Why Did Her Dentist Stain Her Lumineers?

I recently went to the dentist about a smile makeover after I received an advertisement from him about Lumineers. I spoke with him extensively ahead of time about the type of smile I wanted. One of the requests was to have a very white smile. When the Lumineers were placed on my teeth I realized they were darker than I expected. When I questioned him about that he told me he ordered a stain on them so they’d look like natural teeth. He told me I’d realize he was right in a few days. After a few days, I called him back asking him if he could make them whiter. He had me come in and then he drilled off the outer layer to get to the white underneath, but it looks uneven and dull. What do I do?

Melody

Dear Melody,

I am glad you wrote. You are dealing with a family dentist who is in over his head trying to do cosmetic work he doesn’t have adequate training for. My first hint was when you said he advertised Lumineers.

This particular brand of porcelain veneers is highly marketed to inexperienced cosmetic dentists as being easy to place. They say this because the veneers are thinner than some other brands which in some cases means there doesn’t need to be any tooth preparation. Unfortunately, in most cases, they end up looking bulky.

A second thing that told me he was not an experienced cosmetic dentist was his attitude. In dental school, we are taught that we know better than their patients. This philosophy does not work with cosmetic dentistry. With smile makeovers, we are creating an image the patient has in their head. Their dream smile. He doesn’t get to tell you what you’ll like.

The stain is also something taught in general dentistry. Most people have at least some stained teeth so your dentist thought that to make your smile look natural he’d have to add one to yours. However, patients don’t pay to get a smile makeover that looks like every other smile. They want something that looks exceptional.

Finally, he bonded your Lumineers on before letting you see them on your teeth to approve them. Experienced cosmetic dentists will use a temporary try-in paste for you to see the smile makeover. If you don’t absolutely love it, instead of bonding it on, they will send it back to the lab to make any necessary changes.

Unfortunately, you can’t get a refund on a smile makeover just because it is ugly. The standard is function. In your case, this is good news. When he filed away the stain, he also took the protective glazing with it. Now they have no protection and will pick up stains quickly. You should be entitled to a refund because of this.

If he gives you a hard time, contact us again and I’ll tell you how to get a refund from a dentist.

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

Dentist Pulled My Implant Out

I had a dental implant placed on a front tooth. I wasn’t thrilled with how it ended up looking. It was obviously fake next to the other teeth. However, it was better than having a gaping hole in the front of my mouth. A week after the crown was placed, the implant felt loose. I called the office and they told me to come on it. The dentist said the crown was likely loose and he would just rebond it. He had a little trouble getting it off until he got a tool, but when he did, the implant came out with it. Does this normally happen? He said they can re-implant it but I’m nervous.

DeeAnn

Dear DeeAnn,

No, this does not normally happen. However, in your case I am going to call this a blessing in disguise. I am having a hard time fathoming the level of incompetence this rises to. First, when a dental crown is loose, it is easily removed. He would not need a special tool at all.

It was obviously the dental implant that was loose the entire time. Because this implant was defective and unattractive, it is fortunate that your dentist accidentally pulled it out. Now you have the right to demand he pay to have it repaired properly.

Do not just ask for a refund. Instead, I want you to insist he pay to have it replaced by the dentist of your choice. This is because it will be more complicatted to replace the implant and dental crown. You lost bone when he ripped it out. That bone is necessary in order to retain your implant. In order to place it, you will need bone grafting done to build the area back up.

Finding the Right Implant Dentist

Dental implants aren’t really taught in dental school so you need a dentist who has invested in post-doctoral training. You also want to make sure that they have a high success rate with their dental implant procedures.

At the time I’m writing this dental implant failure and the consequences of poor placement is one of the leading dental malpractice suits. Ask about their success rate. I’d like you to see someone with a 95% or higher rate.

In addition to their implant training, you need to consider how skilled they are in cosmetic dentistry. You are replacing a front tooth. As you’ve discovered, getting a perfect match is essential for a beautiful, natural-looking smile. In your place, I would want an AACD accredited dentist to work on my implant crown.

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

Porcelain Veneers are Too Shiny

I have the weirdest problem with my porcelain veneers. They look at bit off and I think it is because they are too shiny. It’s more of an unnatural shine. I wish I had gotten to see them before they were bonded on because maybe I would have noticed it. My dentist says they’re fine and I’m just used to stained teeth. However, I do know the difference between color and shine. Is there anyway to take away some of the shine?

Amanda

Dear Amanda,

Based on some things you said, I think the biggest thing that went wrong with your case has more to do with the skill of the dentist you choose. Most patients don’t realize that cosmetic dentistry isn’t a recognized specialty. Unfortunately, smile makeovers aren’t really taught in dental school so it is up to the dentist to invest in the training that will enable them to create stunning smiles.

Teeth with a natural shine

If you look at the teeth above, you can see that they are not uniform in either color or texture. There are ridges and bumps, as well as difference in opacity from the top to tip.

Your description makes me think your dentist did not add that texture that is necessary to make it look natural. The result will be flat teeth that look excessively shiny.

The only way to remove the shine is to have your hygienist use something like a power prophy jet or acidulated fluoride on your porcelain veneers. However, I am not going to recommend that. It damages the protective glaze on the veneers. This does more than give your veneers their shine. It also protects them from picking up stains.

Once that glaze is removed, your teeth will quickly start to pick up stains. Teeth whitening won’t work on this.

My suggestion is to ask your dentist to re-do the veneers. You paid for a beautiful smile and didn’t get one. An expert cosmetic dentist will not be satisfied if you are not.

When he re-does the veneers, make certain he uses a temporary try-in paste so you can see them in your mouth in several different lights. If you don’t love them, they need to go back to the lab. He should not permanently bond them on until you are thrilled with them.

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

How Do I Touch Up My Whitening Before Getting a Dental Crown

I have to get a dental crown on a front tooth. Because I read the color is permanent, I’d like to touch up my teeth. I had them whitened a few years ago and they’ve been picking up stains again recently. I asked my dentist for some extra whitening gel, but he couldn’t give me an idea of how often and long to use the gel to get my teeth back where they were.. Are there any standards for this?

Meagan

Dear Meagan,

Teeth Bleaching Trays

I’m a little concerned your dentist could not advise you on this. The principles of teeth whitening are fairly simple. It is the easiest cosmetic procedure dentists do. Given his inability to answer this question, I have serious doubts he’ll be able to provide you with a dental crown on a front tooth that looks natural and matches the adjacent tooth.

Crowns of front teeth are much more difficult because of how directly the light hits them. It takes an expert cosmetic dentist to do them beautifully. If you want to stay with this dentist for your dental crown, make sure he uses a temporary try-in paste when your crown is ready and allows you to see it in several types of lighting. If you don’t like how it looks, he needs to re-do it. Don’t let him bond it on.

You may be better served by finding a different dentist to do your crown. The best cosmetic dentists are accredited with the American Academy of Cosmetic dentistry.

How Much Teeth Whitening?

As to how much teeth whitening, the principle is fairly easy. The longer you wear the whitening gel, the faster it will whiten. If you’re in a hurry, I suggest wearing it overnight. First, that allows it to stay on your teeth longer. Second, your saliva production goes down at night which means there will be less dilution.

If you prefer wearing it during the day, that’s fine too. Just wear it for as long as you comfortably can.

The one hard and fast rule here is once your reach the level of whitening you are happy with and you are done with the whitening gel , you want to give it a week for the color to settle before having the color of your crown matched to it.

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