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dentistry

A Way to Guarantee a Beautiful Smile Makeover

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I want to have a smile makeover done because I have never liked my smile. I am ready to invest in something great, but I am concerned about the results. I’ve had two friends get smile makeovers. One looked great and the other really was a disappointment. I think her smile was prettier before her makeover. The veneers are even darker than her original smile. I didn’t want to tell her she got ripped off but that is what I was thinking. If I am going to do this, I want to make sure I get the nice one. Is there a way to make sure that happens?

Kevin

Dear Kevin,

Woman covering her mouth

I commend you for both your caution and your research. To answer your question, yes, there is a way to guarantee that you will receive a great smile makeover. Often we get questions such as, “What materials should I choose for my smile makeover?” or “What type of porcelain veneers should I get, Lumineers or DuraThin?” But the materials do not make the biggest difference when it comes to smile makeovers. My guess is your two friends went to two different dentists because that is the key. The dentist.

Think of it like commissioning a painting. Let’s say you want a portrait of the love of your life done. You hire two artists to do the same portrait. You can give both of them the same materials. The same canvas. The same brushes. The same paints. Yet, the portraits will turn out differently. Why? Because each artist has different skill levels.

If you want a great smile makeover, I would look for a cosmetic dentist who has great post-doctoral training and beautiful artistry. That is a lot of legwork, so if you want a shortcut, my suggestion is to look for an AACD accredited dentist. These dentists have passed stringent exams on their technical knowledge, as well as demonstrated artistry on a large number of cases they’ve done personally. Any one of them can create a gorgeous smile for you.

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

Dental Bonding Problems

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I had a gap at the top of my gums, between my teeth. The empty space looked like tiny black triangles. My dentist told me dental bonding was the solution for that and assured me it would blend perfectly naturally. It did not. Instead, it looked like he put some caulking between my teeth. I expressed how I felt about it and he responded that it was just the harsh lighting in his office.  It wasn’t. When I got back to my home, which had low light, it still looked the same. That night, when I was brushing and flossing, I realized that now I couldn’t floss between those teeth. I’m very concerned about this. Is there a way to fix this?

Bernie

Dear Bernie,

before and after dental bonding

When dental bonding is done well, it will blend seamlessly. You would also be able to floss between your teeth. The fact that you cannot floss is a big issue. This area will become a magnet for trapped food and bacteria leading to decay. In a weird, fortuitous way, though, this benefits you. Without this issue, you would not have had any recourse.

Believe it or not, because cosmetic dentistry is not a recognized specialty, the standard of care is whether or not it is functional, not whether or not it is beautiful. In that case, you would have been stuck with bathroom caulk for your bonding. However, because his repair is not functional, you can ask for your money back to have this redone by a dentist who has the cosmetic skills to do it well.

This type of repair is more challenging than your typical dental bonding case. The area at that part of your gums can be dark, which means there needs to be subtle coloring differences in the bonding that goes in this area. I would think only the top cosmetic dentists can do this correctly.

Once you get your refund, my suggestion is that you look for an AACD accredited dentist to close your black triangles. They are the dentists with the skill and training to pull this off in a way that looks both beautiful and natural.

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

 

My Smile Makeover is a Disaster

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I don’t know what to do. I had four porcelain veneers placed on the teeth adjacent to my front teeth on either side. My front teeth look great and didn’t need any work, but the adjacent teeth have always bothered me. Here’s the problems I have with the work. First, the canine teeth are very bulky. I mentioned that so he tried to shave them down, but on the first one he tried shaving ended up with a dark spot. I decided to leave the other one bulky. I thought I could live with this. Here is the big problem. At the office, with the windows open and sun shining through, the porcelain veneers matched my teeth. However, when I got home, in the artificial light, they don’t match at all. The veneers are much darker than my natural teeth. I spoke to my dentist about that and he said I saw and approved them and he doesn’t know how he can change the color. Is there anything I can do about this?

Laurie

Dear Laurie,

Woman covering her mouth

The biggest problem you are facing is your dentist. He is not a true cosmetic dentist. Worse than that, he is apparently learning as he goes. Let’s start with the canine teeth. He makes them too bulky. Then, he tried makes one smaller, but discovers that changes the color so he stops. Now you have one miscolored tooth and one bulky tooth.

His next discovery is that the teeth look different in different lights. In cosmetic dentistry, this is known as color metamerism. He would have known that had he had any real training. Finally, he says he doesn’t know what to do about the color. I’ll tell you what he can do, he can replace them!

However, I am going to recommend that you don’t let him replace them. He is not the best dentist to do any cosmetic work on your teeth. I would ask for a refund and then look for a dentist with post-doctoral training in cosmetic dentistry. Also, check out their smile gallery to make sure their work is beautiful. If possible, see an AACD accredited dentist. These are the top cosmetic dentists in the country.

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

My Smile Makeover Is Turning Yellow

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I spent a good amount of money hoping to get my dream smile makeover. It’s been a disaster from the beginning. I selected a very white color because my natural teeth were very white. I just didn’t like their shape. My dentist gave me six porcelain crowns. However, when the came in they didn’t look as white as I expected. He assured me it is the color I asked for. Now, to make matters worse, the crowns seem to stain every time I even drink something. I am going in for a consultation with another dentist and I have no idea what to even ask him. Do you have any recommendations?

Dinah

Dear Dinah,

a porcelain veneer being placed on a tooth

Porcelain Veneers

I am sorry this happened to you. The first thing I’d like to ask is why dental crowns? Typically, a smile makeover is done with porcelain veneers. Was there some decay on the teeth that required crowns or were there already crowns there? Either way, it is water under the bridge. Those teeth will always need dental crowns from now on because the structure of the tooth has been ground down to fit the crowns over them.

One other thing that bothers me is why the crowns are picking up stains. If he truly gave you porcelain crowns, they would be very stain resistant. In fact, they’d be even more stain resistant than your natural teeth. I’m prone to wonder if he just said they were porcelain but used some other type of material. That is the first thing I’d have the dentist you are going to for a consultation look at.

However, let’s back up a bit. What makes you think this dentist you are going to get the consultation from is any better than the one who provided your disappointing results to begin with? I would make sure you are going to an expert cosmetic dentist. Look for someone who is AACD accredited. Then you’ll be certain to have an expert with both technical and artistic skill to work on your smile.

By the way, if it turns out your dentist gave you something other than porcelain crowns, you can get your money back because of misrepresentation.

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

My 11-Year-Old’s Dental Bonding Looks Terrible

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I need some advice. My eleven-year-old daughter fell in such a way that it knocked a giant portion of the middle of her two front teeth out. She has some on the sides and top and that is it. Our dentist said the best solution would be to fill in the empty space with dental bonding. We agreed, but in all honesty, it looks awful. Her two front teeth are now lumpy looking and the color doesn’t exactly match the remainder of her natural teeth. This is a very tricky age for kids and she has been in tears since we returned. I don’t know what to do. Can this be fixed? Did he need to do a different procedure?

Avalon

Dear Avalon,

before and after dental bonding

While your dentist was correct about the type of repair that would be the best solution, he doesn’t appear to have the cosmetic training necessary to do the actual work. Cosmetic dentistry is not a recognized specialty. As such, any general dentist can “do” cosmetic work, but very few of them have the actual training necessary to do it right.

Dental bonding is particularly difficult because it has to be done freehand. It also requires special materials in order to match the colors exactly to the remaining tooth structure. On top of that, your daughter’s type of repair is more difficult than most. It’s even on the list of cases dentists have to show proficiency and artistry in for them to pass the AACD Accreditation Exam, which is the one “guarantee”  for knowing that you have an expert cosmetic dentist.

My suggestion is you ask for a refund from your dentist. It doesn’t sound like he even came close to doing this in an acceptable fashion. Then, look for an AACD accredited dentist in your area. They will make certain your daughter has gorgeous front teeth as she returns to school.

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

Teeth Whitening Before a Dental Crown

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I am getting a dental crown on a white tooth and I want to do a touch-up on my teeth whitening before I get it. I asked my dentist how long I would have to whiten my teeth each day and for how many days to get them back to their original color when I first whitened them three years ago. He couldn’t tell me so I am wondering if there are some tips you have.

Bethany

Dear Bethany,

teeth whitening trays

 

I am going to help you with this, but before I do I want to let you know that I am concerned that your dentist was unable to answer these type of questions. Teeth whitening is a fairly straightforward procedure. If he can’t deal with that I would not trust him to place a dental crown on your front teeth. We’ll go over how to find a dentist who can in a moment.

The Basic Principles of Teeth Whitening

The main idea behind whitening your teeth is the longer you wear the whitening gel, the faster your teeth will whiten. You can wear them one hour a day, but they whiten faster than if you wear them several hours a day or overnight. Because each person’s teeth are different in the amount of staining and how white they want them, there is no way to quantify a number of days/hours. The one constant is you want to leave a week between when you stop your teeth whitening and when you begin the procedure for your dental crown. This is because the teeth will continue to whiten during that time period.

Getting a Crown on a Front Tooth

Crowns on back teeth are no big deal. The color doesn’t have to match exactly. However, matching a single crown to a front tooth is a completely different story. All the light hits your front teeth making all the differences much more visible. Even the best cosmetic dentists will do a couple of try-ins before settling on it being just so.

Ideally, you would want an expert cosmetic dentist to do this. Look for a dentist who is AACD accredited. Then you can be certain they will get it right. If your dentist cannot tell you about teeth whitening, I would not let him near this crown.

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

 

Fixing a Gummy Smile

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I have a gummy smile and wondered if there is something my dentist can do to change that and give me one of those smile makeovers I keep seeing online?

Penny

Dear Penny,

before and after a gummy smile makeover

It is possible to have a beautiful smile makeover done for someone with a gummy smile. However, one word of caution. this is very advanced and way beyond the capabilities of your typical dentist. You will need an expert cosmetic dentist for this. Beware of dentists who want to send you to an oral surgeon and cut your upper jaw. Not only is this invasive and expensive, but unnecessary and dangerous. It will likely lead you to TMJ Disorder.

Instead, you want a cosmetic dentist to do what is known as a gum lift. This removes a small amount of gum tissue, which will expose the bone beneath. Then, they can place porcelain veneers, which will cover the bone and completely make-over your smile.

Porcelain veneers can change anything you want about your smile, including the shape, size, and color. Please only go to an expert cosmetic dentist with this. I would look for someone who is AACD accredited. These are among the top 1% of cosmetic dentists in the country.

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

Smile Makeover Disaster with Tetracycline Stains

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I have tetracycline-stained teeth. I went to my dentist who is very reputable and has done a great job for me over the years. I was considering porcelain veneers, but my dentist talked me into porcelain crowns saying that they would help cover the stains better. This did not turn out to be the case. The gray is visible with each of the crowned teeth AND the crowns look fake, so it’s obvious I have fake teeth. But, not even pretty fake teeth. He said he can send them back to the lab. I’m so confused. I looked online and there is a woman from a different dentist who has beautiful teeth after getting her tetracycline teeth made over and she used porcelain veneers! What has gone wrong with my teeth? Will doing them again with crowns make a difference? I don’t think I can get porcelain veneers after I have crowns, right?

Leslie

Dear Leslie,

a porcelain veneer being placed on a tooth

You are correct that you will always have to have crowns now that you have them. This is because the teeth have been ground down to little nubs. That tooth structure is gone. In a way you have answered your other question already. You said, “…a woman from a different dentist.” The key to any smile makeover is the dentist who does it. One warning sign is when a dentist suggests porcelain crowns over porcelain veneers when the tooth is healthy and does not need a crown. These dentists are either not comfortable doing porcelain veneers to begin with or do not have enough skill in them and think that the added structure of dental crowns will make it easier to cover the stains.

Sending it back to the lab will only help if he can give them good directions. A lab is more like a pharmacy who fills the prescription of the doctor. It is the doctor that has to come up with the right diagnosis and the appropriate medicine for it. I am not convinced he can write the correct directions. However, there is no harm in allowing him to try. If you do that, do it on the condition that he uses a temporary try-in paste and if you don’t love them the second time then you get a refund. You should get to see them in several lights before making a decision.

If you end up needing a refund, you will want to look for an expert cosmetic dentist. The easiest way for you to do this is to look for a dentist who is accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists have proven skill and artistry. They can give you a beautiful smile whether using porcelain veneers or porcelain crowns.

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

How Long Do Composite Veneers Last?

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I’ve been looking at options for smile makeovers. Most people suggest getting porcelain veneers, but I am just curious about composite veneers. Would they be less expensive? How long will they last?

Carol

Dear Carol,

before and after dental bonding

In most cases, composite bonding is better used for small repairs, like a tooth gap or chipped tooth. The procedure has to be done freehand, which would take much longer in the dental chair than porcelain veneers will. In fact, many dentists will not do a smile makeover with composite resin for that reason. It would end up costing you more because of the tedious nature of the smile development.  On top of that, the composite bonding will only keep their luster a few years before they begin to pick up stains. On the other hand, well-cared for porcelain veneers can last upwards of twenty years.

My suggestion would be to look for an excellent cosmetic dentist. This is not a skill taught in dental school, nor is it a recognized specialty. If a dentist wants to become skilled, they would need to invest in post-doctoral training. It would be easiest for you to just look for an AACD accredited dentist. These dentists have proven skill and artistry. It will keep you from having to investigate the training of each dentist you look at. Any one of them can give you an extraordinary smile makeover.

Let them look at your teeth and talk to them about the look you want. They will be able to determine what procedure can give you the best outcome.

I hope this helps.

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

Fixing a Gap Between a Crown and a Dental Bridge

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I have a gap between my front teeth I would really like to fix. Unfortunately, the tooth on the right is a dental crown and the left is a crown attached to a dental bridge. Is there a way for me to close this gap without having the fixtures replaced? Maybe by putting something like Lumineers on top of them?

Peggy

Dear Peggy,

Advertisement for Lumineers over dental crowns

Years ago, Lumineers would advertise something like you mentioned. They told patients that old crowns can be restored by placing Lumineers on them, but it ended up not working out as well as they hoped. First, porcelain does not bond to porcelain as well as it does to the natural tooth structure. Second, it takes as much work to place them over crowns as it would to just make a new crown. Finally, you have double the risk of failure because now there are two things bonded.

I am curious why your dentist didn’t place the crown and the bridge in a way where there was not a gap to begin with. That makes me wonder about his skills. In reality, because of that you will likely have to have these two procedures re-done. You don’t want to re-do just one of them because the porcelain would be “lopsided”.

There is a possibility you could have someone do a repair by bonding composite to porcelain, but they would need to have some experience with dental bonding and some special equipment. Your dentist would need to use a micro-etcher on the areas of porcelain near the gap. After that, they’d need to etch the area with a hydrofluoric acid gel. Then it would need to be primed with a silane coupling agent. Finally, a bonding resin and then a composite bonding applied to match the color of your crown and bridge. As you can see this would take some specialty skill. I’m not sure your dentist has it if he or she was not able to apply your procedures without a gap to begin with. If you want to try this repair method before resorting to replacing everything, I suggest you see an AACD accredited dentist.

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