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dentistry

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.

Why Can’t Lumineers Make My Teeth Longer?

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I’m so frustrated right now and need some advice. I’m looking at the Lumineers advertisement holding it in my hands. They show before and after pictures of teeth being made longer. When I went to see my dentist, he said it could happen. All I wanted was whiter, longer teeth. Yet, when the lab sent them back, they weren’t any longer. My dentist called and they said that’s as long as they can get. I don’t get it? Do they falsely advertise?

Mischa

Dear Mischa,

Lumineers Advertisement

So, your biggest problem here is your dentist. Think about this. If the Lumineers lab is right (which they are not) shouldn’t he have known this? Also, He’s the doctor. The lab workers are technicians. They follow the doctor’s instructions, not the other way around. So, what is going on here?

Smile Makeovers Aren’t Taught in Dental School

Many people don’t realize that dental schools are for general dentistry. If a dentist is interested in learning how to do smile makeovers, they have to invest in the time and training for that post-doctorally.

Some dentists do it. Some don’t. Some invest more time and effort into it than others. As a result, some smile makeovers end up beautiful and some end up a disaster.

The Lumineers brand, in particular, is highly marketed to inexperienced cosmetic dentists in being easy to place. However, the brand forces dentists to use their lab, which isn’t known for its beautiful work. That means you have two things working against you– the inexperience of your dentist and the low-quality results of the lab.

How to Get a Guaranteed Beautiful Smile Makeover

Your dentist hasn’t provided the smile he promised. You specifically asked for longer teeth and he didn’t provide that even though porcelain veneers can accomplish that very request. In your place, I’d ask for a refund and start over with a true cosmetic dentist.

Then, go to aacd.com. This is the website of the American Academy of Cosmetic Dentistry. They have an accreditation program where dentists who truly want to excel in cosmetic dentistry can receive training and be tested for their skill and artistry.

They have to pass both oral and written exams as well as show visual evidence of a large number of specific cases they’ve personally done to demonstrate their artistry. Only then can they be accredited. Their website has a link where you can search for AACD accredited dentists in your area.

That would be the dentist I would go to in order to get a stunning smile makeover.

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

Staining Around 1-Year Old Porcelain Veneers

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I’ve had my porcelain veneers for about a year. I thought they were supposed to be pretty stain resistant. Mine seem to be picking up stains on the top edges though. I’m still paying for thise so I’m kind of worried. Is this normal?

Drew

Dear Drew,

A single porcelain veneer being placed

No, this is not normal. Porcelain veneers are very stain resistant unless there was some damage to your veneer’s glaze. This can happen if your hygienist uses something like a power prophy jet or an acidulated fluoride on them. It takes away the glaze and causes staining.

This, however, will cause staining across the veneer and not just the top as you mentioned.

What you’re describing sounds like you have bulky margins. That’s when the porcelain veneers aren’t bonded flush against the teeth. This essentially creates a tiny shelf on the top of the porcelain veneers.

This will harbor bacteria and cause decay. That means it needs to be repaired. Your dentist should re-do this for you. If he doesn’t want to admit this is the problem, then I’d suggest you get a second opinion from another cosmetic dentist.

If they say it is an issue with bulky margins, then you have a right to get a refund. Your porcelain veneers aren’t considered functional if they put you at risk of decay.

If You Need to Replace Your Porcelain Veneers

IF you end up getting a refund. You’ll want to make sure you go to a more experienced cosmetic dentist. Ideally, look for a dentist who is AACD accredited.

The reason you’ll want this is they have both the technical skill and the artistry to create smiles that are not only perfectly bonded (unlike your current veneers), but stunningly gorgeous.

To get an idea of the kind of beauty they can create, look at Dr. Weiss’ smile gallery. You can find an AACD accredited dentist by going to aacd.com where they have a link to help you find them.

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

Dental Implant Doesn’t Match

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I’m devastated by how my dental implant turned out. I lost a front tooth due to a fall down the stairs. My dentist assured me that he’d be able to give me a new tooth that would help me smile again. The dental implant part is fine, but it doesn’t match my other teeth. It’s way more obvious because it’s a front tooth. I haven’t smiled since the fall. I just don’t know what to do. Can this be fixed or whitened? If not, I’m pretty sure I’ll never smile again.

Misty

Dear Misty,

A diagram of a dental implant

I have two pieces of good news for you. First, this can be fixed. Second, you won’t need to do the dental implant over. However, teeth whitening won’t be your solution for two reasons.

One, teeth whitening only works on natural tooth structure. What would happen is the teeth surrounding the implant crown would whiten but not the crown itself.

Second, even if it could whiten, you wouldn’t be able to get an exact match to your tooth that way. You might get close, but front teeth are very exposed. Any little difference is noticeable.

Matching a Single Implant Crown

Because of that, matching a single front tooth requires an expert cosmetic dentist. Only a small percentage of cosmetic dentists are able to do it well.

In your place, I’d look for a dentist who is accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists have passed stringent oral and written exams on technical skill and knowledge as well as submitted a large number of specific cases they’ve done in order to demonstrate their artistry.

If you don’t have one within a reasonable driving distance, a second option would be to look on mynewsmile.com to find one of their recommended dentists in your state.

Cosmetic dentists from either site can re-do your crown to match the adjacent teeth.

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

Cried After Getting Porcelain Veneers

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I have dreamed of getting porcelain veneers for years. I saved every penny I could, stashed away every tax refund, and hadn’t been out to eat in two years. I can’t express how much I was looking forward to finally having a smile I was proud of. But, when my dentist bonded them on, I was so disappointed. They look so thick. I feel like I have donkey teeth. Even though the color and shape are better than my old smile, I was expecting something else. To me, these look fake. My dentist says that’s a common reaction because I’m not used to them and I’ll like them in a week. I could barely see while I drove home, I was crying so much. It’s been a week. They still look fake. What do I do?

Laurie

Dear Laurie,

Porcelain veneer being held up by a dental tool
Beautiful smiles require an expert cosmetic dentist

These type of stories absolutely break my heart. I’m so sorry you’ve made so many sacrifices to end up so disappointed. I can tell you what went wrong right away. You didn’t go to a true cosmetic dentist.

One problem for patients is that cosmetic dentistry isn’t a recognized specialty. It’s an art form that any general dentist can dabble in. It sounds like dabbling is all your dentist has done.

True cosmetic dentists invest serious time with training, study, and practice into learning how to create stunning smile makeovers. All of that has to be done post-graduate school. Smile makeovers aren’t taught in dental school.

How Do I Know Your Dentist Wasn’t a Cosmetic Dentist?

I could tell right away you were dealing with a dabbler. First, he just bonded the porcelain veneers on before getting your okay on the results. Instead, he should have used a try-in paste so you could have seen your porcelain veneers on your teeth and looked at them in several types of lighting.

Second, if you weren’t absolutely over the moon about your new smile, he would have gone back to the drawing board. Never, will a true cosmetic dentist say, “You’ll get used to them.” Nope. You paid for a beautiful smile and that’s what you should get. Don’t even get me started on his “That’s a common reaction.” That should tell HIM something.

Can These Porcelain Veneers Be Fixed?

This is the tricky part. Once they’re bonded in, no changes can be made. The entire case will have to be done fresh with new porcelain veneers. The first thing I would try is to ask your dentist for a refund. You didn’t get to approve the veneers before he bonded them on and that is standard practice with cosmetic dentists.

The problem you’ll run into is if he says, “No.” When it comes to what’s considered a “botched case” with the dental board is different than it should be in cases of cosmetic work. If the veneers are placed properly and your teeth function normally, they won’t force him to refund your money.

Here’s what I’d recommend in that case. Go to an expert cosmetic dentist for a second opinion. You can find one by going to aacd.com and doing a search for an ACCREDITED cosmetic dentist in your area. The accredited part is important. Ask his or her opinion of your case without telling them who the dentist was.

If they agree it was badly done, then solicit their help in getting you at least a partial refund. Sometimes a dentist will listen to a peer more than a patient out of professional pride.

Then, have the smile re-done by someone who knows what they’re doing.

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