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Porcelain Veneers are Too White Again

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I am frustrated and need an objective opinion. I went to a dentist because I wanted my lower teeth to match my uppers that had porcelain veneers placed on them a couple of years ago. The upper veneers were an A2. My dentist placed 8 veneers on the lower teeth. The first set was obviously too white and I asked him to send them back and make sure they match the uppers. When the second set came in, he placed them without me getting to look at them. I thought he was just putting them on with temporary stuff the way he did the first time, but he just bonded them on. He said he did that because he knew they were the right color this time.  They still do not match. They’re still whiter than the upper teeth which is very noticeable to me and makes the top teeth less attractive. To top it off, less than a month later, one of them broke off. He said he’s willing to replace them free of charge for the first year. I’m having doubts about this whole thing. What do I do?

Neva

Dear Neva,

a porcelain veneer being placed on a tooth

 

I’m glad you wrote. Your dentist placing these porcelain veneers without your permission puts him in some trouble. Consent is a very important concept in both the medical and dental fields. You did not give yours, therefore he should not have placed them. He said he “knew” they matched. That obviously wasn’t the case. It sounds like he knew they didn’t match and didn’t want to have to send them back again.

It’s one thing if your upper teeth are whiter than your lowers, but the opposite is unacceptable. Additionally, one of them broke already. They don’t break because they’re not strong enough. They break because the dentist does not bond them on properly.

I’m wondering why your dentist didn’t just suggest whitening your lower teeth, instead of placing eight expensive veneers. Teeth whitening is the standard for lower teeth unless there is some structural changes you want.

Go to your dentist and ask for a refund so you can get this done properly. If he fusses, let him know you’ll be talking to the dental board and an attorney if necessary about him bonding them on without consent. That should sober him up a bit.

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

Can’t Floss My Porcelain Veneers

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I recently had porcelain veneers placed a week and a half ago. I have a couple of questions because they were a huge investment for me and I want to take good care of them. First, is Oral B Pro Expert Toothpaste good for them? Second, I’m having trouble flossing the porcelain veneers. Is there some special tool for them?

Carol

Dear Carol,

a porcelain veneer being placed on a tooth

Let’s start with the easy one. There is nothing unique or special about the Oral B toothpaste. However, there is nothing harmful in it either. One of the things I do warn against is most whitening toothpastes. This is because they use an abrasive to remove your tooth stains. The big problem with that is that it will scratch your porcelain veneers, which in turn will damage the surface and cause them to pick up stains.

There are exceptions. In fact, there is a toothpaste I specifically recommend to use with porcelain veneers because it is designed to be used with cosmetic dental work called Supersmile Toothpaste. While this is whitening toothpaste, it is not made with abrasives. Instead, it uses a chemical ingredient that causes your tooth stains to attach to a protein pellicle that the chemical breaks down.

The flossing is a more complicated issue. It is important that you should be able to floss your teeth with your porcelain veneers. The fact that you can’t means either the lab did something wrong in designing them or your dentist did by not cleaning off the excess cement. This could lead to you developing gum disease. Your dentist needs to look at this to repair it.

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.

Dentist Said I Cannot Have White Crowns

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I had eight dental crowns placed two decades ago. I wanted whiter crowns then they gave me but they insisted they wouldn’t look natural with the white color I wanted. Now, I want to replace them, this time getting the white color I’d always wanted. However, my new dentist said the whitest we should do is B1. The temporaries in that color are hardly whiter than what I have. His reasoning is that there are posts that would show through with a whiter color. I’m so disappointed. Before I have these permanently bonded on I want to see if there is a possibility I could get a BL4 without the posts showing. Just something a little brighter.

Sandy

Dear Sandy,

Woman with a beautiful smile

I don’t know who your dentist is, but I get the impression he isn’t really an expert cosmetic dentist. He is confusing color with translucency. If the posts are not seen through on a B1, they won’t be seen through the BL4 or if you want really white crowns, as it sounds you do, you could even get a BL1. I am not saying you have to switch dentists at this point, but I would insist your dentist give you the color you want for your porcelain crowns.

Additionally, you need to insist he do them with a temporary try-in paste and you get to see and approve them before they are permanently bonded on. If you don’t like them, they should go back to the lab until you do. Sometimes, it is helpful to have a friend with you during the try-in to give you courage and be a second set of eyes for you.

If he cannot or is unwilling to get them the way you want, then it will be time to switch dentists. If you do need to switch, the best cosmetic dentists are accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists have proven expertise and artistry. They will have not only the skill to give you the smile you wanted two decades ago, but the right mindset that it is about what kind of smile the patient wants that matters.

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

360 Wrap Veneer Scam

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Before the holidays, I went to my dentist to have a smile makeover done in time for Christmas with my family. When I went in for my consultation she told me that I was a good candidate for 360 Wrap Veneers. My big concern was that going all around the tooth they would need to take off more tooth structure than I was comfortable with. She assured me they wouldn’t need to take off much. So, I agreed. The temporaries seemed okay, but the permanent ones have had varies “teeth” fall out three different times. Once the wrap veneer came off, I noticed my tooth was just a little nub. This is not what I was expecting. I’ve followed all of their directions religiously. I don’t eat anything hard. I cut things up into tiny pieces and make sure things are further back when I chew. I even wear a nightguard when I sleep. They’re talking about getting a more powerful cement, but wouldn’t they have a good cement to begin with? I am beginning to feel taken for a ride and don’t know what to do. Any advice would be greatly appreciated.

Regina

Dear Regina,

I hate to say this, but you have been taken for a ride. Porcelain veneers are thin wafers of porcelain that go on the front of your tooth. The tooth preparation is minimal, similar to what you see in the image below.

Teeth prepped for porcelain veneers

Porcelain Veneer Preparation

This is not at all what you’ve described. I believe there term 360 Wrap veneers is a deceptive way of saying dental crowns. Crowns go around your entire tooth and would require more tooth structure to be removed in order to make room for the entire restoration. The fact that they can’t keep them in is another issue as well. While creating and bonding porcelain veneers is not taught in dental school, placing dental crowns is the bread and butter of dentistry and no dentist graduates (or at least should not graduate) without knowing how to bond them on properly.  You should not need to take any of the precautions they prescribed for you either. When dental crowns are done correctly, you can eat anything you want. A stronger cement is not likely to fix this. My guess is it has more to do with how they shaped your crowns to begin with.

Instead of just asking for a refund, I want you to tell them you want them to pay for a dentist of your choosing to fix this. Their practice was deceitful in how they handled this so if they give you a hard time about your request, let them know you will be going to the dental board about their ethics violations. That should sober them up.

Who Should Fix This Smile Makeover

You will want an expert cosmetic dentist to create a truly beautiful smile for you. While it is unfortunate that you will be stuck with dental crowns from now on because that tooth structure is gone permanently, you can still have a gorgeous smile. My recommendation is that you look for a dentist who is accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the world.

I am sorry this has happened to you.

This blog is brought to you by Philadelphia Cosmetic 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.

Should I Get My Veneers Online?

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I have a discolored front tooth. Previously, it was damaged from a fall. My dentist did a composite repair on it. It was okay, but there was some color disparity and a small gap. I want to cover four teeth. I am not as worried about the color difference because the whole surface will be covered. The problem I’m having is the cost. It’s pretty steep. I just saw a company online that does snap-on veneers. I can get a full set for $700. Would that be a better option for me?

Kevin

Dear Kevin,

before and after dental bonding

 

Let’s talk about the composite bonding first. Don’t do it. First, you mentioned your dentist had trouble repairing a chipped tooth. There was a mismatch in color as well as a small gap. I’m not sure if you meant a gap between your two front teeth or a gap between the composite and natural tooth structure. Either way, your dentist has a serious lack of skill. If the gap was between the composite and your natural tooth structure, that can lead to serious decay issues. I would love for you to have a thorough check up before moving forward with this just to ensure there is not any build up of decay in the gap.

If your dentist could not handle a chipped tooth, which should blend completely like the case pictured above, then you certainly do not want him doing large surface areas of your teeth. Plus, composite does not last nearly as long as porcelain veneers. You would have to re-do the work every few years. So, even if you could afford what your dentist is suggesting, say no. If you’re going to get a smile makeover, do it with porcelain veneers. Even then, you will want an expert cosmetic dentist, such as an AACD accredited dentist.

As for the snap-on veneers, the best of these options is made by a company that produces Snap-on Smile. You have to understand its limitations before investing. It is not made of porcelain so will not be as beautiful or natural looking. They are made of acrylic. They are not really designed for smile makeovers and are mostly designed to help people with really bad teeth get through an important event such as a job interview or special evening. They will look okay, not stunning. Because they fit over your teeth, they have the tendency to look a bit bulky too.

If you were going to get Snap-on Smile, I say only do it as a temporary measure while you save up for a true smile makeover with porcelain veneers. Done and cared for well, veneers can last your lifetime.

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

Getting Porcelain Veneers and Crowns to Match

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I have five porcelain veneers and one dental crown. The problem I am having is getting the crown to match the veneers. Right now the crown is actually whiter than the veneers. I think that happened because he is trying to overcome the dark stub. I’ve seen these match before on other people, so I’m wondering what I can do to help my dentist get this right. I like the guy, so I don’t want to just ask for a refund and go somewhere else.

Anthony

Dear Anthony,

a porcelain veneer being placed on a tooth

I hope your dentist appreciates your loyalty and willingness to be patient as he learns. To answer your question, yes, there is a way to get this done to where your dental crown matches your porcelain veneers. One of the problems your dentist faces is that cosmetic dentistry isn’t really taught at dental school. they minimize the expertise required to do it well and tell dentists it is easy to learn. All while not teaching them some very basic color theory that will be essential.

There are two ways around this. One is directly with the porcelain at the lab. However, this would require a high level of skill and I am not confident the lab will have the skills. The other is for the dentist to add an opaquer to the tooth before he sends the case off to the lab. This is the way I am going to recommend. Your dentist will shave a little extra layer from the dark part of the tooth. Then, he can directly apply an opaque layer of composite. He will want enough room to create the translucent look with the porcelain that will bond on top of that, so the deeper the layer of opaquer, the more room he will have to do that.

If your dentist has a real interest in cosmetic dentistry, He should invest in some post-doctoral training and work toward becoming accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists have the skills and training to create stunning smile makeovers and are in the top 3% of cosmetic dentists in the country.

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

 

Having Trouble Speaking After Porcelain Veneers

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I had a full smile makeover done with 10 porcelain veneers. The temporaries that he put on felt great and I didn’t seem to have any problems. However, since he’s put on the permanent ones, I have had trouble speaking properly and my tongue seems to feel out of place, like it doesn’t fit in my mouth anymore. Is this normal? If so, will I adjust to them and be able to speak normally?

Alicia

Dear Alicia,

a porcelain veneer being placed on a tooth

To answer your first question, no, this is not normal. It would be hard to tell you exactly what is going wrong without examining you, but I can give you some guidelines. One thing I am concerned about is whether your dentist actually gave you porcelain veneers or if he instead gave you porcelain crowns and called them porcelain veneers. Some unethical dentists do this. The reason I am concerned about this is that veneers just sit on the front of your teeth. Without them being done crazy wrong, they should not affect your speech. Dental crowns, however, go around your entire tooth. If they are not done correctly it will definitely affect your speech pattern.

Another thing that is odd here is your temporaries felt okay and you didn’t have any problems, but the permanent ones are an issue. That means your dentist didn’t send the model to the ceramist and maybe only sent images, or your dentist’s ceramist did not follow directions.

In some cases, people adjust to the position and are able to speak normally again. If you give it a month or so and your speech is still affected, I would insist on a refund so you can get this done right elsewhere. You could give your dentist a chance to do it right, but if he’s dishonest I’m not sure how skilled he is.

Smile makeovers are not taught in dental school. Dentists have to invest in post-doctoral training to know how to do them both properly and beautifully. If you decide to go to another dentist to get this repaired, I would look for an AACD accredited dentist. These dentists are the best cosmetic dentists in the country. To get accredited, they had to pass stringent exams as well as have a large number of their cosmetic cases evaluated for its technical correctness and artistry by a board of examiners. You can feel confident you will not only get a beautiful smile, but a functional one as well.

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

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.