Is a cracked crown an emergency?

My front teeth have had porcelain crowns on each of them for over a decade. I have noticed a very thin crack. It’s not very noticeable and it doesn’t seem to be an issue. But I am nervous that it will break when I least expecting it. Is it a dental emergency or potential dental emergency? The crown runs horizontally.

-Jay in Colorado


Since you are aware of the crack, it would be wise to have the porcelain crown replaced. It wouldn’t necessarily be considered a dental emergency, but it could turn into one if you leave it alone.

Since the crack is visible, it does mean the integrity and structure of the crown is compromised. Porcelain restorations sometimes have tiny lines through them which dentist refer to as craze lines which are not visible with the naked eye. But if you can see it, then the crown is at risk.

If you can also feel the crack, this adds concern to the situation. This would indicate that there is some movement that has occurred.

A cosmetic dentist that has an eye for aesthetics may be able to replace the cracked dental crown. And you should be prepared that even an expert cosmetic dentist may recommend having both of the front teeth crowns replaced. This is so that there is no differentiation in the uniformity and coloration with such a highly visible area.

Be careful if a dentist tells you that it is not possible to replace a single crown. That may indicate that they are not confident in their cosmetic dentistry abilities.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Am I too young to get a partial denture.

I’ll be honest. I think I’m too young to get a partial denture. I feel like the word “denture” automatically makes people think of old people. My teeth have been in bad shape for most of my life. I have several chips and some missing teeth. I can’t seem to find a dentist that has much empathy for me. There was one recent one that recommended a partial denture and I just expressed my thoughts on it. I don’t feel like a partial denture is a very permanent solution for my age. He seems set on doing multiple partials. Thirty-five years old seems to young for a partial.

-Rebecka in Minnesota


Different dentists have different philosophies on salvaging your natural teeth. Some will go to any extent to utilize whatever is existing versus recommending tooth replacement options.

You need to get over the stigma about something being called a partial denture. That said, there is a much better alternative to replace missing teeth called dental implants. Dental implants are a permanent solution that look, feel and function just like your natural teeth. They prevent bone loss around the implant site and look completely natural.

For chips and some missing teeth, it is difficult to give specific recommendations without having seen your case. There are many approaches that may be viable. Dental bonding incorporated with dental implants may be a better approach to someone at your age.

In your situation, it may be in your best interest to seek some additional opinions from implant dentists in your area. You don’t ever want to make a recommendation to a dentist that may push them out of their comfort zone. They have made a recommendation based on their opinion, philosophy and experience. So telling a dentist to place dental implants that doesn’t have the right training and experience could end up disastrous.

Hopefully this is helpful. Good luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.

Would my child be best served by a mercury-free dentist?

I have been considering taking my son to a mercury-free dentist. I feel a bit torn because my fillings are still standing and I have had them for over 20 years and they are the silver, amalgam type. That said, I don’t want to expose my son to mercury if I don’t have to. Any advice on the subject? If I decide to see a mercury-free dentist, the down side is it will be a new dentist. He likes our family dentist and I don’t want him to be nervous either. Can you tell me the benefits of going to a mercury-free practice? Is it worth it?

-Jan in Minnesota

The American Dental Association, the Food and Drug Administration, as well as the Environmental Protection Agency and the American Academy of Pediatric Dentistry still stand behind the claim that mercury-free fillings are completely safe. But, we all know the health dangers of mercury. The main question is that if there is another alternative that functions just as well, then why not go with the mercury-free option?

How certain are you that you need to switch dentists? Almost all dentists offer white composite fillings as an alternative which are completely mercury-free. There are many benefits of choosing a mercury-free dentist. They are actually stronger than amalgam fillings, less of the natural tooth structure is removed and they are tooth-colored so they blend in with the surrounding teeth. So before you make the decision to switch, ask your dentist about the options available to your son at your existing practice.

Sometimes pediatric dentists still prefer to place amalgam fillings on children. This is mainly due to the fact that the child must sit completely still during the procedure and the area must dry completely in order for the bond to be successful. So if your dentist won’t work with you on this, you may need to consider moving to a new mercury-free dentist if that is the route you decide to go. Sedation dentistry or what pediatric dentists like to refer to as “goofy gas” (nitrous oxide) will help keep your son relaxed and help keep him still in the chair. Pediatric dentists also do a lot to help keep children engaged, calm and they often have movies to distract children during appointments and this may be a successful approach to pursue the tooth-colored, mercury-free fillings.

This post is sponsored by Cleveland dentist Hylan Dental Care.

My all-on-4 looks terrible!

My dentist has been promoting the all-on-4 dental implants for years. I finally decided to do it and I hate it. It looks so bad! He convinced me to get the all-on-4 because getting dental implants to replace all my teeth would bankrupt me. I didn’t want to do some of the other lesser expensive alternatives because I didn’t want to compromise on stability. I had no idea my teeth would look so fake. I was told the final product would look completely natural. I feel like a horse – no joke! When I tried to tell my dentist that I wasn’t happy, he basically told me to get over it and that I’d get used to it. He kept reiterating how the feel would improve and over time I would be happy with it. I don’t feel like he’s listening. My unhappiness has nothing to do with how they fit, it’s how they look! Is there anything that can be done to improve them, aside from having them redone?

-Louis in Louisiana


Well, let us apologize on behalf of your dentist. It sounds like you have had a negative experience all around. At the very least, the dentist should acknowledge the way you feel about the end product and then help you work through it. It sounds like he failed on that front. The aesthetics for all-on-4 dental implants relies heavily on the laboratory that he uses. If there is any good news about where you are at in the process, it’s that you don’t have to start completely over to improve the appearance. It sounds like the implants seem to be stable and working well for you from a functional perspective. And that is usually the area that patients become frustrated in. So, as long as you are satisfied with the fit, it is only the denture portion that needs to be redone.

It may be possible that your implant dentist doesn’t have an eye for the aesthetics because having the teeth reshaped and created to appear more lifelike isn’t that difficult of a process. He should absolutely try to improve the aesthetics for you, free of charge. Although, you may be best served by having a consultation with a dentist that is experienced in placing all-on-4 dental implants and has more of an appearance-related dental work portfolio. It would be in your best interest to take the new dentist a photograph of yourself prior to the work being done. This will give him or her a clear direction for the end result you are hoping to achieve.

Keep in mind that over time, an individual’s teeth change. Longer teeth on a denture will make you appear younger. So that’s something to keep in mind. You may consider taking in a photograph of you when you were younger, as well. Hopefully, you are able to find the right dentist to understand the end result you desire. You should not have to settle.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Not sure which dentist to see after a bad car accident?

My wife was in a terrible car accident a couple weeks ago. She will be fine, thank God. But there is a long road of recovery she will be working through. The airbag failed. So her face was severely damaged by the steering wheel. This resulted in several teeth being knocked out. The ER did the best they could with the dental work but we were informed that she would require more oral surgery. When she was discharged, they gave me information for a prosthodontist and an oral surgeon. But I was wondering if we should start with our general dentist that we have seen for over 20 years. Do you have a recommendation on which doctor will be fit her needs?

-Mel in California


That is a good question. Keep in mind that every dentist regardless of their specialty or focus, have the same basic qualifications. The dental schooling is very similar all across the board. But additional schooling and training is required for oral surgery and to be a prosthodontist.

It may not be a bad idea to meet with your family dentist. It is quite possible that your wife’s needs may be well within his skill set. And if you have a certain level of trust with him, his referral may hold more weight than the names you were given in the ER.

Oral surgery will focus on repairing any bone or rebuilding the traumatized site. It sounds like if the teeth have been knocked out, she may also be a dental implants candidate. There are two components to dental implants, the oral surgery and the restorative phase. Some practices provide all these services in-house or they have preferred specialists that they work with.

The prosthodontist will be focused on restoring any of the facial tissue, the mouth or nose if there was damage that she incurred. Dental implants, a dental bridge or other alternative may be recommended.

There is nothing wrong with meeting with all of these doctors and seeking several treatment plans. That said, it sounds like your wife has been through a lot and she may prefer starting with your dentist because she is comfortable there.

Best of luck. Hopefully, she makes a full recovery.

This post is sponsored by Cleveland dentist Hylan Dental Care

I’m pregnant. Do I need a holistic dentist?

I have been obsessed with getting pregnant because we have been trying for over a year to get pregnant. Good news, we are expecting! I have done a ton of research about getting pregnant and have all the doctors set and decided from my OB all the way to my pediatrician. But, I didn’t think about dentistry. I’m wondering if I need to make the switch to a holistic dentist for the duration of my pregnancy. I assumed my dentist would understand my apprehensions. But when he tried to give me an x-ray last week at my regular check-up, I’m doubting he will be the right fit during pregnancy. Do you have any advice on the subject?

-Kendra in Kentucky


It sounds like a congratulations is in order! That is such exciting news. It is understandable that you want nothing but the best for your unborn child and that you would consider switching to a holistic dentist.

First, you need to relax. Added stress and anxiety during pregnancy only increases risk. Try to take it easy. Your regular dentist didn’t necessarily do anything wrong though.

Here’s a little background on pregnancy and x-rays during dental treatment. Dental x-rays are typically considered a safe practice because they have low radiation. Most offices utilize digital x-rays so there is even less radiation exposure. Another factor to consider is that they are focused on such a small area so the scatter is low. The protective lead apron is also there for the safety of you and your unborn child. All that to be said, there are some OB doctors that recommend avoiding x-rays. If that is the case, your doctor can provide you with those recommendations so you aren’t put into a compromising position again. So you can stay with your regular dentist. Yet, it is your choice to make the switch if you are in anyway comfortable. Discuss it with your OB to get further peace of mind and their insight on the matter.

Optimum oral health is essential during pregnancy. Bacteria and gum disease can negatively impact birth weight so it is important to seek regular dental care during pregnancy.

A holistic or natural dentist will take added precautions. If you require invasive treatment, it may be best to put it off until after the baby is born. Again, it’s best to build consensus and buy-in from your OB and run any specific treatment options through them.

Thank you for your question. Enjoy every moment of your pregnancy.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Is a Nesbit partial denture illegal?

I had a cracked root and the tooth was removed. I have a temporary appliance in now and I want to learn more about a Nesbit partial denture to replace it. But my dentist told me it is illegal here in Oregon. Have you ever heard of that? He cautioned me against swallowing or inhaling it. The appliance I have now has wire attachments and a large plastic piece. Can you provide any insight?

The Nesbit partial makes more sense to me because it isn’t made of metal, which I prefer. Do I need to drive out-of-state to find one. Is it illegal in other states to?

-Lauren in Oregon


That recommendation sounds a bit skeptical. To be completely transparent, I am unsure if a Nesbit partial denture is illegal in Oregon. That would be very surprising because I’ve not heard of it being illegal in any other state. That said, it does present some hazards and doesn’t come very highly recommended. So maybe your dentist was cautioning you of the potential dangers with the appliance. Although, that doesn’t necessarily make it illegal.

From what you have described, it sounds like your temporary appliance is a flipper partial which is comprised of a small plastic plate held in place by tiny wire claps. If that is indeed the case, it should continue to function adequately if it is well maintained. You don’t need to dispose of it because it could quite possibly last for several years. Although not an ideal solution for the long term, it still functions just fine.

If you are convinced that a Nesbit is the way to go, contact other dentists around town to get some more insight. It would be unheard of if you had to drive to a neighboring state. Good luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.


The treatment done at the emergency dentist doesn’t look good.

My tooth was killing me and I was out of town for an extended time. So I made an emergency dentist appointment to get it taken care of. I thought the emergency dentist did okay. I don’t mean to complain but I honestly don’t think the crown blends in. Can it be fixed? Is it rude to go back to him to see if it can be done better?

-Paul in Minnesota


Most emergency dentists exceed in making patients comfortable and getting them out of pain. It sounds like that was accomplished, yet their skill-set may not involve cosmetic dentistry.

Sorry to tell you that once a porcelain crown has been placed, the color cannot be altered. The only way to correct the color would be to have the crown redone. It is quite possible that the emergency dentist that you saw was a general dentist and didn’t have extensive training in cosmetic dentistry. Sometimes patients don’t realize this but cosmetic dentistry is like an art. General dentistry is much more focused on fixing a functional problem. Although your crown is likely quite functional, it sounds like it is lacking in aesthetics. It is also worth mentioning that emergency dentistry and cosmetic dentistry are not recognized specialty areas with the industry. So, this means any dentist can claim to offer services and may not excel in them.

If it doesn’t show when you smile and you can live with it, you can have it replaced down the road. If it’s bugging you and you don’t want to deal with the discoloration for the next 10-20 years, it sounds like it’s time to see a cosmetic dentist.

Good luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.


My denture is too hard!

I really don’t like the way my denture feels on the roof of my mouth. It’s too hard and feels fake. Is there such thing as a soft denture?

-Beatrice in Nebraska

There are dentures that are made with a flexible lining. If you have bony ridges or bumps on the roof of your mouth, complete dentures can be very uncomfortable. Many denture wearers report painful sores when that happens too. A soft denture will help with that but tends to be more expensive. Also, they don’t have as long of a lifetime and take more work to keep clean. But your quality of life is definitely worth it.

But there are not “soft dentures” because they require some firmness in order to provide function when you chew. So they cannot be manufactured out of completely pliable material.

Dental implants are an option you may be interested in exploring. You can combine dental implants with a hybrid denture implant restoration. This type of treatment plan would completely eliminate the portion that cover the roof of your mouth. Dentures prevent facial collapse and other common denture problems. They help provide stability and are a permanent solution.

Thank you for your question.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Is a BPA filling worse than a filling with mercury?

I am trying to make some healthier, holistic choices for me and my family. I have decided that I would like to have my old amalgam fillings replaced by a holistic dentist. But the more research I do, I’m discovering that basically means that the white composite material contains BPA. Part of me thinks I may be better off leaving the mercury in my body. BPA is just as detrimental. So, my big question – which is worse? When I tried to discuss this with my current dentist he basically told me that holistic dentistry is a fad. His standpoint was don’t fix it, unless it’s broken.

-Becky in California


When you lay it out in that way, it sounds like your damned if you do and damned if you don’t. The FDA and ADA still support the use of mercury-containing amalgam fillings. But it is no secret how bad BPA and mercury can be to us. These organizations feel that both of these filling materials are safe and effective when used correctly. That said, there is a growing movement of holistic dentists that feel differently.

If you examine the research regarding mercury toxicity, it suggests the possibility of neurological and nervous system problems. Whereas BPA exposure studies site hormonal problems and potential organ failure. So, none of these “evils” sound like a positive choice.

There are holistic dentists that empathize with your views. They support sanitary amalgam removal and will replace the fillings with BPA-free, white composite fillings. This is a relatively newer movement. So, you will need to find the right dentist that aligns with your preferences. But with continued research and perseverance, you should be able to locate a BPA-free and mercury-free dentist in your area. It sounds like the peace of mind will be worth it.

This post is sponsored by Cleveland dentist Hylan Dental Care.