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Cosmetic and
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dentistry

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.

 

Jagged Teeth After Braces

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I am toward the end of my orthodontic treatment. While my teeth look straight, I have noticed the edges are jagged. I am hoping to fix this. After spending all this money to get straight teeth, I don’t want this one little thing to bother me. Is there a way to fix it?

Ellie

Dear Ellie,

Before and after with dental contouring

I’m glad you wrote. There is a procedure known as dental contouring that can solve your issue.  If the problem is minor, your orthodontist should smooth this out as a part of completing your case. If it is more substantial, I would invest in having an expert cosmetic dentist do this. Cosmetic contouring is a fairly advanced procedure and requires a cosmetic dentist that is not only technologically skilled, but artistic as well.

This type of procedure has to be done freehand. It is not something your average family dentist could do. In your place, to ensure you get a good result, you will need to check out the dentist’s smile galleries to make sure they get beautiful results with a variety of different cosmetic procedures. You could start by looking on the mynewsmile.com website to see if there are any dentists in your area they recommend. These dentists have already been prescreened for their training, technical skill, and artistry.

Often you will need some dental bonding done with the contouring. If you look at the before and after images above, you can tell right away that the sides of some of his teeth had bonding material added to them. You can also see that the teeth have varying opacities throughout the lengths of the teeth making them look completely natural and blending them seamlessly with the remainder of the teeth.

You won’t get this type of result with any dentist.

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

 

Thoughts on Premium Home Teeth Whitening

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I’ve been wanting to do a smile makeover for a while. Recently, I received an offer in the mail for Premium Home Whitening. Then, I received a Groupon offer for the same thing. It is less than what my dentist charges. I was wondering if it will really work or if I will be wasting my money.

Katherine

Dear Katherine,

teeth whitening trays

I looked into this. There are some good and bad things about this. First the good. The whitening ingredient they use is 35% carbamide peroxide. This is a valid whitening ingredient and will whiten your teeth. That is great. Now for the less than good news. The light they advertise seems bogus. This makes me uncomfortable with the company. If they are willing to lie to patients to draw them in, how do we know their ingredients are what they say they are? I don’t like deception.

A second thing to consider is the whitening tray. When you get teeth whitening done with your dentist, he or she will prepare custom fitted trays. This both protects your gums for being irritated by the whitening gel as well as keeps the gel concentrated on your teeth by not leaking or by letting saliva in to dilute it.

The tray you get with this will not be not be custom fit. Instead, it will sort of fit. However, your saliva will weaken the gel meaning you won’t get as much whitening out of each kit as you would with your dentist.

You mentioned the price was more than your dentist, but did not say how much more. One thing I would do is tell your dentist how much the kit is and ask him if he can come close to that so you will be able to do the procedure with him under a professional’s care. My guess is if he is not willing to, some dentist will be.

If you are thinking about improving your smile, teeth whitening will make you and your teeth look younger. If you are looking for a complete smile makeover, the way to do that is with porcelain veneers. However, while teeth whitening can be done with any dentist, porcelain veneers require an expert cosmetic dentist. If you decide to go that route, my suggestion is you only do that with a dentist who is AACD accredited.

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

Can I Get a Better Smile without Bonding?

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I have slightly discolored teeth, due to aging. A few years back, I also fell and chipped my front tooth. My dentist did composite bonding on that and I’ve never been happy with it. It doesn’t match the rest of my teeth and never has. Plus, there is a gap that wasn’t there before. I went to him about the discoloration for all my teeth to see what he’d recommend and he wants to do composite bonding on the top eight teeth. I am a little leary of this given how the gap turned out. Is there another way to handle this?

Kevin

Dear Kevin,

before and after dental bonding

You bet there are other ways to handle this. My first suggestion would be to simply have professional teeth whitening done. This will take care of the discoloration you are talking about.

The next step would be to replace the badly done dental bonding. The problem you faced with the bonding was not the procedure as much as it is the dentist who did the procedure. He could have matched your teeth perfectly and not had any gaps. The fact that he was not able to accomplish that tells me he is not a skilled cosmetic dentist.

If the only things you want to change about your smile are the color and this bonding, then I would simply find a better cosmetic dentist. Look for an AACD accredited dentist to do your work. These are the best cosmetic dentists in the country.

If, however, there are other things about your smile you are hoping to change, then I would look into getting porcelain veneers. These can give you a complete smile makeover. They’re able to change anything about your smile, including the color, shape, size, and character.

Like the dental bonding, it will require an expert cosmetic dentist, but when well cared for they will last for many years. Whatever you do, don’t go back to the same dentist who could not get your chip repaired properly.

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

Why You Have to Carefully Pick Your Cosmetic Dentist

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I had a chipped tooth which was repaired with dental bonding. That bonding fell off so I went to another dentist. This dentist said that bonding was not possible because 1/5 of the tooth was chipped and recommended getting a dental crown. That seemed too invasive to me so I asked for a porcelain veneer instead. She said she’d have to do two of them in order to get them to match. I agreed. Before it was bonded on I got to peek at them. They looked fine. They were whiter than my other teeth but we did that on purpose because I was going to whiten after getting the porcelain veneers. I did not see them after they were bonded on but they told me it looked fantastic. I left happy. When I got home, I noticed that one of the “teeth” is longer than the other. Not only that, the longer tooth has a bit of a ledge at the top so it appears they bonded it on too low. I called them, but they said that the tooth must have shifted and there is nothing they can do. How would my tooth shift away from a bonded veneer? Can this be fixed? If so, how do I go about getting it fixed?

Pamela

Dear Pamela,

a porcelain veneer being placed on a tooth

We hear these types of cosmetic dentistry horror stories way too often and it generally distresses me for two reasons. First, it is a burden on the patients. Second, because it was completely preventable. There is so much wrong here with what your dentist did.

We’ll start with her saying that dental bonding was out of the question. Really? Why? Obviously, you had dental bonding done there to begin with so it was not impossible. My guess is your dentist said that because she did not know how to do the dental bonding, so instead she steered you toward the procedure she did know, which is a porcelain crown.

You felt that was removing too much healthy tooth structure (rightly, I might add) and asked to have porcelain veneers instead. Based on what happened next, I would say she wasn’t very comfortable with that procedure either but was too embarrassed to say so. Or, maybe she thinks she’s good at them.

Getting Beautiful Porcelain Veneers

I suspect they knew something was wrong when they bonded your veneers because they didn’t let you look at them. That doesn’t give me much confidence in their professional integrity. So, where do you go from here?

The good news is they messed up big time. That will help you get a refund. If the only thing wrong with your porcelain veneers was they looked bad, it would be up to the dentist whether or not you received a refund.

In your case, they bonded them improperly leaving what you described as a ledge. In dental circles, we call this open margins. This is a functional issue because food and other bacteria will get trapped there putting your teeth at risk of decay and your gums at risk of developing gum disease. She owes you a refund so you can get this fixed.

Once you have secured your refund, I am going to suggest you find a dentist who has been accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the country. You will have a beautiful smile when they do the work.

Oh, one other thing. The teeth whitening should have been done before you had the porcelain veneers placed. That allows the dentist to get an exact match. That was another error on your dentist’s part.

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

Dental Bonding Keeps Falling Off

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I have fluorosis stains and paid my dentist to cover them with dental bonding. It has been a bit of a nightmare and I want to know if I have the right to ask for a refund. When he first placed the bonding, it was a little bit uneven in color, but even worse, you could still see the stains underneath them, which defeated the whole purpose of getting the bonding in the first place. He made them thicker, which did cover the stains. However, they fell off less than a week later. I went back and he did them again and said my bite is the issue and to wear a night guard. So, I paid for one of those and guess what? They fell off again anyway.  He said they’re not permanent and I should not have too high of expectations. I did know they would not last as long as something like porcelain veneers, but he originally hinted they could last around five years. I’m barely getting five days. Is it reasonable to ask for a refund?

Jack

Dear Jack,

A side by side image of mild and severe fluorosis stains

For the benefit of readers who may not know what fluorosis stains are, I’ve placed these two images above. Fluorosis stains result from a child having ingested too much fluoride while their teeth are developing. It is not as common in the United States as it is in other countries but does happen.

While in many cases it is hard to get a refund for cosmetic dental work, yours will be an exception. It is nearly impossible to get a refund just based on not liking how the dental work looks, which is one of the reasons we remind readers of our blog about the importance of going to cosmetic dentists who have invested in the training necessary to do beautiful work.

Cosmetic dentistry is not a recognized specialty, so any general dentist can call themselves a cosmetic dentist and do the procedures. How well they do the procedures varies from dentist to dentist.

Your dentist is obviously in over his head as he can’t even keep the dental bonding on. That is good news for you, though. The basic standard in dental care is that it stays on. Because your dentist seems incapable of that, you should have no problem getting a refund. If he gives you any trouble with that, let him know you’ll be talking to the dental board. That should sober him up.  Then, I want you to get this done by a cosmetic dentist with more expertise.

I suggest you look on the mynewsmile.com website for the dentist to re-do this procedure for you. Each of the dentists listed on this site are pre-screened for both their technical skill and their artistry. They can provide you with beautiful dental bonding that actually stays on your teeth.

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

Getting Two Front Teeth to Match

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My daughter is about to graduate high school. Several years ago, she had an accident which damaged her two front teeth. One needed a root canal treatment and both of them received dental crowns. The one that had the root canal has turned gray over the years.  For her graduation, we were taking her to get these teeth cosmetically fixed. Our intention was for her to have a beautiful smile in time for her senior pictures. Our dentist said he could replace those old crowns with porcelain veneers. The problem we’ve had is they don’t match. The dentist said because one tooth is grayer they can never match. I wish he would have told us this before we spent several thousand dollars. Is there anything we can do to get these teeth closer together in appearance? Are we being too picky? I feel like we’re letting our daughter down.

Lorraine

Dear Lorraine,

You are not letting your daughter down. Your dentist is, though. There are a few issues going on here that need to be addressed. First, I don’t know what your dentist was thinking saying he was giving you porcelain veneers. If your daughter had porcelain crowns, the only thing he could replace the crowns with is more porcelain crowns. It was unethical of him to claim to be giving her veneers when he didn’t. We see this quite often. Patients come to us disappointed in the “veneers” their dentist provided only to find out they are actually crowns.

a porcelain veneer being placed on a tooth

To give you an idea. The image above shows a porcelain veneer being placed. As you can see, it is a thin wafer. A dental crown, on the other hand, is bulkier and completely surrounds a tooth that has to be ground down to a nub to make room for it.

A second issue I see is his inability to match two teeth. When one front tooth has to be replaced, it can be pretty tricky to match to the second one. It takes an expert cosmetic dentist. Because of that, less skilled cosmetic dentists will try to convince their patients they will have to crown both teeth, which is pretty simple to match. Unfortunately, your dentist can’t even do that.

Finally, a gray tooth can be made to look whiter. You are not going to get there with this dentist though. My suggestion is you ask for a refund. He misrepresented what you were being given and he never told you upfront he would not be able to match the teeth.

Once you have secured your refund, I want you to look for an AACD accredited dentist. Accreditation is different from being a member. They had to pass stringent exams and demonstrate a high level of artistry in their work.  These are the dentists that can give your daughter a beautiful smile.

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

Fixing the Appearance of Protruding Teeth

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I have teeth that are slightly protruded and stained. What are my options for getting an attractive smile that doesn’t include braces? Seriously…NO Braces!

Alicea

Dear Alicea,

You have a couple of good options to get a beautiful smile. The first option is to get orthodontics. Now, I can hear you saying, “No braces!” I promise I am not talking about traditional braces. There have been some wonderful advances in dentistry. One of those is an invisible braces option, such as Invisalign. Instead of metal wires and brackets, these use clear aligners that straighten your teeth. For the discoloration, some simple teeth whitening will do the trick.

a porcelain veneer being placed on a tooth

A second option is to have a complete smile makeover done using porcelain veneers. This is the go-to for celebrities that want that Hollywood smile. It can change the shape, size, and color of your teeth simultaneously.

The important thing with porcelain veneers, though, is to make certain you go to an expert cosmetic dentist. Doing smile makeovers is not taught in dental school. Nor is cosmetic dentistry a recognized specialty. If a dentist wants to develop skills in cosmetic procedures, it is up to them how much and how skilled they become. There is no baseline.

Your safest option is to find an AACD accredited dentist. Dentists who seek accreditation through the American Academy of Cosmetic Dentistry have to prove not just their technical knowledge and understanding about cosmetic work, but also have to demonstrate they have artistry by submitting a large number of visual evidence of procedures they’ve done.

With the right dentist, porcelain veneers will give you a smile that lights up a room.

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

Teeth Under My Porcelain Veneers are Turning Dark

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I paid a small fortune for a smile makeover. For some reason, the teeth underneath it are turning dark. My dentist doesn’t seem to believe me. I don’t think I am imagining this. I wonder if it has something to do with the tops of the veneers don’t quite go flush with the gumline. There is a bit of a ledge there.

Portia

Dear Portia,

 

a porcelain veneer being placed on a tooth

Bear in mind I haven’t actually seen your porcelain veneers, Based on what you’ve described, though. you have got a big problem here. It sounds to me that you have some open margins which is leading to leaking. This means your porcelain veneers need to be replaced. There is more at stake here than just the appearance. You are also putting your teeth at risk.

What is going on is your porcelain veneers were not bonded on properly. As a result, there is food and other bacteria getting trapped between your teeth and your porcelain veneers. That bacteria will sit on your teeth and turn into decay.

It doesn’t sound like your dentist is willing to own up to his error without some encouragement. Most dentists want to look good in front of their peers. My suggestion is you get another dentist on your side. In this case, you will want to see an expert cosmetic dentist. I recommend you see if there is an AACD accredited dentist in your area.

Have them look at your smile makeover and see what they say about it. Make sure it is a blind second opinion. By that, I mean don’t tell your dentist who did your smile makeover. If they ask, tell them you want their unbiased opinion.

If it turns out I am right and you do need to have these replaced, the dentist can help you get a refund. Then, I would make sure you have the expert cosmetic dentist do the new veneers. You’ll have much more beautiful results that will last a long time.

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

Dentist Won’t Do Bonding

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I have black triangles that developed after some orthodontics.  I read online that this can be fixed with dental bonding but my dentist is insisting this is a bad idea. I don’t want to leave these holes so what can I say to convince him? I’ve tried showing him an article about it and he really still doesn’t think it is a good idea.

Brenda

Dear Brenda,

example of black triangles

While you are correct that dental bonding will be a good solution for this, I would not push him into this. When a dentist tries to steer a patient away from a procedure, it is usually because they are not qualified to do it but do not want their patient to lose confidence in them.

This is an advanced, tricky procedure to do. In your place, I am going to suggest you see a dentist with the training necessary to do it. The dentists with proven skills and training are AACD accredited. There are other excellent cosmetic dentists as well, but these have already been tested so you know what you are getting into. If I were in your position. That would be the dentist I’d use.

If you are interested in whitening your teeth. Make certain you do it before you have any bonding done. The color can’t be changed on the bonding after it is done, so you want any color matching to be done with the color you are going to keep.

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