Concerns about materials

[Elliott]

Hi, I am a 20 year old male who is currently considering cosmetic dentistry to improve the appearance of my teeth and confidence with it. I have lost a lot of enamel on all my teeth and have quite a few fillings, but they are all on my molars. I am considering the option of having my front upper and bottom teeth fitted with porcelain crowns, but I have some concerns over the materials used.

I understand that different dental materials have varying levels of bio-compatibility, and that porcelain restorations are considered fairly bio-inert. However I have read that composite fillings (white fillings), of which I have many, and the luting cement used to adhere crowns, may leak substances into the mouth which are toxic or estrogen mimicking. There does not however appear to be any definitive answers as to whether this is the case, and whether it is something to be concerned about. As someone who is concerned with health and an avid weightlifter, I am concerned about the prostpect of such substances, and how much I would be exposed to over my life, since I am only 20 years old.

There is a dilemma for me however, because the current appearance of my smile, and my teeth in general, is causing me to be very unhappy and holding me back in life, and I very much want to improve it.

If anyone could anyone shed some light on the situation or offer me some words of reassurance, I would be most grateful.

[Dr Pav Khaira]

There is no good evidence currently to suggest that composite causes any damage. It has been around for a very long time and the chemistry has dramatically improved over the decades. Composites are placed by their millions on a daily basis across the world

I hope thsi helps

Kindest regards

[prosman]

Hi, I am a 20 year old male who is currently considering cosmetic dentistry to improve the appearance of my teeth and confidence with it. I have lost a lot of enamel on all my teeth and have quite a few fillings, but they are all on my molars. I am considering the option of having my front upper and bottom teeth fitted with porcelain crowns, but I have some concerns over the materials used.

You are very young to be considering crowning your teeth! I would be very concerned that you first treat the underlying reasons why you are losing significant amounts of enamel at such a young age?

I understand that different dental materials have varying levels of bio-compatibility, and that porcelain restorations are considered fairly bio-inert. However I have read that composite fillings (white fillings), of which I have many, and the luting cement used to adhere crowns, may leak substances into the mouth which are toxic or estrogen mimicking. There does not however appear to be any definitive answers as to whether this is the case, and whether it is something to be concerned about. As someone who is concerned with health and an avid weightlifter, I am concerned about the prostpect of such substances, and how much I would be exposed to over my life, since I am only 20 years old.

There is a dilemma for me however, because the current appearance of my smile, and my teeth in general, is causing me to be very unhappy and holding me back in life, and I very much want to improve it.

Yes, it is true that there is a hypothesis that the amount of plastics being used nowadays could be related to all sorts of problems, such as decreased male fertility. However, although I think this is interesting and necessary research i have not seen anything definitive one way or another.

However, as a thought... why are we told that amalgam is safe to put in patients mouths... but if we have amalgam waste we have to keep it in a bio hazzard container...

[davidbloom]

Cosmetic dentistry has a lot to offer and I think the key is, because
you are only 20 years old, that things are done as conservatively as
possible. Firstly the cause of the acid erosion, which has led to the
loss of enamel, needs to be ascertained and preventative measures taken
to prevent further erosion.

Whilst crowns are an option they involve a lot more tooth preparation
than adhesive restorations such as tooth coloured fillings/bonding and
porcelain veneers, and so are a lot more destructive of your own natural
tooth tissue. I feel while bonding may be an option for your front teeth
the best and most long lasting results will be gained from porcelain
veneers. There have been some stories about the risks of composite
filling materials but I have seen no evidence to support this and there
are no countries in the world where its use is limited or where these so
called risks are taken seriously enough to even warrant routine warnings
in the consent process.

In view of your age I would urge you to see a dentist who can discuss
all available options with you. A good start would be a dentist
accredited by the British Academy of Cosmetic Dentistry (BACD)

Regards

[Elliott]

Firstly I would like to thank you all for your kind advice, it has reassured me and broadened my avenues of thought on the restorative procedures available to me.

Although I understand that no final opinion can be given without actually seeing my teeth in person, I have a few questions, if you would extend your kindness even further.

The acid erosion my teeth have suffered occurred in my early to mid-teenage years and was a result of drinking a lot of carbonated drinks and fruit juices, combined with eating a lot of sugary snacks. For several years now I have adopted a completely new diet and approach to my health; I eat no sugar except for the occasional piece of fresh fruit, and drink only water. I have noticed no further erosion to my teeth since this time. However, since all my teeth have reduced in size compared to how they were originally, if I were to have to my front upper and lower and teeth crowned and restored to their original size, would this effect my bite in a detrimental fashion?

Also, my front teeth were always quite thin, and are now very thin indeed after the erosion, so I am concerned about having them filed down in order to place veneers. The option of veneers does interest me though, and I have read about a brand called "Lumineers" which claim no tooth surface reduction is needed. Can anybody give me any information/advice regarding these?

If I were to spend a substantial amount of money on cosmetic work on my teeth, I would really like my front teeth restored to their original size, so as to match the shape of my face/jaw better than they do currently. Is this possible to achieve with veneers?

Thank you for reading my concerns, which I know are a little long winded, I really appreciate the time you good people take to respond.

Elliott.

[Dr Pav Khaira]

The goal for someone like yourself would be to restore your teeth to their original dimensions. As you mentioned, Lumineers "CLAIM" to require not tooth structure removal.

A good cosmetic dentist working with a top technician can provide natural looking results, sometimes with no tooth removal (where appropriately used). The goal should always be minimal preparations in order to achieve maximum results, and remember that minimum preparation does not mean compromised result or strength!

[prosman]

The goal for someone like yourself would be to restore your teeth to their original dimensions.

If this is the case then looking at crowns on the most badly effected teeth, depending on the amount of tooth surface loss may be a sensible idea.

[davidbloom]

Cosmetic dentistry has a lot to offer and I think the key is, because
you are only 20 years old, that things are done as conservatively as
possible. Firstly the cause of the acid erosion, which has led to the
loss of enamel, needs to be ascertained and preventative measures taken
to prevent further erosion.

Whilst crowns are an option they involve a lot more tooth preparation
than adhesive restorations such as tooth coloured fillings/bonding and
porcelain veneers, and so are a lot more destructive of your own natural
tooth tissue. I feel while bonding may be an option for your front teeth
the best and most long lasting results will be gained from porcelain
veneers. There have been some stories about the risks of composite
filling materials but I have seen no evidence to support this and there
are no countries in the world where its use is limited or where these so
called risks are taken seriously enough to even warrant routine warnings
in the consent process.

In view of your age I would urge you to see a dentist who can discuss
all available options with you. A good start would be a dentist
accredited by the British Academy of Cosmetic Dentistry (BACD)

Regards

David Bloom
Past President BACD
Accredited member BACD

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Senova Dental Studios
10 Beechen grove,Watford,
Herts. WD17 2AD
United Kingdom T: 01923 233600
F: 01923 440041

[prosman]

it still depends a lot on the areas that you have lost tooth tissue. if it is mainly on your molars and/ or palatally to your front teeth/ or your enamel has been eroded to expose dentine, then this will not be dealt with that easily with veneers