Best Way to Fix My Nephews Teeth

My nephew wants to be an actor but his teeth are pretty crooked, at least in my opinion. He is about to graduate from high school. I want to get his teeth repaired for him as his graduation present so he can pursue his dream of being an actor. I spoke to one dentist who suggested Lumineers, but I’m a little concerned about this option. It doesn’t have the best reviews. Plus, from what I hear they will only last about 15 years. Should I look for something more permanent?

Aunt Mary

Dear Aunt Mary,

Clear Invisalgin Aligner
Invisalign’s aligners are invisible, even at a conversational distance.

If only everyone had an aunt like you! What a great way to help your nephew. I’m actually very glad you wrote because I want to make sure your money is well spent and not wasted on such a kind gift.

With how you described your concerns with your nephew’s smile, you have two options. Let’s start with the one your dentist recommended— Lumineers.

Option One: Porcelain Veneers

Lumineers is one brand of porcelain veneers and you’re wise to be concerned about the reviews you’ve read. It is highly marketed to inexperienced cosmetic dentists as being easy to place. The company claims it doesn’t require any tooth preparation (which is what they say makes it easy). In most cases, that makes the teeth look bulky.

A secondary problem is the company which makes Lumineers requires dentists to use their lab, which isn’t known for its beautiful work. Because of that, most expert cosmetic dentists prefer other brands of porcelain veneers.

If you decide to go the route of porcelain veneers, make sure you take your nephew to an AACD accredited dentist. These are the top cosmetic dentists in the country. They’ll know which brand will work best for your nephew’s smile goals and will create a gorgeous smile for him.

As far as the longevity of porcelain veneers. A lot of that depends on how well cared for they are. If they are not taken care of, they will only last around five years. If they are cared for diligently, they can last 20+ years.

However, you have a second option, which costs significantly less.

Option Two: Invisalign and Teeth Whitening

If all he really needs is orthodontics, I would suggest you go this route. With Invisalign, he can straighten his teeth without anyone knowing in half the time of traditional braces. Instead of metal wires and brackets, these use clear aligners. A sophisticated software program plans out his treatment then produces the aligners which he’ll switch out every two weeks.

Additionally, if his teeth need whitening, the aligners can double as teeth whitening trays which will allow him to straighten and whiten his teeth at the same time.

I hope this helps.

Chest Pain and Dental Care

Can chest pain accompany dental problems or is it always a sign of a heart attack? My mother is getting older and doesn’t enjoy dentists. I have trouble getting her there unless she has a toothache. This time she’s mentioned her chest hurts too. When I mentioned taking her to the doctor she said not to bother that it’s happened with other toothaches. Is that connected or is she avoiding the doctor on top of the dentist?


Dear Elisabeth,

Woman holding her jaw in pain from TMJ

While there is a link between oral health and cardiovascular health, chest pain should never be ignored. Ever. I think it is important you have your mother seen right away by a doctor to be safe.

About 10% of heart attacks report jaw pain as a symptom. Though, that is usually throughout the jaw and not localized to a single tooth. The most common description is pain throughout the lower jaw. Some people describe this pain but don’t have any accompanying chest pains, yet they were still having a heart attack. It is always better to have pain looked at. Each person’s anatomy and responses vary. There isn’t a single common symptom to look out for.

Some Other Symptoms of a Heart Attachk

The Mayo Clinic gives other signs of a heart attack to be aware of:

  • Nausea, indigestion, heartburn or abdominal pain
  • Shortness of breath
  • Cold sweats
  • Fatigue
  • Lightheadedness or sudden dizziness

Oral Health’s Connection with Heart Health

A number of studies have shown that people with gum disease are at a much higher risk of both heart disease and diabetes. The converse is true as well. Those with heart disease and diabetes seem to be at a greater risk of gum disease.

You said your mother tends to wait until she is in pain to deal with her dental health. Not only is oral care by dental emergency a painful and dangerous way to function, it puts her at a much greater risk of periodontal problems which will negatively impact her cardiovascular health. Not to mention that severe gum disease will lead to her losing her teeth!

If she avoids the dentist because of anxiety, she is not alone. Fortunately, there is a solution. Look on reviews of dentists to see who is considered gentle. For instance, with Dr. Burba, most children can’t even tell he gave them a shot. That’s the type of dentist your mother may need.


Full Mouth Reconstruction Disaster

I’m having a full mouth reconstruction and things keep seeming to go from bad to worse. When the temporaries were done, everything felt fine. However, once the permanent ones came in nothing is occluding well. Some of the teeth are hitting too soon and some aren’t hitting at all. My mouth feels awful. I can’t even eat. He’s tried to adjust them with grinding them down a bit but everything got progressively worse. I offered to pay lab fees to have these re-done, but he keeps trying to fix it himself. I went to see another dentist, but once he found out who did the work he wouldn’t say anything negative about the work. Before that, he seemed concerned about some things, but now I think he’s just trying to protect his colleague. What do I do?


Dear Bruce,

A man in pain needs to see a Salem Emergency Dentist

There are two things going on here. The first is that your current dentist is in over his head. A full-mouth reconstruction is something that is very advanced. It takes a significant amount of post-doctoral study. For instance, Dr. Burba studied about TMJ Disorder and occlusion at both the Dawson Academy and the Spear Institute. This type of intentional training is necessary to do the type of procedure you are trying to get done.

Occlusion is the study of how your teeth come together properly. You noted that some of your dental crowns were hitting before others. This is why you’re in pain. Normally, your biting force is spread across a group of teeth, but when you have a tooth that is hitting before the group then it is taking all the brunt of your biting force. That is a significant amount of pressure and will lead to pain.

Please bear in mind that I haven’t examined you. However, it also sounds like he’s thrown off your bite as well. This can mess with your jaw joint. That, in turn, will lead to TMJ Disorder, which is a whole other set of pain.

You are probably going to need to have this case re-done. In order to get some of your money back to make it possible for you to get it done right, you’re probably going to need to get a second opinion.

I know you’ve tried this already, but there is a trick to doing it in a way to get an unbiased answer.

Getting an Unbiased Second Opinion

I would look for a dentist who has experience in occlusal studies. In addition to the institutes I mentioned which Dr. Burba attended, you could also look for someone in your area who has attended the Las Vegas Institute of Advanced Dental Studies, often abbreviated LVI.

Once you feel confident that the dentist has the requisite knowledge to know what is going on, tell him (or her) what you’re experiencing. Under NO circumstances should you tell them the name of the dentist who did the original work. That is where you went wrong with your last second opinion.

Dentists know one another. Some are even close friends. They may feel conflicted in criticizing the work of a close colleague. If they ask you who did the work, tell them you just want an unbiased opinion so you won’t be naming the dentist. They shouldn’t have a problem with that.

If the second opinion dentist agrees the work isn’t done properly, you should be able to get at least a partial refund.
