THanks for the help. Mark L.- Ohio

Mark,

I suspect this is the first time you’ve had cosmetic work done by this dentist. Someone can be excellent general dentists, but horrible cosmetic dentists. Vivaneers are a brand of porcelain veneers that are similar to Lumineers. Both are advertised as a no-prep technique, which make general dentists feel comfortable placing them. Unfortunately, when they are placed without any prep they tend to be bulky.

Regarding your dry mouth, first I must say that there is no way for me to give any definitive answer you would need to be examined. However, I can make some deductions. There is nothing in porcelain veneers and their applications that can react in a way that would cause dry mouth.

However, it is possible that because your veneers are so bulky you may be having trouble getting them closed all the way and are now breathing out of your mouth. This will cause dry mouth. It probably won’t get any better.

If that is the case, I would suggest that you get your porcelain veneers re-done. However, don’t go to this dentist. I’m sure he is an excellent general dentist and you would be wise to keep going to him for your general work. For your cosmetic work, you really need to see an expert cosmetic dentist. First, see if there is someone in your area who is accredited with the American Academy of Cosmetic Dentistry (AACD). Note that I said accredited and not just a member. If there isn’t one without driving distance, then you can look on the mynewsmile.com website to see who they recommend within your driving area. Either group of dentists will serve you very well.

This blog is brought to you by Boston Cosmetic Dentist Dr. Randall Burba.

Burke I.- Detroit, MI

Burke,

You have asked one of the most important questions there is regarding cosmetic dentistry.  Most people don’t know that cosmetic dentistry is a completely unregulated field. That means any general dentist can learn a few cosmetic procedures and call themselves a cosmetic dentist. Even the standard for acceptable care in cosmetic dentistry is really low. For instance, as long as your cosmetic work is functional, it is considered acceptable, regardless of how unattractive you may feel it to be.

This lack of regulation is a problem. Very few “cosmetic” dentists are skilled enough to create a truly beautiful smile. It takes a significant amount of post-graduate training to be able to adequately do cosmetic procedures. So, knowing this, how can you know if a cosmetic dentist is really qualified?  That is where accreditation comes in.

The American Academy of Cosmetic Dentistry (AACD) has an accreditation program. Dentists are not required to participate in the program. Those that do have to pass a stringent written exam, as well as a clinical exam where they have to give five case samples of their work. Only about 1-2% of dentists in the world acheive this level of qualification. You can be certain that if a dentist is AACD accredited, you are in fantastic hands.

You may be interested in learning about our porcelain veneers cosmetic procedure.

This blog is brought to you by Boston Dentist Dr. Randall Burba.

We wanted to give acknowledgement to one of those dedicated professionals, Dr. Arthur Chal, who was recognized recently for 16 years of service as an accreditation examiner for the AACD. This is the longest tenure of any member of this examining board, and represents a tremendous commitment to the profession.

Congratulations, and thank you for your service, Dr. Chal.

This blog is sponsored by AACD Accredited cosmetic dentist Dr. Randall Burba.

Jenneatte M.- Pelican Bay, TX

Jenneatte,

Generally, the problem is not the material, but the dentist. It takes a real artistic dentist to make porcelain veneers and crowns to look both natural and translucent. It is especially difficult when dealing with tetracycline stains. An amateur cosmetic dentist tends to make them too translucent because of trying to cover the  tetracycline stains, which are tricky.

However, the top 1-3% of cosmetic dentists can give you a gorgeous smile even with those difficult stains. What you need to do is find a dentist who is accredited with the American Academy of Cosmetic Dentistry (AACD). Anyone who reaches the level of accreditation will be able to give you the smile you desired.

This blog is brought to you by Boston Cosmetic Dentist Dr. Randall Burba.

Dana S.- Austin, TX

Dana,

Yes, your dentist is giving you a reasonable price quote. In fact, $1000.00 per crown is on the low end of a crown fee.  Dental insurance does not work like medical insurance. Generally, with medical insurance, the higher the cost of the procedure, the more the insurance is helpful to you. With dental insurance it is different. They are in business to make money. The more the procedure costs, the more you’ll have to pay.

I would like to address one other thing. You mentioned you told your dentist you would like all-porcelain crowns, but he preferred the porcelain-fused-to-metal crowns. While you have a right to have the type of crown you prefer, it may be wiser for you to go to another dentist  for the procedure. You’re taking a huge chance pushing your dentist into a procedure he is not comfortable doing. All-porcelain crowns require very sophisticated bonding techniques that if not done properly will cause you a lot of problems.

It doesn’t mean you cannot go to your dentist for other procedures that he is qualified to do. But, you need to go somewhere else for the crowns  you want.

This blog is brought to you by Boston Cosmetic Dentist Dr. Randall Burba.

Brandon L.- Lubbock, TX

Brandon,

Yes, some Parkinson’s medications can lead to teeth grinding.  Are you taking Sinement CR Oral, Atapryl, Carbex, or Selegiline? These are some of the culprits. There are also some anti-depression and dementia medications that can cause the same problem. However, by far, the largest contributor to teeth grinding are stress, anxiety, or anger.

Symptoms of Teeth Grinding:

• Aches in your jaw
• Breaking or Cracking Teeth
• Teeth Wear
• A clicking sound in your jaw
• Gum Recession
• Headaches/migraines
• Ear Aches
• Teeth that are worn down

If you have any of these symptoms, I would look for a dentist who has experience treating TMJ disorder. He can design a custom fitting night guard for you that will protect you from the effects of grinding your teeth.

This blog is brought to you by Boston Cosmetic Dentist Dr. Randall Burba.

Deanna K.- Parkhill, KS

Deanna,

The problem isn’t the lab, it is your dentist. There are bad labs, but expert cosmetic dentists know who they are and don’t use them. The fact that your dentist sent you to the lab is a big warning sign to me. Cosmetic dentists know much more about color matching than lab technicians. It is the dentist that should be giving detailed instructions to the lab about how to produce the look you are looking for.

Only a small percentage of dentists have the skill to be truly artistic with cosmetic work.  I’m guessing you spent a small fortune to get this work done. You should definitely get two crowns you’re proud to wear. I suggest you look for someone in your area who is accredited with the American Academy of Cosmetic Dentistry (AACD). There is a difference between membership and accreditation. Matching the porcelain crowns for your dental implants will be no problem at all for with that level of expertise. If there is no one close that is accredited, contact me again and I’ll try to help you locate someone qualified in your area.

This blog is brought to you by Boston Cosmetic Dentist Dr. Randall Burba.

Jeffery A.- Pennsylvania

Jeffery,

You’re right, this isn’t normal. Your teeth should meet up together perfectly on both sides, not just the side that had the implant. If this isn’t repaired, you could end up with TMJ Disorder. Dental implants is becoming one of the leading areas of dental malpractice.

Many patients don’t know that Implant dentistry isn’t a specialty, so any general dentist can place them no matter how little training they’ve received. Plus, there are varying levels of involvement when it comes to placing dental implants. Some dentists do the surgery and the restoration. Others hire out the surgery and just do the restorations.

In your case, either your implants were restored improperly or the surgeon placed the implants in the wrong spot. If your dentist hired out the surgery there could have been communication problems as to where the implants were to go.  The safest practice is for your dentist to place a surgical guide that fits in your mouth and outlines the exact position and angle where the implants should be placed. It is very likely your dentist skipped this step.

If my assumptions are correct, your dentist has some legal liability to make this right. To make sure, I suggest you get a second from an implant dentist with credentials from either the International Congress of Oral Implantologists (ICOI) or the American Academy of Implant Dentistry (AAID). If it is determined the problem is the location of the implants you have a right to not just ask for a refund, but to ask your dentist to pay for it to be repaired properly.

This blog is brought to you by Salem, MA dentist Dr. Randall Burba.

Desi J.- Anaheim, CA

Desi,

You can absolutely switch. Your dentist is under an ethical obligation to make sure the transition goes smoothly. The two dentist will need to get together to work out what needs to be done and what payments will need to be made to whom.

I understand your thinking behind getting a prosthodontist, however, they tend to be engineers and are not experienced with aesthetics. Getting a cosmetic dentist is a good step, but not everyone who calls themselves a cosmetic dentist is actually skilled in the artistry required to give you the type of smile you are looking for. You want to find an expert cosmetic dentist.  See if someone in your area is accredited by (not just a member of)  the American Academy of Cosmetic Dentistry (AACD). If so, they will be completely qualified. If you can’t find one close enough to travel to, then look on the mynewsmile.com website. They list expert cosmetic dentists by state. You’ll also be safe with anyone listed on their website.

If you choose the right dentist, you will have beautful, natural looking porcelain crowns.

This blog is brought to you by Boston Cosmetic Dentist Dr. Randall Burba.

Bernadette P.- San Francisco

Bernadette,

The DenMat company is the only one I know of that puts this out, but that is the device you already have. Because it snaps on to the top of your teeth, it makes your teeth feel bulkier. This could be what is affecting your speech. If you want to upgrade your smile, without something bulky on your teeth, you may want to look into getting porcelain veneers. They are more expensive than Snap-On Smile, but they are significantly more beautiful and last for decades as opposed to a few years. Plus, they are permanently bonded to your teeth. You’ll never have to worry about them coming off or needing to take them off to clean your teeth.

If you decide to get them, make sure you go to an expert cosmetic dentist. This way you’ll be sure to get a stunning smile.

This blog is brought to you by Boston Cosmetic Dentist Dr. Randall Burba.