Call Us: (267) 763-1500

261 Old York Rd, Ste 517, Jenkintown, PA 19046

Banner image on site front page
Cosmetic and
restorative
dentistry

Should Porcelain Veneers Have a Hump at the Gumline?

Posted on by .

I wanted to fix the appearance of my two front teeth. At first, my dentist covered them with dental bonding. This ended up looking terrible. When I told her how awful they looked, she agreed to switch to porcelain veneers. My question is should they have a hump at the top by the gumline? The rest of them look okay. They certainly look better than the bonding, but this hump makes them uncomfortable. Maybe it is just because I know it is there, but I swear I can feel it all the time. This is my first time having porcelain veneers, but some of the pictures I have seen seem smoother at the top. Should I ask her to re-do them? I am starting to feel like a difficult patient.

Haven

Dear Haven,

a porcelain veneer being placed on teeth

I am very glad you wrote, if only to tell you that you are not a difficult patient. You paid for a beautiful result and you should get one. In fact, I think you’ve been overly patient. Let’s start with the dental bonding. Why did you have to tell her they were terrible? She should have realized that. A true cosmetic dentist would not be satisfied with anything but a gorgeous result for a thrilled patient.

Then, she’s tried her hand at porcelain veneers and struggled to do those right as well. This hump is not correct and can actually lead to both decay and gum disease. So, yes, these porcelain veneers need to be redone. By the way, you shouldn’t settle for veneers that are just okay. You should find them stunning.

Here’s the problem you are facing. Cosmetic dentistry is not a recognized specialty. That means any general dentist can “try their hand” at it. Unfortunately, it takes a significant amount of post-doctoral training to have the technical skill and artistry necessary to produce a beautiful and correct result. I sincerely doubt that your dentist has this training.

The best thing for you to do for the health of your teeth and gums, as well as get a truly attractive smile, is to not ask this dentist to do something beyond her ability. Instead, ask for a refund, then have this redone by a dentist who has the training necessary to do it correctly.

The easiest way to find a dentist with the artistry and skill to do your smile makeover, is to go to the American Academy of Cosmetic Dentistry (AACD) Website— aacd.com. They have a “find a cosmetic dentist” link. Make sure you check that you are looking for an accredited dentist. AACD accredited dentists have passed stringent exams and demonstrated artistry on a large number of cases before an examination board. They are in the top 3% of cosmetic dentists in the country.

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

Full Mouth Reconstruction Going Badly

Posted on by .

I needed a full-mouth reconstruction because of how bad my smile looked. My dentist provided crowns on all my teeth, with the exception of one tooth which he extracted and placed a dental implant. When he did the temporaries for the crowns, everything seemed fine to me. However, now that the permanent ones are in things are off. Some of my teeth are not lining up properly. Because of this, it hurts when I eat. When I spoke to my dentist he said he met all the checkpoints and just to give it time. I went to get a second opinion and the other dentist said, “Oh, Dr. —- [name withdrawn] is a great dentist.” I got the feeling that he didn’t want to disagree with this dentist because they must know each other. In the meantime, I am stuck with this bite that is killing me. Is there any advice you can give me?

Laurie

Dear Laurie,

woman holding her her jaw in pain

I want to make sure I understand that your dentist gave you a full mouth reconstruction simply for cosmetic reasons. Is that right? If so, that is a massive overtreatment. A smile makeover is typically done with porcelain veneers and even then you would not put them on each and every tooth. You would only place them on the teeth that are visible when you smile. Generally, that is the eight to ten upper teeth, depending on the smile.

A full mouth reconstruction is for much more serious conditions and removes a LOT of your tooth structure. A couple of reasons for a reconstruction would be serious TMJ Disorder which does not respond to less invasive treatments; or to cover teeth that are worn down to nubs by bruxism (teeth grinding). Without a clinical reason for crowning all your teeth I would say this was unnecessary. Now, there may have been a good reason that just didn’t get mentioned because it was not relevant to your question. I just wanted to make sure.

Not that it is funny, but I chuckled a little at your dentist’s comment that he met all the checkpoints and you just need to get used to it. That is often dental speak for, “I want you to leave me alone. This is hard and I don’t know how to fix it.” Plus, I’m pretty sure any dentist should consider “My patient is not in pain” as a checkpoint. Just saying…

Occlusion, the term for how your teeth meet together, is an advanced subject. It takes post-doctoral training to understand this properly. It is very possible that your dentist does not have enough training in this area.

Getting a Real Second Opinion

I’m not surprised you didn’t have much luck with your second opinion. One of the cardinal rules in getting an unbiased second opinion is to not tell them who your dentist is. Just ask them about the way the crowns are meeting together and explain you’re in pain. If they ask before giving you their diagnosis, tell them you want an unbiased opinion so don’t want to tell them. They should understand that. When you get that second opinion, make sure you go to a dentist with the training you need. Unfortunately, there is not a recognized specialty in this type of work so you will just need to look for the right training. Two great post-doctoral institutes that instruct on TMJ and occlusion are the Dawson Academy and the Pankey Institute. Any dentist who has studied there, will be able to give you a truly educated diagnosis.

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

Can I Bleach My Non-Veneered Teeth?

Posted on by .

I have four porcelain veneers placed on my teeth. I asked for them to be really white, which they are, but wasn’t thinking about how dark the teeth next to them would look. Is there a way for me to whiten them with something like Crest Whitestrips?

Evie

Dear Evie,

teeth whitening trays

Professional Teeth Whitening Trays

I have a solution for you but I want to address your smile makeover first. Most smiles are eight to ten teeth wide, so four porcelain veneers will make your non-veneered teeth quite obvious. Because of the difference in color, it can even make the veneered teeth look fake. Don’t beat yourself up about not knowing this. It was your dentist’s job to point this out. When a patient cannot get enough teeth to cover their smile, teeth whitening is recommended before the veneers are placed. That is too late for you now, but that doesn’t mean this can be worked around.

Though, Crest Whitestrips will whiten teeth, I do not recommend them in this situation. First, the gel that they use are much weaker because they are over-the-counter. Second, they are only designed to cover your front four to six teeth, depending on the size of your teeth. Those are the veneered teeth and not what you want to whiten. It won’t damage them, but it is pretty useless.

My suggestion is that you go to your dentist and have him custom design teeth whitening trays to fit around your porcelain veneers. This will allow you to whiten your teeth much more quickly while protecting your gums and avoiding your veneers.

I hope this helps.
This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

A Single Porcelain Veneer Turning Dark

Posted on by .

I have eight porcelain veneers on the top arch and six on the bottom. A few months after they were placed, I chipped one in a fall. The dentist buffed the tooth down so it would be even. Then he had to buffer down the partner tooth on the other side so they would be even. Fast forward a few months and now one of her teeth has turned bluish and has a darker spot underneath. I went back to the dentist and he said that he had no idea what I was talking about. He was pretty put out and said he was “excellent with color design.” His professional opinion is that I’m being too picky. However, I assure you that the color has changed. I don’t know what to do and I am worried that this veneer will fall off. Do you have any recommendations?

Carolyn

Dear Carolyn,

a porcelain veneer being placed on teeth

First, I am going to tell you that your dentist does not sound like a true cosmetic dentist. A dentist who has done a significant amount of post-doctoral training would never tell a patient they are being too picky. Their goal is to make sure the patient has the smile of their dreams.

Bear in mind that I haven’t examined you or even seen images. However, going solely on your description it sounds like you have a leaky veneer. This means that the bond between your tooth and your porcelain veneer is failing. The changing color is debris getting caught between your porcelain veneer and your tooth.

This needs to be fixed or you can end up with severe decay on that tooth. My suggestion is to go back to your dentist and have him fix this tooth. You may need to show him this blog post. If that doesn’t work, get a second opinion from an expert cosmetic dentist that examines you. One way to find an expert cosmetic dentist is to go to the American Academy of Cosmetic Dentistry Website (aacd.com). In their “Find a Dentist” link make sure you check that you want a dentist who is accredited. AACD accredited dentists are among the top 1% of cosmetic dentists in the country with proven skill and artistry.

When you get that second opinion, make sure it is a blind one. They should not know who your dentist is or what he said about the veneer that you are concerned about. If it turns out that it is a leaky veneer and needs to be replaced/rebonded, then he or she can give that recommendation to your dentist. Peer pressure is a thing, even in professional circles.

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

My Smile Makeover is a Disaster

Posted on by .

I don’t know what to do. I had four porcelain veneers placed on the teeth adjacent to my front teeth on either side. My front teeth look great and didn’t need any work, but the adjacent teeth have always bothered me. Here’s the problems I have with the work. First, the canine teeth are very bulky. I mentioned that so he tried to shave them down, but on the first one he tried shaving ended up with a dark spot. I decided to leave the other one bulky. I thought I could live with this. Here is the big problem. At the office, with the windows open and sun shining through, the porcelain veneers matched my teeth. However, when I got home, in the artificial light, they don’t match at all. The veneers are much darker than my natural teeth. I spoke to my dentist about that and he said I saw and approved them and he doesn’t know how he can change the color. Is there anything I can do about this?

Laurie

Dear Laurie,

Woman covering her mouth

The biggest problem you are facing is your dentist. He is not a true cosmetic dentist. Worse than that, he is apparently learning as he goes. Let’s start with the canine teeth. He makes them too bulky. Then, he tried makes one smaller, but discovers that changes the color so he stops. Now you have one miscolored tooth and one bulky tooth.

His next discovery is that the teeth look different in different lights. In cosmetic dentistry, this is known as color metamerism. He would have known that had he had any real training. Finally, he says he doesn’t know what to do about the color. I’ll tell you what he can do, he can replace them!

However, I am going to recommend that you don’t let him replace them. He is not the best dentist to do any cosmetic work on your teeth. I would ask for a refund and then look for a dentist with post-doctoral training in cosmetic dentistry. Also, check out their smile gallery to make sure their work is beautiful. If possible, see an AACD accredited dentist. These are the top cosmetic dentists in the country.

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

How Do I Avoid My Sister’s Veneers Problem?

Posted on by .

My sister and I had planned on getting smile makeovers for years. She saved up faster than I did. She didn’t want to wait. At first, I was bummed because I’d really hoped we could do it together. Now, though, I am really glad it didn’t. Her smile looks really fake, chalky, and bulky. On top of that, one of them fell off. She said she got Lumineers. I haven’t told her how fake they look. I am worried that mine will look that way as well. I know they can actually be beautiful because I have seen them on other friends of mine. So, how do I get those porcelain veneers? Is it a matter of not getting Lumineers? In that case, what brand should I get?

Mirrabella

Dear Mirrabella,

a porcelain veneer being placed on teeth

I am sorry this happened to your sister. The good news is that it will be completely preventable for you. The most important thing is not the brand. It’s the dentist. Think of a smile makeover as a work of art. If you have two artists of varying skills and give them both a canvas, the same subject, and the same brand of paint, I can assure you the results will be drastically different. This is what happened to your sister. She went to a sub-par cosmetic dentist.

If you want to have a beautiful smile makeover, you need to go to an excellent cosmetic dentist. The problem patients face is knowing who is qualified. This is difficult because there is not a recognized specialty in cosmetic dentistry. Any general dentist can call himself a cosmetic dentist.

Because of that, I would recommend looking for an AACD accredited dentist. In order to receive accreditation, a dentist has to pass stringent exams as well as demonstrate their artistry in a significant number of specific cosmetic cases. It takes years and a great deal of skill to pass. Only the top 1% of cosmetic dentists in the country actually achieve accreditation. If you want a stunning smile with porcelain veneers, that is the type of dentist I would go to.

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

Can I Get Porcelain Veneers with a Missing Front Tooth

Posted on by .

I have a removable partial denture on a front tooth, which looks absolutely awful. Even having my dentist redo the work a couple of times made no difference. My two front teeth look totally different. I’d like to get a pretty smile, but don’t know if it is even possible to get porcelain veneers when I am missing a tooth. Help!

Deanna

Dear Deanna,

Diagram of a dental implant

Dental Implant

 

There are some great options for you. I should tell you off the bat, you will probably have to go to a different dentist to have them done, though. Even your removable partial denture could have been made to look beautiful if your dentist and the lab he used had artistic ability. Most family dentists are of an engineering rather than aesthetic mindset. You need one with both.

If you are perfectly happy with your teeth, other than the replacement, your first and cheapest option is to just replace the partial using an expert cosmetic dentist. I’d suggest someone who is AACD accredited, which is different than just a membership with the American Academy of Cosmetic Dentistry. If, however, you want the best tooth replacement, you could upgrade to a dental implant (pictured above). This places a prosthetic root in your jaw and then a dental crown on top. It’s the most secure replacement you can get.

a porcelain veneer being placed on a tooth

Porcelain Veneers

As for a smile makeover, if you are not pleased with the remainder of your teeth, then yes, you can still get a smile makeover with porcelain veneers. A great cosmetic dentist will be able to seamlessly blend all the materials used to create a uniform, beautiful, and natural looking smile. Just make sure you go to the right dentist to do it. Otherwise, you are just spending more money for poor results.

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

 

Discolored and Crooked Teeth

Posted on by .

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.

 

Porcelain Veneers are Too White Again

Posted on by .

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

Posted on by .

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.