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There are a few reasons why the "mock up smile" may not be an exact replica of the final veneers.&nbsp; The teeth have been prepared on the model but not in your mouth&nbsp;so they are definitely going to feel a little fat.&nbsp; The material used to make the mock up is nice but it's not as nice as the ceramic of the final product.&nbsp; On your natural dentition,&nbsp;I feel like the two central incisors stick out a bit too much so I don't think there's any way around preparing those teeth.&nbsp; An alternative, which will certainly add some time and cost to the procedure, is doing some orthodontics (Invisalign or traditional) to align the teeth&nbsp;before&nbsp;placing veneers. Results are really nice this way and the preparations on the teeth&nbsp;are kept to a minimum.&nbsp; Don't feel bad if you don't want to go through all that, you are not alone. You can still get a nice result by just going straight to veneers.&nbsp;&nbsp;Picture your anticipated final result looking like it does in the mockup but just a bit thinner and set back a bit.&nbsp;&nbsp;If that is OK&nbsp;with you then I think it's totally achievable and&nbsp;you're going to look great with your new smile.&nbsp; By all means have this conversation with your doctor.&nbsp; If he is going through the effort of making a diagnostic waxup doing a "mock up smile" for you and working with a good lab like DaVinci then this sounds to me like somebody who takes a lot of pride in his or her work.&nbsp; Tell them everything that's on your mind so there are no surprises at the final visit.&nbsp; I sometimes modify my diagnostic waxup a few times before I ever touch the teeth so it is not an odd request.&nbsp; Think of this as getting the blueprints correct before starting on the house.&nbsp;&nbsp;Enjoy that great smile!

I plan to shortly have Da Vinci veneers fitted and beforehand my dentist agreed to place a temporary mould atop of my teeth to see if I like them. Clearly this doesn't quite reflect the final product, but is an indication. I've attached pictures of my current teeth and planned veneers. I'm concerned they look too big relative to my natural teeth and protrude somewhat, giving a fake/stuck on look. Any thoughts? Will this go away with the final product? What can my dentist do to address this?

Do these Veneers look fake? Are they too large and perfect relative to my normal teeth? (photos)

By now you should be enjoying&nbsp;the&nbsp;results of the Juvederm as it settles in.&nbsp; The Vampire Facial does a really beautiful job on the surface of the skin to give it a smooth, glossy look and feel.&nbsp; We often perform both the Vampire Facial+Dermal Filler at the same time in what's referred to as the Vampire Facelift so yes they are safe to do together or in your case a week apart.&nbsp; Hopefully it's the same doctor that did the dermal filler but if it's not then just let him know you had the filler done a week ago.&nbsp; If it were me, I would do the micro-needling with the PRP and avoid injecting the sites that were recently treated with Juvederm, especially if you already had a satisfactory correction from the Juvederm.&nbsp; I would be absolutely OK to inject PRP into areas that did not receive the Juvederm.&nbsp; No hard rules on this,&nbsp;I&nbsp;tend to be a little more conservative so take my advice with that in mind.&nbsp;&nbsp;Hope this helps.&nbsp;&nbsp;

Is it okay to get a vampire facial one week after Juvederm injections?

Vampire Facelift

It's nice when you can treat 3 conditions with one treatment modality.&nbsp; Botox will slim the hypertrophic masseter muscle, it will improve the tension in the muscle and help&nbsp;with lateral grinding type bruxism.&nbsp; I say it like that because the masseter muscle seldom acts alone.&nbsp; There is another gigantic and super strong muscle that is more likely the one causing&nbsp;the headaches and the severe clenching.&nbsp; That is the temporalis muscle.&nbsp; Make sure that your doctor palpates the temporalis muscle as well as the masseter&nbsp;and treats it accordingly.&nbsp; If not, you may get slimming of the muscle but the headaches will persevere as will the clenching.&nbsp; As far as units are concerned, I make a determination&nbsp; once I palpate the muscles so I would go by the recommendation of your doctor.&nbsp; In the meantime if you are chewing a lot of gum you may want to swap out for mints as gum gives those muscles thousands of reps at a time and contributes to the hypertrophy.&nbsp;&nbsp;A little bit of gum in moderation is OK.&nbsp; I hope you give this a try, we have been treating these since 2004 and done correctly you will be looking and felling great in no time.&nbsp;&nbsp;Good Luck.&nbsp;&nbsp;Hope this helps.

The grinding and accompanied headaches and jaw aches have been getting worse. I was hoping botox would help reduce the pain and tension while also making my jawline less square. How many units are suggested for someone with a prominent jawline and masseter muscles as large as mine (I've added a photo in)? And should I be seeing a plastic surgeon or a dermatologist or an ENT for this?

Botox for bruxism and enlarged masseter? (photo)

Hello. &nbsp;Thanks for your question. &nbsp;I feel like you may look into the cause for the premature failure of your crowns. &nbsp;Generally speaking implant crowns are very robust and should give you years of trouble free service. &nbsp;The first thing I&nbsp;would look at is:&nbsp;Is this a short crown due to not enough space from the implant to opposing tooth on the bottom or a collapsed bite? &nbsp;If so this ones easy. &nbsp;Instead of a cement-retained crown go to a screw-retained crown which screws onto the implant instead of cement. &nbsp;It's also better for the implant health than cement. &nbsp;If finances are tight you could also make a screw retained temporary crown for much less money. &nbsp;(This would be a great space maintainer until you can place a permanent crown.)&nbsp;The second question I&nbsp;would ask is: Are you clenching or grinding?&nbsp;As strong as our biomaterials are they are no match for clenching or grinding. &nbsp;Agree with the doctor who stated that a nightguard is a must. &nbsp;If you cannot tolerate a nightguard then consider botox injections to the temporalis and masseter muscles to attenuate the force of contraction during bruxism episodes. &nbsp;Hope this was helpful. &nbsp;Good Luck.

I had an implant done with bone graft on my left upper molar 4-5 years ago. The implant was put in strongly due to bone decay. My crown will not stay on. My first crown started to break off pieces of porcelain. When it got to the point of no porcelain, I opted to pay (out of pocket) for a new crown. It's been about two months, and not only did the new crown come off but a large piece of porcelain broke off too. Insurance won't pay and can't afford to pay for another crown. What can I do? Help!

Is there any way other than cement to keep a crown on? Can I just get a spacer rather than a new crown to hold the space open?

Hi. &nbsp;Thanks for your question. &nbsp;The thing that makes this tricky is that the bony defect looks to include the back wall (lingual) of the jaw so it makes it hard to get anything to stay in place. &nbsp;That's not to say that it can't be done. &nbsp;There are more advanced grafting techniques than&nbsp;just particulate grafting.&nbsp; Ask your dentist &nbsp;about 1. grafting with PRP or PRGF, 2.&nbsp;the technique of guided bone and tissue regeneration with barrier membranes and 3.&nbsp;possibly&nbsp;block grafting. &nbsp;The thing is that you have to remove the tooth and you might as well do some kind of grafting because as the other doctor stated you really need to start thinking about those neighboring teeth and a graft could possibly&nbsp;help those teeth. &nbsp;Also don't rule out the possibility of re-entering the site a second time after the first one heals and re-grafting.&nbsp;&nbsp;It's&nbsp;definitely a challenging situation but certainly possible. &nbsp;Good Luck. &nbsp;Hope this was helpful

I want to replace a bad tooth on my lower jar with an implant. But my dentist thinks I have lost too much bone on that tooth, a bone graft may not succeed. To succeed with bone graft the remaining bone on my jaw should be in a bowl or cylinder shape to hold the bone powder. I may not have a such shape bone socket after tooth extraction. The bone powder may be held by soft tissues and bone graft may fail. My dentist wants me to know the risk and decide whether I want to do this or not.

Requirement for a successful bone graft? (photo)

Hi. &nbsp;Thanks for your question. &nbsp;While Invisalign does a great job of of straightening teeth I don't feel that there is any orthodontic system that can accomplish that kind of bodily movement in any reasonable amount of time. &nbsp; I also&nbsp;doubt you could bring both the second molar and the wisdom tooth over to cover the space. &nbsp;I have been working with Invisalign since it started (about 20 years)&nbsp;and would not feel comfortable taking on a case like that. &nbsp;Don't worry there is hope. &nbsp;Look into placing a dental implant into the first molar position. &nbsp;Compared to orthodontics it will be much quicker and possibly&nbsp;more economical. &nbsp;The long term prognosis is excellent as well. &nbsp;Good luck. &nbsp;Hope this was helpful

So back in college, I had a molar removed. When I was getting a cleaning, I was speaking to the hygenist about invisalign, and she told me that my wisdom tooth could actually be shifted forward, and I would have a normal bite. Is this true? The tooth is fully erupted. It is the first molar that is missing.

Invisalign with missing molar/erupted wisdom tooth (Photo)

Hello. &nbsp;Thank you for your question. &nbsp;As dentists we oftentimes try really hard to save teeth. &nbsp;Experience teaches us that there are times when it's better to remove the tooth. After reviewing your CT scan images, it looks like the bony defect is just too much. &nbsp;The most important determinant for&nbsp;success is how completely&nbsp;the underlying infection can be removed. The best way to do that in&nbsp;this case is to&nbsp;remove&nbsp;the tooth. &nbsp;With good ridge preservation at the time of removal&nbsp;you will have the option to restore with&nbsp;&nbsp;either a bridge or an implant. Don't decide right now. If the bone height after healing is optimal then definitely go with the implant. If the resulting bone height is too high then consider a second graft or just go straight to a bridge.&nbsp;It is going to take a bit longer to complete treatment but the long term prognosis is going to be way better. &nbsp;Hope this helps. Best of luck.&nbsp;

Got an apicoectomy on lateral incisor 4 years ago due to a big apical abcess. Initial cause still unknown, supposing it's teeth grinding during the night that might cause the tooth's pulp death. First apicoectomy failed, maybe bad root canal work or residual bacterias, infection is back. Should I go for another apicoectomy to try to save the tooth or expand its life with several years? Or should I go for an extraction and implant? Note the bone loss from CT and the length of remaining root.

Second apicoectomy will save my tooth? (Photo)

Julio Rodriguez, DDS

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I have been a patient of Dr. Rodriguez for many years. I have always been self concious of my smile and would avoid smiling in pictures. As an adult the thought of going through braces was very intimidating. I';m glad I finally bit the bullet and went through with Invisalign. The process was fairly easy, the follow ups were easy and most importantly fast with my very busy life. He was very thorough and listened to all of my concerns. Adjusted the treatment course with what I wanted to achieve and gave me free whitening throughout the invisalign process to use with my aligners. So I ended up with both straight teeth and a white smile. I couldn't be happier!

Finished Full Course of Invisalign

BetteringMyMommySelf

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