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Cosmetic and
restorative
dentistry

Protecting a Porcelain Veneer during a Root Canal Treatment

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I have porcelain veneers and my dentist recently told me I needed a root canal treatment because of a periapical abscess. I’ve heard that root canals can turn the teeth dark. I’m afraid that will ruin the smile makeover. I’m also worried it will damage the veneer. Do you have any suggestions?

Carolyn

Dear Carolyn,

A tooth being prepared for a porcelain veneer I’m a little concerned you needed a root canal treatment to begin with. When teeth are properly prepared for a root canal treatment, there is very little tooth preparation done. The photo to the left shows the deep limiting diamond bur that is used to remove about a 1/2 millimeter of enamel. It adds the grooves and then a dentist will go back and remove the ridges with a traditional diamond.

Unfortunately, some dentists get aggressive and remove all the enamel and down into the dentin. Others actually do porcelain crowns, which requires massive tooth grinding, and just call them veneers. Both of these last two methods put you at greater risk of needing a root canal treatment. I’m wondering if this is what happened to you.

In your situation, however, it’s already done and you need to deal with what is happening now. You have to have the root canal. You don’t want to leave an infection in your bone. That can lead to serious complications. Fortunately, I have some advice to give your dentist to protect your porcelain veneers.

Protecting the Appearance of Porcelain Veneers after a Root Canal

You are correct that a root canal treatment can make a tooth look dark. Because your porcelain veneers are translucent, that will show through and make the color look off. This can be prevented. Make sure your dentist knows that most of the darkening of the tooth comes from the remnants of tissue left over in the canals. Have him read this post so you can feel confident he knows the right technique for this situation. Here’s what he needs to do.

He needs to clean out any of those materials from the crown of the tooth. Then he’ll need to place a white fiberglass post down into the root and fill the rest of the space in the crown with a light-colored composite. While it won’t forestall the tooth turning dark forever, this method along with the fact that you have a porcelain veneer should keep the tooth white for many years.

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

Porcelain Veneers During Pregnancy

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I’ve been saving up for a smile makeover for years. Now, when I finally have the full amount I needed I find out I’m pregnant. Is it safe for me to go forward with this or do I need to wait until after delivery?

Madison

Dear Madison,

A single porcelain veneer being placed

While there are some procedures which are not recommended in the first trimester, such as teeth whitening, porcelain veneers should be quite safe. The concern is about introducing chemicals to the baby. With porcelain veneers, the only thing you have to worry about is the anesthetic used. Fortunately, lidocaine has been tested and proved safe for use during pregnancy and even delivery. You and your baby should be fine.

Who Should Do Your Porcelain Veneers?

There is another important consideration— who should do your smile makeover. This isn’t a skill taught in dental school, nor is there a recognized specialty where dentists become graduates in the field. Instead, dentists with an interest in cosmetic dentistry have to take the initiative to get the proper training post-doctorally.

This makes it a little challenging for patients. How can they separate the sheep from the goats, so to speak? The easiest way to handle this is to find an AACD accredited dentist in a reasonable distance to you. These dentists have been tested vigorously for both their technical knowledge and their artistic ability and are among the top 1% of cosmetic dentists in the country.

They will give you a stunning smile.

If you can’t find an accredited dentist without a significant amount of travel, which you’re probably not keen on while pregnant, you still have options.

The mynewsmile.com website also recommends excellent cosmetic dentists. Not all of them have reached accreditation, but they’ve all been carefully screened for their ability to do beautiful smile makeovers. Most are on their way to accreditation.

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

My Porcelain Veneers Look Fake

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I’ve cried since getting home from the dentist. I spent years worth of savings to get a beautiful smile, but it looks totally fake. They’re bulky and chalky white. Honestly, to me, it looks like my dentist bonded pieces of white chicklet gum to my teeth. I told him what I thought and he said I am overreacting and am just not used to what they look like. He said in a week I’d be thanking him. Maybe he’s right but all I can do right now is cry. Am I overreacting?

Patricia

Dear Patricia,

A single porcelain veneer being placed

I can’t tell you how much it breaks my heart every time I hear a story like this. It sounds like you went to a family dentist who dabbles in cosmetic dentistry but hasn’t invested time in serious training to develop his knowledge, skill, or artistry. Based on the description of the results (and I’m taking a guess here) he likely placed Lumineers.

Lumineers are a brand of porcelain veneers which are highly marketed to inexperienced cosmetic dentists as being easy to place because they are considered “no-prep”. The problem with no-prep veneers is they often look bulky when they’re finished. Their lab also isn’t known for its beautiful work. Most expert cosmetic dentists prefer other brands of porcelain veneers.

If they are permanently bonded on, the only way to fix it is to have them replaced. The first thing I would do is tell your dentist this isn’t the smile you paid for. If he cares about the quality of his work and satisfaction of his patients, he’ll be willing to re-do it. If he does, make sure he lets you see them on your teeth with a temporary try-in paste. This way you can approve them before he bonds them on again.

If he’s unwilling, one thing I’m going to suggest you do is see an expert cosmetic dentist. Look for one in your area who is AACD accredited. They are the best cosmetic dentists in the country. They may be able to help you secure at least a partial refund. Then, you can let the skilled dentist do your smile makeover.

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

Cried After Getting Porcelain Veneers

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I have dreamed of getting porcelain veneers for years. I saved every penny I could, stashed away every tax refund, and hadn’t been out to eat in two years. I can’t express how much I was looking forward to finally having a smile I was proud of. But, when my dentist bonded them on, I was so disappointed. They look so thick. I feel like I have donkey teeth. Even though the color and shape are better than my old smile, I was expecting something else. To me, these look fake. My dentist says that’s a common reaction because I’m not used to them and I’ll like them in a week. I could barely see while I drove home, I was crying so much. It’s been a week. They still look fake. What do I do?

Laurie

Dear Laurie,

Porcelain veneer being held up by a dental tool
Beautiful smiles require an expert cosmetic dentist

These type of stories absolutely break my heart. I’m so sorry you’ve made so many sacrifices to end up so disappointed. I can tell you what went wrong right away. You didn’t go to a true cosmetic dentist.

One problem for patients is that cosmetic dentistry isn’t a recognized specialty. It’s an art form that any general dentist can dabble in. It sounds like dabbling is all your dentist has done.

True cosmetic dentists invest serious time with training, study, and practice into learning how to create stunning smile makeovers. All of that has to be done post-graduate school. Smile makeovers aren’t taught in dental school.

How Do I Know Your Dentist Wasn’t a Cosmetic Dentist?

I could tell right away you were dealing with a dabbler. First, he just bonded the porcelain veneers on before getting your okay on the results. Instead, he should have used a try-in paste so you could have seen your porcelain veneers on your teeth and looked at them in several types of lighting.

Second, if you weren’t absolutely over the moon about your new smile, he would have gone back to the drawing board. Never, will a true cosmetic dentist say, “You’ll get used to them.” Nope. You paid for a beautiful smile and that’s what you should get. Don’t even get me started on his “That’s a common reaction.” That should tell HIM something.

Can These Porcelain Veneers Be Fixed?

This is the tricky part. Once they’re bonded in, no changes can be made. The entire case will have to be done fresh with new porcelain veneers. The first thing I would try is to ask your dentist for a refund. You didn’t get to approve the veneers before he bonded them on and that is standard practice with cosmetic dentists.

The problem you’ll run into is if he says, “No.” When it comes to what’s considered a “botched case” with the dental board is different than it should be in cases of cosmetic work. If the veneers are placed properly and your teeth function normally, they won’t force him to refund your money.

Here’s what I’d recommend in that case. Go to an expert cosmetic dentist for a second opinion. You can find one by going to aacd.com and doing a search for an ACCREDITED cosmetic dentist in your area. The accredited part is important. Ask his or her opinion of your case without telling them who the dentist was.

If they agree it was badly done, then solicit their help in getting you at least a partial refund. Sometimes a dentist will listen to a peer more than a patient out of professional pride.

Then, have the smile re-done by someone who knows what they’re doing.

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

4 Ways Porcelain Veneers Can Help You Look Younger

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In a survey by the American Academy of Cosmetic Dentistry, 54% of participants agreed that as they age, a beautiful smile can withstand time and contribute toward a more youthful appearance. If you’re interested in rejuvenating your smile, consider four ways porcelain veneers can help.

What Are Porcelain Veneers?

Photo of a single porcelain veneers being held by the tip of dental forceps.
Porcelain veneers can rejuvenate your smile

Thin wafers of porcelain are custom made and bonded to the fronts of the teeth that show when you smile. Your natural teeth will be conservatively prepared to ensure the veneers fit well and look natural.

How Can They Help?

Porcelain veneers can rejuvenate your smile and make it look younger in several ways.

Alignment and Spacing

If your teeth are misaligned, orthodontic treatment might not be necessary. In a few weeks, misalignment, gaps, and spaces between teeth can be corrected with porcelain veneers. Teeth that are well aligned can give you a more youthful smile.

Color         

Usually, teeth whitening treatment breaks down deeply embedded stains. Porcelain veneers can be used for complex whitening cases, including:

  • Fluorosis stains
  • Tetracycline stains
  • Genetically discolored teeth
  • Changes in tooth color due to medical conditions or prescription medications.

Size

A variety of factors can influence the size of your teeth. If the size of your teeth is properly proportioned, your smile can have a more youthful appearance. Veneers can help in the following situations:

  • Worn teeth
  • Trauma
  • Genetically small teeth

Shape

Well-shaped teeth contribute to an attractive smile. If your teeth are too pointy, round, or square for your preference, porcelain veneers can reshape them in a way that looks natural and complements your facial features.

Protect Your Investment in Porcelain Veneers

If you take good care of them, porcelain veneers can last 15 to 20 years or more. Ensure your maintenance and dental cleanings and exams are only performed by a dentist and hygienist who have been specifically trained to care for porcelain veneers. If the wrong dental tools are used, your veneers can be damaged.

This post is sponsored by Philadelphia, PA cosmetic dentist Dr. Michael Weiss.