Megan Shelton, DMD

Veneers are thin pieces of porcelain that are often translucent.  If the tooth is dark and the dentist preps into it it will usually be darker under the enamel, so trying to cover that with a veneer is hard.  The dentist can have the lab put a thin layer of zirconia or other opaque material to block out the darkness and then have a nice translucent porcelain layered on top for optimal esthetics.  I'm guessing the tooth with the root canal is a crown... Since your tooth is non-vital and it is after the fact, one option would be to try internal bleaching.  The dentist can drill a hole through the back of your crown and place a medicament that can lighten that darkness showing through.  Talk to your dentist about these options!  I wish you the best.  Smiles, Dr. Shelton

Hello!  Yes!  Those are great items to eat.  You're on the right path by avoiding foods with bright pigments.  Neutral colored and pH foods and beverages are best for you to achieve optimum results.  Stray from red sauces, mustards, red wines, etc.  The whitening can make the teeth a porous and therefore can hold stain easier.   Tea is another culprit!  Be careful while you are bleaching and a few days after and you will be fine.  Good Luck!  I wish you the best and brightest.  Smiles, Dr. Shelton

You are correct, periodontal disease is an aggressive disease.  The first step would be making certain that you and your clinician have teamed together to achieve optimal results, it sounds like you're in a stable state, but always keep a close eye on it.  There are different periodontal mouth rinses that can be used, and more frequent deep cleanings that may be done to reduce your risk for bone loss.  Since the bone cannot be brought back, and implant wouldn't necessarily change the spaces, and the other concern is that implants can still get periodontal disease.  One option you could do is to crown the teeth, it would afford you the ability to eat out comfortably by closing the spaces, if done correctly. Since implants are based on bone, the implants would not offer any better result that your natural teeth.  Another option for you might be orthodontics with interproximal reduction, but that can be limited.  Check with an orthodontist or your general dentist to see which options are best for your situation.  Smiles, Dr. Shelton

Without a 3D CBCT it can be difficult to detect all bony defects or infections.  The xrays that most dentists take are 2D and if the infection was directly to the cheek side or tongue side it would be difficult to see, the implant would block the view of the infection. I wish you the best in resolution of your infection. Smiles, Dr. Shelton 

Hello.  The best routine is.... 

Floss, brush, rinse with mouth wash.  If you are going to do your morning hygiene after your breakfast, you need to wait 30 minutes from the time you stop eating or drinking.  Brushing too soon after can be harsh on your enamel because of the acidic nature of your oral cavity.  This same routine should be followed in the evening right before bed, floss, brush, rinse.  By flossing first, you remove the debri between the teeth and allow the toothpaste and bristles to access the interproximal spaces.  Just remember, but first FLOSS! 

Based on the photos you have not had dental care for a while.  It is urgent for you to see a professional to have a comprehensive exam including perio chart, radiographs, and occlusal analysis.  You have periodontal disease and tartar build up that needs removed.  Then you will want to have comprehensive orthodontics done to align your teeth and open up your arches which will enhance your breathing and sleep.  Besides the functional enhancements, orthodontics will improve the esthetics of your smile.  You could do traditional brackets or invisalign with an experienced clinician.  The investment of your time, work, and money will be rewarding.  Smiles, Dr. Shelton

The immediate concern should be to address the chronic infection.  It seems that the tooth has a hopeless prognosis even after root canal treatment, so it would be ideal to remove the tooth and place a bone graft.  This would allow your body to heal in that area, and allow you to continue your invisalign without disruption.  Once the site is healed, the bone can be evaluated for implant placement.  With your clenching, a night guard would be ideal if you have an implant placed, but your dentist who is placing and restoring the implant should be able to go over prognosis with you.  Wish you the best.  Smiles, Dr. Shelton

Without seeing your radiographs and knowing the periodontal health of the tooth it is hard to definitively give you an answer.  Trismus is usually due to having your mouth open too long during treatment, and can come from any dental procedure.  If you choose to have a root canal see a specialist that is aware of your history and who can hopefully accommodate you by working efficiently and prescribing an anti-inflammatory for healing.  Implants are great for replacing teeth, but if your tooth does not need replaced yet I would go for the root canal and preserve natural dentition.  Consult with your general dentist and they will be able to give you the best option and do a risk benefit analysis for you.  Wish you the best. Smiles, Dr. Shelton

Keep in mind they are temporaries, temporaries do look fake and bulky.  My hope is that now you have the permanent veneers and they are translucent and beautifully mimic your natural enamel.  With that, it would have been better had you done 10-12 veneers.  When I look at your smile the front four teeth look big and it is exaggerated (an illusion almost) because you have a narrow arch, meaning your back teeth go straight back so they don't show much.  Had you had 10-12 veneers done they would have filled the corners of your smile (the buccal corridor) giving you a full broad smile. I hope you had a great outcome or that you added the needed veneers to achieve the look you are going for!  You're beautiful anyway, but being comfortable in your own smile is important.  Smiles, Dr. Shelton

Hello, 

Short answer, you will be fine, as long as you do replace them.  But remember that bone is lost overtime and face shape relies on bone.  Budget your money so that you can add 2 implants a year and you will be able to prevent yourself from losing more bone and a collapsed face.  Good for you for recognizing the need and setting goals!  Your confidence and mental health will greatly benefit from your investment!  I wish you the best. 

Smiles, Dr. Shelton