Dental crowns are no longer just for celebrities. My patients who get crowns cross all socioeconomic groups. Most people I know wouldn’t go through life with a giant wart on their cheekbone. With modern technology it’s too easy to get it removed. Why then, would someone walk around with worn or broken down teeth?

Decades ago getting dental crowns was called it etting your teeth “capped.” Men and women whose careers thrived on their looks invested in dental crowns to increase their bankability as actors. Today, that economic advantage has spread to all professionals.

Let’s face it: a nice smile on any face is pleasant to look at. I don’t know of a single woman or man who likes to get up in the morning, look in the mirror and say, “hey, I’m likin’ those worn down decayed looking teeth!”

Dental crowns, along with dental implants, are the most asked for service in my practice. Beyond the appearance factor, crowns allow you to restore natural chewing function. When you allow decayed teeth to remain for extended periods, or walk around with root canals that aren’t crowned, you compromise your chewing function. You also put stress on muscles and this often leads to head, neck and jaw discomfort. The body is a finely balanced mechanism and the teeth are integral elements in maintaining that delicate balance.

The best dental crowns, in my thirty-five years’ experience, are those made by technicians who have mastered their art. I send my crowns to be made in a lab because I find the workmanship to be superior to anything that can be made in an office. Although in-office dental crowns offer you a faster turnaround, this benefit is outweighed by the fact that they’re not being made by a skilled lab technician who crafts natural-looking and perfect-fitting crowns every day. To say a dental assistant or even a dentist can produce the same quality is like comparing fast food to a slow cooked gourmet meal. We all know there’s a difference. In the case of dental crowns, the fees usually are the same regardless of where they’re made. So, given the option myself, I’d wait and get the crowns made by experts since I’m paying the same anyway.

The practice of replacing silver fillings with white, tooth-colored material for health reasons has been promoted by “biological” dentists who believe silver fillings are detrimental to your health. You may have heard these referred to as “silver”, “mercury”, or “amalgam.” These three terms are used to refer to the silver material which contains more mercury than silver, along with other metals.

If you’re confused about whether mercury fillings are safe or not, you’re not alone: even the FDA has seemingly changed their opinion. On June 4, 2008, the agency issued this statement on their website:

“Dental amalgams contain mercury, which may have neurotoxic effects on the nervous systems of developing children and fetuses.” And: “When amalgam fillings are placed in teeth or removed from teeth, they release mercury vapor. Mercury vapor is also released during chewing.”

The FDA also agreed to release a new ruling in July 2009, and alert consumers about potential related hazards.

Instead, on July 28, 2009 the FDA issued the following statement, as reported by Reuter’s:

“While elemental mercury has been associated with adverse health effects at high exposures, the levels released by dental amalgam fillings are not high enough to cause harm in patients,’’ the FDA said, citing an agency review of roughly 200 scientific studies.

The American Dental Association stands behind mercury filling safety, stating:

“Dental amalgam has been studied and reviewed extensively, and has established a record of safety and effectiveness.”

For cosmetic reasons 90% of our patients prefer the white, tooth-colored material. If you’re among those of us who grew up when mercury fillings were the only option and you haven’t had these replaced, you can whiten and update your smile by replacing these with this new tooth-colored material.

I don’t see enough hard science confirming claims that mercury fillings are linked to such conditions as Chronic Fatigue Syndrome or Alzheimer’s. However, I’ve been using the white, tooth-colored non-metallic filling material since 1987, thereby eliminating the issue for my patients. That said, some people are allergic to this non-metal material.

A “biological dentist” would recommend you remove these fillings for health reasons, believing that the longer you leave these in your mouth, the longer you are exposing yourself to metal toxicity.

I recommend replacing decades-old mercury fillings for two reasons: one is cosmetic and the second is tooth preservation. You see, as a dentist, my primary role is to enable you to chew. Since mercury expands and contracts with temperature changes, over time the teeth underneath can crack, which has been the case with some patients. Sometimes, the tooth can crack so deeply it must be removed and replaced with an implant and crown.

Ok, let’s address some common questions.

1. Are white fillings weaker than amalgams?

Yes, however, if you take the total result—the filling plus the tooth—the composites are stronger

because they bond to the tooth, making the tooth more resistant to fracture.

2. Why don’t all dentists offer white fillings?

Many dentists don’t feel comfortable using white filling material on back teeth—it requires special

training to do so. The experience and training ensures the filling isn’t vulnerable to leakage and

new decay. The material has been around since the 70’s, but it wasn’t until the mid-80’s that technology was developed to bond it to your tooth.

The distance between your nose and chin is detemined by your back teeth. So your entire face, lips and smile is dependent on your back teeth.

The teeth in the back of your mouth serve a vital chewing function. If that function is compromised due to missing or broken down teeth that need to be capped or replaced, the entire chewing mechanism is compromised.

This sets the scene for more tooth loss in the future. Besides, it reduces the ability to chew up your food and puts the brunt of digestion on your stomach. This often results in gastointestinal problems.

So, replacing missing teeth or getting crowns in the back of your mouth is not a cosmetic decision — but a decision in favor of maintaining overall health.

Julia Roberts Movie Star Smile

Julia looks like one of those lucky ones with a naturally gorgeous smile. But consider if she’d be as successful if that smile weren’t stunning.

You can transform your appearance from ordinary to extraordinary with the use of porcelain crowns (caps) and veneers. These dental procedures are called “cosmetic dentistry.”

Before you invest in this treatment, let me point out that you’re not just interior decorating. There’s two major areas of outcome you need to be concerned with: Do your teeth look natural? and do they chew comfortably?

Often when someone has extensive work done in their mouth, it’s noticeable. Sometimes the teeth seem to be out-of-proportion to the mouth. Or, they don’t look natural. With the technology available today, there’s no reason crowns and veneers can’t look like your own teeth and not like dental work, even to the most discerning eye.

An experienced dentist utilizing the latest technological advancements can give you a complete cosmetic makeover that is dazzling, and yet entirely natural looking and feels comfortable.

The hallmark of good dental work is it enhances your smile without being obvious. It’s beautiful, but natural looking and natural feeling. Let me give you some examples of what I consider dental work that is far too obvious. Dick Van Dyke and Carol Burnett had smiles that looked fake – their bite planes are off and their teeth don’t look natural. 

For those of you too young to remember those famous TV stars, just start looking at the smiles of stars in the magazines you see at the supermarket checkout counters. You’ll notice there are those that simply don’t look right to you. The teeth can seem out of proportion to the mouth or seem fake looking. Once you start looking, you’ll see what I mean.

When someone has had good dental work, you’d never guess they’ve had any work at all.

The three keys to a successful cosmetic makeover:

1. Correct the Structure First. You don’t want to do interior decorating of the teeth until the foundation tissues of the mouth and teeth are stable and balanced. The foundation of your mouth includes balanced jaw joints and healthy bone and ligaments surrounding the teeth.

2. Function Must Go Hand in Hand With Appearance.No matter how good the dental work looks, it has to be able to function in a way that facilitates chewing. If it impedes chewing or restricts jaw movements a person makes, the treatment will not hold up. Improper chewing can lead to muscle spasms, jaw joint dislocations, with mild to severe muscle pain, creating headaches, neck aches and back pain.

3. A natural look is not necessarily the whitest look. A tooth’s shade varies from the area at the gum line through the biting edge of the tooth. That’s why monochromatic tooth colors appear very unnatural.

Also know that if you’re just getting a single crown or veneer, the hardest thing to do is match that tooth color to its neighboring teeth. Therefore, if you’re crowning or veneering just one tooth, it’s vital your practitioner matches the shade exactly. Otherwise, that one tooth will shout to all its presence. If you’re interested in rejuvenating your smile, use the coupon above for an introductory consultation with me.

I look forward to seeing you at our St Louis office!

Over 2000 people were surveyed in Great Britain on the subject of attractiveness and teeth. Overall, the study revealed that nearly 1/3 of those between the ages of 45-54 have had some cosmetic dentistry vs. 20% of 18-24 year olds.

The same study also revealed that those seeking a new smile would prefer the more natural look of a celebrity like George Clooney to the dazzling white “Hollywood” grins of the likes of Simon Cowell. The academy’s Dr James Goolnick said “People want a nice healthy smile that looks natural. They don’t want people to say, ‘Where did you get that done? ‘”

Seems women in their late 40s and early 50s are the most inclined to have cosmetic dentistry. The British survey also found that almost twenty percent of those responding are so concerned about the state of their teeth that they refuse to smile when photographed.

Another independent study conducted on behalf of the American Academy of Cosmetic Dentistry discovered that the most common answer to the question “what would you most like to improve about your smile?” was whiter teeth.

According to the same survey:
-99.7% of Americans believe a smile is an important social asset.
-96% of adults believe an attractive smile makes a person more engaging to members of the opposite sex.
-74% of adults believe an unattractive smile can lessen a person’s chances for career success.
-88% say they remember someone with an attractive smile.

Only half of Americans are satisfied with their smiles.

Research and polls done in the last few decades repeatedly show that your smile influences how you are perceived and treated by others in every situation in life.

A survey done by the American Academy of Cosmetic Dentistry found that 74% of American adults believe an unattractive smile can harm a person’s chances of career success. Julia Roberts was at one time the highest paid actress in Hollywood. She also was voted as having the best smile in the business. Think there’s a connection?

People see your smile or teeth as the first or second thing they notice when they look at you. Some studies say it’s the eyes – others say the smile. Either way, when you come into contact with other people they will notice your teeth and smile no matter what, since the mouth and eyes are the chief vehicles for communication.

This is not a recognized specialty in dentistry. Rather, it’s a term we use in our office to describe the Pagano Protocol – the sequence in which your teeth, gums and structure are treated which results in a dazzling smile that sits in a structurally sound foundation.

What do we mean by “orthopedic cosmetic dentistry?” Think of your teeth and gums as the inside of a house and your jaw and head bones as the structure and foundation. Once Doc ensures that the structure is balanced and stable – which often includes treatment that eliminates headaches,

teeth grinding and other unwanted conditions – then the restorative and cosmetic treatments on your teeth and gums can be performed on a stable foundation. This results in cosmetic treatment that lasts, a bite that feels natural, and eliminates redoing your work.

One patient with lifelong headaches experienced complete relief. Her treatment included straightening her teeth and getting a gorgeous smile.

You can read more about orthopedic dentistry in Doc’s free downloadable ebook: Lifetime Smile at www.stlouisdentistdrpete.com.

Correct the Problem and These Symptoms Go Away. That’s Done By Balancing Your Head, Neck and Jaw Before Doing Dental Work. That’s What Orthopedic Dentistry Is All About. It Also Ensures Your Cosmetic Enhancements Don’t Create An Imbalance.

In a perfectly constructed mouth, the teeth and jaw fit together to perform the function of chewing. The slightest adjustment to a tooth can throw this precise functioning off-balance. Even the replacement of a filling can make your bite feel different if it’s not balanced correctly and if not adjusted, can cause your jaw joints to move out of place.

If just a simple filling requires such precision, imagine the skill required in placing veneers or implants while ensuring they not only look great but are completely natural in their feel and fit.

Like a perfectly balanced bridge constructed to withstand the elements of weather and carry immense weight, your teeth and jaw are designed with a similar precision. The ability to work with the precision of an engineer and the talent of a master artisan ensures your dental outcome is both sound and beautiful.

Rather Than Dread Dentures, View Them as a Chance to Design Your Own Smile

Morton came in as a new patient asking for a new set of dentures. In collaborating with him so we

could make him dentures he would be proud to wear, I asked him questions such as:

Do you want spaces between your front teeth?

What type of smiles do you like?

Who do you want to look like?

Do you want big teeth, little teeth, long teeth, wide teeth?

Do you want personalization, such as little character flaws built into your teeth?

Do you want perfect alignment?

Morton told me he’d never been consulted to that degree like when getting dentures made previously.

He said for the first time ever, he was excited to get his new denture appliance.

According to the Center for Disease Control, 1 out of every 4 adults over 60 have lost all of their natural teeth due to gum disease and tooth decay. Another CDC report says 1 out of every 5 adults over 65 have lost all of their teeth. Once that occurs, your choices are dentures or implants.

Although dental implants are an excellent alternative to dentures, not everyone can get them. This doesn’t mean you have to dread dentures. The biggest reason denture wearers switch to implants is:

• Their dentures are ill-fitting and uncomfortable;

• They don’t like how their dentures look.

You can dread dentures or view them as an opportunity to design your smile. If you want to pay $99 and get “teeth-on-a-plate” then the old adage “you get what you pay for” applies.

On the other hand, if you want someone to craft an appliance that feels and looks natural, you can spend the money and get something that will make you feel confident.

As an Art Minor in college, I see beyond the science of dentistry. Although an appliance needs to be engineered perfectly, the aesthetic appeal must also be present.

If you need a denture, view it as an opportunity to design the smile you’ve always wanted.

The American Academy of Implant Dentistry reports, “As the Baby Boomers begin filing for Social Security, they’re replacing teeth weakened from periodontal disease with dental implants instead of bridgework and removable dentures. Further incentive is that highly precise computer-guided dental implant surgery has made the procedure faster, highly predicable and long-lasting with a success rate of 97 percent.”

Trend #2: Teeth straightening will increasingly become the first step in a cosmetic makeover. It’s been a common practice to place porcelain veneers on crooked teeth. While this gives the appearance of straight teeth, it does nothing to address the health conditions caused by uneven teeth. These create uneven bite pressure which can lead to health problems, including headaches and migraines. With more dentists understanding the connection between the bite and jaw joints and head, neck and back pain, concern for health will lead to correcting the uneven bite rather than covering it up with veneers.

Trend #3: Gum Contouring Will Become More Popular. Just like lip plumping or botox improve appearance without surgery, contouring gum lines will become popular as more dentists investing in acquiring and learning how to use laser dental equipment. With laser technology being used in everything from skin care to knee replacement surgery, it was only a matter of time before it would be more routinely employed in your dental care. In addition to gum contouring which, by the way, is also great for men, lasers can disinfect diseased gum tissue. They can also cut into the teeth, making it faster and more comfortable to get fillings.

Trend #4: 3D x-rays will enable more precise dental treatment. Technology called “cone beam” takes two dimensional x-rays and makes them 3D. This allows your dentist to provide more precise dental treatment. For example, with a 3d picture, your dentist can see the nerve tissue surrounding impacted wisdom teeth. This allows for a better surgery. With implants, we’re able to determine more exactly their correct placement.

Trend #5: Teeth whitening will become part of a daily makeup routine for women. Whitening pens like Liquid Smile will make a professional in-offce whitening last a lot longer. Instead of bulky whitening trays sitting in your mouth for an hour with saliva coming out the side of your mouth, pens allow you to touch up the teeth that are visible.