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writeradmin writes blog posts on behalf of Dr. Kasia Lopez

Invisalign with Crooked Gums

Can you get Invisalign if you have crooked gums? I had asked the hygienist if Invisalign would fix my smile. She just kind of laughed and said, “Not really”. I was a little embarrassed so I didn’t bother asking the dentist. But, that doesn’t fix the fact that I am embarrassed to smile. Is Invisalign impossible for me? I keep hearing they’re better than normal braces.  If I have to do regular braces, I will. I’d like to do something to help my appearance.

Lara S.

Dear Lara,

The hygienist was quite insensitive and partially wrong. If your teeth are crooked, Invisalign can help.  Some of the reasons people prefer them to traditional braces are you can straighten your teeth in secret, they’re more comfortable, they work faster than braces, and you can eat and brush more easily.

Regardless of what your hygienist says, you should always be comfortable asking your dentist anything. He or she should have the answers for any dental question you have. Even if the thing you inquire about isn’t the correct procedure, a good dentist would tell you what is, and not just leave you without answers.

While Invisalign can straighten your smile, it will not repair the crooked gums. There are procedures which will. There are two potential procedures which come to mind immediately. You’ll want something to reshape the tissue.  If the unevenness is from one tooth to the next, your dentist can do a gingivectomy, it removes extra gum tissue. If, however, the  gums are bulky, it would be called a gingivoplasty it involves reshaping them. Either procedure is fairly quick. It’s done in-office in a single visit and your gums will heal up fairly quickly after.

The dentist will know which procedure will help you. If there are other things such as the shape and color of your teeth bother you, the “Cadillac” of smile makeovers is to get porcelain veneers. That can completely change the appearance of your teeth and the character of your smile.

One word of caution. Almost any dentist can do the Invisalign procedure, but you’ll really need an expert cosmetic dentist to do a complete smile makeover. Something like porcelain veneers requires an artistic eye. Be sure they have some type of beautiful smile guarantee. You can look up expert cosmetic dentists in your area on the website.

I hope this helps. This blog is brought to you by Dr. Kasia Lopez.

Daughter’s Orthodontist Said Dentists Shouldn’t Place Invisalign

I was at my daughter’s orthodontic appointment and mentioned to him that I’m getting Invisalign. He said he hoped I wasn’t doing it through a dentist instead of an orthodontist. When I said I was, he told me it was a huge mistake because dentists can’t make adjustments and I’m putting my treatment at risk. Is this true? I don’t want to damage the teeth I’m trying to fix.

Melanie M.


It sounds to me like your orthodontist isn’t happy that so many patients go to their general or cosmetic dentist for Invisalign treatment. While orthodontists do receive some specialized training, many dentists are equally capable of placing braces and have even made the effort to train in their placement, adjustment, and care.

However, Invisalign is different from traditional braces and was designed with general dentists in mind. The treatment plan is computer designed and milled, so the time you have to wear orthodontics is significantly reduced.

If you’ve already been approved as a good candidate for Invisalign, then you shouldn’t have any issues. A dentist will do just fine. In fact, in some ways, a cosmetic dentist will be superior. For instance, if you also wanted to get your teeth whitened, a cosmetic dentist could oversee both procedures. In fact, your Invisalign aligners could be used to double as teeth whitening trays allowing you to do both simultaneously.

I’m sure your dentist would never have invested in becoming an Invisalign provider if he (or she) wasn’t serious about developing their qualifications to place them. Nor would they risk patient safety and care.

It wasn’t ethical of your daughter’s orthodontist to suggest it wasn’t safe for you to go to a dentist, especially without any evidence to the fact. All that does is cause a patient unnecessary worry and expense.

This blog is brought to you by Dr. Kasia Lopez.

Are Holistic Dentists Quacks?

My sister’s been going to something called a holistic dentist. She keeps talking about how important it is I do the same.  She gets a little weird about health sometimes and uses the oils for medicine, calling it natural. Now she’s saying this dentist is natural too. I’m worried she’s getting taken in by a quack. I don’t mind her using the oils, they won’t hurt her, but I’m concerned if she doesn’t get proper dental care it will have long term consequences. What do you think? Are they even really dentists? Will they take care of her teeth?

Hunter W. – Tennessee


I love that you’re looking out for your sister. It shows how much you love her. Let’s start by putting your mind at ease. If the dentist has a DDS or DMD by their name, they’re a dentist. A holistic dentist isn’t like a naturopathic doctor, which aren’t always doctors. Holistic dentistry is more a philosophy of treatment, but they’re actually dentists. They’ll clean and check her teeth, treat cavities, do root canals, extract and replace unsavable teeth, and do all the other things imperative for a healthy mouth.

It’s a belief that diseases of the mouth affect your overall bodily health and vice-versa. Recently, studies have shown a substantive link between gum disease and heart disease. Holistic dentists believe it’s important to avoid using harmful substances in dental care. Some dentists believe it’s all about the teeth, but if you’re using something that may help their teeth, but could negatively impact other aspects of their body it’s unacceptable.

You’ll mostly see this put into practice with dental fillings. A holistic dentist will not place an amalgam (ie. silver) filling. Why not? Because they’re made mostly of mercury. Sure they’ll fill the cavity and help your tooth, but mercury is a known toxic substance. Why introduce it into your body when we have a much safer, healthier, and I would add a more effective option with composite (white) fillings.

You may also find they are more determined to save natural tooth structure. While some dentists are perfectly fine with extracting and replacing teeth, a holistic dentist will strive to keep the natural tooth for as long as possible.

This blog is brought to you by Dr. Kasia Lopez.

Worried I Can’t Trust My Dentist

I’m confused and unsure of what to do. I’ve had orthodontics done. Over two years of braces AND I was the good girl who wore her retainer the whole time she was supposed to. My teeth look fine to me, but my dentist says my bite isn’t right. He wants me to get crowns on ALL my teeth to fix it. In all fairness, I’ve already had a couple of cavities, and I think we got on this because I said I wanted my teeth whiter, but getting crowns everywhere seems excessive to me. Should I get a second opinion from a TMJ specialist or is what he’s telling me on the up and up?

Stephanie – Boston

Dear Stephanie,

We need to reign this in very quickly. And, yes, a second opinion from a TMJ specialist would be a good idea. I haven’t the slightest idea why your dentist is recommending a full-mouth reconstruction. You haven’t indicated any TMJ symptoms. Usually, patient’s mention jaw pain, popping, grinding, clicking, or generalized mouth pain. Even migraines can be a symptom of a TMJ problem. If you have these kinds of severe symptoms, you should have a consultation with a TMJ specialist.

As for having the crowns done, this is one way to go about correcting bite issues, but there are also less invasive and less expensive ways to go about doing it, too. In fact, the simpler solutions should always be checked first. Crowns aren’t the solution for whiter teeth either.  The simplest solution would be teeth whitening.  It will do the job beautifully while preserving your healthy tooth structure. Like a full-mouth reconstruction, it’s way too large an overtreatment. Unless you’ve already got crowns on your front teeth, you can have whitening done.

If you were suffering from TMJ issues, it doesn’t necessarily mean it’s because of your bite. Like I said earlier, there are many other TMJ treatments (and causes). However, let’s say for arguments sake you have TMJ and your bite is the problem. It would require someone with serious expertise in TMJ. Someone who has undergone additional training and routinely performs full mouth reconstructions. It’s an advanced procedure. When done incorrectly can cause more problems than it solves.

My bottom line on this is ALWAYS try to preserve healthy tooth structure and get a second a second opinion.

This blog is brought to you by Dr. Kasia Lopez.

Why Can’t Children Have Mercury Free Fillings?

I took my son to the dentist and discovered he has a cavity. I told the dentist I didn’t want a filling that contained mercury and preferred he do a white filling. He told me children can’t have white fillings. Is that true? Why?

Danielle – Idaho


No, it’s not true. Though, I wouldn’t push this dentist to do the white filling. It would likely fail. It takes a special skill to do composite (mercury-free) fillings. It’s a different technique than the old amalgam fillings. He may not know the new techniques. Or, he may know how to do it, but doesn’t like doing it on children.

It is more challenging to do young children. It requires them to be very still and keep their mouth open. The composite material needs to remain dry throughout the procedure for the bonding to stay secure.

Some children have trouble doing that. However, there are ways around that. Sedation dentistry is a good option for children who struggle with following directions or are afraid in the dental chair. It is safe and gives them a calm, cheerful feeling.

You’re more likely to find a dentist to do what you want by looking for a mercury-free dentist or a holistic dentist.

I’m glad you’re looking out for your child and doing some research before caving to your dentist.

This blog is brought to you by Dr. Kasia Lopez.

Did the Dryer Destroy My Invisalign?

I mistakenly put my Invisalign aligners in the washer/dryer. It went all the way through the washer cycle and got about 15 minutes into the dryer cycle before I realized my mistake.  I had them in the pocket of my PJs during breakfast. I’d tossed them in the washer. It wasn’t until after I brushed my teeth that I noticed they weren’t with me.  I grabbed them out of the dryer as soon as I could. They still fit, but feel different on my teeth. Did I ruin them?

Cyndy M. – Tennessee


We’ve all accidentally watched something, so I wouldn’t feel too bad about it. However, I wouldn’t continue wearing them. Your Invisalign aligners are likely warped. Wearing them will set your treatment back.

If you’re close to the end of this two-week cycle, you could just go on to your next set of aligners. You don’t want to switch early very often, because it puts the roots of your teeth at risk of coming loose. But, just this once should be okay.

If you’re at the beginning of your two-week cycle, you’ll need to have the aligners re-made. Your dentist can do that without too much trouble. But, call the office as soon as possible so they can get it made quickly for you. If you’re without aligners for even just a few days your teeth with start to shift. That will be disastrous for your treatment.

Hopefully, you still have your last set of aligners handy and can wear them until the new ones are ready. That will prevent any shifting.

This blog is brought to you by Dr. Kasia Lopez.

Do Braces Require Extractions?

I’m getting braces and wondered if it’s normal for an orthodontist to insist on extracting teeth. I thought dentists want to save teeth. I’d hate to lose healthy ones for no good reason.

Jose L. – Florida


Yes, that’s standard operating procedure in some cases. There are several reasons an orthodontist might do that, but the most common one is overcrowding. If you have a small arch and a full set of teeth, it causes overcrowding. They press up against one another and go crooked. It also makes it hard to clean which leads to decay.

If you’re still concerned, you can go to another orthodontist. Don’t tell him anything about the earlier dentist. If he recommends the same course of treatment, you know you’re on safe ground. If he doesn’t, you can decide which you like better and move forward.

This blog is brought to you by Dr. Kasia Lopez.

Does TMJ Require a Full-Mouth Reconstruction?

I’m trying to figure out if I really need a full mouth reconstruction for TMJ. My dentist had been trying to treat my TMJ himself, but it only seems to get worse. Last week I had to eat through a straw because my jaw locked up. He sent me to a TMJ Specialist. He says I need a full mouth reconstruction. If that’s my only option, I’ll do it. I just want to be sure first.

Lana – Sacramento


A full-mouth reconstruction is an option, but it’s usually an option after all other, less invasive, options have been tried.  However, there may be circumstances that I’m unaware of.

This is a major undertaking. You’re talking about putting a crown on possibly all your teeth. If you do this, make sure your dentist is a TMJ Specialist. By that, I don’t mean a special degree, because there isn’t a recognized specialty in TMJ.

However, there are post-graduate training programs that will give the dentist expertise. For instance, Dr. Lopez received TMJ training at the Las Vegas Institute for Advanced Dental Studies.

This blog is brought to you by Dr. Kasia Lopez.

Has the ADA Admitted Amalgam Fillings are Dangerous?

I read on a natural health website that the US signed an agreement to get rid of amalgam fillings. Does that mean the ADA has finally admitted they’re dangerous? If so, why are dentists still using them?

Kate C. – New Hampshire


I don’t know of a treaty that requires the United States to get rid of amalgam fillings. You may be thinking of the Minamata Treaty. The US did sign that. It’s more related to how mercury affects the environment, not dentistry. However, it did list specific precautions which were supposed to be taken regarding the disposal of amalgam fillings. This is designed to keep mercury from negatively impacting our environment.

Neither the FDA nor the ADA has admitted there is anything unsafe about amalgam fillings. In fact, they still insist the fillings are perfectly safe. Most patients don’t care what the party line is on that one. All they hear is that amalgam fillings consist mostly of mercury. Mercury is a toxin. Put those both together and they don’t want amalgam fillings in their mouths. I can’t say I blame them.

If you’re concerned about amalgam fillings I’d suggest you go to a holistic dentist or a mercury free dentist. They’ll be certain to give you fillings you will feel safe to have in your body.

This blog is brought to you by Dr. Kasia Lopez.

Invisalign Versus Lingual Braces

I’m a 40+ year old professional with a public speaking job. I had braces in my younger years so my teeth are okay. They’ve just drifted a little and I need to look my best. I’m trying to decide between Invisalign or Lingual Braces. Do you have a recommendation?

Jane F. – Maine


Both are great treatments. In your professional capacity, I’d recommend Invisalign. The biggest reason for that is your speaking roll with your job.

Lingual braces are great. They’re behind your teeth. The biggest issue with them is a patient’s tongue is generally drawn to them. And, they will affect your speech.

Invisalign sometimes can affect patient’s speech in the beginning. However, most patients recover from that quickly. If you happen to be among the few that struggles with the adjustment, there is a simple solution.  Take them out before you speak for an important public engagement–so long as you wear them the prescribed amount of time.

This blog is brought to you by Dr. Kasia Lopez.