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Having Trouble Speaking After Porcelain Veneers

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I had a full smile makeover done with 10 porcelain veneers. The temporaries that he put on felt great and I didn’t seem to have any problems. However, since he’s put on the permanent ones, I have had trouble speaking properly and my tongue seems to feel out of place, like it doesn’t fit in my mouth anymore. Is this normal? If so, will I adjust to them and be able to speak normally?

Alicia

Dear Alicia,

a porcelain veneer being placed on a tooth

To answer your first question, no, this is not normal. It would be hard to tell you exactly what is going wrong without examining you, but I can give you some guidelines. One thing I am concerned about is whether your dentist actually gave you porcelain veneers or if he instead gave you porcelain crowns and called them porcelain veneers. Some unethical dentists do this. The reason I am concerned about this is that veneers just sit on the front of your teeth. Without them being done crazy wrong, they should not affect your speech. Dental crowns, however, go around your entire tooth. If they are not done correctly it will definitely affect your speech pattern.

Another thing that is odd here is your temporaries felt okay and you didn’t have any problems, but the permanent ones are an issue. That means your dentist didn’t send the model to the ceramist and maybe only sent images, or your dentist’s ceramist did not follow directions.

In some cases, people adjust to the position and are able to speak normally again. If you give it a month or so and your speech is still affected, I would insist on a refund so you can get this done right elsewhere. You could give your dentist a chance to do it right, but if he’s dishonest I’m not sure how skilled he is.

Smile makeovers are not taught in dental school. Dentists have to invest in post-doctoral training to know how to do them both properly and beautifully. If you decide to go to another dentist to get this repaired, I would look for an AACD accredited dentist. These dentists are the best cosmetic dentists in the country. To get accredited, they had to pass stringent exams as well as have a large number of their cosmetic cases evaluated for its technical correctness and artistry by a board of examiners. You can feel confident you will not only get a beautiful smile, but a functional one as well.

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

New Lumineers Over Old Ones

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When I first got my Lumineers my dentist knew that I wanted them to be whiter than they were made, but his lab guy said that it wasn’t quite possible to do them that white. They could only do what he called “natural” looking styles.  These days I see people with very white teeth and figure they are now able to do them whiter. Is it possible for me to have new Lumineers placed over my old ones so I can have the smile I really wanted?

Kelly

Dear Kelly,

a porcelain veneer being placed on a tooth

Should you place new veneers over old ones?

While it is possible for you to place new Lumineers over old ones, I am not going to recommend it. First, it is just as much work for the dentist to do that than to just provide you with a totally new smile makeover. to begin with. Second, it will be less secure. Porcelain bonds much better to natural tooth structure than it does to porcelain. That puts you at a greater risk of bonding failure for your new Lumineers, not to mention that you have double the risk because at some point your old Lumineers bonding could give out. I am going to recommend something completely different.

The first thing you should be aware of is that Lumineers is simply one brand of porcelain veneers. That particular brand is heavily marketed to inexperienced cosmetic dentists and I believe your dentist falls into that category. One reason I think that is he just agreed with the lab when they said your Lumineers could not be as white as you wanted. That was not true. Even then, you could get veneers of any brand as white as you wanted. The lab was wrong about that. That brings me to a second issue with Lumineers, which is their lab. The DenMat company, which owns this brand, insists you use their lab. They are not known for their artistic, quality work.

What I would like you to do is look for an expert cosmetic dentist and have them just re-do your smile makeover altogether. Do not be surprised if they suggest a completely different brand of porcelain veneers than the one you currently have. There are many brands that are far superior and will give more artistic results. The best cosmetic dentists are AACD accredited dentists. You can find them listed on aacd.com. They have extensive training and have passed stringent exams as well as proven their artistry before a board of examiners on a large number of their cases.

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

 

Malpractice Smile Makeover

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I feel like I’ve ruined my mouth and my hard-working husband’s finances. I had some chipped teeth and some other minor issues with my smile. I asked my dentist about possible fixes and she suggested I get a smile makeover with porcelain veneers. She said it is what the celebrities use to get their gorgeous smiles. My husband and I discussed it as it was a big chunk of change and decided to go ahead with it. I’ve regretted this decision ever since. I’m about to move and running out of time to get this fixed. Here are my problems:

1. The teeth (eight of them) were ground down to nubs. Disgusting little yellow nubs. This wouldn’t be such a big deal if it weren’t for the second problem.
2. They don’t stay on. In the course of this year, they have fallen off eleven times. One of them over a major holiday when I couldn’t get in to get them fixed. The humiliation of having those tiny, yellow nubs was almost unbearable.
3. She says I’m being too rough on them, but one of them fell out while I was eating pasta. How is that too hard?

Please tell me a way to get this to work. I’m worried after we move no one will help because it is another dentist’s problem.

Katy

Dear Katy,

I have to express how sorry I am for what has been done to you as well as the anguish you’re going through. It shouldn’t have happened. The good news is you have a pretty solid case for malpractice. Additionally, this can be fixed. The bad news is she has misled you and done some things which will affect the repair as well as how your teeth function for the remainder of your life.

Porcelain Veneers verss Porcelain Crowns

Based on your description, your dentist gave you porcelain crowns, not the veneers she said she would. I know that based on your description of the teeth being ground down to nubs. Look at the two pictures below:

tooth preparation for porcelain veneers

This is what teeth look like when being prepped for porcelain veneers. There is minor removal of tooth enamel, around the width of a fingernail. This is not what you described.

tooth preparation for a porcelain crown

This is closer to what you described and is the preparation for a porcelain crown. Yours may even be more aggressive than this. Here’s where she has done some permanent damage. We don’t currently have the ability to regrow tooth enamel. Because of that, even when this is repaired properly, you will always have to have porcelain crowns instead of the porcelain veneers you were told you were getting.

Here’s where some “good” news kicks in. First, she lied. You were told you were getting porcelain veneers, which incidentally is the go-to procedure for Hollywood celebrities, but instead received dental crowns.

Second, she’s had gross incompetence in her handling of the dental crowns. While smile makeovers, including the procedure of porcelain veneers, isn’t taught in general dental school and therefore isn’t a required knowledge for dentists, dental crowns are a staple. They should NOT be coming off at all, let alone as much as you’ve had them come off.

Her blaming you is unacceptable. You could have been eating steak and apples every day and your dental crowns should have stayed in place.

Getting this Fixed

She needs to pay to have this done correctly. I don’t want you just getting a refund, because it is very likely going to cost more than your original price. You can let her know up front what you want, but don’t get them fixed until you move. I want you under the care of a long-term provider for you.

After you get to your new location. I want you to look on the website for the American Academy of Cosmetic Dentistry (aacd.com) for an AACD accredited dentist. This is different from just being a member, so make sure you check the accredited dentist option. Accredited dentists are in the top of the cosmetic field and will give you a stunning smile.

If your current dentist refuses to make this right and you have to go to court, make sure to ask for additional money because giving you crowns instead of veneers has damaged your teeth and changed your care for the remainder of your life. I think her malpractice insurance will tell her to pay up quick, because if it ends up in court, you will likely get a substantial amount.

Again, I’m sorry this has happened to you. I don’t like dentists who give our practice a bad name either through incompetence or lack of ethics.

Keep your chin up. You will soon have a smile you will be proud of.
This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Dental Bonding Disaster- Help!

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I had my four front teeth bonded. One of my front teeth sticks out too far over the second one. One of the lateral teeth is too far back and the other one has a big chip. He said he could fix this, but it’s ended up a disaster. First, he ground down the front overlapping tooth, then he added bonding material to the lateral teeth to fill in the missing depth and fix the chip. However, he insisted on doing them yellowish, even though I wanted them white. Now I feel they look ugly, plus the one he ground down is sharp and painful. I know there is no going back, but can this be fixed? My dentist seems to think he did a great job.

Adabelle

Dear Adabelle,

woman giving a thumbs up from the dental chair

Getting a beautiful smile requires a skilled cosmetic dentist

Even though I don’t have a picture of your smile and can’t give you specifics of what was done incorrectly, I do know what the major problem is. Your dentist is likely a very good family dentist who did his absolute best for you, but he was in over his head. Maybe he could have pulled off a basic dental bonding case. Maybe. Those are difficult to begin with because they need to be done free-hand. Your case requires an even more advanced dentist because of the structural issues that need to be dealt with.

This would need a dentist in the top 1-2% of cosmetic dentists, which requires significant training outside of general dental school. They’d need training in color theory, polishing the bonding material, and shaping the teeth. Your dentist obviously didn’t have this. Plus, a true cosmetic dentist would never be satisfied if his patient wasn’t thrilled with the results.

What you need is an AACD accredited dentist. These are the top cosmetic dentists in the country. In order to become accredited, they have to pass stringent exams, as well as have a large number of specific cases they’ve personally done evaluated for technical proficiency, beauty, and artistry. You can locate them by going to the website of the American Academy of Cosmetic Dentistry. Make sure you check you want an accredited or accredited fellow. Being a member isn’t enough.

Once You Have an Accredited Dentist

Once you’ve located an excellent cosmetic dentist in your area, you have two choices to get the smile you want.

Option 1: Re-do the Dental Bonding

Dental bonding is less expensive than the next option I’m going to make you aware of. When done by an expert cosmetic dentist it can blend in perfectly with your teeth, comfortably, with a natural translucency. If you want your bonding whiter than your adjacent teeth currently are, it will be in your best interest to whiten all of your teeth first. This will enable the dentist to blend the bonding material to your beautiful new white color.

Option 2: Get Porcelain Veneers

While these are more expensive than bonding, porcelain veneers can change anything about your smile— the shape, the size, the color, even the character. The other big benefit is they last much longer. Well taken care of porcelain veneers can last a lifetime. The dental bonding will have to be re-done every five years or so. Either one can be made beautifully.

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

Her Gums Inflammed After Getting Porcelain Veneers

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I’m a little worried about my gums. I had porcelain veneers placed a couple of months ago. Since it happened. my gums have been inflamed and painful. I went back in and the hygienist said she’s never seen it happen before. The dentist came to look and both of them accused me of not brushing enough. I was quite annoyed. I’m a grown adult and know how to brush my teeth. Why in the world would I not brush after spending a fortune on these porcelain veneers? When I went back in for a routine one-month follow up he removed some excess cement. That has helped some but I’m still in pain. What do you recommend I do?

Avery

Dear Avery,

illustraing on lateral incisors inflammed by poorly done porcelain veneers

These lateral incisors are inflamed from poorly done porcelain veneers

When patients have a smile makeover they’re proud of, they tend to take better care of their teeth, not worse. I don’t like it when medical practitioners blame patients for things they don’t quite understand. Please bear in mind that I haven’t examined you so I can only give possibilities.

There are a few possibilities going on here. It can be one or a combination of them. With the first possibility, he could have left some cement in that is irritating the gums. This seems a very real possibility, especially because you said he removed some excess cement a month out from placement. The cement should have been removed right away, while it was still soft. The fact that your gums felt a little better after he finally did remove it. Now it is getting a chance to heal.

That doesn’t mean that is the only thing irritating your gums, though. I say that because It doesn’t sound like your dentist has invested a lot of time in understanding cosmetic dental work. Another option is there is some unevenness or temporary shelving in the margins between the porcelain veneers and the gumline. This is sometimes called bulky margins.

This will cause things to get trapped in between the gums and the porcelain veneers, leading to inflammation and, eventually, gum disease and tooth decay.

There are other possibilities too such as the extended wearing of temporaries, the veneers encroach on the gingival attachment, and, allergies to the materials used in bonding.

Dealing with a Disastrous Smile Makeover

The first thing I suggest you do is get a second opinion. When you do, make sure it is a blind second opinion. Don’t ask your dentist for a recommendation and don’t tell whomever you do see who your dentist was. Most of the time, they know one another. You want an unbiased opinion. What you don’t want is him feeling torn between an honest evaluation and betraying his friend. That’s why a blind second opinion is best.

If it is just a matter of the cement being trapped there, then when your dentist removed it at the last follow-up, that should help as it heals. The second opinion dentist can make sure there isn’t any more there. If, however, the problem is with the margins, the porcelain veneers will have to be completely re-done. Because it puts your oral health at risk, you are entitled to have them re-done free of charge. Though, my recommendation would be to get a refund and have a more experienced cosmetic dentist do this.

Look for someone who is recommended on the mynewsmile.com website. They are highly skilled and they will sort them by area of the country for you.

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