New Lumineers Over Old

I had Lumineers placed quite a few years ago. I’ve never been happy with the color. My dentist knew I wanted whiter ones, but his tech guy told him it wasn’t possible to get them that white. In recent years, I think that has changed because I see a lot of people with really white teeth. I’ve been told that I can’t whiten them, but my dentist suggested we place new Lumineers on top of old Lumineers to make them look better. Have you heard about that being done before?


Dear Madison,

porcelain veneer being placed on a tooth

The one thing I agree with your dentist about is that using teeth whitening will not help with dingy Lumineers. Teeth whitening only works on natural tooth structure. Everything else he’s either done or suggested in regard to this case, I have serious concerns about.

Let’s start with the original color. Even several years ago, you would have been able to get your smile as white as you wanted. One thing you should know is that Lumineers is just one brand of porcelain veneers. This brand is highly marketed to inexperienced cosmetic dentists. However, most expert cosmetic dentists do not prefer that particular brand. The main reason for that is the company that owns Lumineers insist dentists use their lab, which isn’t known for its artistry or skill. This may be why that particular technician didn’t get them white the first time.

The second issue I have is his suggestion of new Lumineers over old. This is a really bad idea for a few reasons. First, it is just as difficult to place the Lumineers on top of the old ones as it is to just replace them.

Second, the Lumineers will not bond as well to porcelain as it will to your natural tooth structure. This puts it at risk of bonding failure. Finally, the chance of bonding failure doubles because both the new ones and the old ones are at risk.

Getting the Smile Makeover You Want

If you truly want a smile you will be proud of, you will need to go to a different dentist to get it. If you are happy with him as your general dentist, you can still use him in that capacity. Many patients have one dentist for general work and one for cosmetic work.

While there isn’t a recognized specialty in cosmetic dentistry, there is a way to ensure you have a skilled and artistic cosmetic dentist. I recommend that you see an AACD accredited cosmetic dentist. These dentists are in the top 1% of cosmetic dentists in the country. They can create a stunning smile for you. In fact, most of them even have a beautiful smile guarantee.

Don’t be surprised if whichever dentist you end up with suggests a different brand of porcelain veneers. They will know the strength and weaknesses of each and based on what type of smile you want, they will pick the brand whose strengths will give you the most benefit.

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

Covering Tetracycline Stains Attractively

My sister and I both have tetracycline stains. Years ago, she had hers covered by porcelain veneers. At the time, the only way to cover the stains was to make the veneers more opaque. I am hoping that there have been some developments in the technology which will enable the porcelian veneers to look more natural. Is that a possibility?


Dear Dinah,

The ability to make porcelain veneers look natural has been around for many years, even when your sister had hers done. The problem lay in the dentist who did the work for her.

Porcelain veneers are an advanced cosmetic dentistry procedure which takes extensive post-doctoral training to do well. Combine that with tetracycline stains, which are among the hardest types of stains to cover and you have a recipe for disaster if you don’t use a truly trained dentist.

Unfortunately, there isn’t a recognized specialty in cosmetic dentistry, This means any general dentist can call themselves a cosmetic dentist. When an inexperienced cosmetic dentist try to do a tetracycline case, they usually make one of three mistakes. Some are so concerned that they can’t cover the stains that they insist on doing porcelain crowns, which unnecessarily grinds down healthy tooth structure. Even then, they don’t get a beautiful result.

A second issue is they do what happened to your sister and make them too opaque in an effort to cover the stains. Finally, some dentists just do the veneers as they always have and the stains show through.

Without a specialized degree, it hard for patients to know which dentists have the requisite training and which do not. That is where the American Academy of Cosmetic Dentistry (AACD) created a way to help patients with this conundrum.

They began an accreditation program whereby dentists can prove they have what it takes to do the best work possible. In addition to taking stringent exams, the candidates also have to provide visual evidence for a large number of cases they have personally done in order to demonstrate their artistry. AACD accredited dentists are the best cosmetic dentists in the country.

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

A Healthy Smile with Lupus

Ever since my lupus has gone active, my teeth have become a mess. I have had to have several fillings and a dental crown. The crown is on my front tooth and I read whenever you have dental work Supersmile toothpaste is the right toothpaste. Will it also help my regular teeth are do I need to brush wtih two different types of toothpaste?


Dear Diana,

I am sorry you are having to go through this. For those who are unfamiliar with this, Lupus is a horrible disease that effects every system in your body. Essentially your immune system goes haywire and your body starts to fight itself.

Your oral health is greatly impacted along with the rest of your body. According to, oral lesions occur in 40% of people with Lupus. These mouth ulcers can lead to oral cancer. If that weren’t enough, 100% of patients with Lupus have tooth decay and they are more likley to develop TMJ Disorder. Fun, right?

This means regular dental care is essential if you want any shot at healhty teeth and gums. The good news for you is that you seem to be staying on top of things. It is great that you are using Supersmile toothpaste. This removes stains without using any abrasives, that will destroy the protective glaze on your dental work.

There is no need to use more than one toothpaste. It is equally able to clean your natural tooth structure and even contains an appropriate amount of fluoride, which will help prevent decay.

One thing you will want to be aware of to protect your dental crown along with any other dental work you have is actually your dental cleaning appointments.

You do not want your hygienist to use anything like acidulated fluoride or a power prophy jet during the cleaning process. Both of these, while excellent tools for natural teeth, will damage or completely remove the glazing on your dental crown. As mentioned above, the glazing is what protects them from picking up stains.

Unfortunately, if your dental work does pick up stains, they will have to be replaced. Some patients are under the mistaken impression that they can just have teeth whitening done, but that isn’t the case. Even professional teeth whitening will only work on natural tooth structure.

One other bit of counsel. Make sure your fillings are mercury-free composite fillings. Your immune system has enough going on and is already in overdrive. You don’t want it reacting to the mercury, which it may perceive as an enemy to your body because of its toxic properties. Having white fillings placed should prevent that.

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