The Solution: It is very important to develop good proportions when closing spaces and not just fill the gaps. The two front teeth should be prominent and the side teeth smaller with a slight angle. Most “cosmetic” dentistry I (Dr. D) see looks too plump and without natural inclinations. The porcelain veneers we did here compliment the patient’s fresh youthful beauty. Click on the photo of her face to see her smile more closely.

Before porcelain veneers:

After porcelain veneers:

Both Dr. Guenther and Donaldson (and our hygienists) get very positive feedback about how we make people comfortable with good gentle anesthesia technique as well as many other factors. To make dentistry even more anxiety free, more comfortable, less stressful, safer and even possible for more people, Dr. Donaldson & Guenther are advancing their training in oral sedation techniques from DOCS (the Dental Organization for Conscious Sedation). The medical word is “anxiolysis” which means “anxiety free”. With the help of light oral sedation ( as directed in our state: Michigan) many many people can overcome their fear, gagging problems, problems with not getting numb enough and post treatment discomfort. If you are one of those people, you should contact us to find out more. You may well be able to have the smile and dental health you only dreamed of until now.

The Solution:Eight porcelain veneers on top and eight below rendered a beautiful result. Sorry, we can’t show you more, like her full smile. People just think her teeth are bleached. Only her husband and best friend know. Her teeth are truly bright and beautiful.. and very natural looking when you see her smile.

The Solution: We fulfilled the patient’s hopes by grafting in bone to permit several implants in the back areas and developed a beautiful smile and functional bite with comprehensive porcelain crowns and veneers. What a great gift before heading off to college!

Before restoration:

After restoration:

The Solution: At Donaldson and Guenther, we increased the patient’s tooth size and length by opening the bite dimension. He had gum treatment while in beautiful temporary restorations. Finally, we added full mouth crowns with a bridge replacing the top left front tooth. John and his wife are both thrilled with the results. John’s comment appears in our blog. The result is a wonderful and healthy smile!

You can also read the patient’s testimonial.

Before Restoration:

After Restoration:

“Wow” is what I hear after their appointment with us. I am always honored and amazed at how moved they are by their experience. It is what sets us apart! We provide excellent information to assist our patients in making good personal decisions. We do this by providing a long and short term plan, with a focus on current, emerging, and completely optional treatment. We help fit treatment into their life.

This is why I love what I do and why I look forward to coming to work after 15 years! Wow!

Unfortunately, a simple filling does nothing to help strengthen the tooth or stop the fracture. A filling sits within the fracture (almost like a wedge in a log). It is only a matter of time for the crack to grow.

The ideal strategy for keeping your own tooth is to use restorations that reinforce the tooth, holding it together and making it strong. You thereby dramatically improve the chances of avoiding more extensive treatment. The longer we wait, the greater the chance that pain and loss can occur.

Insurance companies bet it all happens on someone else’s plan. Unfortunately, as a patient you are confronted with a choice. Do you invest in your own preservation or bet that when the tooth finally splits, it will be minor and the insurance company will then help out?

From almost 25 years of experience here is a close estimate of the risks:

• Teeth with angular cracks at the corners of a filling usually break off a corner or a half of the tooth to the gumline. These teeth are successfully treated with a build up and a type of crown. We see this almost every week.
• Teeth with a vertical crack eventually become occasionally tender to biting. If restored early enough, we avoid the additional need for a root canal about 80% of the time. We see this many times a month.
• If a cracked tooth always hurts upon biting, it probably needs a root canal, build-up and crown to save it. We see this a couple or few times a month. If the fracture runs deep there remains a small chance of fracture progression.
• If a large part of the tooth breaks away under the gumline, it becomes increasingly difficult and risky to treat and save the tooth. We see this a few times a year.
• If the tooth splits in half or far under the gumline, it needs to be extracted. Replacement, usually means a three tooth bridge or an implant. We see this several times a year.
• Every day we see prominent stress cracks growing under fillings we are removing. Crown type restorations save these teeth.

With each of the above situations, the increased treatment of a root canal and tooth build-up doubles the cost. If a tooth is lost and you have a bridge or implant, the cost is 3-4 times a single overlay or crown.

At Donaldson and Guenther, your personal best interest is our foremost concern. We repeatedly see patients and their teeth stay happier when appropriate treatment is done “in time” before something breaks or becomes painful. We understand dentistry is expensive. That is why we try to do the right thing–the first time. Nothing is more expensive and frustrating than needing more extensive treatment later because an insurance company encouraged people to gamble against themselves.

Of course not. We all understand that the situation can become much worse if we let fractures expand. However, many dental insurance companies eliminate coverage for restorations that are designed to make a fractured tooth strong again. Why? And why is it an important issue to you?

Why do insurance companies have an elimination clause on fractures and wear?

• Many fractured teeth have relatively small fillings or none at all. So, from looking only at an x-ray that doesn’t show the crack, it can look like over-treatment. (That is why we also send photos, but even that does not usually help)
• There may not be pressing painful symptoms at the time.
• Fractured teeth may take several years to split or need a root canal treatment.

Also, insurance companies “bet” that you will be gone before the problem becomes a crisis. They know the average subscriber will be on a different plan in two years, which means another company will have to pay. Insurance companies eliminate benefits on fracturing and heavily worn teeth as a short term strategy to get cash flow savings.

We wish we could predict exactly when teeth will fracture away, need a root canal treatment, or be lost due to splitting in half. We do know that timely, adequate treatment most often prevents bigger problems later. The next post will describe the risks of not investing in early preservation of your teeth.

Well, this year it happened. I lost the tooth. I was terrified of losing my front tooth and the aesthetics of the replacement. I was excited and relieved to be working at Donaldson & Guenther because I knew they were the ones to do the best work.

Dr. Donaldson removed the tooth, did an implant and made me a beautiful temporary. I had little to no pain. My family and close friends have noticed my “happier smile” but don’t know about the procedures. My natural smile has been enhanced. I had worried about this for years. I couldn’t be happier!

Lori

For the last 17 years we have provided dentistry that rarely needs replacement, is beautiful and done in a comfortable caring way. I am constantly overwhelmed by how much patients appreciate how they are cared for. I am reminded of the saying, “Excellence is a habit, not a single occurrence.”

Kristin Guenther