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

September 11, 2011 alexnguyen

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,

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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?

June 27, 2011 alexnguyen

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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What to do when a crown or a bridge falls out?

April 30, 2011 alexnguyen

Crown and bridges are cemented or bonded in place. Although we can make them look exactly like the real teeth, they are not truly "permanently" attached to the teeth. They can de-bond (detach) from the teeth for many reasons, including heavy uncontrolled teeth grinding, chewing of strong sticky candies, etc... When a crown or a bridge falls out, it is best to try to:

1. Reinsert it into the exact place, EVEN if the tooth does not hurt.

2. Keep it in the exact place until you are able to see your dentist, EVEN if you cannot get to your dentist for an extended period of time.

3. Have your dentist evaluate the underlying tooth structure to make sure that decay is not the cause of the detachment.

Do not use glues such as Crazy Glue. Household glues do not work, and they will distort the fit between the tooth and the restorations.

Do not leave them out of the mouth: The adjacent teeth can easily move into the space where the crown or the bridge was occupying. When this happens, the restoration will no longer fit and the only solution may be to replace it with a new one.

As always, a little common sense will save you and your dentist both time and money.

Thanks again for reading my blog.

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Naturally Beautiful Smiles

March 5, 2011 alexnguyen

Occasionally I have the pleasure to invite some of my patients to do a photo shoot for ... fun ! Here are some samples of our latest collection of beautiful smiles. Whether it is a full mouth of restorative works or a few enhancements, I want the smiles to be simply beautiful and natural looking.

Thanks to Ivy, Alydia, and Saifon for allowing me to showcase your smiles.

My sincere appreciation to our stylist Jackie ( www.jolidejackie.com) and our photographer Paul (www.ferradasphotography.com).

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

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Can a Smile Makeover be Done in Two Visits?

February 14, 2011 alexnguyen

On December 19th, 2010 I posted a blog entry with a wonderful smile guide sent to me by a well-informed patient. Last Friday I delivered the porcelain restorations which completed his smile makeover process. I will still have to bring the patient back to fine tune and touch up some of the detail work. I could not have done the job in two simple visits like many advertisements claim to be able to do. The process cannot be done in two visits because a number of critical steps must be carried out:

- Diagnostic work-up of the case

- Laser contouring of the gum

- Equilibration of the bite

- Bonding of some of the teeth

- Preparation of the teeth for porcelain

- Working with the ceramist while the case is at the lab

- Tryin/delivery of the final restorations

Depending on what level of quality you are looking for, the process typically defines the end result.

Here is the feedback I received from the same patient today via email about his feelings regarding the end result of the case.

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From: S

Subject: teeth

Date: February 14, 2011 11:54:26 AM PST

To: Alex Nguyen

Hi Dr. Alex, just wanted to drop a quick note to express how happy I am with how my smile has turned out (the gums are much better and closer to normal now) The teeth are exactly what I wanted: shapes/edges are just as envisioned, and the whiteness and translucency couldn't be any more perfect. I noticed the very slight decalcification on the inciscor is exactly as I wanted. The bite feels solid and like my own teeth.

In short I can't stop myself from looking in the mirror and smiling :) Thanks for your hard work and attentional to detail. Looking forward to the fine-tuning and tweaking of the bicuspids and wrapping up the case.

See you soon

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