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dentistry

Did I REALLY Get daVinci Crowns?

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I wanted to get a smile makeover, but have never been happy with the dental work that gets done in my area. I was very upfront with my dentist about this. He suggested that I get dental crowns and we have the work done by the da Vinci lab in California. He said they have a reputation for being the best of the dental labs. I thought this sounded okay and we went forward. When the crowns finally came in, my dentist called me for a try in, but when I got there he said they weren’t happy with the crowns and were going to have them readjusted to meet with what he asked for. I was a bit confused by this because he told me they were the best. Then, before I left, some man came to pick them up and work on them. I don’t think they noticed I saw that. Now, how would a guy from a California lab get all the way to Mississippi the same day? I mean, yes, he could fly, but would they really fly someone out for this or just have the dentist send them back? I’m worried I’m being taken.

Evie

Dear Evie,

a porcelain veneer being placed on teeth

I’m afraid you are being taken as well. My best guess is, if he sent them to daVinci to begin with, that he’s having a local guy make the changes. That is not what you agreed to so he is being dishonest there. I will say there are some other red flags here as well.

When someone wants a smile makeover, the standard for that is porcelain veneers, not porcelain crowns. Now it is possible that you already had dental crowns there and that is why your dentist suggested them. If you didn’t, then that is a sign your dentist is not a skilled cosmetic dentist. They will often suggest crowns because that is a basic procedure they were taught in dental school and porcelain veneers require post-doctoral learning.

What Matters Most – the Dentist or the Lab?

The truth is even though the daVinci lab has branded itself as one of the top ceramist labs in the country, they are a large lab. Not all of their ceramists are what is known as master ceramists. These are the ones who would create the most beautiful work. daVinci will save their master ceramists for some of the top cosmetic dentists in the country and then give the unskilled dentist’s work to one of their lower level ceramists. Why is this?

The reason behind that is no matter how good a ceramist is, it will not make up for the deficiencies of the dentist. When it comes to smile makeovers it is the skill of the dentist that makes all the difference. They design the smile. All the lab can do is follow directions. Granted some follow directions better than others, but even the best ceramist cannot make up for a poorly designed smile makeover.

I am going to suggest you not allow your dentist to bond on these porcelain crowns until you approve them. He should use a temporory try in paste and you should get to see them in several different lightings. If you don’t love them, have him send them back to the lab. If he tells you that you are being too picky, remind him that it is a smile makeover and you are supposed to be picky. If he can’t get it right then maybe he should refund you and let you see a dentist that can do it the way you want.

If it comes to that, you will want to see a dentist who is AACD accredited. These are the top cosmetic dentists in the country.

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

Can Dental Bonding Fix My Peg Laterals?

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I have peg laterals on my upper on either side of my two front incisors. I’ve had them since childhood and I really dislike how they appear. I’ve heard that I may be able to have them “fixed” using bonding–is this true? I’d love to smile without reservation at last.

Many thanks,
Moira

Dear Moira,

before and after dental bonding

This is a great question and one that is frequently asked by others as well.

What Are Peg Laterals?

For those who may not be aware of what you are referring to, let me give a quick rundown. Peg laterals are when the teeth lateral to the upper incisors are malformed. Often they are small and occasionally even pointed. Considered a form of microdontia, peg laterals are congenital and can be hereditary. They are rarely seen in lower teeth.

Will dental bonding help?

The short answer is yes. In fact, dental bonding is often one of the best ways to treat peg laterals and gain an esthetically pleasing smile. You also have the option of porcelain veneers as a solution. Veneers last longer, but are more expensive so which you pick will depend on your budget.

During the bonding process, your natural peg lateral teeth are left in place, and a tooth-colored material is bonded to the surface to bring the size and shape of the teeth in alignment with the rest of the natural incisors. They will be expertly shade-matched, shaped, adjusted, smoothed and polished to match your other teeth and your occlusion, resulting in a pleasing smile.

These should last you several years. As I mentioned earlier, porcelain veneers will last longer and will be more stain resistant, so you will want to look at both options to decide which is best for you.

Getting Beautiful Dental Bonding

The real trick to this is who you have do the procedure, regardless of whether you choose bonding or veneers. Cosmetic dentistry is not taught in dental school so for a dentist to do it well, they need to have post-doctoral training. The top cosmetic dentists are AACD accredited. In your position, I would look for that type of dentist. This way, you will be pretty much guaranteed a gorgeous result.

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

Picking the Color for my Smile Makeover

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I am finally getting a smile makeover and I am trying to pick the color so I know what I want to get when I see the dentist. I am thinking about a BL4 because I want a white smile, but I don’t want it to look unnaturally white. Do you think this is the right choice for me?

Teddy

Dear Teddy,

Comparison of color shades for smile makeovers

 

How exciting that you are finally getting the smile makeover you have always wanted! If you want quite a white smile, but not unnaturally white, I would say either a BL4  or an A1. To be honest, though, the key to a beautiful smile makeover is not the color you choose, but the artistry of the dentist.

You should be aware going into this that cosmetic dentistry is not a recognized specialty. Any general dentist can call themselves a cosmetic dentist even though smile makeovers are not taught in dental school. If a dentist wanted to develop real skills in cosmetic dentistry, they would need to invest in post-doctoral training. It takes both technical skill and an artistic eye to create a beautiful smile.

A great cosmetic dentist will sit down with you and talk about what type of smile you want. They would go over the character (youthful, sporty, etc), color, and a few other things to have a real idea of the smile design you have in mind when you think about the smile of your dreams.

From there, the dentist will design the smile and make a mock up. Even after the lab finishes the porcelain veneers, your dentist should place them with a temporary try-in paste and make certain you get to look at them in a variety of lighting. You should be able to give your approval or suggest changes before anything is permanently bonded.

The safest way for you to find a true cosmetic dentist with real skill is to look for someone who is AACD accredited. These dentists have proven skill and artistry.

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

Are Lumineers My Only Option to Repair Old Dental Bonding?

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I had dental bonding done years ago to cover some tetracycline stains. Over time, the bonding has worn off and picked up stains. I wanted to replace the bonding, but I am in a new state with a new dentist. He is insisting that dental bonding cannot be replaced and I have to get Lumineers. That is a much more expensive procedure than I remember my dental bonding costing me. Are Lumineers the only option or is there something else I can look at, such as teeth whitening?

Carmella

Dear Carmella,

before and after dental bonding

It sounds to me like you are with a dentist that does not do much cosmetic dental work. For one thing, dental bonding can absolutely be replaced. I’m not sure how he does not know that. Secondly, he is recommending Lumineers. This particular brand of porcelain veneers is highly marketed to inexperienced cosmetic dentists as being easy to place.

You have three options for covering tetracycline stains. The first is porcelain veneers. This is the best option because the veneers will last longer than dental bonding. While bonding can give you a few years of stain resistance and heartiness, the porcelain veneers can last your lifetime when well taken care of. This means you won’t have to keep replacing them.

Your second option is to replace the dental bonding. Depending on the surface area, this may actually require more chair time for the dentist which could raise the price. They also have to be done free hand, so you will want to find a cosmetic dentist with a lot of experience covering tetracycline stains with dental bonding.

Finally, teeth whitening is sort of an option but you have to be very determined and patient in order to get it to work. It could take months and months of teeth whitening, which could lead to tooth sensitivity. I would only recommend professional strength take home whitening in this situation.

Your Most Important Decision

Your top priority should be to find a qualified cosmetic dentist to do this work. Tetracycline stains are some of the toughest to deal with. It will require a dentist with a significant about of post-doctoral training as well as an artistic eye. In your place, I would only allow a dentist who reached accreditation with the American Academy of Cosmetic Dentistry touch this. AACD accredited dentists are the top cosmetic dentists in the country. Listen to what his or her recommendation is before deciding on a procedure.

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

Fixing a Broken Front Tooth

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I have a ten year old son who broke his front tooth. I wanted a repair right away because we are traveling for the holidays. He can’t deal with the tooth until the end of January. When I asked for a referral somewhere else, he told me the tooth needed time to desensitize anyway and will be ready by the time he is available. Is this legitimate? I don’t want to seek treatment elsewhere if it will be a difficult appointment for him as a result.

Karyn

Dear Karyn,

before and after dental bonding

I am sorry about your son’s fall. It sounds like you’ve got an active boy, which is a great thing. There is no real reason to wait, so I am not sure why he said that except possibly to make sure he did the repair. This is a tricky repair though, so before you schedule your appointment with someone, make sure that you evaluate their ability to do the repair well.

You didn’t mention if you have the piece that was broken off. It is possible that it can be bonded back on. If you don’t have it, that is okay. Dental bonding can repair it but both of these are very advanced procedures. Dental bonding is done freehand and requires an artistic eye and a high level of technical skill.

In your place, I would look for an AACD accredited dentist. These are the top cosmetic dentists in the country and they had to demonstrate artistry with bonding cases in order to pass accreditation.

Do not be surprised if, when he is older and the pulp of his tooth is smaller, he needs a dental crown. In fact, it will almost be guaranteed.

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

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.