Why Are My Gums Bleeding After Porcelain Veneers?

I’m a little concerned. Around six months ago I had porcelain veneers done. My gums were irritated from the beginning. I called the office. They said it is normal to have a little irritation after dental work and it should resolve itself. Then a month or two later the gums started bleeding when I brush. Not every time I brush, but enough that I wondered what’s going on. Now I went in for my six-month check-up and the hygienist said I’m not brushing and flossing well enough because I’m developing gum disease. I was horrified. I always am so careful about my oral care and have never had a problem before. Is this a common side-effect from porcelain veneers? My dentist said no, but I didn’t have any issues until I had them placed.

Carina

Dear Carina,

A single porcelain veneer being placed

It’s not a side-effect of porcelain veneers, but like you said, it’s rather suspicious it started when you had them placed. I have an inkling of what may be going on here. Is it possible your dentist is a family dentist who doesn’t do cosmetic work as a large portion of his practice?

My guess is your dentist isn’t a skilled cosmetic dentist and maybe just dabbles. With your gums being affected, it sounds like your dentist didn’t get the veneers flush against your teeth. When that happens, it’s what’s known as bulky margins.

What this does is create a tiny “shelf” at the top of your veneers, which allows for food and other bacteria to get trapped there. This is what is probably what is irritating your gums and leading to the bleeding and gum disease.

Who Should Replace Your Porcelain Veneers?

Here’s what I’m going to recommend in your place:

First, you have a great case for a full refund. In your case, I wouldn’t consider developing gum disease a functional case, which is the standard for whether or not you’d get a refund. If he gives you a problem about that you can get a second opinion from another dentist. Tell him what’s going on with your gums without making a comment about bulky margins. If he or she gives you that diagnosis as well, then the dentist will be more likely to refund you. Dentists have pride and don’t want to look bad in front of their peers.

One tip. Don’t tell the second opinion dentist who placed them, just in case they’re buddies. If he asks, tell him you just want an unbiased opinion and would prefer he not know. He should be fine with that.

Once you’ve gotten your refund, you need to go to a different dentist to replace them. Ideally, you’d want to go to a dentist who’s reached accreditation level with the American Academy of Cosmetic Dentistry. AACD accredited dentists are in the top 1% of cosmetic dentists in the country.

I wouldn’t be surprised if when you had your new case made that you found the end result to be much more beautiful. In fact, most expert cosmetic dentists have a beautiful smile guarantee.

If there’s not an accredited dentist within a reasonable distance from your home, you can go to the mynewsmile.com website. They recommend expert cosmetic dentists by zip code. Not all of them are accredited, but every one of them are skilled and artistic enough to give you the stunning smile you deserve.

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

What if You Hate Your Smile Makeover?

I’ve always hated my smile and am considering getting a smile makeover. However, my husband mentioned something that gave me pause. He asked me what happens if I spend all that money and hate my smile makeover? It’s a valid question. He’s not just asking because he doesn’t want to spend the money. Do you have an answer for that? Does it vary from dentist to dentist?

Brittany

Dear Brittany,

Pretty brunette with a beautiful smile
Can a beautiful smile be guaranteed?

Your husband asks a great question, one I wish more patients would ask before investing in their smile makeover. The answer varies from dentist to dentist. But, that being said, there is a “right” answer your dentist should be giving you. If they don’t give the right answer, go elsewhere.

A smile makeover is a work of art. Therefore, the first thing you should do is make sure you’re getting an artist to do it. If you were going to commission a portrait, I’m sure you’d check out the reputation and skills of the artist first. Please do the same with your cosmetic dentist.

Ideally, you’d want a dentist who’s reached accreditation level with the American Academy of Cosmetic Dentistry. AACD accredited dentists have guaranteed technical skill and artistic prowess. You will get a stunning smile through them.

However, just because something is stunning, doesn’t mean it’s what YOU dreamed of.

What You Should Expect From a Cosmetic Dentist

Your cosmetic dentist should sit down with you and have a consultation about what is your dream smile. You can bring pictures or discuss the character you’re going for. For instance, do you want a sporty smile, an authoritative smile, a youthful smile? All of these are formed with different shapes.

He or she should also let you test drive your porcelain veneers after they’re created using a try in paste. You should get to look at them in several types of lighting and also have your family and/or friends look at them. If you LOVE them (and I mean really love them) great. If not, your cosmetic dentist should be willing to go back to the drawing board.

Most skilled cosmetic dentists call this a beautiful smile guarantee. If they don’t offer one, walk away. Once you’re satisfied, then and only then should you allow him to permanently bond them on.

I hope this helps! Enjoy your new smile. It will bring with it amazing doses of confidence.

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

My Husband’s Dentures Hurt

I don’t know what to do for my poor husband. He had to get dentures because he lost his teeth, but he absolutely cannot wear them. They hurt. The dentist keeps telling us he’ll adjust to them but he hasn’t. Now it’s getting impossible for him. Is there any way to help him?

Lena

Dear Lena,

Mature couple smiling
You can have a gorgeous smile that feels good no matter what your age!

It’s a shame your dentist hasn’t been more helpful to you. It doesn’t sound like he’s even tried to make any adjustments on your husband’s dentures. That’s the first thing I’d do. However, from what you’ve said, it sounds like you’ll need to see a different dentist to do it. One who is compassionate about his patients. Sometimes, all it takes is some small adjustments and all that pain goes away.

You should be aware, while many patients do fine with dentures. Others spend a lifetime hating them. I don’t know where your husband will fall in that spectrum. Do you know if your dentist told him about options before giving him dentures? Technically, he’s obligated to present all options, but I’m not feeling complete confidence in the thoroughness of your dentist at the moment.

A Helpful Option to Dentures

If adjustments don’t help him, you may have him look into switching to implant overdentures. These anchor his dentures to a series of dental implants, usually four or six. Aside from him never having to deal with the friction of dentures. They’re perfectly secure.

They have a more important function as well. With each passing year, your husband’s jawbone is shrinking. The reason for that is the loss of his teeth roots. When his extractions took place his body recognizes he no longer needs the bone support for his teeth, so it resorbs the minerals from the jawbone to use elsewhere in his body. This leads to a condition known as facial collapse. Eventually, he’ll have so little bone left he won’t have a way to keep his dentures in.

Having implants placed will help his body to understand that bone is still necessary. That will completely save him from losing his jaw bone and giving him a lifetime of healthy tooth replacements. They’ll look and function just like his natural teeth did when they were healthy.

There are other options as well. The key for you guys is finding a dentist which you believe in and can trust. Then ask him to give you all your options.

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

Tired of Dealing with Dentist. Can I Get Dentures Instead?

It seems like every single time I go for a checkup and cleaning my dentist finds several things wrong. Then, I spend the next few months fixing them. All my money goes to my dentist. Can I just extract them and get dentures so I can use my money on things I want?

Dan

Dear Dan,

An illustration of both a denture and a dental implant

I understand your frustration. However, I’m going to warn you that this decision, if you follow through with it, can ruin your life. Here is why. It sounds like you’re still pretty young. Unless you’re in your eighties, I wouldn’t recommend dentures. Instead, I’d recommend dental implants to prevent you from losing your jawbone.

When your teeth are removed, your body reabsorbs the minerals in your jawbone to distribute elsewhere throughout your body, where it deems it more needed. This slowly shrinks your jawbone. After about ten years or so, you no longer have enough jawbone left to retain a denture. This is known as facial collapse.
So, unless you plan on going on a liquid diet in about ten years for the remainder of your life in about ten years, you need a better plan.

Alternatives to Removable Dentures

If you’re determined to remove your teeth, the ideal solution is a to get dental implants. You can see one in the illustration above. This is a surgical procedure which puts prosthetic tooth roots in your jawbone, using either titanium or zirconia. Then, after a healing time, you can have dental crowns put on top, or in your case, you’d have a set of dentures anchored to them. This protects you from facial collapse. It also avoids all the other problems that come with dentures.

However, dental implants, especially the amount you need, is going to cost you way more money then if you just really bore down and had your teeth fixed.

Another alternative is to get snap-on dentures. These just use two implants and your dentures snap on to them. They’re not as stable as implant overdentures, but it will keep them in your mouth.

Truthfully, though I’m sure this isn’t what you want to hear, your best solution is finding out why your teeth are struggling so much. Go over your oral hygiene routine with your dentist to see if you’re missing any important steps. Also, until your teeth are back up to snuff, you can request to have a prescription fluoride to take home and use in order to give them some extra protection.

If you can get your decay under control, you’ll save a lot more money and have a much higher quality of life than if you simply extracted and replaced your troublesome teeth.

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