaches are most likely caused by a TMJ disorder, which comes from your bite discrepancy. One other piece of good news is that most expert cosmetic dentists are also fairly well trained in treating TMJ disorders, which requires restoring your bite to it’s normal state. Brace yourself – you are probably facing the need for porcelain crowns on most if not all of your teeth. But the end result, if you go to the right dentist, will be a beautiful, radiant smile.

Congratulations on overcoming your disease! You have made great strides. The worst is behind you, and I anticipate things will just get better for you from this point on.
– Dr. Lavacca

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