How Come the Color Could Never Match For Crowns on the Front Teeth?

The two front teeth are the most commonly restored teeth.  They erupt into the mouth at about the age of eight, and being positioned in front of the mouth they often sustain the most damage. Color is not the only parameter required to match the two front teeth with the rest of the teeth in the smile.  Among other factors, we have to also match contour, surface texture, and shade variations of different areas of the teeth.  Matching the front teeth is like sculpting a portrait of what they used to look like. That is the only way they will blend in with the natural dentition. Furthermore, the two front teeth serve as a very important guidance for joint stability and function.  We must approach the front teeth in more than one dimension.

When done correctly,  restorations for the front teeth will disappear into the rest of the smile.  Here is a testimony from a recent case I delivered last week.

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Email dated 9/09/2011

Dear Dr. Alex,

I want to personally thank you for the wonderful job you did on my case. Although it took longer than I anticipated, it was worth the wait and I am very pleased with the end result. You definitely have the knack for how teeth should look and function. I really appreciate your thoughtfulness and professionalism. ...Again, I want to thank you for a job well done.

P.S. you will soon have another positive review on Yelp :)

Sincerely,

K

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Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.

Why Should Adults Consider Orthodontic Treatments?

It is not uncommon that I recommend my patients to consider orthodontic treatments to straighten their teeth.  Sometimes my adult patients' initial reaction would sound something like:  "I am too old for that, and I never thought about the cosmetics of my smile..." Having straight teeth is not ALL about cosmetics.

The misalignment of teeth can cause a variety of problems ranging from TMJ issues, to bone loss, to excess fractures and wear facets on the teeth.  This type of break down in the dentition can take many years to manifest. Unfortunately, sometimes when the patient starts to notice the problems, the solutions may require a complex combination of orthodontics and restorative treatments.

Properly aligned teeth actually follow very scientific principles created by nature to establish the most stable functional foundation.  When teeth are properly aligned, certain functional movements of the jaw allow for optimum chewing, relaxed muscle state, and ideal joint health.  The cosmetics of the smile is automatically achieved secondarily when the functional foundation is established.  Finding the right orthodontist is key to successful treatment.

Hence, when you choose to have orthodontic treatment done, you are stabilizing the most important aspect of the dentition:  To allow you to sustain life by being able to chew effectively throughout the course of your life span.  As the human life span continues to lengthen, it is extremely important to make sure that you will continue to have a stable dentition for your chewing needs.

In the photos below you will find a smile with "crooked teeth".  Whereas the patient was never concerned with the cosmetics of her smile before, she has lately been concerned with the fractures lines and wear facets indicated by the red arrows.  Her question to me at the last check-up was:  "What would my teeth look like...say ten years down the line..."

My answer to her was:  "They would look more broken down, and you will also notice problems with the back teeth as well."

So as you can see... My recommendation for this patient to choose orthodontic treatment was based on achieving proper function, and not ALL about cosmetics.

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Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.

My tooth hurts. Does it mean that I have a cavity?

Today I will tell you that the answer to this blog heading is:  NO ! Sometimes when a tooth comes into contact with the opposing teeth in a way that directs excess force to the neck of the tooth,  this can cause micro-fracture of the enamel there.  When the outside layer of the tooth (enamel) is stripped, the inside layer (dentin) is exposed.  The tooth can become sensitive to substances that are cold, sweet, sour, etc...

There is no cavity in the photographs below, but the symptoms make the patient think that a cavity is there.

Take a look at the indentation (the notch) at the neck of this tooth:

Now...

Observe how the same tooth is the only one that contacts the lower teeth when the patient moves her jaw from side to side.

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Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.

What is tetracycline stain?

Tetracycline is an antibiotic. At the age of three, children have already developed tooth buds of the permanent teeth inside the jaw.  When tetracycline is given to children, this drug penetrates the developing tooth buds and incorporates itself into the tooth structure. When the teeth erupt into the mouth, the result is bands of dark stains with usually a combination of brown, gray, and yellow colors. These stains make up the actual colors of the teeth and are impossible to bleach completely into normal white teeth colors.

Note:  Once a tooth has erupted into the mouth and the root of that tooth has completely formed, tetracycline cannot affect that tooth.  It is also a misconception that all antibiotics will cause yellowing of teeth.

The human eyes are used to seeing the smile with white teeth.  Smiles with dark tetracycline teeth are not as esthetically pleasing as smiles with normal white shades of teeth.

Porcelain veneers done on tetracycline stained teeth are very difficult for many reasons.  A clinician has to mask out the dark colors underneath, and create at the same time the proper tooth form, contour, texture, and details of the edges of the natural tooth.

Here are the before and after photos of a case where I used porcelain veneers to enhance a severely tetracycline stained smile.  The after photo was taken two weeks after delivery.  The gum tissue will continue to heal and adapt to the new porcelain, and the colors of the porcelain teeth will become even more realistic after some time.  In this case the patient opted for a super white shade, yet with proper planning and execution we can still create a natural looking smile.

Images of actual patients of Alex Nguyen, DDS are Copyrighted and Digitally Embedded to track Unauthorized Use.

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Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.

From a patient who moved to Hawaii

Email dated June 23, 2011 to her parents. Aloha Dad and Momma,

Dr. Jonathan Kam is my dentist who went to college at UCLA and Stanford. He told me that he knew Dr Nguyen from conferences and his excellent reputation. In fact, when Dr Kam examined my fillings, Dr Kam asked me who did my fillings because they were some of the best fillings he had ever seen and reported he was a "filling snob." I told him Dr Nguyen in San Jose did my fillings and Dr Kam said, "Oh my gosh, I know him! He is an excellent dentist and one of the best." Dr Kam told me to tell Dr Nguyen what an excellent job he did with my fillings. So, That's the story:)

 

The waves were huge in Waikiki today! They were about 15 ft and yes, I surfed them! It was really fun and I had a great time surfing because it is very rare that Waikiki has big waves like today. I am really excited for Mom to come and wish you were coming too, Dad:( Hope you have a nice rest of the week and talk to you both soon.

 

I love you,

J

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Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.