Denver Doctors

Tooth #8: Internal Beaching or Porcelain Crown? Discolored(pink) and Slight Fracture

About 3 weeks ago I had a trauma to my mouth and my #8 tooth (front) has become discolored pink and has a slight fracture on the surface. I have been to a dentist and an endodontist. My tooth still responds to the vitality tests but it is just discolored and has a slight fracture.Digital radiograph in 2 weeks. Does a tooth turn back to a natural color after several months? I would like to know more about the pros and cons for internal bleaching and if it lasts. Would a porcelain crown be better?

Trauma can cause all sorts of discolorations to front teeth. Some are transient, some are harbingers of the nerve eventually dying. Some barely discolor, some turn very dark. If you have an Endodontist involved, that's great. I would be patient and wait for their advice.  Some mildly traumatized teeth just return back to normal.

It's just too early to decide some of these things. After more than twenty years as a cosmetic dentist, you'll just need to see what you have to work with in a few months. 

As the course for this tooth becomes more defined, make sure to have a Cosmetic Dentist on board. They can help you make solid, conservative choices and beautiful results whatever happens.

Scott Greenhalgh, DDS

Lakewood Cosmetic Dentist

How Do I Know the Difference Between Sun Damage and Melasma?

I understand Melasma is untreatable (except for bleaching creams) but sun damage can be removed by fraxel lasers and/or photo facials. Both are large brown spots.

A lot of my patients have a difficult time seeing the difference between sun damage and melasma, so you are not alone!  Sun damage has a smaller, more random pattern on the skin, and is generally more superficial, whereas melasma looks almost like a shadow and covers a larger area.  When you actually see pictures (check some out online) you can tell the difference but it can be difficult without doing some research or having a professional diagnose you. 

Sun damage can be more easily remedied than melasma, as there is not a "cure" for melasma.  Melasma is hormone-induced, and sun damage is caused by previous years in the sun.  You can certainly quiet the melanocytes that cause melasma to look more prominent with in-office treatments by a doctor (or experienced aesthetician), or you can use creams that contain retinols and hydroquinone. 

Sun damage responds well to IPLs, lasers, or chemical peels on MOST skin types.  As always, before signing up to receive any treatments, do your research and make certain your skincare professional is experienced.   I hope this helps!

Joseph Serota, MD

Denver Plastic Surgeon

PIP Victim is Sub Muscular Implant AND Capsule Removal my Best Option?

I am 38 have had PIP submuscular implants I think 220 for 6 years I want them removed and not replaced I have read a lot about the capsule and would like advice. Should I insist on capsule removal because of the possible contamination through the faulty toxic implants that may have been absorbed into the protective capsule? I am concerned that even if I have the implants removed I will still be at risk from the industrial silicon.

I would add that I don't think it's possible to "clear" your tissues of microscopic silicone whether the implants are intact or not and whether the implant is intact or not. It's certainly not possible to know that all silicone and risk is removed although there's no solid evidence to support the supposed specific risk of the "industrial silicone". Removing the capsule if it is normal looking involves a bigger operation with more risk of bleeding and scarring and no assurance that this will remove all risk or all microscopic silicone. However, if the patient is properly informed as to the increased risks and costs of removing the capsule as well as the inability to completely clear all silicone from the tissues even with the capsulectomy, I would feel that the patient could make this choice. 

Scott L. Replogle, MD

Denver Plastic Surgeon