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Cosmetic and
restorative
dentistry

Fixing a Gummy Smile

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I have a gummy smile and wondered if there is something my dentist can do to change that and give me one of those smile makeovers I keep seeing online?

Penny

Dear Penny,

before and after a gummy smile makeover

It is possible to have a beautiful smile makeover done for someone with a gummy smile. However, one word of caution. this is very advanced and way beyond the capabilities of your typical dentist. You will need an expert cosmetic dentist for this. Beware of dentists who want to send you to an oral surgeon and cut your upper jaw. Not only is this invasive and expensive, but unnecessary and dangerous. It will likely lead you to TMJ Disorder.

Instead, you want a cosmetic dentist to do what is known as a gum lift. This removes a small amount of gum tissue, which will expose the bone beneath. Then, they can place porcelain veneers, which will cover the bone and completely make-over your smile.

Porcelain veneers can change anything you want about your smile, including the shape, size, and color. Please only go to an expert cosmetic dentist with this. I would look for someone who is AACD accredited. These are among the top 1% of cosmetic dentists in the country.

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

Discolored and Crooked Teeth

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I finally have money to do something about my hideous smile and wanted to find out what my options are. My teeth are both stained and crooked. What are some ways I can approach this?

Mindy

Dear Mindy,

You actually have a couple of good options. The first is porcelain veneers and the second is Invisalign combined with teeth whitening.

Option One: Porcelain Veneers

a porcelain veneer being placed on a tooth

 

A skilled cosmetic dentist can use porcelain veneers to do a total smile makeover. This can make your teeth look straight while making them any shape, size, and color you want. The key to this is the dentist who does the procedure. You need someone who has advanced training in cosmetic dentistry. This would need to be post-doctoral training because it is not adequately taught in dental school. Unfortunately, it is not a recognized specialty. This means any dentist can call themselves a cosmetic dentist regardless of the amount of training they have invested in. So, how is a patient supposed to know whether or not a dentist is truly qualified to give them a smile makeover?

The simplest way is to look for a dentist who is AACD accredited. This is different than just being a member of the American Academy of Cosmetic Dentistry. To receive accreditation, they not only have to pass difficult exams on the procedures and technique but also have to demonstrate their artistry in a demanding number of cases with visual evidence of their results. These are among the top 1% of cosmetic dentists in the country.

Option Two: Invisalign and Teeth Whitening

teeth whitening trays being put on teeth

 

Invisalign uses clear aligners to straighten your teeth. They are a huge improvement on braces. No one will even know you are straightening your teeth because they are even invisible at a conversational distance. Additionally, the aligners can double as teeth whitening trays, which means you can do them simultaneously instead of one at a time.

This is something I would recommend if you can’t afford (or don’t want) porcelain veneers. They don’t need someone with special cosmetic training. You simply have to find a dentist that offers Invisalign.

Enjoy your new beautiful smile whichever procedure you decide on.

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

 

Smile Makeover Disaster with Tetracycline Stains

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I have tetracycline-stained teeth. I went to my dentist who is very reputable and has done a great job for me over the years. I was considering porcelain veneers, but my dentist talked me into porcelain crowns saying that they would help cover the stains better. This did not turn out to be the case. The gray is visible with each of the crowned teeth AND the crowns look fake, so it’s obvious I have fake teeth. But, not even pretty fake teeth. He said he can send them back to the lab. I’m so confused. I looked online and there is a woman from a different dentist who has beautiful teeth after getting her tetracycline teeth made over and she used porcelain veneers! What has gone wrong with my teeth? Will doing them again with crowns make a difference? I don’t think I can get porcelain veneers after I have crowns, right?

Leslie

Dear Leslie,

a porcelain veneer being placed on a tooth

You are correct that you will always have to have crowns now that you have them. This is because the teeth have been ground down to little nubs. That tooth structure is gone. In a way you have answered your other question already. You said, “…a woman from a different dentist.” The key to any smile makeover is the dentist who does it. One warning sign is when a dentist suggests porcelain crowns over porcelain veneers when the tooth is healthy and does not need a crown. These dentists are either not comfortable doing porcelain veneers to begin with or do not have enough skill in them and think that the added structure of dental crowns will make it easier to cover the stains.

Sending it back to the lab will only help if he can give them good directions. A lab is more like a pharmacy who fills the prescription of the doctor. It is the doctor that has to come up with the right diagnosis and the appropriate medicine for it. I am not convinced he can write the correct directions. However, there is no harm in allowing him to try. If you do that, do it on the condition that he uses a temporary try-in paste and if you don’t love them the second time then you get a refund. You should get to see them in several lights before making a decision.

If you end up needing a refund, you will want to look for an expert cosmetic dentist. The easiest way for you to do this is to look for a dentist who is accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists have proven skill and artistry. They can give you a beautiful smile whether using porcelain veneers or porcelain crowns.

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

How Long Do Composite Veneers Last?

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I’ve been looking at options for smile makeovers. Most people suggest getting porcelain veneers, but I am just curious about composite veneers. Would they be less expensive? How long will they last?

Carol

Dear Carol,

before and after dental bonding

In most cases, composite bonding is better used for small repairs, like a tooth gap or chipped tooth. The procedure has to be done freehand, which would take much longer in the dental chair than porcelain veneers will. In fact, many dentists will not do a smile makeover with composite resin for that reason. It would end up costing you more because of the tedious nature of the smile development.  On top of that, the composite bonding will only keep their luster a few years before they begin to pick up stains. On the other hand, well-cared for porcelain veneers can last upwards of twenty years.

My suggestion would be to look for an excellent cosmetic dentist. This is not a skill taught in dental school, nor is it a recognized specialty. If a dentist wants to become skilled, they would need to invest in post-doctoral training. It would be easiest for you to just look for an AACD accredited dentist. These dentists have proven skill and artistry. It will keep you from having to investigate the training of each dentist you look at. Any one of them can give you an extraordinary smile makeover.

Let them look at your teeth and talk to them about the look you want. They will be able to determine what procedure can give you the best outcome.

I hope this helps.

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

Does the Dentist Matter If They Outsource Their Porcelain Work?

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I am getting a smile makeover, which will include porcelain veneers on the top arch and some dental bonding for some broken teeth on the bottom arch. I understand that they outsource their porcelain work, so I don’t have to worry about that as much, but the dental bonding is done by the dentist in the office. How do I know if they can do quality bonding work or not?

Billy

Dear Billy,

before and after dental bonding

 

You are correct that dental bonding is tricky and that the dentist really needs to know what he or she is doing. Not only is it done in the office, but it is done freehand. However, be careful about thinking the dentist won’t matter for the porcelain veneers. That is like saying it doesn’t matter what doctor you go to because it is the pharmacist who gives you the medicine. The reality is the pharmacist can only do what is precribed. If the doctor makes the wrong diagnosis and prescribes the wrong medicine, the result will be a disaster even if the pharmacist fills it perfectly.

With porcelain veneers, the cosmetic dentist prescribes the map for the ceramist to follow. He can do the work perfectly according to the dentist’s instructions, but unless the dentist is skilled and artistic the results will be disappointing. So, I would say you will need to find an expert cosmetic dentist for every part of the smile makeover.

How to Find an Expert Cosmetic Dentist

The hands down easiest way to guarantee you will have one of the best cosmetic dentists in the country is to look for a dentist who is AACD accredited. In order for a dentist to reach accreditation with the American Academy of Cosmetic Dentistry. They have to pass oral and written exams as well as have a large number of cases they’re required to do examined in front of a board to ensure they have artistry. You can be assured that they will give you both stunning porcelain veneers and dental bonding. It will be the complete package.

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

What Do You Think of GlamSmile?

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I want to get a smile makeover and recently read about something called GlamSmile. It is supposed to be less expensive and the dentist can place them in just one hour. Have you looked into these? If so, what do you think of them?

Brooke

Dear Brooke,

a porcelain veneer being placed on a tooth

 

I’m glad you wrote. I think I can help you and save you a major disappointment. Here are some things to consider with GlamSmile:

First, similarly to Lumineers, they are marketed to inexperienced cosmetic dentists as being super easy to place. GlamSmile tells them that the lab does all the work so they don’t need extensive post-doctoral training to place these. There are countless examples of cosmetic dentistry horror stories of patients from both Lumineers and GlamSmile, and even other brands of traditional porcelain veneers. where patients were distraught because they spent a fortune on a smile makeover that actually made their smile look worse. This is because the brand does not matter nearly as much as the technical and artistic skill of the dentist doing the makeover.

Second, they have another marketing push that is telling dentists that they can make five times their normal means in the same amount of time they normally would spend with a patient in the chair. Whenever you push how much you’ll make to dentists, it stops becoming “which is best for the patient” and tempts dentists to push certain procedures which can increase their profit.

Finally, I am quite skeptical about their suggestion that this can be done in one hour. In fact, even they say the dentist may need to schedule a second appointment to finish up removing excess cement. Generally, to do this well, would take around three or more hours.

So, what should you do? Instead of looking for a specific brand, I am going to suggest you change your thought process to looking for the right dentist. You need someone with extensive post-doctoral training, as well as technical skill and artistry. The easiest way to find a dentist like this is to go to an AACD accredited dentist. These have proven skills.

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

Adult with Baby Sized Teeth

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I need to figure out if there is anything I can do to improve the appearance of my teeth. I am a 33-year-old adult with baby-sized teeth. It is very embarrassing to smile. One of the things I am considering is dental bonding to make the babyish teeth look better.  Is that a good solution? Is there a better one?

Lindsey

Dear Lindsey,

before and after dental bonding

While you could use dental bonding for this, there are drawbacks. First, dental bonding does better on tiny repairs, such as a chipped tooth. For larger repairs, such as what you are facing, you will be much better off with porcelain veneers. Compared to your natural enamel, dental bonding is quite soft. It will scratch and stain easily, making it only a short term solution.

Porcelain veneers, on the other hand, are stronger than your enamel when they are bonded to your teeth. They are also much more stain resistant. When well cared for, you can expect them to last a lifetime in many cases.

Who Should Do Your Porcelain Veneers?

It is important you find an expert cosmetic dentist to do this. Cosmetic dentistry is not a recognized specialty so any general dentist can “do” cosmetic dentistry. On top of that, smile makeovers do not get taught in dental school. If they want to learn how to do beautiful cosmetic work, dentists have to invest in post-doctoral training on their own.

So, how will you know which dentists have this training and which do not? The easiest way is to use an AACD accredited dentist. These dentists have passed stringent exams on both their technical skill and their artistry. They are the top cosmetic dentists in the country and any one of them can create a stunning smile for you.

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

Can Snap-on Smile Make for a Nice Smile Makeover?

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I want to get a smile makeover but my dentist quoted me quite a bit of money. I did some online research and it looks like I can get snap on porcelain veneers for a fraction of the cost. Is this as good a deal as it looks?

Carter

Dear Carter,

snap on smile

When it comes to snap on veneers, such as a Snap-on Smile, which is the best brand of this sort, your expectations are way too high. These are made of acrylic and fit over your teeth. These are mostly intended as a temporary solution. the best uses for these are a job interview or photo shoot where you need to upgrade your smile quickly. However, they do not last long, nor do they look nearly as beautiful as a smile makeover with porcelain veneers will. Additionally, because they fit over your teeth, many of them look bulky.

My suggestion if you are in a hurry but do not have the money right now is to get Snap-on Smile only as a temporary solution while you save up for a real smile makeover with porcelain veneers. In reality, it will only last about three years tops anyway.

How to Get a Beautiful Smile Makeover

To get gorgeous results, you will need an expert cosmetic dentist. Don’t judge that by cost alone. Look for someone with extensive post-doctoral training in cosmetic dentistry. If you want an easy button for this, I would look for an AACD accredited dentist. These are the best cosmetic dentists in the country. Any one of them can create a stunning smile for you.

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

Crowns Versus Veneers for Tetracycline Stains

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I have tetracycline stains on my teeth and really want a pretty smile. I spoke to one dentist who has a good reputation in cosmetic dentistry, name Dr. —–[name withheld].  He wants to charge me $42, 000 for upper and lower full mouth veneers. Another dentist is suggesting porcelain crowns and is only $28,000. I really only have $30,000 to budget for this, so I should probably go with the crowns. However, I wanted to double check with someone not invested in getting my business as to crowns versus veneers for tetracycline stains. Is one better than the other for this? Plus, you should know I have a tooth grinding problem, which may impact your answer.

Carla

Dear Carla,

a porcelain veneer being placed on a tooth

 

The first dentist you mentioned, who is suggesting porcelain veneers is one of the top cosmetic dentists in the country. If you decide to go with him, he will provide you with a stunning smile. You didn’t give the name of the second dentist, but I am cautious about recommending him either way because he is suggesting dental crowns.

Tetracycline stains are some of the trickiest to deal with when it comes to a smile makeover. You have to get the teeth opaque enough to cover the stains, while still creating a natural looking translucency to the teeth. To compensate for the difficulty, some dentists will suggest dental crowns instead of porcelain veneers thinking the added thickness will make it easier for them. It doesn’t. I find porcelain veneers to be the superior treatment. As for your bruxism (teeth grinding), if you get a nightguard to wear while you sleep it will protect you from the grinding damage. So that will not be an issue.

If your budget is the main reason for going to the cheaper dentist, I am going to suggest a different approach. I know the quality you will get with the first dentist. Why don’t you have him just do your upper arch and use a strong teeth whitening, such as Kor Whitening to do on your lower teeth. It will take a bit to get the lower teeth to match, but if you are persistent they will. Then, you are only paying $21,000, which is below budget and will have a stunning smile.

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

Solution for a Tooth Turning Dark

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I’ve had a tooth that has gradually been turning dark over the last five years. My dentist said a root canal treatment may be needed. While there is no infection there is a possible fracture. I don’t know if I should go ahead and have the root canal treatment or just do cosmetic work to repair the graying tooth and only worry about the root canal treatment if it becomes absolutely necessary or if I should just bite the bullet and do the root canal and get it over with. One thing my dentist mentioned is that I would need bonding on several teeth in order to make them look uniform. In that case, would it be better to get porcelain veneers?

Laura

Dear Laura,

before and after dental bonding

 

I am going to be quite blunt here and say that you are not in the hands of the best dentist. Let’s start with the root canal treatment. Either the tooth is infected and you need one or it isn’t and you don’t. You said there was no infection, just a possible fracture. With a fracture, you would not want to do a root canal treatment, which could lead to leaking.

Bear in mind that I haven’t examined you, but given your description of the darkening happening over a period of years, I think you’re dealing with the aftermath of trauma that happened to the tooth several years ago. Over time, your body builds up defenses in the tooth which creates a secondary layer of dentin making the tooth look darker.

The solution to this is cosmetic. You can either do dental bonding or a porcelain veneer. The veneer will be more expensive but has the benefit of lasting longer. With either one you will need an expert cosmetic dentist and I will be honest that your dentist is not going to fit that bill. I know that because of his comment that you’d have to do several teeth to get them to look uniform. That is not the case when you have an expert cosmetic dentist. And with someone who is not an expert, just because they are uniform does not mean they are beautiful. My recommendation is you look for an AACD accredited dentist to do this work for you.

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