Archives for April 2020

Why Is there Too Much Shine on My Porcelain Veneers?

Posted on April 30, 2020 by writeradmin.

I don’t know why, but my porcelain veneers have so much shine on them, they look fake. My dentist disagrees and thinks they are beautiful. He says it is because of the whiteness I wanted that they are so shiny. I did ask for very white porcelain veneers. But, I don’t understand the brightness. I have seen other white veneers and, while they shine, they still look natural. Mine look like shiny pieces of chicklet gum.

Tanya

Dear Tanya,

It simultaneously amuses and annoys me when a dentist puts the problem off on the patient, like it was their fault he didn’t produce a nice result. While I wish I had an image of your smile to be certain, I do have a sneaking suspicion of what is going on here.

It takes an expert cosmetic dentist to get porcelain veneers to look natural. Unfortunately, cosmetic dentistry isn’t recognized specialty so any general dentist can call themselves a cosmetic dentist. Even more unfortunate, smile makeovers aren’t taught in dental school. This means if a dentist wants to know how to create beautiful, natural looking smiles, they have to invest in post-doctoral training.

I want you to look at the picture below. Notice how the teeth have texture to them. If that texture isn’t added, the porcelain veneers will look flat, giving it an overly shiny appearance.

The texture in the teeth needs to be varied as well. Plus, younger smiles have more texture because as we age, parts of that texture wears down. Believe it or not, one of the teeth in the image above is actually a dental crown. This is the kind of work a true cosmetic dentist does.

One thing I want to know is if your dentist bonded them on before or after you told him you didn’t like them. True cosmetic dentists will put your porcelain veneers in with a temporary try-in paste. They’ll have you look at them in various lights and make sure you absolutely love them. If you don’t, they’d go back to the lab.

If your dentist bonded them on and then you said you didn’t like them, you may not have much recourse. However, you could appeal to his ethics. You paid for a beautiful smile and should get one. If you got to try them on and told him you didn’t like them and he bonded them on anyway, then he didn’t have consent and you have the right to a refund. Ask for one.

Then, I would go to an AACD accredited dentist to get your smile makeover done. These dentists have proved their knowledge, skill, and artistry. In order to become accredited, a dentist has to pass stringent exams and turn in visual evidence on a large number of cases they’ve done.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Her Dentist told Her to Expect Her Porcelain Veneers to Fall Off!

Posted on April 21, 2020 by writeradmin.

I just had six porcelain veneers placed on my teeth and, as I was leaving, the dentist told me to expect them to fall off every few months. I knew up front that I would no longer be able to eat crunchy foods, such as apples or nuts, but I really thought they’d stay on other than that. Do you know if I’m expected to pay for the rebonding every time?

Caitlin

Dear Caitlin,

I’m astounded at what I’m hearing! First, let me start off by saying that one of the problems you are facing has to do with the fact that cosmetic dentistry isn’t a recognized specialty. This makes the standard of care a very low bar. It wouldn’t matter if they looked awful, as long as they were functional. That is actually the basis for a large number of cosmetic dentistry horror stories. They pay a fortune for a smile makeover and end up with a smile that looks worse.

The good news, though, is that your porcelain veneers falling off is NOT functional. It’s a basic standard of care. If your porcelain veneers fall off even once, go back and demand a refund. In fact, he should not have put eating restrictions on you at all. There are very few restrictions when it comes to porcelain veneers, such as not biting metal and wearing a nightguard if you are a teeth grinder. In your place, I’d go ahead and test the veneers by eating an apple the next time you feel like it. If they’re going to come off and need to be replaced (by a different dentist this time), it is better for you to know sooner rather than later. This way you can get a functional smile and not live in fear.

Finding an Expert Cosmetic Dentist

Without there being a recognized specialty in cosmetic dentistry, any general dentist can call themselves a cosmetic dentist. Unfortunately, creating beautiful smile makeovers isn’t taught in general dental school. Instead, a dentist has to invest in a significant amount of post-doctoral training as well as have an artistic eye.

It’s almost impossible for patients to know which dentists have done this and are truly qualified and which haven’t, essentially turning your trip to the cosmetic dentist into a gamble. The American Academy of Cosmetic Dentistry recognized this issue. As a result, they started an accreditation program. To become AACD accredited, dentists have to pass stringent exams that prove their technical knowledge of the procedures. Additionally, they’re required to submit a large number of specific cases they’ve personally done to show they can not only implement their technical knowledge but have the artistry required to create beautiful smiles.

If I were getting a smile makeover, I’d want an AACD accredited dentist to do it. When your porcelain veneers fail, and it sounds like your dentist is sadly confident they will, that is what you should look for in the dentist that will replace them.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

I’m In Tears After My Smile Makeover

Posted on April 18, 2020 by writeradmin.

I had a few teeth with composite bondings to repair some chips. They needed some repair. My dentist retired and said the man who took over his practice said they’d need to be replaced with porcelain crowns because you can’t just replace composite bonding. I didn’t realize at the time that wasn’t true and allowed him to do six dental crowns. The two front teeth look a darker grayish compared to the other teeth. Is there any way to fix this? My dentist insists they’re the exact same color as the others. It almost feels like I’m being gaslighted.

Elaine

Dear Elaine,

I’m very sorry you’re going through this. I can tell you the biggest obstacle you face is you have a bread and butter family dentist trying to do cosmetic dental work. One of the big problems in dentistry right now is the fact that cosmetic dentistry isn’t a recognized specialty. This means any general dentist can call themselves a cosmetic dentist regardless of the amount of training they’ve received.

This puts patients in a difficult position. They may not know that smile makeovers and other advanced cosmetic procedures are not taught in dental school. In order for a dentist to become skilled in those areas, it requires a significant amount of post-doctoral training. The best dentists invest in this type of training on a regular basis and are constantly improving their skills. My guess is your dentist didn’t receive that. This is what landed you in this position.

Getting Your Smile Disaster Fixed

A true cosmetic dentist would never tell a patient their smile looked fine when they were unhappy with it. Instead, they would re-do the work until the patient was thrilled. Because they want total patient satisfaction, they’ll use a temporary try-in paste. This allows the patient to get a good look at their smile before it is permanently bonded on.

It is unfortunate you now have dental crowns. You’re stuck with those the remainder of your life because it required your teeth to be ground down. The good news is he misrepresented to you the options available. It is not true that dental bonding could not be replaced. My guess is he said you had to have dental crowns done because that is all he knew how to do. In your place, I would ask for a refund and then go elsewhere to get them done properly.

If you’re happy with all the crowns except the two front ones that don’t match the adjacent teeth, you can just get those re-done. Either way you are going to need to find a top of the line cosmetic dentist. The best are AACD accredited cosmetic dentists. They’ve passed stringent exams as well as demonstrated their artistry on a large number of cases they’ve done.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Dentist Won’t Match Implant Crown

Posted on April 10, 2020 by writeradmin.

I have had the dental crown placed on my implant three different times and none of them matched the adjacent teeth. My dentist said I’m being too picky and my tooth color is between A1 and A2 and I will never be satisfied. She’s refusing to do it again. I hinted I will try somewhere else and she said that puts my dental implant in danger of coming loose because she’s already removed the crown two other times. Now I’m worried. Am I stuck with mismatched teeth? I don’t want to risk the implant itself. Could I just whiten everything, crown included?

MaryAnne

Dear MaryAnne,

Using teeth whitening won’t help in this case. It will whiten your natural teeth, but the crown will stay the same shade, making the differences even more obvious. I’m very sorry that your dentist is treating you this way. She seems to be transferring her inability to match the crown for your dental implant to you. This isn’t your fault. Based on what you said, there are probably two problems going on with this. My first guess is this is a front tooth she’s trying to match. Those are trickier than others. Even top cosmetic dentists will do several try-ins before getting an exact match.

Notice I said try-in. There are temporary try-in pastes which allow you and the dentist to see what the dental crown will look like in place without using the permanent bonding materials that require her to grind your crown off every time you request a change. These are inexpensive. There are usually only two reasons a dentist doesn’t carry them. The first would be they don’t care what you think and will only look at it themselves. The second is they don’t know about it because they have not invested in cosmetic training, which has to be done in a post-doctoral setting. I believe your dentist falls into this latter category.

This leads me to her second problem. She’s just going by the standard Vita shade guides and expecting your tooth to be a perfect match. But, your teeth are between an A1 and A2. For back teeth, her method would work fine. However, a front tooth gets all the light when we smile, which shows the color and variations in striking clarity. The standard shade guide isn’t enough.

This is an example of a color map a cosmetic dentist will send to the ceramist. Yes, it will have the basic shade, but there are also instructions for different tints to go in a variety of sections on the tooth, which changes the visual perception of the color. Our natural teeth aren’t one flat color. There are differences in opacity throughout the tooth. This is how you get a tooth to look natural and perfectly match its neighbor.

The truth is your dentist is in over her head. Ask for a partial refund and go elsewhere to get it done. See if you have an AACD accredited dentist in your state. They’re at the top of their field.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael WEiss.