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dentistry

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.

Dental Work in Costa Rica

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I need twelve dental crowns done. After doing some calling around, I learned I can get this done for just $6000 in Costa Rica. I would have to stay two weeks, but that’s like a vacation and it is still cheaper than what I can do in the states. My sister is freaking out saying this is a huge mistake. She asked me to at least call my dentist and get his opinion on this plan, but of course he’s going to say don’t do it because then he gets my money. I came across your website. You are across the country from me and have no chance of getting my money, so what do you think of my plan?

Mason

Dear Mason,

map of costa rica

Should you get dental work done in Costa Rica?

 

I’m glad you wrote. I think I can save you a lot of grief. The dental industry is a real risk in Costa Rica. Because of the way their legal system is set up you have no recourse if something goes wrong. And let me tell you, a LOT can go wrong. Here are just a handful that come to mind:

  • A tooth can be broken off or lost
  • Overdrilling could take place causing nerve or root damage
  • You could end up needing a root canal treatment
  • Your bite can get thrown off leading to painful TMJ Disorder
  • Once you return home, the crowns can fall off
  • The crowns could look terrible, pasty, fake, and the wrong color
  • Poor placement of the crowns can impact your speech

Believe me, I am not exaggerating here. I recently read a case that you can read about in total here, but I will sum it up. A woman went to Costa Rica to save money on her dental care. The job was so badly done that she was in terrible pain. A dentist in the states called it criminal negligence and it would cost her around $35,000 to get the needed repairs done. Of course, she didn’t have that kind of money. She tried to get her money back from the Costa Rican dentist, even hiring a lawyer from the area, who was on her side. However, the law in that area is very corrupt and she ended up getting in trouble for complaining about a Costa Rican dentist publicly who had not been convicted of any crime and they put a warrant out for her arrest. She ended up having to flee the country.

You are at particular risk because of the number of dental crowns you need. There is a lot that could go wrong with that type of bite placement. My advice is to find a dentist here in the states with good qualifications and let him or her do the work. You may even be able to work out payment arrangements. Leave the Costa Rica trip for a true vacation, where you are not putting yourself at risk.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss, an AACD accredited dentist.

Does the Dentist Matter If They Outsource Their Porcelain Work?

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I am getting a smile makeover, which will include porcelain veneers on the top arch and some dental bonding for some broken teeth on the bottom arch. I understand that they outsource their porcelain work, so I don’t have to worry about that as much, but the dental bonding is done by the dentist in the office. How do I know if they can do quality bonding work or not?

Billy

Dear Billy,

before and after dental bonding

 

You are correct that dental bonding is tricky and that the dentist really needs to know what he or she is doing. Not only is it done in the office, but it is done freehand. However, be careful about thinking the dentist won’t matter for the porcelain veneers. That is like saying it doesn’t matter what doctor you go to because it is the pharmacist who gives you the medicine. The reality is the pharmacist can only do what is precribed. If the doctor makes the wrong diagnosis and prescribes the wrong medicine, the result will be a disaster even if the pharmacist fills it perfectly.

With porcelain veneers, the cosmetic dentist prescribes the map for the ceramist to follow. He can do the work perfectly according to the dentist’s instructions, but unless the dentist is skilled and artistic the results will be disappointing. So, I would say you will need to find an expert cosmetic dentist for every part of the smile makeover.

How to Find an Expert Cosmetic Dentist

The hands down easiest way to guarantee you will have one of the best cosmetic dentists in the country is to look for a dentist who is AACD accredited. In order for a dentist to reach accreditation with the American Academy of Cosmetic Dentistry. They have to pass oral and written exams as well as have a large number of cases they’re required to do examined in front of a board to ensure they have artistry. You can be assured that they will give you both stunning porcelain veneers and dental bonding. It will be the complete package.

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

What Do You Think of GlamSmile?

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I want to get a smile makeover and recently read about something called GlamSmile. It is supposed to be less expensive and the dentist can place them in just one hour. Have you looked into these? If so, what do you think of them?

Brooke

Dear Brooke,

a porcelain veneer being placed on a tooth

 

I’m glad you wrote. I think I can help you and save you a major disappointment. Here are some things to consider with GlamSmile:

First, similarly to Lumineers, they are marketed to inexperienced cosmetic dentists as being super easy to place. GlamSmile tells them that the lab does all the work so they don’t need extensive post-doctoral training to place these. There are countless examples of cosmetic dentistry horror stories of patients from both Lumineers and GlamSmile, and even other brands of traditional porcelain veneers. where patients were distraught because they spent a fortune on a smile makeover that actually made their smile look worse. This is because the brand does not matter nearly as much as the technical and artistic skill of the dentist doing the makeover.

Second, they have another marketing push that is telling dentists that they can make five times their normal means in the same amount of time they normally would spend with a patient in the chair. Whenever you push how much you’ll make to dentists, it stops becoming “which is best for the patient” and tempts dentists to push certain procedures which can increase their profit.

Finally, I am quite skeptical about their suggestion that this can be done in one hour. In fact, even they say the dentist may need to schedule a second appointment to finish up removing excess cement. Generally, to do this well, would take around three or more hours.

So, what should you do? Instead of looking for a specific brand, I am going to suggest you change your thought process to looking for the right dentist. You need someone with extensive post-doctoral training, as well as technical skill and artistry. The easiest way to find a dentist like this is to go to an AACD accredited dentist. These have proven skills.

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

Implant Teeth Don’t Match

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I had to get two dental implants on teeth that you can see when I smile. One is a front tooth and one is a canine. The implants themselves seem okay, but the teeth parts don’t match my other teeth. I’m guessing if they were beside one another they’d match each other, but they look weird and matte compared to the rest of my teeth. Is there anything that can fix this?

Ruth

Dear Ruth,

Diagram of a dental implant

There is always a way to get a dental crown to match your other teeth. However, your dentist may not have the cosmetic skills to do it. I would start by asking him to redo them. But, this second time, tell him you want them placed with a temporary try in paste, so you can make certain they match before they are permanently bonded on.

If he’s unwilling to re-do them, and the dental implants themselves are in good condition, you won’t have much recourse. You may have to bite the bullet and pay for new porcelain crowns by a dentist who has more cosmetic skills than your current dentist.

If it does come down to that, look for a dentist who is accredited with the American Academy of Cosmetic Dentistry or one recommended on the mynewsmile.com website. Dentists from either group will be able to create beautiful crowns that blend in perfectly with your natural teeth. Just make certain they have dental implant training as well so they understand how the crown will fit with the implant.

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

360 Wrap Veneer Scam

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Before the holidays, I went to my dentist to have a smile makeover done in time for Christmas with my family. When I went in for my consultation she told me that I was a good candidate for 360 Wrap Veneers. My big concern was that going all around the tooth they would need to take off more tooth structure than I was comfortable with. She assured me they wouldn’t need to take off much. So, I agreed. The temporaries seemed okay, but the permanent ones have had varies “teeth” fall out three different times. Once the wrap veneer came off, I noticed my tooth was just a little nub. This is not what I was expecting. I’ve followed all of their directions religiously. I don’t eat anything hard. I cut things up into tiny pieces and make sure things are further back when I chew. I even wear a nightguard when I sleep. They’re talking about getting a more powerful cement, but wouldn’t they have a good cement to begin with? I am beginning to feel taken for a ride and don’t know what to do. Any advice would be greatly appreciated.

Regina

Dear Regina,

I hate to say this, but you have been taken for a ride. Porcelain veneers are thin wafers of porcelain that go on the front of your tooth. The tooth preparation is minimal, similar to what you see in the image below.

Teeth prepped for porcelain veneers

Porcelain Veneer Preparation

This is not at all what you’ve described. I believe there term 360 Wrap veneers is a deceptive way of saying dental crowns. Crowns go around your entire tooth and would require more tooth structure to be removed in order to make room for the entire restoration. The fact that they can’t keep them in is another issue as well. While creating and bonding porcelain veneers is not taught in dental school, placing dental crowns is the bread and butter of dentistry and no dentist graduates (or at least should not graduate) without knowing how to bond them on properly.  You should not need to take any of the precautions they prescribed for you either. When dental crowns are done correctly, you can eat anything you want. A stronger cement is not likely to fix this. My guess is it has more to do with how they shaped your crowns to begin with.

Instead of just asking for a refund, I want you to tell them you want them to pay for a dentist of your choosing to fix this. Their practice was deceitful in how they handled this so if they give you a hard time about your request, let them know you will be going to the dental board about their ethics violations. That should sober them up.

Who Should Fix This Smile Makeover

You will want an expert cosmetic dentist to create a truly beautiful smile for you. While it is unfortunate that you will be stuck with dental crowns from now on because that tooth structure is gone permanently, you can still have a gorgeous smile. My recommendation is that you look for a dentist who is accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the world.

I am sorry this has happened to you.

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

Adult with Baby Sized Teeth

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I need to figure out if there is anything I can do to improve the appearance of my teeth. I am a 33-year-old adult with baby-sized teeth. It is very embarrassing to smile. One of the things I am considering is dental bonding to make the babyish teeth look better.  Is that a good solution? Is there a better one?

Lindsey

Dear Lindsey,

before and after dental bonding

While you could use dental bonding for this, there are drawbacks. First, dental bonding does better on tiny repairs, such as a chipped tooth. For larger repairs, such as what you are facing, you will be much better off with porcelain veneers. Compared to your natural enamel, dental bonding is quite soft. It will scratch and stain easily, making it only a short term solution.

Porcelain veneers, on the other hand, are stronger than your enamel when they are bonded to your teeth. They are also much more stain resistant. When well cared for, you can expect them to last a lifetime in many cases.

Who Should Do Your Porcelain Veneers?

It is important you find an expert cosmetic dentist to do this. Cosmetic dentistry is not a recognized specialty so any general dentist can “do” cosmetic dentistry. On top of that, smile makeovers do not get taught in dental school. If they want to learn how to do beautiful cosmetic work, dentists have to invest in post-doctoral training on their own.

So, how will you know which dentists have this training and which do not? The easiest way is to use an AACD accredited dentist. These dentists have passed stringent exams on both their technical skill and their artistry. They are the top cosmetic dentists in the country and any one of them can create a stunning smile for you.

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

Can Snap-on Smile Make for a Nice Smile Makeover?

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I want to get a smile makeover but my dentist quoted me quite a bit of money. I did some online research and it looks like I can get snap on porcelain veneers for a fraction of the cost. Is this as good a deal as it looks?

Carter

Dear Carter,

snap on smile

When it comes to snap on veneers, such as a Snap-on Smile, which is the best brand of this sort, your expectations are way too high. These are made of acrylic and fit over your teeth. These are mostly intended as a temporary solution. the best uses for these are a job interview or photo shoot where you need to upgrade your smile quickly. However, they do not last long, nor do they look nearly as beautiful as a smile makeover with porcelain veneers will. Additionally, because they fit over your teeth, many of them look bulky.

My suggestion if you are in a hurry but do not have the money right now is to get Snap-on Smile only as a temporary solution while you save up for a real smile makeover with porcelain veneers. In reality, it will only last about three years tops anyway.

How to Get a Beautiful Smile Makeover

To get gorgeous results, you will need an expert cosmetic dentist. Don’t judge that by cost alone. Look for someone with extensive post-doctoral training in cosmetic dentistry. If you want an easy button for this, I would look for an AACD accredited dentist. These are the best cosmetic dentists in the country. Any one of them can create a stunning smile for you.

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