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Cosmetic and
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dentistry

3 Reasons Porcelain Veneers Might Turn Dark and What You Can Do About It

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In January, I received six porcelain veneers. Two of them are turning dark. I am originally from Indiana, and I’ve been with my dentist for a little more than a year now. I asked him about the veneers, and his response was, “Hmm. I am not sure what’s going on.”  This is making me nervous. Why would my veneers be turning dark in just a few months? – Vivian

Photo of a single porcelain veneers being held by the tip of dental forceps.

Porcelain veneers can rejuvenate your smile

Vivian – Dr. Weiss would need to examine your porcelain veneers for us to identify the exact problem. We can tell you that porcelain is stain resistant and very hard—much more so than natural teeth. So why might they turn dark?

Reasons Porcelain Veneers Might Turn Dark

  1. A gap between the veneer and your tooth – If your dentist left a small gap between the two porcelain veneers and your teeth, bacteria can leak in and attract stain. Correcting the issue can be tricky, and only a highly skilled cosmetic dentist should attempt it.
  2. Excess composite – If your dentist didn’t polish away any excess dental composite when bonding on your porcelain veneers, it could cause them to look dark. Excess composite can easily be polished away by a cosmetic dentist who regularly creates beautiful smile makeovers.
  3. Power-polishing equipment – If a dentist or dental hygienist uses power-polishing equipment on your porcelain veneers, the glaze on them can be quickly destroyed. It only takes a few weeks for the damaged glaze to attract stains and make your teeth look darker. Trained cosmetic dentists and hygienists understand which tools to use on porcelain veneers and which tools to avoid. Ultra-fine polishing strips and ultra-fine aluminum oxide polishing paste help in several ways:
  • Keeps the area smooth
  • Helps it resist stain
  • Helps prevent plaque accumulation
  • Helps prolong the life of your porcelain veneers

Although your dentist or hygienist might have been negligent in the placement or maintenance of your porcelain veneers, we recommend that you only let a skilled cosmetic dentist correct the issue.  An expert cosmetic dentist has the tools needed to correct the problem. He or she also knows the techniques required to polish your veneers properly. Find an experienced cosmetic dentist to examine your veneers and recommend the options for lightening them.

Philadelphia, PA accredited cosmetic dentist Michael Weiss, DDS sponsors this blog post.

$100k for a Smile Makeover?

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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,

Woman with a beautiful smile

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.

Cosmetic Solution for Fluorosis Stains

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I have fluorosis stains on my teeth and wondered if teeth whitening is a good cosmetic fix for someone in my position? I want to have a smile I am proud of.

Diego

Dear Diego,

I will say right off that teeth whitening will not be the solution. It whitens teeth evenly and is only more likely to make your fluorosis stains more obvious. For the benefit of those who are unfamiliar with what fluorosis stains are, it happens when someone ingests too much fluoride while the teeth are still forming. The fluoride in the water in the United States is optimized for the right consumption so we don’t see much of it here.

There is good news, though. Your teeth can be attractive again. Which solution depends on the amount of fluorosis you are dealing with. For either repair, you will need an expert cosmetic dentist. My suggestion would be to find an AACD accredited dentist.

If You Have Mild Fluorosis

 

mild fluorosis stains

The picture above is an example of mild fluorosis. If this is what you are facing, then dental bonding can be a sufficient repair. Your dentist will gently shave about 0.5 millimeters of your tooth enamel. Then, he or she will replace it with direct composite bonding. It doesn’t last as long as the next repair I will talk about, but it does cost less.

If You Have Darker Fluorosis

heavier fluorosis stains

In some cases, as in the picture directly above, the stains are more prominent. In this case, simple dental bonding will not be enough. Instead, I suggest you have porcelain veneers placed. This is actually the go-to procedure for a smile makeover. It is what gives people that “Hollywood Smile.”

This procedure can last for a lifetime. However, don’t try to cut corners by going to an inexperienced cosmetic dentist for this. It’s not an easy procedure to do under the best of circumstances. With severe stains like these, it will take someone highly skilled. This is why I recommended an AACD accredited dentist earlier, these are the best cosmetic dentists.

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

Can You Get Porcelain Veneers if You Have an Overbite?

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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,

Photo of a single porcelain veneers being held by the tip of dental forceps.

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

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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.

Discolored Dental Bonding

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I’ve got dental bonding that is seeing the end of its lifespan. It is picking up stains and isn’t nearly as bright as it once used to be. I honestly don’t know if I should whiten them or replace them. If whitening would work then I’d like to do that. I’ve moved since then and don’t feel confident my new dentist can do the job. He said he’s willing to learn but I’d be his first case. Is there a specific type of teeth whitening that would work better with dental bonding?

Eliza

Dear Eliza,

before and after dental bonding to repair a chipped tooth

There isn’t a teeth whitening that will remove the stains from your dental bonding, unfortunately. In fact, because it only works on natural tooth structure, your teeth would whiten but not the dental bonding, making the disparity even worse. That being said, I am glad you are not just going to let your new dentist try his hand at dental bonding on you.

This requires some expertise because it is a procedure that is done freehand. A dentist needs training as well as artistry. However, you do need to have the bonding replaced. If you are happy with your dentist in every other aspect, you don’t have to switch practitioners. Cosmetic dentists are used to patients coming to them just for specific advanced procedures and then returning to their regular family dentist for the bread and butter type of care.

With that in mind, how do you go about finding a dentist to replace your worn out work? The easiest way would be to find an AACD accredited dentist in your area. These are dentists who have proven their technical knowledge and artistry to an examination board. They are more than qualified.

Should You Whiten Anyway?

Because the bonding color is permanent during its healthy lifespan, if you have any plans to whiten your teeth, the time to do that would be before you have the bonding re-done. This way when they replace the bonding, it can be done to the color you will want to keep for some time.

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

Dental Bonding Doesn’t Match

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I chipped a tooth and did some research on repairs. The consensus was dental bonding was the best repair. I did get that, but the bonded part doesn’t even come close to matching the tooth part. It is so obvious there is a repair there. Is that normal? If not, who do I get this fixed? Will I have to pay for it?

Casey

Dear Casey,

before and after dental bonding

As you can see from the image above, dental bonding can and should look completely natural blending in seamlessly with the natural tooth structure around it. The problem you are facing is the dentist who did the procedure, not the procedure itself. It can be fixed and should be done at the dentist’s expense.

Doing bonding well is challenging because it has to be done freehand. This means the dentist either needs some natural artistic ability or invest significant time and money in the practice and training necessary to do it well. Not many dentists do that.

The first thing I recommend is you give your dentist another chance to get the dental bonding to look natural with your other teeth, with the understanding that if he can’t do it to your satisfaction, he’ll provide you with a refund so you can get it done properly. There is a reasonable expectation that the bonding matches the tooth.

If it turns out he can’t do it or just prefers to give you a refund, you’ll want to find an expert cosmetic dentist to do your dental bonding.  I suggest looking for an AACD accredited dentist or a dentist recommended on the mynewsmile.com website. These are the dentists that have the skill and artistry to give you a natural-looking result.

One other thing to be aware of in case your dentist didn’t tell you before your original bonding. Once the bonding is completed, the color is permanent. If you want to whiten your teeth later on, your natural tooth structure will whiten but not the dental bonding. Then, the only way to get them the same color again is to re-do the bonding. Because of that, I generally recommend to patients that they have any teeth whitening done before the bonding. However, you also have the option of waiting until it is time to replace the bonding. I just didn’t want you unaware of the limitations and then having to spend unnecessary money replacing your bonding early.

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Full-Mouth Reconstruction to Whiten Teeth?

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I need to make some important choices soon. I have a dental crown that is about 20 years old and two porcelain veneers that are a bit older. I’ve been experiencing some dry mouth. I’ve chipped the veneers on the front teeth and now there is a gray line at the gumline by the crown. I went to my dentist to discuss replacing them. Because my smile is no longer very white, he is suggesting I get crowns on both my upper and lower arch to do a smile makeover of sorts. The more I think about it, the more concerned I am, especially with my dry mouth. It may be better for me to just replace the old work and wait to see what happens with the dry mouth first. What do you think?

Carolyn

Dear Carolyn,

teeth whitening trays

The first thing I am going to suggest is that you get a different dentist. If I understand you correctly, your dentist is suggesting crowning all of your teeth because your teeth need to be whitened? Really?

So, here’s the thing. Whitening your teeth will bring him in a few hundred dollars. Crowning all your teeth, known as a full mouth reconstruction, will bring him in $30,000+. Your dentist is being self-serving. The best dentists are doing their best to serve their patients without unnecessary expense for his or her benefit and while preserving as much tooth structure as possible. He’s doing neither.

My suggestion is you have your teeth whitened and then just replace the damaged dental work. However, I don’t think your dentist should be the one to do it and not just because he’s grabbing for the bucks. There is another warning sign that he isn’t what you need. When a dentist suggests dental crowns instead of porcelain veneers for a smile makeover, it is because they are not comfortable doing porcelain veneers. Doing crowns in a case where they are not needed is a waste of healthy tooth structure.

As you likely know from the crown you already have, in order to make room for the restoration, he’d have to grind your teeth down to nubs. This is irreversible. Once you have dental crowns you will always have to have dental crowns. It is much better to do porcelain veneers when it comes to a smile makeover.

Now, you do already have one crown. You mentioned a gray line at the gumline. This tells me the original dentist did a porcelain-fused to metal crown. On a front tooth, what you really want is an all-porcelain crown.

What you need is a skilled cosmetic dentist to take over. In your place, I’d look for an AACD accredited dentist. These dentists are in the top of the cosmetic field and have proven skill and artistry. You’ll have a smile you are proud of.

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

Can My Smile Be Pretty after Dentures?

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Around 30 years ago, I lost all my teeth. My dentist never mentioned dental implants so I don’t think that was an option. I have a friend who has them and her smile is so much prettier. Plus, she can eat anything she wants. I don’t know which I’m longing for more, but I think it is a pretty smile. If I got dental implants now, could they be as pretty as her smile?

Alice

Dear Alice,

Illustration of a dental implant next to a natural tooth
I’m so sorry you have been going through this for so long. It is not the dentures that are the reason your smile doesn’t look pretty to you. Both dentures and dental implants can be beautiful giving you a smile you are proud of. The problem lies in the artistic skills of the dentist. My guess is your dentist thirty years ago had good intentions but not the skill. I truly wish he would have mentioned dental implants to you. They were available then and it would have made the last 30 years significantly more pleasant for you. However, that is water under the bridge and all we can do now is go from here.

There’s one obstacle you will face when it comes to dental implants— the aftermath of facial collapse. When your teeth were first removed, your body decided without the roots of your teeth you no longer needed the minerals in the jawbone that are used to help retain your teeth. After all, they are already gone. Slowly, that leeches your jawbone away. After 30 years, I’m guessing you are having quite the time keeping those dentures in any more.

As you can see from the image above, like your teeth, dental implants need bone to keep them secured in your jaw. There is a solution to this, though. There is a bone grafting procedure that can build that missing bone structure back up for you. Once that is done, you will be right as rain for dental implant again.

How to Get that Beautiful Smile

As I mentioned earlier, it is the dentist who does your procedure that determines how beautiful your smile is. You need a dentist who is both qualified to give you dental implants along with the artistry to make the dentures that anchor to them beautiful. My suggestion is you start by looking for an AACD accredited dentist. These are proven artists when it comes to dental work. You will finally have that smile you have always wanted and you can share it while you eat some steak!

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

Bonding Color is Wrong

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I have these exposed places at the top of my teeth that are very sensitive. Other than that, my teeth were attractive. They showed me their plan and I knew immediately the color would need to be whiter. I pointed that out and they agreed. Then, they put in the new “whiter” color. It still doesn’t match my teeth. Plus, it looks opaque and is rougher looking than my natural tooth structure. I feel like what was an attractive smile has been made less attractive in order to prevent the sensitivity I was feeling. Is there a fix for this?

Callie

Dear Callie,

abfraction lesionWhen done well, dental bonding should blend seamlessly with the remainder of the tooth. I’m especially sorry for what you are going through because what your dentist is trying to do is even easier than when you have to repair a chip. If I understand your description correctly, you are dealing with what is known as an abfraction lesion (pictured left).

We used to think these were caused by brushing too hard. We now think it has more to do with clenching and grinding of your teeth. This flexes the tooth right at your gumline, adding stress. That repeated movement wears away the gumline. One thing you will want to do after this is repaired is to have a night guard made. This is a custom fit mouthpiece, similar to a sports mouthguard that you will wear while you are sleeping. Nighttime is when most grinding and clenching takes place. Usually, until their teeth are worn down, the patient has no idea it is taking place. Over time, this can lead to TMJ Disorder as well as wearing your teeth down to numbs.

Repairing Your Dental Bonding

before and after dental bonding to repair a chipped tooth

Pictured directly above, you will see a case of dental bonding done well. You can’t tell where the bonding ends and the natural tooth structure begins. Your teeth can look this way too. Unfortunately, the only way to fix this is to have it done over again.

Being blunt, I think this is beyond the scope of your dentist’s abilities. You will need to have a dentist with more cosmetic training step in and repair this. Ask your current dentist for a refund. Then, look for an AACD accredited dentist in your area. They can give you the results you are looking for.

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

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