Smile Makeover Archives - Philadelphia Cosmetic Dentist

Why Has My Smile Makeover Lost its Shine?

July 3, 2021 by writeradmin

I am planning on asking my cosmetic dentist the same question I am asking you, but want to go into the appointment with as much knowledge as possible. Just over six months ago I had a total smile makeover done on my upper teeth with porcelain veneers. For the bottom teeth, we just did teeth whitening. I chose my cosmetic dentist very carefully and he is one of the tops in the field. The smile makeover itself was stunning and I was thrilled with the results. It cost me quite a bit of money, but I have looked at it as an investment. I’ve been very diligent with my oral hygiene as I want this to last for many years to come. My routine consists of brushing twice a day with Crest 3D Glamorous White Toothpaste, flossing once a day, and then rinsing with Listerine Whitening 6 in one with Fluoride. Despite all this effort, my porcelain veneers have lost their shine. Now they look quite dull instead of having the lovely sheen they had when I first came home with them. I went online where someone suggested I use baking soda. I did, but did not see any improvement. Can you help me here?

Samantha

Dear Samantha,

I am delighted to hear that you were satisfied with your smile makeover and that you are striving to take such good care of it. Let’s start with what you are using to care for your smile. Both the toothpaste and the mouthwash you are using can cause some minor damage to your porcelain veneers. Nothing to the extent you are describing, but they will contribute. Typical whitening toothpaste at the stores rely on abrasives to remove the stains on your teeth. With porcelain veneers, these abrasives will scratch the veneer and eventually, leave it very susceptible to staining. Listerine, like most mouthwashes, contains alcohol. This will also damage the veneer, but it mostly damages the bonding materials.

As I mentioned before, this isn’t really enough to lead to the amount to anything significant this quickly, I can think of two things that would result in the damage you are describing. The first is if your dentist provided you with composite veneers instead of porcelain veneers. While porcelain is extraordinarily stain-resistant, even more so than your natural teeth. Composite, however, picks up stains quite easily. You said you researched your dentist quite carefully, so I am not inclined to think this is the issue. It would take a very unethical dentist to place composite veneers but call them porcelain.

A second possibility is that your hygienist used something on your porcelain veneers that damaged the glazing. A couple of things you need to avoid during your cleaning/checkup appointments are the power prophy jet and the acidulated fluoride. If you go to a practice that does a lot of cosmetic work, the staff should be well trained enough to know this, but it is always possible you had someone new.

Your dentist can repair this. He should do so at his cost. Once they have that shine again, I want to make sure you have the right toothpaste to care for them. If you want a whitening toothpaste, the only one I recommend for people who have had any type of cosmetic work, especially a complete smile makeover, is to get SuperSmile Toothpaste. This is specially formulated to work with cosmetic procedures. There are no abrasives at all. Instead, it uses knowledge of chemical binding to remove the stains on your veneers. It is 100% safe. As for mouthwash, you can forgo it altogether or look for one that does not contain alchohol.

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

Teeth Under My Porcelain Veneers are Turning Dark

January 28, 2021 by writeradmin

I paid a small fortune for a smile makeover. For some reason, the teeth underneath it are turning dark. My dentist doesn’t seem to believe me. I don’t think I am imagining this. I wonder if it has something to do with the tops of the veneers don’t quite go flush with the gumline. There is a bit of a ledge there.

Portia

Dear Portia,

Bear in mind I haven’t actually seen your porcelain veneers, Based on what you’ve described, though. you have got a big problem here. It sounds to me that you have some open margins which is leading to leaking. This means your porcelain veneers need to be replaced. There is more at stake here than just the appearance. You are also putting your teeth at risk.

What is going on is your porcelain veneers were not bonded on properly. As a result, there is food and other bacteria getting trapped between your teeth and your porcelain veneers. That bacteria will sit on your teeth and turn into decay.

It doesn’t sound like your dentist is willing to own up to his error without some encouragement. Most dentists want to look good in front of their peers. My suggestion is you get another dentist on your side. In this case, you will want to see an expert cosmetic dentist. I recommend you see if there is an AACD accredited dentist in your area.

Have them look at your smile makeover and see what they say about it. Make sure it is a blind second opinion. By that, I mean don’t tell your dentist who did your smile makeover. If they ask, tell them you want their unbiased opinion.

If it turns out I am right and you do need to have these replaced, the dentist can help you get a refund. Then, I would make sure you have the expert cosmetic dentist do the new veneers. You’ll have much more beautiful results that will last a long time.

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

They Should Be Worried About Their Smile Makeover

December 5, 2020 by writeradmin

My husband and I went to a local dentist who advertised smile makeovers with Lumineers. We were both excited about getting our smile re-done. Our impressions were taken and we were told it would be two weeks. About the time they were supposed to be in, the dentist called and told us that the impressions were bad and we’d need to come in and have them re-done. It seems odd to me that they were still on the impression part when they were supposed to be done. Should I be concerned? Do you think we’ll actually get them? We’ve already paid upfront.

Miranda

Dear Miranda,

I am not concerned that you will not get them. I feel certain you will get them. The thing I am concerned about though is whether you’ll be happy with them. There are some things here that concern me. The first is the impressions. It doesn’t bother me that the first impressions were not good and needed to be re-done. That can happen from time to time even at the best of cosmetic offices. What does worry me is how long it took them to tell you.

I obviously wasn’t with your dentist but I can tell you what it sounds like to me. The lab would have known fairly quickly that the impressions were not good, so why didn’t they call you then? My guess is your dentist felt embarrassed that the impressions weren’t good. Maybe he or she is insecure about their cosmetic skills and they don’t have a ton of experience. Maybe they didn’t realize everyone has bad impressions now and again. Either way, for it to go that long they would have had to try to tell the lab to try anyway. After some effort, the lab called back saying the impressions were unworkable. Now they have to call you to re-do them.

Lumineers are a particular brand of porcelain veneers that are often marketed to inexperienced cosmetic dentists as being easy to place. However, doing smile makeovers is not taught in dental school; nor is cosmetic dentistry a recognized specialty. A dentist has to invest in post-doctoral training in order to learn how to create beautiful smiles. Lumineers just requires them to do a single seminar and then the dentist is officially “Lumineers Certified”.

Unfortunately, that isn’t enough. Most patients who go to dentists with this type of training end up disappointed at best. Here is how you can prevent that. When the Lumineers come in, tell your dentist you want them to try them on with a temporary try-in paste. This is to give you time to look at them and decide if you love them. If you don’t, they should go back to the lab to make any changes you request. They shouldn’t get permanently bonded on until you are thrilled with them.

I suggest you call the dentist now and ask them to agree to this. If they don’t, ask for a refund. Then go to a great cosmetic dentist with extensive cosmetic training. The best cosmetic dentists are AACD accredited. Don’t be surprised if they suggest a different brand of porcelain veneers.

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

Horrible Color on My Front Teeth

November 24, 2020 by writeradmin

I had to have zirconia crowns placed on my front teeth. My dentist sent me to a prosthodontist. I have a bit of dental anxiety and so he suggested dental sedation. He assured me I’d be able to see the crowns before they were bonded on. Unfortunately, that didn’t happen. He said I saw them and approved them, but I have no recollection of that. I am sure that if I had seen them, I would not have approved them. They are completely gray compared to the rest of my teeth. The dentist is absolutely refusing to replace them, saying that I approved them and they are fine. What do I do? I absolutely do not smile anymore. My teeth look ridiculous to me.

Marion

Dear Marion,

You shouldn’t feel ashamed to smile after having dental work done.

I’m very sorry for the experience you’ve had. We often see these type of cosmetic dentistry horror stories with people who get smile makeovers from an inexperienced cosmetic dentist. Most patients don’t realize that cosmetic dentistry isn’t a recognized specialty. If a dentist wants training in cosmetic work, they have to invest in post-doctoral training.

Unfortunately, this means every general dentist can call themselves a cosmetic dentist, regardless of the amount of training they’ve attained. This has resulted in some disastrous results. With a prosthodontist, it can actually be a worse scenario. This is because they think their extra training in restorations also makes them experts in cosmetics as well. Unfortunately, that is not the case.

This seems to be what you are facing. He fancies himself an expert and feels justified in not replacing his ugly work. Unfortunately, if the work is functioning it can be hard to get a refund, but I’ll give you some tips for that later. You do have one thing working in your favor.

He would be hard-pressed to say you were lucid enough to truly give approval. It’s never a good idea to use a strong sedation when there is cosmetic work involved, unless the patient is highly anxious. If that is what you are dealing with it is in both your and the dentist’s best interest to try you in provisionals for a while to ensure that you are satisfied with them, while you are in the best possible state of mind.

I’m also a tad curious about his choice of zirconia crowns for front teeth. These come in blocks and are milled into the shape needed for the tooth. Unfortunately, this has a very flat appearance. A wise cosmetic dentist would put a layer of porcelain on top of the zirconia. Porcelain can be done in varying levels of translucency which more mimics your natural tooth structure.

The best way to get a refund from one dentist is to get another one on your side. Often when a dentist won’t listen to a dentist they will listen to a peer. My first recommendation is for you to get a skilled cosmetic dentist, preferably an AACD accredited dentist, to look at them and share their opinion about the appearance. There are some more tips that you can find here.

I also think the dentist who referred you has some responsibility to make this right as well. If your teeth look bad, he or she could pressure the dentist into replacing them. After all, much of his patients will come from referrals. He should want to make sure your dentist is comfortable recommending him.

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

Smile Makeover on a Fractured Tooth

October 12, 2020 by writeradmin

Years ago, I had an accident which fractured some teeth. They received both root canals and dental crowns. As years past, my smile started to show it’s age. I decided to get a smile makeover after my last promotion. I went to see a highly recommended cosmetic dentist in my area. She did a combination of dental crowns and porcelain veneers. I love how it looks and am much more confident. My problem now is with tooth #9. It’s been sensitive ever since and there is a pimple on the tooth next to it. My cosmetic dentist thinks that the tooth needs to be extracted and to have a dental implant placed. I’m also getting a root canal treatment on the adjacent tooth. I’m attaching the x-ray to see if you think the tooth really needs to be extracted. I just had the restoration done and it seems like a waste of money to remove the tooth. I’ll also send a picture of the new smile in case you need it.

Aaron

Dear Aaron,

I am in agreement with your cosmetic dentist. Looking at the circled tooth, in the middle of the root there is a horizontal radiolucent line. This is an old fracture that was either missed by your old dentist who worked on your teeth after the accident or he thought he could get out all the necrotic tissue and save the tooth.

Below the fracture looks healthy. However, above it the tooth looks moth-eaten. That tells me there is probably an infection there. Removing the tooth, will be the safest thing to do. A dental implant is a fantastic replacement so your dentist was right about that too.

Looking at the images you shared of your smile makeover, the dentist you choose was skilled. I’d stick with her for the dental implant as well. However, she should have caught the fracture and infection.

Because she didn’t, it isn’t unreasonable to expect some flexibility in how this is paid for. Originally, had it been properly diagnosed at the beginning, you would have paid for an implant and a crown. I’m going to suggest you ask to pay for the implant, but not the new dental crown to go on top of it because you just paid to have one placed. I don’t think she’ll have a problem with that.

From your x-ray, I have noticed one other issue. It looks like another tooth that had a root canal treatment, didn’t get done properly. You see the tooth on the left has filling material that stops a few millimeters short of the end of the root. I wouldn’t do anything about it unless it flares up. For now, the tooth itself looks healthy.

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

$100k for a Smile Makeover?

September 17, 2020 by writeradmin

I’m so frustrated. I’m having trouble getting the right cosmetic dentist for my smile makeover. The first go-round I used my normal dentist. It turned out a complete disaster. He was gracious about it and completely refunded my money. Next, I went to someone who is supposed to be the top cosmetic dentist in our city. He said my bite is off and quoted me close to $100,000. There is no way in the world I can afford that. Is that the right amount for a top cosmetic dentist?

Jane

Dear Jane,

You are running into two problems when it comes to cosmetic dentistry. First, it isn’t a recognized specialty. This means any general dentist can call themselves a cosmetic dentist regardless of the amount of post-doctoral training they received. Unfortunately, creating smile makeovers isn’t taught in dental school. If a dentist wants to develop the skills needed to do it well, they need to invest in the training on their own. This is the issue you ran into with your family dentist. He obviously meant well and wanted to try to give you what you wanted. When he couldn’t, he had the integrity to return your money when he couldn’t.

The second dentist had a completely separate issue. The cost he quoted is quite high for porcelain veneers. He mentioned your bite was off. It’s possible what he was recommending was actually a full-mouth reconstruction, which is a completely different and much more involved procedure as well.

I would get a second opinion before moving forward. To be safe, I’d like to make certain you are seeing a qualified cosmetic dentist and not just someone trying to bring in a large fee. My suggestion is you look for an AACD accredited cosmetic dentist. These dentists have proven themselves by passing stringent exams as well as demonstrating the artistry to a committee.

If it turns out that you do need a full-mouth reconstruction, I think you should verify his qualifications. You need a TMJ Dentist with advanced training. Take a look at Dr. Weiss’ qualifications to get an idea of what type of dentist you would need for this type of procedure. Even then, I don’t think it would cost you $100K.

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

Can You Get Porcelain Veneers if You Have an Overbite?

August 3, 2020 by writeradmin

I have tetracycline stains that I have always wanted to be covered. I asked my dentist about porcelain veneers and he said I can’t get them because I have an overbite which makes my upper teeth cover my bottom teeth. Instead, he wants to do six porcelain crowns on the upper teeth. Because my lower teeth can’t really be seen, what do I do with those, whiten them?

Elisabeth

Dear Elisabeth,

Please don’t let this dentist do your smile makeover. He’s making quite a few errors and he hasn’t even started. Him telling you that porcelain veneers don’t work for an overbite isn’t true. Instead, it is likely just an excuse because he doesn’t know how to do porcelain veneers. In fact, veneers make more sense in a case where there is an overbite involved because dental crowns must surround the whole tooth. This will cause it to hit up against your lower teeth. Instead, porcelain veneers are thin wafers of porcelain that only cover the front and hug the sides a smidge. This is a much better fit for someone with an overbite.

A second concern I have is that dentists who recommend dental crowns for a smile makeover when it isn’t necessary are generally not experienced cosmetic dentists. They think they have done dental crowns for treatments before with decayed teeth. How hard could it be just to add a few more? Actually…quite hard. In your case, this is especially true. You are dealing with tetracycline stains which are among the most difficult and advanced cosmetic procedures there are to do well.

He’s also recommending just six dental crowns. Most smiles are at least 8 – 10 teeth wide. What does he intend to do to make those adjacent, visible teeth do to match? Teeth whitening, which could be an acceptable option on many cases, will not work in yours because of how deep and dark the stains are with tetracycline. This will make the six teeth that are crowned, look obviously fake and silly, like children playing dress-up in their parent’s shoes. They obviously don’t fit, but at least they’re trying.

Teeth whitening could help with your bottom arch. This arch won’t be so obvious when the color doesn’t match exactly. However, I’d recommend a strong whitening system such as KoR whitening. Plus, you will have to be persistent and stick with it much longer than the average patient.

Your Smile Makeover Requires an Expert Cosmetic Dentist

Especially because of the difficulty with your type of smile, you need a top of the line cosmetic dentist. My suggestion would be to find an AACD accredited dentist. This is different from being a member of the American Academy of Cosmetic Dentistry. To reach accreditation, the dentist has to pass stringent exams as well as provide visual evidence on a large number of specific cases they’ve done that are assessed by a panel of judges on their technical quality along with their artistry.

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

Can’t Speak after Closing a Tooth Gap

July 30, 2020 by writeradmin

I had a tooth gap that my dentist closed and talked me into a smile makeover at the same time. I had porcelain crowns done from one canine tooth to the other. Ever since then I have had problems speaking, closing my mouth, my mouth is dry all the time, and my neck hurts constantly. Is there a way to put the gap back? Everything was fine with those things before. I just didn’t like the gap.

Carl

Dear Carl,

woman smiling with a gap between her two front teeth

The easiest way to close a tooth gap is with dental bonding

I want to start with the fact that crowning six teeth is a massive overtreatment for a tooth gap. It wouldn’t even be my solution for a smile makeover. Generally, tooth gaps are closed with dental bonding, which is much less evasive, doesn’t remove healthy tooth structure, and is much less expensive.

However, let’s say you really wanted a total smile makeover. As I said above, porcelain crowns still would not be the best choice. The go-to procedure for a smile makeover is porcelain veneers. The reason a dentist would suggest a porcelain crown if you don’t already have crowns there is because he or she doesn’t feel qualified to place porcelain veneers. That’s not a good reason. It would be better for them to refer you to a cosmetic dentist who would be able to give you a beautiful smile without having to grind down all your teeth. Unfortunately, once all that tooth structure is removed, you are stuck with crowns for the remainder of your life.

As to the issues you are facing, they are not from the gap being closed. Opening that back up won’t help. However, the issues are serious and are a result of the dental crowns not being placed properly. Based on your description, it sounds like your dentist opened your bite too far. This means he’s either made the crowns too thick or too big for the shape of your mouth. It is imperative this is repaired–The sooner the better.

Here’s what is leading to the problems you’re facing. The neck pain is a result of your bite being thrown off and now you’re straining. Until that is restored, you will continue to be in pain.

Not being able to close your mouth properly is called lip incompetence. This is leading to the dry mouth you are experiencing. While I’m sure you know why the pain has to be dealt with, the lip incompetence is also a serious issue. Our saliva is a major force in fighting decay in our mouth. Whenever you have dry mouth, you no longer have the minerals from your saliva to protect your teeth. It will lead to massive decay.

To get this properly fixed, I want you to get a second opinion from an experienced cosmetic dentist. Find an AACD accredited dentist in your area. These are the top cosmetic dentists in the country. They can help you get a refund from your dentist and then you can get this done properly so you have the proper function of your bite. Not only will you have a functioning bite, but it will also give you a stunning smile.

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

Full Mouth Reconstruction Disaster

June 8, 2020 by writeradmin

I needed to replace some old veneers and two crowns. When I saw my dentist, he said that he’d need to open my bite a bit so my teeth would show more. I never considered that a problem, but figured there was a reason. The temporaries are very uncomfortable I asked him to redo them twice. Then when the permanents came in, he put them in so fast, I hardly had a chance to check them out before they were permanently bonded on.

I’ve had massive problems since and can’t even shut my mouth all the way. I have been drinking water and sloshing it around my mouth constantly. If I don’t, my lips stick to my teeth. I spoke to my dentist about it and he said he’s hit all the checkpoints and his work is perfect. What do I do? I don’t feel like I can continue like this.

Pam

Dear Pam,

This is unacceptable for you. When your dentist tried to open your bite, which I am not convinced was necessary, it sounds like he was in over his head as well. Additionally, it doesn’t sound like he cares. He ignored every concern you had during the temporaries. This is the stage that is imperative to help ensure the bite is perfect. He should never have moved forward until your bite was completely comfortable. He blew past that and placed the permanent ones in a rush.

Now that they’re on and not doing well, he’s ignoring you again. This time, putting your oral health at risk. What you are experiencing is lip incompetence because he opened your bite too much. He’s really messed up and doesn’t want to admit it.

The only way to fix this at this point is to completely have the case re-done. However, you don’t want to have this dentist do it. To be frank, he doesn’t know what he’s doing. You need another dentist to do this for you. I also think your dentist needs to be the one to pay for it. It is his mistake.

Who Should Re-Do This?

You need a dentist with both cosmetic and restorative training. When you do, make sure the temporaries are exactly the way you want them before the case goes any further. A good dentist will know this, but I don’t want you suffering the same way again, so I just want to make sure you don’t allow anyone to move forward without satisfactory temporaries.

What that means is, your lips will come naturally together, your bite “feels” normal to you, and you love how they look. Unfortunately, smile makeovers and advanced restorative procedures aren’t taught in dental school. A dentist has to study this in a post-doctoral setting, though it isn’t required for them to practice. If at all possible, you should get an AACD accredited dentist to do your case. They will be the most likely to have the training and the skills necessary to do this for you.

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

Do Dental Crowns Cause Dry Mouth?

May 30, 2020 by writeradmin

I’m having a really hard time with dry mouth ever since getting all my teeth crowned. I know it was a cosmetic procedure, and while the teeth look okay, I have to really focus on keeping my mouth closed. Never in my life did I think I’d be what my kids call a “Mouth Breather.” Is there a way to fix this or is it normal and I’m just not used to a wider smile?

Kathy

Dear Kathy,

No this isn’t normal. Was there a particular reason your dentist did dental crowns instead of porcelain veneers. You mentioned it was cosmetic work. Generally, when someone is getting a smile makeover, porcelain veneers are the go-to. It removes less tooth structure.

Some inexperienced cosmetic dentists will do porcelain crowns for smile makeovers because that is what they’re familiar with, but it unnecessarily grinds down healthy tooth structure. It’s water under the bridge at this point as it is already done. I just wondered if there was a functional/mechanics reason for doing something so drastic. That leads me to my next question.
Why every tooth? Most smiles are about eight to ten teeth wide. Doing every tooth is excessive, not to mention expensive.

What your dentist did is known in dentistry as a full-mouth reconstruction. It’s an advanced procedure that isn’t typically taught in-depth, if at all, in dental school. Instead, dentists would seek out post-doctoral training.

Lip Incompetence is Dangerous

When you can’t close your lips naturally and are having to consciously force it, we call that lip incompetence. It is going to rain havoc on your teeth and oral health. While many people think brushing is our biggest defense against decay, the reality is our saliva has an even greater impact. It contains bacteria-fighting minerals that protect your teeth. Dry mouth deters saliva and allows that bacteria to multiply unhindered.

In creating this problem, y our dentist made a serious mistake. He (or she) needs to pay to get this fixed. Don’t just ask for a refund because the fix will likely be more expensive than the original procedure. If he complains about this, you may want to hint to him that another dentist told you that you have a valid case for malpractice damages. That should get his attention.

A Word about Smile Makeovers

You said the smile was “okay”. An okay smile would not be what you were stuck with when it came to a true cosmetic dentist. When you go to get this full mouth reconstruction done correctly, I want you to look for a dentist who is accredited with the American Academy of Cosmetic Dentistry.

AACD accredited dentists are in the top 1% in their field. Not only will you be able to close your mouth naturally and comfortably, but you’ll also have a stunning smile you will be thrilled to show off to the world.

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