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dentistry

What If You Don’t Like Your Smile Makeover?

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I wanted a smile makeover. I asked my dentist if he was a cosmetic dentist and he said no one is actually a cosmetic dentist they’re just dentists who did cosmetic work. He then asked what procedure I wanted. When I told him a smile makeover he told me that he could give me Lumineers. He showed me before and after pictures that looked good. When my porcelain veneers were first placed. I didn’t like them. I could tell that before they even put them on. They weren’t the right color. I told him that and he sent them back. When they came in the next time, I had a hard time seeing them on my teeth because they kept falling out. He assured me they could make adjustments after they were bonded on. It turned out that isn’t true. When I finally got a good look at them at home, I was super disappointed. First, they were whiter, but it had a chalky flat looking white, not a shiny one I was hoping for. Second, they are way bulkier than natural teeth. It was shortly after this that the quarantine started and his office closed. I called and left a message, but he hasn’t gotten back with me. I don’t know if that’s because his office is closed or he’s ignoring me. I’m hoping to get this fixed, but what if he’s actually just avoiding me?  The answering machine does say they’re checking messages and will get back with us, but he hasn’t.

Carol

Dear Carol,

A single porcelain veneer being placed on a tooth.

While technically your dentist is correct, there isn’t a recognized specialty in cosmetic dentistry, that doesn’t mean some cosmetic dentists aren’t more qualified than others. Doing smile makeovers aren’t taught in dental school. It is up to the dentist to invest the time and money into learning them well.  It doesn’t sound like your dentist has done that based on what you’ve described.

Problem One

The first thing that caught my attention was his recommendation of Lumineers. This is a brand of porcelain veneers that is highly marketed, especially to inexperienced cosmetic dentists as being easy to place. They say that because they are considered easy to place as they are an ultra-thin and don’t necessarily require any tooth preparation. However, they have two big problems working against them.

The initial problem is the inexperience of the dentist. Some smiles will look fine without tooth prep. Others will look bulky. A second big issue with Lumineers is their lab. Unlike other brands of porcelain veneers, the company that produces Lumineers require dentists to use their lab, which isn’t known for its high-quality work. In fact, many expert cosmetic dentists would consider it sub-par.

I know your dentist showed you before and after pictures, but did he say they were HIS before and after pictures. They may have been stock photos.

Problem Two

A second big problem I noticed is that your dentist either doesn’t know or doesn’t care about temporary try-in paste. If he didn’t know, he has done practically zero training with cosmetic work. If it is, instead, that he doesn’t care, then he is definitely NOT a dentist you would want working on your smile. So you’ll be aware for next time, a temporary try-in paste allows you to get a good look at your porcelain veneers on your teeth for an extended period of time, without them having to be permanently bonded.

Problem Three

Finally, he told you he could make adjustments after they were bonded on. Cosmetic Dentistry 101 teaches you that is not possible. Again an indication he either doesn’t know he’s doing or he doesn’t care. The good news is this last issue works in your favor. He told you something that absolutely wasn’t true. I think this can help you get a refund.

So, once you’ve got that juicy refund in your hand, who should you go to in order to have a beautiful smile crafted for you? Ideally, you’d get an AACD accredited cosmetic dentist. They are at the top 1% of their field. If that isn’t possible, my next recommendation is you go to the website mynewsmile.com. They recommend expert cosmetic dentists in every area. A dentist cannot just pay to be listed. They have to provide their cosmetic dentistry training as well as visual evidence with before and after pictures of cases they’ve done themselves in order to prove their artistry. Any one of the dentists listed there can create a stunning smile for you. Many of them are on their way to accreditation, which is a process that can take many years.

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

Her Dentist told Her to Expect Her Porcelain Veneers to Fall Off!

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I just had six porcelain veneers placed on my teeth and, as I was leaving, the dentist told me to expect them to fall off every few months. I knew up front that I would no longer be able to eat crunchy foods, such as apples or nuts, but I really thought they’d stay on other than that. Do you know if I’m expected to pay for the rebonding every time?

Caitlin

Dear Caitlin,

a porcelain veneer being placed on a tooth

I’m astounded at what I’m hearing! First, let me start off by saying that one of the problems you are facing has to do with the fact that cosmetic dentistry isn’t a recognized specialty. This makes the standard of care a very low bar. It wouldn’t matter if they looked awful, as long as they were functional. That is actually the basis for a large number of cosmetic dentistry horror stories. They pay a fortune for a smile makeover and end up with a smile that looks worse.

The good news, though, is that your porcelain veneers falling off is NOT functional. It’s a basic standard of care. If your porcelain veneers fall off even once, go back and demand a refund. In fact, he should not have put eating restrictions on you at all. There are very few restrictions when it comes to porcelain veneers, such as not biting metal and wearing a nightguard if you are a teeth grinder. In your place, I’d go ahead and test the veneers by eating an apple the next time you feel like it. If they’re going to come off and need to be replaced (by a different dentist this time), it is better for you to know sooner rather than later. This way you can get a functional smile and not live in fear.

Finding an Expert Cosmetic Dentist

Without there being a recognized specialty in cosmetic dentistry, any general dentist can call themselves a cosmetic dentist. Unfortunately, creating beautiful smile makeovers isn’t taught in general dental school. Instead, a dentist has to invest in a significant amount of post-doctoral training as well as have an artistic eye.

It’s almost impossible for patients to know which dentists have done this and are truly qualified and which haven’t, essentially turning your trip to the cosmetic dentist into a gamble. The American Academy of Cosmetic Dentistry recognized this issue. As a result, they started an accreditation program. To become AACD accredited, dentists have to pass stringent exams that prove their technical knowledge of the procedures. Additionally, they’re required to submit a large number of specific cases they’ve personally done to show they can not only implement their technical knowledge but have the artistry required to create beautiful smiles.

If I were getting a smile makeover, I’d want an AACD accredited dentist to do it. When your porcelain veneers fail, and it sounds like your dentist is sadly confident they will, that is what you should look for in the dentist that will replace them.

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

I’m In Tears After My Smile Makeover

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I had a few teeth with composite bondings to repair some chips. They needed some repair. My dentist retired and said the man who took over his practice said they’d need to be replaced with porcelain crowns because you can’t just replace composite bonding. I didn’t realize at the time that wasn’t true and allowed him to do six dental crowns. The two front teeth look a darker grayish compared to the other teeth. Is there any way to fix this? My dentist insists they’re the exact same color as the others. It almost feels like I’m being gaslighted.

Elaine

Dear Elaine,

Woman covering her mouth with hand.

I’m very sorry you’re going through this. I can tell you the biggest obstacle you face is you have a bread and butter family dentist trying to do cosmetic dental work. One of the big problems in dentistry right now is the fact that cosmetic dentistry isn’t a recognized specialty. This means any general dentist can call themselves a cosmetic dentist regardless of the amount of training they’ve received.

This puts patients in a difficult position. They may not know that smile makeovers and other advanced cosmetic procedures are not taught in dental school. In order for a dentist to become skilled in those areas, it requires a significant amount of post-doctoral training. The best dentists invest in this type of training on a regular basis and are constantly improving their skills. My guess is your dentist didn’t receive that. This is what landed you in this position.

Getting Your Smile Disaster Fixed

A true cosmetic dentist would never tell a patient their smile looked fine when they were unhappy with it. Instead, they would re-do the work until the patient was thrilled. Because they want total patient satisfaction, they’ll use a temporary try-in paste. This allows the patient to get a good look at their smile before it is permanently bonded on.

It is unfortunate you now have dental crowns. You’re stuck with those the remainder of your life because it required your teeth to be ground down. The good news is he misrepresented to you the options available. It is not true that dental bonding could not be replaced. My guess is he said you had to have dental crowns done because that is all he knew how to do. In your place, I would ask for a refund and then go elsewhere to get them done properly.

If you’re happy with all the crowns except the two front ones that don’t match the adjacent teeth, you can just get those re-done. Either way you are going to need to find a top of the line cosmetic dentist. The best are AACD accredited cosmetic dentists. They’ve passed stringent exams as well as demonstrated their artistry on a large number of cases they’ve done.

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

Horrible Solution for a Tooth Gap

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I have a tooth gap I want to fix. My dentist is suggesting Lumineers. I’ll do it if it is my only option but it is quite expensive. Can you give me a second opinion as to whether I have other options?

Susan

Dear Susan,

woman smiling with a gap between her two front teeth

Please run away from your dentist as quickly as possible. This is a horrible suggestion to fix a tooth gap. Lumineers are a brand of porcelain veneers, which are used for complete smile makeovers. They’re also a bit pricey. You’re asking for a solution to a tooth gap.

The simple solution for that is dental bonding. It is much less expensive and will only affect the teeth you want to close the gap on. What your dentist is suggesting is a massive over treatment. So why would he do that?

My first guess is he doesn’t know how to do dental bonding. Truthfully, that wouldn’t surprise me at all based on the fact that for your porcelain veneers he is suggesting the Lumineers brand. These are highly marketed to inexperienced cosmetic dentists as being easy to place.

They tell dentists that because they are an ultra-thin brand of porcelain veneers, leading the dentists to believe there will be no need to prepare the teeth the way many other brands of porcelain veneers require. Unfortunately, this often ends up looking bulky. Some patients have even described the results as horse teeth.

Finding an Expert Cosmetic Dentist

If you were going to get a true smile makeover, then you would want a highly skilled cosmetic dentist, such as one who is AACD accredited. Let them pick the brand.

As for your tooth gap, again, you’ll want an expert cosmetic dentist. Dental bonding, the treatment I suggested, is done freehand and takes some serious expertise.

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

Will Supersmile Whiten My Dental Bonding?

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I’ve had dental bonding on eight teeth for about ten years. They’re starting to pick up stains. I’ve heard Supersmile toothpaste is good at removing stains. Will that help with my situation or do I need to replace them?

Ellie

Dear Ellie,

Supersmile does a great job removing surface stains. It does it with an ingredient called Calprox, which dissolves the protein pellicles on your teeth. Stains attach to the pellicles and when they are dissolved the stains follow with it. One thing to be aware of is this works on surface stains only.

You mentioned your dental bonding is about ten years old. That is a long lifespan for bonding. My guess is they’ve been slowly picking up stains for a while. If those stains have become internal, there is nothing that will help. Even professional teeth whitening will only whiten natural tooth structure.

You can try the Supersmile toothpaste. I recommend it to anyone with any type of cosmetic work anyway because it does a wonderful job of keeping them bright without damaging the glazing. If that doesn’t work, then it means the stains are now internal and it is time to replace your bonding.

A More Permanent Solution for Your Smile Makeover

Dental Bonding is a great solution for small amounts of cosmetic work, such as chipped teeth or tooth gaps. It sounds like you were using them for a smile makeover. That’s fine, but you will get a significantly better, more permanent smile makeover with porcelain veneers.

There is one important factor in that. You will need an expert cosmetic dentist. Smile makeovers are an art form which are not taught in dental school. Because of that, you’ll want a dentist who invested a great deal of time or training in learning the art.

It is hard for patients to know which dentists have done this and which haven’t. There isn’t a recognized specialty in cosmetic dentistry. Because of that, the American Academy of Cosmetic Dentistry began an accreditation program. Dentists who obtain AACD accreditation are in the top 1% of artistic dentists in the country. They can give you a stunning smile.

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

Getting a Smile Makeover Through Yelp?

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I’m having trouble deciding on which cosmetic dentist to use for my smile makeover. I’m looking at the top three recommended in Yelp. I was thinking of doing composite bonding because it is cheaper, but I can’t tell which of them would be better for that over porcelain veneers. Any advice?

Hannah

Dear Hannah,

Brunette with a beautiful smile

AACD accredited dentists are in the top 1% in the country.

I’m glad you are writing. I think I can save you a lot of grief and wasted money. Let’s start with the way you’re going about finding the dentist you want to do your smile makeover. While Yelp is a great resource for many things, I don’t think its algorithms are going to be useful in this case.

They make their recommendations based on reviews. However, they don’t really make a distinction on what type of dental work is done. For instance, if you were to look at many of the reviews of those dentists, how many are based on their work doing smile makeovers? Most are likely just about how friendly the office is or some of the general dental work they’ve had done.

I’ll discuss how to get the best cosmetic dentist for your smile makeover in a moment. Before we do that I want to talk about the two procedures you were considering. You won’t find many great cosmetic dentists who will do a complete smile makeover with composite bonding. It actually takes significantly longer to do it with composite than porcelain and get it to look beautiful. Because of that, they’d actually end up having to charge you more. Plus, composite doesn’t last nearly as long as porcelain, so your investment isn’t as durable. Dental bonding is best done with small areas, such as repairing a chipped tooth or closing a tooth gap.

If you’re going to invest in a new smile and want it both beautiful and durable, then porcelain veneers would be the better investment for you.

Finding a Cosmetic Dentist for Your Smile Makeover

There isn’t a recognized specialty in cosmetic dentistry, nor is doing smile makeovers taught in dental school. That leaves patients in a bit of a quandary. Because of that, the American Academy of Cosmetic Dentistry began an accreditation program. Dentists who pursue accreditation have to pass exams demonstrating their technical knowledge. They also have to demonstrate their artistry by presenting visual evidence of a large number of cases they’ve done. Those are examined carefully to ensure they meet the highest standards. Only then will they be accredited.

If I were getting a smile makeover, I would look for an AACD accredited dentist.

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

Will Porcelain Veneers Solve My Problem?

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I have never liked my smile and I am finally in a position to do something about it. Here are the issues:

  • It’s extraordinarily difficult to show my upper teeth.
  • When my mouth is at rest you cannot see them at all.
  • I have pretty constant jaw pain, except for when I wear my nightguard at night for my teeth grinding.

What I’d like is to be able to see my teeth and maybe even improve my appearance. I’d also like my jaw to hurt less, like the way it does when I’m wearing my nightguard. Would porcelain veneers be my best solution?

Laurie

Dear Laurie,

woman holding her her jaw in pain

While porcelain veneers are the go-to procedure for a smile makeover, your situation is a little more complicated. It sounds like you are facing a collapsed bite along with TMJ Disorder. This requires a different approach. You will need to open your bite. This is typically done as full-mouth reconstruction with dental crowns. However, I want you to proceed with caution.

Only a small percentage of dentists are able to do this procedure correctly. When it isn’t properly done, it ends up making things much worse. Here is the way I’d recommend a dentist proceed.

You want whoever does your full-mouth reconstruction to start by using provisional crowns to open your bite. This way it is reversible. When you are completely out of pain and love the appearance of your smile, that is the time to move forward and the dentist can make the permanent crowns.

What Qualifications Do You Want in Your TMJ Dentist

It’s important whatever dentist you choose has extensive post-doctoral training in TMJ Disorder. For instance, Dr. Weiss did his TMJ training with the renowned Dawson Academy. Other reputable institutions would be the Kois Center and the Las Vegas Institute for Advanced Dental Studies.

You also want to ask them what experience they have in full-mouth reconstruction. You definitely don’t want to be their first case.

Cosmetic Considerations with Your New Bite

While you are opening your bite, you are also getting a smile makeover. Because of that, it is important you find a dentist who is a top of the line cosmetic dentist. Ideally, you’d want an AACD accredited dentist. The good news is finding such a dentist will likely take care of both sets of qualifications.

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.

Dental Insurance for Dental Implants

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I want to replace all of my teeth with dental implants. They are in pretty bad shape and I want a smile I can be proud of. Is there a dental insurance that will cover these?

Kevin C.

Dear Kevin,

When you say your teeth are in pretty bad shape, you didn’t specify whether you meant in appearance or in health. If it is just an appearance issue, getting dental implants would be an overtreatment. This is designed for patients who need to replace their teeth because they have to be removed as a result of decay and infections. If that’s not you, a great cosmetic dentist can create a stunning smile for you, while enabling you to keep your natural teeth using porcelain veneers.

If, however, the teeth are unhealthy and have to be removed, then dental implants will be the right way to go. If you already have dental insurance, they will cover part of the cost but probably not as much as you would hope. Dental insurance tends to only want to cover the least expensive option. For tooth replacements, that is dentures. Though I only recommend dentures as an absolute last resort for reasons I’ll go over in a moment.

If you don’t already have dental insurance, be aware that most policies have a waiting period for anything other than cleanings and checkups. That may defeat the purpose if your teeth need to come out right away.

Why Not Dentures?

Two profile photos of a woman who experienced jawbone shrinkage and facial collapse, which can be prevented with implant overdentures, available from Philadelphia cosmetic dentist Dr. Michael Weiss.

Jawbone shrinkage results in facial collapse

When your teeth are removed, your body begins to resorb the minerals in your jawbone to use elsewhere. This is in an effort to be efficient with its resources. Unfortunately, this also has the result of slowly shrinking your jawbone. Eventually, you won’t have enough jawbone left to retain your dentures. This is known as facial collapse.

Getting dental implants signals to your body your jawbone is still necessary and will leave the minerals in place, thereby protecting you from facial collapse.

Implant Overdentures

Implant overdentures

Implant overdentures are a combination of dental implants and dentures

You don’t have to get a dental implant for every tooth. Instead, you can get implant overdentures. This will use between four and six dental implants and will anchor a set of dentures to them. This has the benefit of being more affordable while still providing you with all the benefits of dental implants.

If You Want a Stunning Smile

Whether you get dental implants or porcelain veneers, you still need a dentist who is skilled in cosmetic dentistry to give you that gorgeous smile you want. The top cosmetic dentists are AACD accredited. When you’re looking for natural results that look great, then you need to see an accredited dentist.

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

Can Dental Bonding by Safely Removed?

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I have dental bonding I’m not too thrilled with. I’m moving and want to find a better cosmetic dentist. However, before I do anything I wanted to ask if it is possible to remove dental bonding without damaging the tooth. Have you had experience with that?

Mazie

Dear Mazie,

before and after dental bonding case

Yes, it is possible to safely remove dental bonding on two conditions: First, you must go to a dentist who understands the procedure and has the equipment. Second, the dental bonding has to be attached to the enamel of your tooth and not the soft dentist which is beneath the enamel.

Here are three ways to safely remove dental bonding:

Sandpaper disks

Dentists use these to polish composites. These are probably the easiest for a dentist to use for this particular job. They are flexible enough to form to the shape of the tooth and leave a nice smooth, polished tooth surface.

Carbide Drills

These have a high-speed. If the dentist is able to use them with light pressure, they will do the job faster than the sandpaper disks. Their big disadvantage is they tend to leave streaks of material on the tooth. If a dentist uses this, they’ll want to finish up with the sandpaper disks to get that nice smooth finish.

Air Abrasion

It will be hard to find dentists who have this equipment. It’s not as commonly used as the other options.

Getting Your Beautiful Smile

Whether you just have a dentist re-do your dental bonding or you get a full smile makeover with porcelain veneers, you want to make sure you have an expert cosmetic dentist do the work. In your place, I’d look for a dentist who is AACD Accredited. These are the top cosmetic dentists in the country.

Some, less experienced dentists, will try to tell you if you get Lumineers they will be reversible. This is absolutely not true. They say this because they are marketed as a no-prep veneer. However, the material in porcelain veneers, including the Lumineers brand is much harder than the composite material and the tooth will almost positively end up damaged in the removal process.

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

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