436 N Roxbury Drive Suite 100, Beverly Hills, CA 90210 Call Us: (310) 276-2468
Beverly Hills Institute of Dental Esthetics
Model Smiling

Brian LeSage, DDS, FAGD, FAACD

Imagine yourself with an
exquisitely beautiful smile.
Request an Appointment
Request an Appointment

My Dentist Can’t Adjust My Bite and Is Destroying My Crowns

Posted on by .

My December 2022 smile makeover included ten zirconia crowns. My dentist has had countless challenges with my bite. He can’t seem to get it right despite grinding on every crown. He is destroying them and grinding my money into dust. I didn’t have dental anxiety before, but now I have hives inside my lips and gums, which I think is anxiety. Someone suggested I may have had an allergic reaction to all the grinding on the crowns. Could I be allergic to zirconia? Thanks. Karson

Karson,

We are sorry to hear about your stressful dental experiences. Zirconia is such a high-strength material that repeatedly grinding it down to correct your bite can make you dread dental visits.

Could You Be Allergic to Zirconia Crowns?

Although zirconia allergies are rare, it is possible to be allergic to them. The International Journal of Prosthodontics published a study of 14 patients with zirconia fixed dentures reports. The patients had no reactions to zirconia after a three-year follow-up. You could get an allergy test if you suspect the zirconia dust is causing a reaction. However, you probably would have reacted to the crowns when your

What Causes Hives After a Dental Appointment?

Stressful dental experiences can trigger burning mouth syndrome, which may cause hives. If you had no symptoms before the problems with your occlusion, your hives may be related to dental anxiety. You can get a second opinion from another dentist or your medical doctor if you think the hives are unrelated to your dental concerns.

Adjusting Your Bite with Multiple Dental Crowns

Achieving a harmonious bite requires advanced training in occlusion and bite. Dentists need post-graduate training beyond dental school to understand what is necessary to ensure crowns fit correctly so you can speak and chew normally. Otherwise, you can experience jaw-muscle spasms, headaches, earaches, and other TMJ symptoms.

Additionally, a mishappen smile makeover can increase your overall anxiety, even if you do not develop dental anxiety. We recommend getting a second opinion from an advanced cosmetic dentist with occlusion and bite training to transform your smile and ensure it is healthy.

Beverly Hills accredited fellow of cosmetic dentistry Dr. Brian LeSage sponsors this post. Visit his smile gallery of before and after photos for cosmetic dentistry patients.

Before and after Beverly Hills smile makeover photos from the smile gallery of Dr. Brian LeSage.

Smile makeover photos from the smile gallery of Beverly Hills accredited fellow of cosmetic dentistry Brian LeSage.

 

Can I Trust Smile Makeover Before and After Pictures?

Posted on by .

Are smile makeover before and after pictures reliable? I had a consultation with a dentist who took pictures of my smile and then showed me after pictures. The way my smile looked in the after pictures was not much better than it is now. I am afraid to move forward with the dental work. My teeth are crooked and too small. I am concerned about spending thousands of dollars for a new smile that is just okay. What can I expect? Thank you. Montana from NM

Montana,

Thank you for contacting Beverly Hills Institute for Dental Esthetics regarding your smile makeover. Dr. LeSage would need to examine and x-ray your teeth to determine their condition and listen to your smile goals before explaining treatment options.

Can You Trust Smile Makeover Before and After Photos?

Whether you can trust smile makeover before and after photos of your face and smile depend on several factors, including:

  • Your explanation and the dentist’s understanding of your smile goals
  • The technology the dentist uses
  • The dentist’s skill in transforming your smile
  • The dentist’s artistic ability
  • The collaboration between your dentist and the ceramist who crafts your restoration
  • The quality of materials used for your smile makeover

Can You Trust a Smile Makeover Photos of a Dentist’s Patients?

Before your smile makeover begins, you can expect a cosmetic dentist to show you before and after smile makeover photos of their patients. You know you can trust the photos and the dentist’s ability to give you a natural-looking smile makeover by verifying their training and credentials in cosmetic dentistry. Look for training and accreditation in the American Academy of Cosmetic Dentistry (AACD) or the American Academy of Esthetic Dentistry. According to the AACD, dentists who achieve accreditation demonstrate the highest levels of these qualifications:

  • Continuing education
  • Experience
  • Ability

How to Select a Dentist for Your Smile Makeover

You can select a cosmetic dentist for your smile makeover by taking these steps:

  • Ask friends or family members for referrals.
  • Check each dentist’s credentials on the AACD’s or American Academy of Esthetic Dentistry’s website.
  • Look on the dentist’s website for evidence of how active they are in continuing education.
  • Look for before and after smile makeover photos on each dentist’s website.
  • Schedule a consultation with at least two cosmetic dentists to discuss your goals and concerns.
  • Ask the dentist how many cases like yours they have completed.
  • Take notes to compare each dentist’s credentials, experience, ongoing training, treatment recommendations, and smile gallery. Ensure you are comfortable with the dentist’s chairside manner and communication style.

Beverly Hills accredited fellow of cosmetic dentistry Dr. Brian LeSage sponsors this post. Visit Dr. LeSage’s smile gallery for examples of his work, including smile makeovers.

Smile makeover before and after photos from Beverly Hills accredited fellow of cosmetic dentistry Dr. Brian LeSage.

Dr. LeSage of Beverly Hills gave his patient a beautiful smile makeover with porcelain veneers!

 

 

My Lateral Incisors Are Too Short, But I Don’t Want Crowns

Posted on by .

My left and right lateral incisors are way too short. I am 37 yrs old, so there is no hope of a growth spurt. Can the incisors be moved down with braces or lengthened somehow? My dentist said he could lengthen my teeth with ceramic crowns, but is that the only solution? – Vivian

Vivian – An examination and diagnostic studies are required to determine why your lateral incisors are too short. The examination will reveal if your teeth have fully erupted and are correctly positioned. If they are, orthodontic treatment is probably not the answer.

What Are the Treatment Options for Short Lateral Incisors?

Before-and-after minimal prep porcelain veneers from Beverly Hills dentist Brian LeSage

Dr. LeSage placed eight porcelain veneers on this patient’s upper front teeth for beautiful shape and form

An artistic cosmetic dentist can examine and x-ray your lateral incisors to determine treatment options. A porcelain crown is an aggressive treatment that requires shaving down your natural tooth on all sides. Alternatives for lengthening lateral incisors are listed below.

  • Gum contouring – Using a dental laser, a dentist can shorten your gums, contouring them around your incisors to help them look longer. This is a possibility only if gum contouring will not expose tooth roots.
  • Cosmetic bonding – Skilled cosmetic dentists blend dental composite to match the color and translucence of your natural teeth. After cleaning and lighting etching each tooth, the dentist applies a bonding agent. Afterward, the cosmetic dentist will layer dental composite on each tooth and shape and harden the composite. Further shaping and polishing help the composite look natural. If you receive quality dental bonding, take care of it, and have it regularly maintained by a cosmetic dentist, it can last ten years or more.
  • Porcelain veneers – Thin layers of porcelain can fit over the fronts of your lateral incisors. A cosmetic dentist may lightly save the teeth to prevent the porcelain veneers from looking bulky. Porcelain veneers will not stain. When well maintained by you and your dentist, they can last 15 to 20 years.

Whether you receive porcelain veneers or some other form of cosmetic dentistry, the quality, durability, and look of the restoration you receive depend on the skill of the cosmetic dentist you choose. We recommend finding two or three experienced cosmetic dentists with whom you can schedule consultations. Ask about each dentist’s training, credentials, and experience. Also, ask to see before-and-after photos of each dentist’s patient cases like yours.

Beverly Hills accredited fellow of cosmetic dentistry Dr. Brian LeSage sponsors this post.

Read our post about whether dental bonding or veneers are best for peg laterals.

 

Which Teeth Whitening Brands Improve Tetracycline Stains?

Posted on by .

I’ve had tetracycline stains on my teeth since I was about 10 years old. I’m 47 now, and the stains are still there. I’m trying to figure out the best way to get rid of the stains without wasting money. I’ve tried five teeth whitening brands over the past two years, but none have helped. I have chips in three left front teeth, and my whitening attempts have made my smile look worse because the chips are more noticeable now. Do I need professional whitening, or do you recommend specific brands for me to try? Thank you. Caleb

A note for our readers – Intrinsic teeth stains develop when tetracycline antibiotics are consumed during childhood while teeth are forming. Other medications can cause teeth stains in children and adults.

Caleb,

Thank you for your question. Dr. LeSage would need to examine and x-ray your teeth before recommending treatment, but we will explain so many people do not achieve success with whitening attempts on tetracycline-stained teeth.

Which Teeth Whitening Brands Improve Tetracycline Stains?

Patients cannot purchase a brand of teeth whitening to improve tetracycline stains. Concealing tetracycline stains is among the most challenging cosmetic dentistry procedures, even for experienced dentists. Often, the color and depth of the stains—beyond the tooth enamel—prevent the bleaching gel from improving them. After examining your teeth, an advanced cosmetic dentist can determine whether teeth whitening, porcelain veneers, or a combination of treatments is best for your case.

How Can You Find a Dentist to Treat Tetracycline Stains?

You can find a dentist to treat tetracycline stains with these steps and precautions:

  • Find a dentist with extensive post-graduate training in cosmetic dentistry, preferably an accredited dentist.
  • Ask the dentist to show you their tetracycline cases’ before-and-after photos.
  • Schedule consultations with at least skilled cosmetic dentists.
  • Avoid shopping around for the lowest rates.
  • Instead of asking dentists for a specific treatment or method, trust the artist behind the technique, their training, and their experience with tetracycline cases.
A porcelain veneer - as a potential solution for a tetracycline stains smile makeover

A skilled cosmetic dentist may include porcelain veneers for a tetracycline stains smile makeover

An experienced cosmetic dentist will consider multiple factors before recommending treatment, including:

  • The location of the affected teeth
  • The condition of the teeth
  • Your overall oral health
  • The extent of stains across your teeth
  • The darkness of the stains

A skilled cosmetic dentist will explain all factors that affect treatment recommendations and give you the healthiest, most natural-looking smile makeover.

 

In Beverly Hills, Dr. Brian LeSage is an accredited Fellow of the American Academy of Cosmetic Dentistry and the American Academy of Esthetic Dentistry. Only three dentists in the world have achieved both credentials. Request a consultation with Dr. LeSage today.

 

I’m Suspicious About Two Failed Root Canals and Extractions

Posted on by .

Mature woman portraying disappointment over failed root canals and extractionsI don’t know if I can trust my dentist anymore. Despite taking care of my teeth with twice daily brushing and daily flossing, It seems that he always finds a tooth to watch. Four years ago, my dentist said he was watching a tooth. He said that the tooth was infected at the next visit, and I needed a root canal. But the root canal didn’t save the tooth, so he extracted it and replaced it with an implant.

Early last year, a filling fell out a molar tooth. The dentist said he could not just replace the filling because I needed a root canal. Eventually, I needed an extraction and implant because the root canal failed.

I have asked my dentist about the rapid decline of teeth that he watched, and his answers are so messy that I cannot repeat them. I am getting nervous that if I stay with this dentist, I will be paying for a smile makeover that I don’t want or need! Is it my misunderstanding of what leads to a root canal that causes concern? Or do these events sound suspicious to you, too? I hope other patients are not going through this.  Thank you. Neeta

Neeta,

Your concerns are valid. Although Dr. LeSage would need to examine your teeth and x-ray history for an accurate diagnosis, we can offer some insight.

Reasons You May Need Root Canal Treatment

If you need root canal treatment, the cause can be any of these factors:

  • Tooth trauma
  • Damage
  • Untreated tooth decay
  • Decay beneath an old dental filling that infects the tooth pulp

Progressive decay beneath a filling happens more often with amalgam fillings. The decay is easier to spot with newer composite.

How Fast Does a Tooth Decline If Your Dentist Is Watching It?

If your dentist is watching a tooth, it means that they see the beginning signs of decay. It is reasonable for you to expect your dentist to remove the decay before your tooth needs a root canal or extraction. Otherwise, if your dentist saw the decline, he should have treated it rather than watched it.

Why Did Your Dental Fillings Fall Out?

A dental filling may fall out due to poor technique to secure it. Or the filling might be old and not well-maintained. Still, if a filling falls out and the tooth needs root canal treatment, your dentist should have noticed its decline if you get route exams.

If you are thinking about getting a refund, you will have to prove that your dentist was negligent. Unless you have photos and progressive x-rays that show the problem, your dentist probably will not be willing to refund you. If you are determined to get a refund, you can tell your dentist that you will report the issue to the state dental board. But that might not prompt him to refund you.

Look for an Accredited Cosmetic Dentist

But look for another dentist. We recommend an accredited cosmetic dentist because they have a proven competence record and successful patient cases to earn accreditation. Otherwise, schedule a consultation with a dentist who has advanced cosmetic and implant training. The dentist will conduct an exam, review your x-rays, and take more if needed. They will not recommend unnecessary dental work or make you feel like you are getting smile makeover that you did not request.

 

Dr. Brian LeSage, a Beverly Hills accredited Fellow of the American Academy of Cosmetic Dentistry and the American Academy of Esthetic Dentistry, sponsors this post.

My tooth is fractured beneath a new crown and needs extraction

Posted on by .

I fractured two front teeth in 2010, and my family dentist did root canals and crowns on both teeth. As the crowns aged, I noticed them more and did not like the way my smile looked. Also, a left molar tooth was aching on and off, so I decided to see another dentist for a smile makeover.

I love the look of the smile makeover, but my left front tooth became sensitive a few months ago, and my dentist said the tooth needs extra care. She noticed a pimple on my gums and referred me to a periodontist for an exam.

My dentist prescribed antibiotics, and the periodontist confirmed that I need extraction. My dentist disagrees about the extraction and is now referring me to a periodontist. I do not want to lose my front teeth, especially after all the work and money I spent on a smile makeover. – Eiso from NV

Eiso,

Although your smile makeover looks beautiful, we wonder if your dentist took x-rays before completing it. If she took x-rays, saw the fracture, and put a crown over the tooth anyway, maybe she did not understand the potential results.

Root fracture on your left central incisor

Thank you for sending us a picture of your x-rays. Your fractured tooth does not look good.

  • Root fracture – In the middle of the tooth root, we see an old, horizontal fracture line that is likely from your original accident. The dentist who did your root canal at that time either did not see the fracture or tried to navigate through it. The necrotic (dead) soft tissue is gone, so the dentist must have removed it and hoped the tooth would heal.
  • Above the fracture – The inside of your tooth looks choppy and eaten away. Some of the root canal filling material is missing. If your gum pimple originates from that area, it suggests an infection is eating at your tooth roots. And if that is true, you will lose the tooth.

Your right central incisor

Diagram of a two dental implants - before and after crown placement

If a dentist or specialist cannot save your tooth, a dental implant is the best treatment option

Your right central incisor (front center) does not look stable either.

  • Root canal filling material – It stops several millimeters before the tooth ends. You have a new crown on the tooth, it might be best not bother the tooth unless you experience a flare-up. We do not see any signs of infection on the x-ray.

Although your dentist missed the diagnosis of your cracked tooth, you need to get it corrected. You can decide if you want an endodontist (root canal specialist) to examine your tooth and try to save it or proceed with the extraction and dental implant.

You can negotiate with your dentist on the cost of continued treatment for your left incisor because she missed the fact that it is fractured and problematic.

Best wishes for a thorough resolution.

 

Dr. Brian LeSage, a Fellow of the Academy of General Dentistry, sponsors this post.

My tooth is fractured beneath a new crown and needs extraction

“Because of your smile, you make life more beautiful.”
– Thích Nhất Hạnh

Request an Appointment