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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.

Did Listerine Turn My Porcelain Veneers Gray?

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I had ten porcelain veneers placed on my upper teeth about 7 months ago. I have tried to take very good care of them by brushing thoroughly with a hard toothbrush and using Listerine to keep the bacteria away. Now my porcelain veneers have turned gray over the entire surface. Could the Listerine have done this? They never really gave me any instructions on how to take care of them so now I wonder if I did something wrong without knowing it. If I damaged them, is there any way to fix it?

Mary Ellen

Dear Mary Ellen,

a porcelain veneer being placed on a tooth

 

I am sorry that your porcelain veneers have turned gray. I am disappointed that your dentist never gave you instructions on how to care for these. While Listerine can damage your porcelain veneers because of the alchohol content in it, the damage would be more to the margins, not the surface. There are a couple of things that could be the cause of them turning gray.

The first is that you do not actually have porcelain veneers. Some unethical dentists tell their patients they are getting porcelain veneers, when in reality they are only giving them composite bonding. This will deteriorate and stain much sooner than veneers.

A second possibility is that your dentist or hygienist did something to damage the surface of the porcelain veneers at your last cleaning. If they used something like a Power Prophy Jet or acidulated fluoride, it will destroy the glazing on your porcelain veneers.

Either way, it is your dentist’s fault that this happened. My recommendation is that you go to see an expert cosmetic dentist. Don’t tell them who did the work, just ask them if they are actually porcelain or composite and whether or not they can tell what is wrong with them. Look for someone who is AACD accredited. These are the top cosmetic dentists in the country and can give you some good feedback.

Caring For Your Porcelain Veneers

  1. Mouthwash is not really necessary, but if you feel you need it, make sure you look at the ingredients and only get some that is alchohol free.
  2. Use a soft-bristled toothbrush. These are actually better for your natural teeth too.
  3. Most over-the-counter toothpastes are fine, with the exception of whitening toothpastes. Whitening toothpastes tend to have abrasives in them, which you do not want. However, if you are looking for the best toothpaste for porcelain veneers, I would look into SuperSmile toothpaste. This brand is specifically designed for cosmetic dental work.

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

Solution for Brown Stains on Teeth

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My son has brown fluorosis stains on his teeth. They’re not very big, however it does cause him some embarassment. We’ve been to our dentist and did teeth whitening. That didn’t work. Somehow it made them more noticeable. Now she is talking about doing veneers, but they are quite expensive. Is that the best solution?

Kelly

Dear Kelly,

before and after dental bonding

I am very glad you wrote. I don’t want you going to this dentist for the solution to your son’s fluorosis stains.  She may be a great general dentist but she has no idea what she is doing with cosmetic work. Teeth whitening is the simplest cosmetic procedure and she didn’t know the basics on that. The reason it didn’t help your son’s situation is that the bleaching gel will whiten the teeth evenly, which tends to make stains more noticeable instead of less.

Dental bonding would be a better solution in your son’s case. However, you would need to take him to an expert cosmetic dentist. Even if you have to travel to another city to find one, it will be worth it. This is a very advanced cosmetic procedure that has to be done freehand. In your position, I would look for an AACD accredited dentist. If there is not one in a reasonable distance, try someone recommended by the mynewsmile.com website.

Any of those dentists will do an excellent job for you son. They are the top cosmetic dentists in the country. He will finally have a smile he will not be embarassed by.

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.

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.

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.

Fixing Black Triangles

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My orthodontist did some shaving of my teeth to fit me for a retainer and it has resulted in black triangles. Is there a gum grafting procedure I can do to fix these? My smile looked great before he did the shaving.

Andrew

Dear Andrew,

example of black triangles

Black Triangles

 

I haven’t examined you so cannot tell you if the shaving was necessary or not. It is very likely that your orthodontist is planning on dealing with the black triangles when your procedure is over. If he doesn’t, there is a solution. I would not consider gum grafting. Our gums respond to the position of our teeth. If your teeth are straight, the gums will move back to the open position even after the grafting.

The solution to this when your treatment is done and your teeth are perfectly straight would be to have dental bonding placed in the open spaces on either side of the teeth. Be careful though. I would not expect your average family dentist to be able to do this procedure. Dental bonding is quite tricky and has to be done freehand. You will need an expert cosmetic dentist for this procedure. I would look for someone who is AACD accredited. These are the top cosmetic dentists in the country and will give you a natural looking result that blends perfectly with the rest of your teeth.

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

Should I Get My Veneers Online?

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I have a discolored front tooth. Previously, it was damaged from a fall. My dentist did a composite repair on it. It was okay, but there was some color disparity and a small gap. I want to cover four teeth. I am not as worried about the color difference because the whole surface will be covered. The problem I’m having is the cost. It’s pretty steep. I just saw a company online that does snap-on veneers. I can get a full set for $700. Would that be a better option for me?

Kevin

Dear Kevin,

before and after dental bonding

 

Let’s talk about the composite bonding first. Don’t do it. First, you mentioned your dentist had trouble repairing a chipped tooth. There was a mismatch in color as well as a small gap. I’m not sure if you meant a gap between your two front teeth or a gap between the composite and natural tooth structure. Either way, your dentist has a serious lack of skill. If the gap was between the composite and your natural tooth structure, that can lead to serious decay issues. I would love for you to have a thorough check up before moving forward with this just to ensure there is not any build up of decay in the gap.

If your dentist could not handle a chipped tooth, which should blend completely like the case pictured above, then you certainly do not want him doing large surface areas of your teeth. Plus, composite does not last nearly as long as porcelain veneers. You would have to re-do the work every few years. So, even if you could afford what your dentist is suggesting, say no. If you’re going to get a smile makeover, do it with porcelain veneers. Even then, you will want an expert cosmetic dentist, such as an AACD accredited dentist.

As for the snap-on veneers, the best of these options is made by a company that produces Snap-on Smile. You have to understand its limitations before investing. It is not made of porcelain so will not be as beautiful or natural looking. They are made of acrylic. They are not really designed for smile makeovers and are mostly designed to help people with really bad teeth get through an important event such as a job interview or special evening. They will look okay, not stunning. Because they fit over your teeth, they have the tendency to look a bit bulky too.

If you were going to get Snap-on Smile, I say only do it as a temporary measure while you save up for a true smile makeover with porcelain veneers. Done and cared for well, veneers can last your lifetime.

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

Getting Porcelain Veneers and Crowns to Match

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I have five porcelain veneers and one dental crown. The problem I am having is getting the crown to match the veneers. Right now the crown is actually whiter than the veneers. I think that happened because he is trying to overcome the dark stub. I’ve seen these match before on other people, so I’m wondering what I can do to help my dentist get this right. I like the guy, so I don’t want to just ask for a refund and go somewhere else.

Anthony

Dear Anthony,

a porcelain veneer being placed on a tooth

I hope your dentist appreciates your loyalty and willingness to be patient as he learns. To answer your question, yes, there is a way to get this done to where your dental crown matches your porcelain veneers. One of the problems your dentist faces is that cosmetic dentistry isn’t really taught at dental school. they minimize the expertise required to do it well and tell dentists it is easy to learn. All while not teaching them some very basic color theory that will be essential.

There are two ways around this. One is directly with the porcelain at the lab. However, this would require a high level of skill and I am not confident the lab will have the skills. The other is for the dentist to add an opaquer to the tooth before he sends the case off to the lab. This is the way I am going to recommend. Your dentist will shave a little extra layer from the dark part of the tooth. Then, he can directly apply an opaque layer of composite. He will want enough room to create the translucent look with the porcelain that will bond on top of that, so the deeper the layer of opaquer, the more room he will have to do that.

If your dentist has a real interest in cosmetic dentistry, He should invest in some post-doctoral training and work toward becoming accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists have the skills and training to create stunning smile makeovers and are in the top 3% of cosmetic dentists in the country.

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

 

Tooth Dark After a Root Canal Treatment

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My left front tooth (central incisor) had a root canal treatment several years ago and has since turned a grayish color. My dentist was suggesting a dental crown for it, but I really would rather be more conservative with the tooth structure. He doesn’t think a porcelain veneer is a good idea and so I am wondering about composite bonding. Would that work? One thing I am worried about is that every time it has to be redone that I will lose more structure. I like my dentist but I’m starting to lose confidence in him. He’s just not interested in keeping this tooth as intact as possible. What would your advice be?

Matthew

Dear Matthew,

beautiful smile

I’m glad you wrote. Either a porcelain veneer or some direct dental bonding will be fine, with a catch. You have to be careful who does it. If it is done right you won’t have to worry about losing structure during updates. Let’s start with the direct composite bonding. The benefit to this is the dentist can work with the color right there instead of having to go back and forth with the lab. This will last between three to five years. If well cared for, even longer. My suggestion, if you go with the bonding, is to use Supersmile Toothpaste. It is specifically designed for cosmetic work. The porcelain veneer will last longer, but will cost more.

Now for that catch I mentioned earlier. Matching a single tooth is super advanced. If your dentist is suggesting a dental crown on a healthy tooth, it tells me that he is not comfortable with cosmetic dentistry. I honestly think this is beyond the skills of your family dentist. It doesn’t mean that you have to give him up altogether if you like him. He may be a perfectly respectable general dentist. Many cosmetic patients go to one dentist for their general work and another for their specialized cosmetic work.

To match a front tooth, I would only go to an AACD accredited dentist. They are the top 3% of dentists in the country. These are the only dentists I would trust with such a difficult procedure.

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