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dentistry

Dentist Gave Me a “Wallace & Grommit” Smile

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I have a disastrous smile makeover. The closest way I can describe it is he’s given me a Wallace & Grommit smile. My front teeth are way too big and make it hard to even close my mouth all the way! He also provided a few mini implants for missing teeth in the back of my mouth. What do I do? It is so bad that my friends ask me if they made my dentures too big. I don’t have dentures! That’s how ridiculous I look. My dentist thinks it is fine. What do you recommend?

Monica

Dear Monica,

Image of Wallace & Grommit

I’m sorry this has happened to you. I’ve put a photo of Wallace & Grommit here for the sake of those who may be unfamiliar with the reference. I’m afraid we hear about these smile makeover disasters way too often. Most of the problem stems from dentists who are inexperienced in cosmetic work. While cosmetic dentistry isn’t a recognized specialty, it does require specialized training. Smile makeovers aren’t taught in dental school, so they have to invest the time and training to study the skills in a post-doctoral setting. Not all dentists have invested in the necessary training or could just be he’s just started out. We have all had our first few cases.

Generally, if the problem with your case is simply it doesn’t look good, you don’t have much recourse. You could appeal to the dentist’s sense of integrity in his work or get another cosmetic dentist on your side to appeal to the dentist’s sense of peer respect. Another option is to threaten to write a bad review.

That being said, you are in a better position. Your mouth doesn’t close. This causes serious problems to your dental health and would not be considered a clinically sound case. When your mouth doesn’t close, it leads to dry mouth. This means you are not producing enough saliva. Our saliva is a key factor in preventing cavities. It contains minerals and other properties that help fight the bacteria in our mouths. People with dry mouth suffer from decay and gum disease and a much higher rate than normal.

Getting Your Smile Makeover Fixed

Frankly, your case needs to be redone. This is actually good news for you. I don’t want your current dentist doing the work. I’m concerned about what I”m hearing from you. You need a better cosmetic dentist. So, before you ask for your refund, I want you to see a better cosmetic dentist, preferably an AACD accredited dentist. While you are there, ask them to look at your implants too. I don’t like hearing he put mini implants in. While they are fine to help with securing a denture, they are not a good option for a single dental crown. For that, you would need a full-sized dental implant.

If your second opinion dentist thinks they are fine, then you can simply get a refund on the other work. If he thinks you’ve had the wrong tooth replacement then you will want to get a refund on both. Plus, have him pay the additional cost of the bone grafting which would be necessary to do the replacement.

You then have your second opinion dentist do the work or get another dentist.

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

Victim of Dental Tourism for a Smile Makeover

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I went to Croatia and was able to receive $60,000 worth of cosmetic work for just over $10,000, including airfare. I thought I was getting the deal of the century. When I asked them how they could afford to do that, they told me health care was more affordable in their country because they don’t have as many laws and restrictions. I fell for it hook line and sinker. I’ve been home two weeks and have followed all their instructions including not to eat with my front teeth for a few months. But, since then four of them have already fallen out including one of the front teeth. I promise I haven’t been eating with it. What do you recommend?

Stacey

Dear Stacey,

A woman smiling with a beauttiful smile

The most important factor in a smile makeover is the skill of the cosmetic dentist.

Dental tourism is a booming industry, especially for advanced cases like smile makeovers. Unfortunately, as you are discovering, it rarely works out the way the tourist hopes. While it is true we have more regulations in our health care system, most of that is to protect the patient from unhealthy or incompetent practices.

If they truly gave you porcelain veneers, telling you to avoid eating with your front teeth sends off huge warning bells to me. With correctly bonded porcelain veneers, you should be able to eat anything you want. It sounds to me like these “dentists” may not truly understand how to bond them. Though, there is always the possibility they didn’t provide you with true porcelain veneers.

Getting this Smile Makeover Repaired

You are going to need the expertise of a top of the line cosmetic dentist. Look for one who is AACD accredited. They are in the top 1% of cosmetic dentists in the country.

The first thing you’ll want to find out is if they are truly porcelain veneers. That is your best-case scenario. If they are, an expert cosmetic dentist can bond them back on properly. This isn’t something any dentist can do. It requires techniques and skills most dentists don’t have. I’d recommend having the rest of them re-bonded as well if that is the case.

If they are not porcelain veneers, you can try to get your money back, but most of that will depend on the laws available to the consumer in Croatia. It’s not likely to be anywhere near as useful as what you have here.

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

Trouble with Porcelain Veneers

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I have this set of porcelain veneers and I’ve had nothing but trouble with them. First, they kept coming off. Then, once they started staying on permanently, I noticed one of them has a horizontal divot which I hadn’t noticed before. I called my dentist and graciously agreed to buff it out, but now that tooth looks more matte than the surrounding teeth. What’s going on? I thought porcelain veneers were the top of the line for smile makeovers.

Pamela

Dear Pamela,

A single porcelain veneer being placed on a tooth.

You say that your porcelain veneers are the problem. On the contrary, I’m pretty sure it’s your dentist who is the issue here. First, you said they wouldn’t stay bonded. This shows a lack of basic technique. Then, you came to him with a divot in your veneer. While he may have buffed out the divot, he simultaneously took off the glazing on the veneer as well. This has ruined your porcelain veneer and it will begin to pick up stains rather soon.

You have three choices here.

  1. Have the veneer polished.
  2. Have your dentist replace your veneer.
  3. Have another dentist do the work.

First, you can have your dentist polish the damaged veneer. It’s not complicated, but it does require knowledge and equipment your dentist likely doesn’t have. You start by using diamond polishing instruments and polishing paste, then end with an ultra-fine diamond polishing paste. I recommend Brasseler’s Dialite Porcelain Polishing System.

If you aren’t confident your dentist can pull this off or he’s not interested in investing in the right equipment, then you can require him to replace the porcelain veneer. This would require he has improved his bonding technique.

Finally, if you don’t have confidence in him to be able to do either of the above correctly, then you simply ask him to pay for the repair from a more qualified dentist, whom YOU pick.

Who Should Do Your Porcelain Veneers?

You were correct in thinking that porcelain veneers are the top of the line smile makeover procedure. However, to get that gorgeous celebrity smile, it also requires having a top of the line cosmetic dentist. I always recommend you look for an AACD accredited dentist in your area.

These are the dentists who, not only invested in advanced cosmetic training, but also have an artistic eye with the ability to craft stunning smiles.

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

Three Different Colored Teeth After Getting Porcelain Veneers

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Help me! I had four porcelain veneers placed on my teeth. As a result, I have three different colored teeth. My natural teeth are yellowish. The four porcelain veneers I received were all the same color, but now have a grayish tint in a splotchy way all the way down. I’m so frustrated because I paid a lot for these. What do I do?

Dania

Dear Dania,

A single porcelain veneer being placed on a tooth.

I’m sorry this has happened to you after investing in a beautiful smile. When you pay for a smile makeover, you expect it to be something you can be proud of. This isn’t what you received. My guess is your dentist is just your bread and butter general dentist, who hasn’t invested a lot of training in cosmetic work.

Unfortunately, this has its most negative impact on you. Most patients don’t realize that cosmetic dentistry isn’t a recognized specialty in the dental field. Any dentist can do it and it is up to them how much time they invest in training Think of it as an art form. If one person had a year of violin lessons and dabbled in practice and another person studied for years and practiced diligently, which one would you want to play at your wedding?

Getting Your Porcelain Veneers Done Right

There are some solutions to your situation. Let’s start with the visibility of your yellowed natural teeth. You received four porcelain veneers. Most smiles, including yours, are wider than four teeth. To keep that smile as uniform in appearance as possible, you have two options. One is to get enough porcelain veneers to cover all teeth which are visible when you smile. The second, if you can’t afford that many veneers, is to whiten your teeth. This is typically done before getting your veneers, so they can be made to match the color of your new white natural teeth as closely as possible. However, you can still get your teeth whitened now. The procedure will not damage your veneers.

As for your graying veneers. It sounds like the bonding isn’t well done on those teeth. Because it is splotchy, I believe there is food and bacteria getting caught between your teeth and the veneers. The only solution to this is to have them re-done. In fact, you need them to be replaced. Otherwise, your teeth will begin to decay under the porcelain veneers.

In some way, this is actually good news for you. It gives you a case for getting a refund from this dentist. Then, you can invest that money in a dentist who has done more training and has an artistic eye as well as the technical skill. My suggestion is you find an AACD accredited dentist. They’re the top cosmetic dentists in the country. They’ll give you a stunning smile.

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

Will Dental Implants Look Fake?

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My mother had dentures and, to me, they always looked fake. I now need to get my teeth replaced. I want to get implant-supported dentures and am hoping they look more natural these days. I’m rather young for dentures at 40 so I don’t want to look old before my time.

Pamela

Dear Pamela,

Implant overdentures

Implant overdentures are a combination of dental implants and dentures

First, I’m going to say you were wise to choose implant overdentures, especially at your young age. Once your teeth are removed, your body will recognize that and begin to resorb the minerals in your jawbone to use elsewhere in your body where it perceives it will be more useful. Eventually, you won’t have enough jawbone left to retain your dentures. This is known as facial collapse.

Getting implant-supported dentures, puts prosthetic roots into your jaw. This tells your body there are still “teeth” that need to be retained, therefore preventing facial collapse. You’ll also find it will improve your chewing capacity.

The Secret to Beautiful Dental Implants

Both dentures and dental implants can be made to look both natural and beautiful. That was true when your mother received her dentures. The beauty of dental implants is correlated to the artistic skill of the dentist. If you want a gorgeous smile, you need to find a dentist who creates beautiful smiles.

In your place, I’d look for a dentist who has reached accreditation with the American Academy of Cosmetic Dentistry (AACD) dentists have done extensive training and are the top cosmetic dentists in the country. They will give you a stunning smile. You’ll actually be thrilled to share your smile with the world.

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

She’s Going to Need a Better Dentist

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I need to replace six crowns. They were done by another dentist but I’ve since moved. I really loved them, but they’re old and need to be replaced. I want to replace them all at the same time. I don’t like the temps my new dentist has provided. They’re much more yellow than my old crowns and are shaped differently. I liked my other smile. When I told him I didn’t like the temporaries, he raised his voice and said he’s the dentist and they’re perfect. What do I do?

Kelly

Dear Kelly,

woman giving a thumbs up from the dental chair

Your bumping up against the difference in philosophy between a standard dentist and a dentist who really invests in cosmetic dentistry. In dental school, we’re taught the dentist knows what is best. But, cosmetic work is different. You are creating a smile which the patient wants. The best cosmetic dentists are more interested in how the patients feel about their smile.

Your current dentist doesn’t understand this. He’s not going to work with you. If I were in your place, I’d go to a different dentist to get this finished. Your current dentist is ethically obligated to pass on all your diagnostics, etc. to the new dentist.

Finding the Best Cosmetic Dentist

Cosmetic dentistry isn’t a recognized specialty. It is up to the dentist how much training they get after they graduate dental school. When you are talking about a smile makeover, you want the best cosmetic dentist possible. These are the dentists who take their craft seriously.

They’ve done significant post-graduate training and have an artistic eye. In your place, I’d look for an AACD accredited dentist. These are the top cosmetic dentists in the country. Through the American Academy of Cosmetic Dentistry, they’ve passed stringent exams which test their technical knowledge. They also have to provide visual evidence of a large number of cases they’ve done in order to gauge their artistry.

I hope this helps you. This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Will These CEREC Veneers Look Good?

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I am going to a new dentist because of a job relocation. Before moving, I’d been saving up for porcelain veneers and now have the sufficient funds. However, my new dentist wants to do CEREC veneers which are 1.5mm thick. I’m worried that is too thick and he doesn’t have any before and after pictures to show me of cases he’s done in the past. My last dentist had something called a smile gallery. Should I be worried?

Elaine

Dear Elaine,

A woman smiling with a beauttiful smile

The most important factor in a smile makeover is the skill of the cosmetic dentist.

The materials and thickness of any smile makeover are not nearly as important as having the right cosmetic dentist do the work. Of course, a great dentist will choose the best materials, but it is their skill and artistry which matters. Doing smile makeovers are not taught in dental school. Instead, a dentist interested in doing cosmetic work must invest in post-doctoral training.

I’m a little concerned about the fact this dentist does not have any visual evidence for you. Any dentist who wants to be taken seriously as a cosmetic dentist will have what is known as a smile gallery. This should show before and after pictures of various cosmetic procedures which they have done.

Can CEREC Veneers be Beautiful?

You can get a beautiful smile with CEREC veneers as opposed to porcelain veneers, however, it is more challenging. I would say only about 1-2% of cosmetic dentists could do it well. Some dentists try to do this to save on fees with a ceramist which isn’t a great reason.

So how would you know if your dentist can pull this off before investing all your hard-earned (and saved) money? There are two great resources to tell you about skilled cosmetic dentists. The first is aacd.com. This is the website for the American Academy of Cosmetic Dentistry. They offer an accreditation program. In order for dentists to get accredited, they have to pass stringent exams as well as provide visual evidence of their artistry with a large number of specific cases. AACD accredited dentists are in the top 1-2% of cosmetic dentists in the world. When you use their search feature, make sure you check the box for an accredited dentist.

Your second resource is mynewsmile.com. They don’t allow dentists to just pay to be listed. Instead, they check their educational qualifications for cosmetic work as well as require evidence of cases they’ve done to ensure they have an artistic eye. Many of their listed dentists are either accredited or on their way to accreditation. Any of them can create a beautiful smile for you.

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

Can I Get a Beautiful Smile with Dental Implants?

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I’ve had dentures for about ten years. I’ve hated them from the very beginning. They’re unattractive and uncomfortable. Their comfort has been going downhill from the beginning. I’m wondering if dental implants will be better. Will they be more attractive than the dentures? And possibly even fit better?

Kitty

Dear Kitty,

Implant overdentures

A beautiful smile isn’t dependent on whether or not you have dental implants or dentures. What creates the beauty is the skill of the dentist. The other issues you mentioned, however, are specifically a denture issue. Those can be fixed with dental implants. Let’s go over that first, then we’ll talk about how you can be sure they’re beautiful.

When your teeth were removed, your body recognized there were no longer any teeth roots in your mouth. As a result, it began to resorb the minerals in your jawbone in an effort to be as efficient with your body’s resources as possible. This has the unfortunate result of shrinking your jawbone. This is known as facial collapse and why it feels like your dentures no longer fit properly. Eventually, you won’t have enough jawbone left to even retain your dentures.

The dental implants serve as prosthetic tooth roots, thereby letting your body know the minerals in your jawbone are still necessary. This preserves your jawbone.

When you’re talking about full removable dentures, such as you have, you wouldn’t do a one-to-one ratio dental implants to teeth. While you could, it is the “Cadillac” of tooth replacements and would cost a pretty penny. Instead, it’s usually recommended you get implant overdentures, which you see pictured above. This uses dental implants spaced around your arch and anchors your dentures to them. They’ll fit perfectly and be completely secure. You won’t feel uncomfortable with your dentures any more.

Dental Implants after Years of Dentures

You will have to deal with the loss of jawbone you’ve likely experienced after ten years with dentures. In order for the implants to be secure, there needs to be enough bone there to retain them. It’s possible you won’t have enough, but that can be solved with an outpatient bone grafting procedure. This builds up the bone enabling you to get the secure treatment you want.

Getting Beautiful Dental Implants

As I mentioned earlier, the best way to get a beautiful result is with an excellent cosmetic dentist. The best of the best cosmetic dentists are AACD accredited. That’s what I’d look for in your case. In a way, this is a blessing in disguise. It gives you a chance to get a stunning smile, like you see celebrities get.

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

Porcelain Veneers During Pregnancy

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I’ve been saving up for a smile makeover for years. Now, when I finally have the full amount I needed I find out I’m pregnant. Is it safe for me to go forward with this or do I need to wait until after delivery?

Madison

Dear Madison,

A single porcelain veneer being placed

While there are some procedures which are not recommended in the first trimester, such as teeth whitening, porcelain veneers should be quite safe. The concern is about introducing chemicals to the baby. With porcelain veneers, the only thing you have to worry about is the anesthetic used. Fortunately, lidocaine has been tested and proved safe for use during pregnancy and even delivery. You and your baby should be fine.

Who Should Do Your Porcelain Veneers?

There is another important consideration— who should do your smile makeover. This isn’t a skill taught in dental school, nor is there a recognized specialty where dentists become graduates in the field. Instead, dentists with an interest in cosmetic dentistry have to take the initiative to get the proper training post-doctorally.

This makes it a little challenging for patients. How can they separate the sheep from the goats, so to speak? The easiest way to handle this is to find an AACD accredited dentist in a reasonable distance to you. These dentists have been tested vigorously for both their technical knowledge and their artistic ability and are among the top 1% of cosmetic dentists in the country.

They will give you a stunning smile.

If you can’t find an accredited dentist without a significant amount of travel, which you’re probably not keen on while pregnant, you still have options.

The mynewsmile.com website also recommends excellent cosmetic dentists. Not all of them have reached accreditation, but they’ve all been carefully screened for their ability to do beautiful smile makeovers. Most are on their way to accreditation.

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

Implant Overdentures with Diabetes

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I’ve had dentures for a few years and really hate them. Now I learned that they’re the worst replacement I could have gotten because they will contribute to my jawbone shrinking. I’d like to get implant overdentures to replace them, but I have Type 1 Diabetes. My dentist said that is a contra-indication for dental implants. If so, what can I do?

Martin

Dear Martin,

Implant overdentures

 

I feel like you haven’t been getting the best dental advice available. Your dentist should have forewarned you about facial collapse when he suggested dentures. He also hasn’t been completely forthright in regard to your question about diabetes. It is not a contra-indication. However, it does put you at a greater risk of implant failure than other patients.

What you’ll need is careful diagnostics previous to your procedure and close monitoring throughout. Make sure they are willing to take more care with you. I want you to see a dentist with significant post-graduate training in the dental implant procedure. Look for someone who’s trained at the Dawson Academy or the Las Vegas Institute of Advanced Dental Studies.

I think it’s also important you go to a dentist who is skilled in both the placement and the restorative (cosmetic) aspect of your case. If they can’t be the same person, they’ll need to work in close communication so there is complete coordination between them to ensure everything goes smoothly.

Benefits of Implant Overdentures

You’ve already mentioned the biggest benefit to implant overdentures. You will no longer have to worry about losing the minerals in your jawbone. Instead, having implants will signal to your brain that those minerals are needed. You will not suffer from facial collapse the way you will if you continue with dentures.

There are other quality of life improvements as well. You won’t ever have to worry about your overdentures slipping or sliding. They will be completely secure. You can eat what you want. You can brush and floss normally. It’s like having a healthy set of teeth again.

Who Should Do the Cosmetic Work?

When it comes to the appearance of your new teeth, you’ll want them to look natural. However, this is also an opportunity to improve the look of your smile at no extra cost. As I said earlier, your dentist should also be skilled in cosmetic work along with the implants. The best cosmetic dentists are accredited by the American Academy of Cosmetic Dentistry. He or she can help you design the smile of your dreams.

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