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All Posts By

Dr. Anthony LaVacca

Jul 15

Can I use Invisalign if I’m missing teeth?

By Invisalign

I should have had braces when I was a child, because my bottom teeth are terribly crooked. Also, my bottom left back molar, and two bicuspids that were still baby teeth, had to be removed.

I’ve been considering getting Invisalign, but I’m not sure if it will work if I have missing teeth. I really don’t want to have the traditional braces now that I’m older. Also, I’m concerned that I may need dental implants to fill the gaps from my missing teeth.

Another concern is my underbite and the lack of space between my top and bottom. Can this be corrected with Invisalign too?

Jessica from St. Louis

Jessica,

There are a couple things that may prevent you from using Invisalign, excluding missing teeth. Invisalign works fine with missing teeth. In cases when there is an underbite and/or severe crowding, Invisalign may be difficult to use.

Some dentists are willing to use Invisalign on patients who have crowded teeth, while orthodontists may be more conservative. Orthodontists tend to shy away from new technology since they have been trained to work with brackets and wire.

Do your research first before making a hasty decision. Visit a few Invisalign general dentists to see what they recommend. If you decide to go with a general dentist, all cases are required to be supervised by orthodontists who are on staff at Invisalign headquarters.

Depending on difficulty of your case and the positions of your teeth, Invisalign could close the spaces in your lower jaw, and it may help move your upper teeth out without the need to replace those missing teeth.

I wish you the best.

Jun 29

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 

 

　

Jun 16

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

May 13

Should I see another dentist to fix my son’s teeth?

By Dental Bonding, Pediatric Dentist

My 10-year-old son fell off his bike yesterday and broke his upper front tooth and cracked another one horizontally. Thankfully, we managed to get him in to see the dentist. However, the dentist said he was unable to fix his teeth until next month. He also said that we should wait a few weeks to allow the root to desensitize. Is this waiting period standard procedure, or should I find another dentist?

-Jennifer from Texas

Jennifer,

You shouldn’t have to wait to fix your son’s teeth.

If you happened to find the piece of tooth that was broken off, it can still be reattached. Find a good cosmetic dentist to do this procedure though. You’ll want someone who knows how to match the other front tooth, and this requires someone who has excellent aesthetic dental skills.

If you don’t have the broken piece of tooth to reattach, then direct dental bonding can be used to repair the tooth. In time, the pulp will become smaller as your son ages, so depending on the extent of damage to both teeth, he may need a single crown or more.

Learn more about pediatric dentistry and about kid’s basic dental care.

May 03

Can I use peroxide to whiten my teeth?

By Teeth Whitening

Is it possible to use 3% hydrogen peroxide that you can buy over the counter to whiten teeth?

Wendy from Edmund, OK

Wendy,

It is possible to rinse with peroxide, but it won’t make that much of a difference. You can still use an at-home treatment, but you should use one that is supervised by a dentist. Trays and a whitening agent will give you nice results just as long as you allow the solution to penetrate your teeth for a minimum of fifteen minutes. And for quicker results, the trays and whitening agent can safely be worn for a couple hours per day or overnight.  Keep in mind that tooth stains are typically deep, so you want to be sure to whiten the dentin, which is beneath the tooth enamel.

Another alternative is to wear the Crest Whitestrips thirty minutes per day for two weeks. They have roughly a 6% peroxide concentration. This method will provide mild whitening, and it outperforms rinsing with 3% peroxide. This should give you a good perspective of how long it would take to whiten your teeth when just rinsing with peroxide.

Learn about options to whiten discolored teeth, such as Zoom whitening and cosmetic dentistry procedures.

Apr 22

I’d like to know how much dental work can be done in one visit.

By Sedation Dentistry, Teeth Whitening

I’m in need of extensive dental work including a tooth that needs shortening and whitening, 7 root canals, and 3 cavities. I’m trying to avoid making several appointments with my dentist. Can you tell me how much work can be done in one visit?

Jake from Carson City

Jake,

Each dentist is different regarding how much work they’re willing to do in one sitting. You’ll need to ask your dentist what he or she is willing to do for you.

Dentists that provide sedation dentistry are often the ones willing to do more work in one sitting. Check with your dentist to see if sedation is available, and if not, then you’ll need to find another general dentist or cosmetic dentist that offers it.

If you want to remain with your current dentist, then the amount of work depends on how long you can withstand the visit. It is possible to sit  through a four-hour appointment if you feel at ease with dentistry. A lot can be done in this amount of time if your dentist is capable of working fast.

Providing there are no complications with your front tooth, your dentist should be able to do the tooth whitening and shortening.

Your dentist should be able to complete your seven root canal treatments in one sitting as long as they are on your front teeth. If you require root canal treatments on your molars, and you prefer minimal appointments, then you could go to an endodontist. Endodontists are root canal specialists with the ability to perform a molar root canal in one hour, while a general dentist can take up to two hours per molar.

Apr 16

Can I use Invisalign if I’m missing teeth?

By Invisalign

I should have had braces when I was a child, because my bottom teeth are terribly crooked. Also, my bottom left back molar, and two bicuspids that were still baby teeth, had to be removed.

I’ve been considering getting Invisalign, but I’m not sure if it will work if I have missing teeth. I really don’t want to have the traditional braces now that I’m older. Also, I’m concerned that I may need dental implants to fill the gaps where those teeth were pulled.

Another concern is my underbite and the lack of space between my top and bottom teeth. Can this be corrected with Invisalign too?

Jessica from St. Louis

Jessica,

There are a couple things that may prevent you from using Invisalign, excluding missing teeth. Invisalign works fine with missing teeth. In cases when there is an underbite and/or severe crowding, Invisalign may be difficult to use.

Some dentists are willing to use Invisalign on patients who have crowded teeth, while orthodontists may be more conservative. Orthodontists tend to shy away from new technology, because they have been trained to work with brackets and wire.

Before making any decisions, do your research by visiting a few Invisalign general dentists and see what they recommend to you. And if you do decide to go with a general dentist, all cases are required to be supervised by orthodontists who are on staff at Invisalign headquarters.

Depending on the difficulty of your case, and the positions of your teeth, Invisalign may close the spaces in your lower jaw, and it could help move your upper teeth out without the need for replacing those missing teeth.

I wish you the best!

Feb 08

Will my son’s baby teeth return to their normal color after bumping them?

By Pediatric Dentist

My 4-year-old son fell and injured his top front teeth. After the fall, I noticed his teeth began to change color. Will it help if I change his diet?

Tammy in Ontario

Dear Tammy,

Since he is four, these will be your son’s baby teeth. There really isn’t much you can do to get them to return to their normal color. I would get the teeth checked, though. The discoloration to your son’s two front teeth may be from the tissue inside dying, and that will need to be treated. They may also be perfectly healthy, and the darkening may be from a natural buildup of dentin inside the teeth, which is provoked by the injury.

Changing your son’s diet won’t be of any help either.

It will only be a matter of two to three years more years until your son’s front teeth naturally fall out, and then his adult teeth will begin to come in.

Learn more about pediatric dentistry by clicking here.

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