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How to get rid of a black triangle between teeth after braces.

I’ve had braces in the past, but a tooth shifted out of place, so my current orthodontist ground down part of my tooth by about 2 millimeters to fit the spring retainer he made. The problem is that shaving my tooth like that has left this weird black triangle between my teeth where the gums don’t fill in.

Is it possible to make the gums grow to fill in this space? I hate the way it looks!

Thanks for any advice you can share!

Gina from New Jersey

A photograph of teeth that have black triangles of empty space between them near the gum line.
One or more black triangles after orthodontic treatment can make you feel self-conscious about the appearance of your smile.

Hello, Gina

We can’t give you any definitive advice based on our limited understanding of your situation, however, we can share some basic information.

For starters, your orthodontist may have a plan to correct that gap. Your treatment is not yet complete, so you can continue working with him to find out what kind of results he hopes to achieve with the spring retainer or other orthodontic appliances.

Second, your gums are not likely to grow in enough to fill the empty space. Your gum line will follow the natural contours and spacing of your teeth because gum tissue doesn’t grow over nothing; it needs a foundation. Even if you were to surgically alter your gum tissue with a graft to fill in the gap, the tissue would shrink back to its normal contours over time.

Finally, closing up a black triangle like yours can be quite challenging, depending on the shape of your teeth. Sometimes teeth are left with these gaps even when they are perfectly straight and even when they touch evenly on the sides. So once your orthodontic treatment is complete, we recommend that you see an excellent cosmetic dentist who can apply just the right amount of natural-looking dental bonding to change the shape of your teeth and close the gap.

This post has been published on behalf of Dr. Heng Lim, an Owasso dentist who takes a comprehensive treatment approach to orthodontics.

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Help! My dental implants fell out after just three days.

I’ve wanted to have a more stable bite for a few years now, so I recently decided to go ahead and get dental implants to give my denture more support. The dentist I saw told me I needed eight implants in total, and said they’ll cost me about $2,000 each. That’s a lot of money, but I decided to bite the bullet and get them done because I figure this is a once-in-a-lifetime kind of thing.

So I agreed to treatment, and the dentist placed six of the eight implants. I’m supposed to come back later for the last two. But the problem is that after the first six were placed, three of them fell out just three days later.

Is this normal? I’m trying to figure out what to do before I see the dentist again. I’m worried I’ll have to pay again to have these implants replaced.

Do you have any advice?

Thanks,

— Doug from Pittsburgh, PA

Hi Doug,

We’re really sorry to hear about your experience with dental implants. What happened to you is absolutely not normal; dental implants are supposed to stay put. So there is no need to worry that you’ll be charged again for replacement implants.

In fact, you should be able to get a refund for the work that has already been done.

Here are the usual reasons a dental implant might fail and fall out:

  • The dentist did not properly evaluate your mouth and overall health to determine whether implants are right for you
  • The dentist did not adequately plan the surgical aspect of implant placement
  • The dentist used poor quality implant materials
  • The implant was not correctly placed
  • An infection developed around the implant
  • The implant was put under stress before it had completely healed

Dental implants have an extremely low failure rate of just 5%, and even then, the reason for failure is often traced back to an error or lack of experience on the part of the dentist. If you have had six implants placed and three of them fell out, that’s a 50% failure rate and a sign of a serious problem.

A cross-sectional illustrated diagram showing how a dental implant needs to be firmly embedded in the bone to provide support to a dental restoration.
A dental implant must be firmly embedded in the bone tissue to provide support for a restoration such as a crown or denture.

With a failure rate like that, the prospects don’t look good for the three implants that are still left in your mouth nor for the last two your current dentist wants to place.

What you need to do now is seek a second opinion from another dentist who has more experience with dental implant treatment. Search for a provider who has professional distinctions or qualifications in dental implant treatment. An experienced implant dentist will help you find out why your implants fell out and they can help you negotiate a refund from your first dentist for all of the dental implants you have had placed thus far. This new provider can then complete your treatment plan to help you get the results you want.

When placed correctly, dental implants can truly make a world of difference in your bite, so don’t give up! We wish you all the best in your journey towards a better-fitting denture with dental implants.

This post has been published on behalf of Owasso dental implant dentist Dr. Heng Lim.

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Why are my porcelain crowns turning dingy and yellow?

I got four porcelain dental crowns placed on my upper front teeth less than a year ago, and they’re already getting discolored. This is frustrating because they’re practically new and I don’t smoke or drink a lot of dark-colored beverages. Why are my crowns turning yellow so quickly? Do they need to be replaced?

— Eliza from Eugene, OR

Hello, Eliza

Porcelain does not stain easily. Your natural teeth are actually more likely to pick up stains and turn yellow than porcelain because porcelain restorations are covered with a non-porous glaze. So if your new crowns already look discolored, then this is a sign that something is wrong with them. Either they were not of the quality you were led to believe at the time they were placed, or something has happened in the months since that caused damage to them.

Here are three possible reasons that your dental crowns are turning yellow:

1. You have recently whitened your teeth.

Teeth whitening treatments do not affect the color of porcelain dental crowns, but as your natural teeth lighten in color, this can make your crowns look dull and yellow in comparison. Granted, you did not mention that you have had whitening treatments, but if you have done any teeth bleaching treatments lately, then this could be a very simple explanation for the reason your crowns look discolored.

2. Your crowns have been damaged.

The protective glaze that helps porcelain crowns retain their color and gloss could have been compromised. The most likely way this could happen is if a hygienist used a power cleaning device on your teeth during a professional teeth cleaning appointment. Hygienists sometimes use a device that blasts a high-pressure stream of baking soda and water on teeth to remove stubborn stains. If your hygienist used this instrument on you, he or she was not careful to avoid your porcelain crowns. The high abrasiveness of this treatment could then have stripped the glaze from your crowns and left them susceptible to picking up stains.

Another possible way your crowns could have been damaged is if you were given an in-office fluoride treatment with acidulated fluoride. This type of fluoride can chemically damage the glaze on porcelain crowns.

Yet another possibility is that your crowns were damaged before they were even placed on your teeth. Perhaps they were not properly glazed during the fabrication process or maybe the glaze was worn down when your dentist was making adjustments.

3. Your dentist placed crowns made of a cheaper material instead of porcelain.

This may be the least likely scenario, but unfortunately, it’s not unheard of. Some patients have received what they thought were porcelain crowns only to learn later that they were made of composite instead, which is prone to staining.

At any rate, it’s clear that something is wrong because your porcelain crowns should not be turning yellow, even if you drank coffee all day, every day.

At this point, we recommend that you seek a second opinion from a cosmetic dentist you can trust. This new dentist can help you learn more about the actual composition and condition of your four so-called porcelain crowns and help you find out the cause of their discoloration.

You are very likely entitled to a refund and then some, if it turns out that your current dentist performed sub-par restorative work. Please see our post responding to a concern about a shoddy porcelain veneer to see our advice for negotiating a refund from your dentist.

This post has been published on behalf of Dr. Heng Lim, an Owasso dentist with experience in smile makeovers and other cosmetic dental procedures.

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