Category Archives: Porcelain Veneers

Unhappy with Porcelain Veneers

I’m a little frustrated. My daughter had a bicycle accident when she was younger and it knocked her tooth crooked. We originally wanted to get her teeth straightened but the orthodontist told us the ligament damage would make that a bad idea. So, we opted for porcelain veneers when she got older. We went to see a dentist who said he was a cosmetic specialist and had six porcelain veneers placed. We never really got to see them on her before he cemented them on. Neither of us likes how they look. Plus, they’re too big for her mouth and look bulky as well. Is there anything we can do about this? Would the dentist be obligated to make them pretty?

Penny

Dear Penny,

Woman covering her mouth

It is a horrible feeling when our children are embarrassed by their smile. Normally, when getting a smile makeover the dental board will only consider whether or not the work is functional. If it is, then it would be up to the dentist’s personal ethics to do something about this. However, somethings you’ve mentioned regarding your daughter’s porcelain veneers make me wonder if you might have some more leverage here.

There is No Such Thing as a Recognized Specialty in Cosmetic Dentistry

Did the dentist tell you he was a specialist? There isn’t such a thing as a recognized specialty. If that’s the case he misrepresented himself which could work in your favor. Any general dentist can call themselves a cosmetic dentist if they do any type of cosmetic work, but there isn’t a specialty. That doesn’t mean it doesn’t require special training. Unfortunately for the patients, it is up to the dentist how much, if any, training they get. Smile makeovers aren’t taught in dental school. They have to invest in post-doctoral training on their own to develop the knowledge, technical skills, and artistry necessary.

Another thing you mentioned which has me wondering is that they are too big for her mouth. If it causes one of two problems, this will mean they aren’t actually functional. The first problem could be speech-related. Maybe she’s having trouble forming certain letters or sounds that weren’t a problem before.

Another problem with her porcelain veneers being too big could be dry mouth. If she’s having trouble keeping her mouth closed naturally, it will dry up the saliva in her mouth. Our saliva is an invaluable tool in our fight against decay. It contains key minerals which fight bacteria. If her mouth is dry as a result of her veneers, then you have a great case to get this made right.

Getting Her Porcelain Veneers Done Correctly

The first thing I’d do is just ask for a refund. You paid for a beautiful smile. You should get one. If he says no, then you’ll have to get another cosmetic dentist on your side. Sometimes, a dentist will listen to a peer when they won’t listen to a patient. I recommend you see an expert cosmetic dentist. Without a specialty, how will you know who is an expert and who isn’t?

The easiest way to do that is to see an AACD accredited dentist. You can find them on aacd.com. These dentists are proven for both their skill and artistry. The accreditation program requires them to pass rigorous exams as well as provide visual evidence of their artistry on a large number of cases they’ve done.

If they agree with you that the case needs to be re-done, it will be a huge help in you getting a refund so this can be done properly.

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

Can Porcelain Veneers Cause a Lisp?

I have had the absolute worst luck with my smile makeover. I’m on dentist number three. Here’s what happened.
Dentist #1: The porcelain veneers literally crumbled and fell off. I got a refund.
Dentist #2: They fractured the very next day. I got a refund.
Dentist #3: They seem too long and I’ve started to lisp as a result. The dentist insists that my lisp isn’t from the porcelain veneers, but I never had one before. Can porcelain veneers cause a lisp?

Samantha

Dear Samantha,

A dental tool holding up a porcelain veneer

Man, you have had the worst luck with “cosmetic” dentists. This is a great illustration of a point we’ve tried to warn patients about. Most dentists cannot do cosmetic dental work. Because there is not a recognized specialty in cosmetic dentistry any dentist can do cosmetic work. However, that doesn’t mean they have developed the skills to do them. For instance, smile makeovers such as you’d get with porcelain veneers are not taught in dental school.

The result is what you’ve experienced. They dabble. Dabblers create cosmetic dentistry horror stories. You’ve had the misfortune of three of them. Truthfully, there are a small percentage of dentists who’ve truly invested in learning how to do cosmetic dental work.

The easiest way for a patient to find those is to either find a dentist who has reached accreditation with the American Academy of Cosmetic Dentistry or who are listed on mynewsmile.com. AACD accredited dentists passed exams to show their technical knowledge and have presented a large number of cases they personally did to show they have the artistry required to do great work. The mynewsmile.com website doesn’t something similar. While they don’t give the dentists exams, they do verify that they have done significant post-doctoral studies in cosmetic work. They also have to provide visual evidence of their artistic skill in doing a smile makeover.

As for your porcelain veneers, yes, they are very likely the cause of your lisp. Both when veneers are too long and when they are too thick, it will result in speech problems. You need to get a refund from dentist number three.

Moving forward, I want you to find a recommended dentist from one of the sites I mentioned. If you go to aacd.com, make sure you look for an accredited dentist. That is different from being a member. Anyone on mynewsmile will be a good choice.

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

Lumineers for Sensitive Teeth

I have very sensitive teeth and I can’t figure out why. It’s been causing me to lose a lot of weight. I can’t eat. It’s too painful. My dentist suggested we place Lumineers on my teeth to cover them. Will that help with the sensitivity?

Madison.

Dear Madison,

A single porcelain veneer being placed

Yes, getting a smile makeover can help with the sensitivity. However, before you do that, it is important you isolate the cause. Here are just a few things which could be giving you the problem:

  • Tooth decay. Though, if you’ve been having regular checkups, that should already have been eliminated.
  • Leaky fillings which need to be replaced.
  • You grind or clench your teeth. This can happen without you knowing it while you are sleeping.

There are other causes as well. The key is to evaluate why.

A Smile Makeover

I’m concerned your dentist immediately jumped to Lumineers. This is a brand of porcelain veneers often marketed to inexperienced dentists as being easy to place. That isn’t always the case. Plus, there is a lot more to a beautiful smile than the bonding procedure.

If you’re going to invest in a smile makeover, you’ll want to do it right with a dentist who has both the technical skill and artistry to do it well. There isn’t a recognized specialty in cosmetic dentistry. Any general dentist is allowed to do it. It’s also up to them how much training they get. Unfortunately, it is not a skill taught in dental school. Dentists have to take the initiative to get the training needed in a post-doctoral setting.

If I were investing in a new smile, I’d want the best dentist to do it. Dentists who’ve reached accreditation with the American Academy of Cosmetic Dentistry are the top of their field. They can provide a stunning smile for you. The kind you see the Hollywood celebrities get. I will tell you, they will likely suggest a completely different brand of porcelain veneers than what your family dentist suggested. Lumineers aren’t known for their beauty.

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

Problem Speaking After Porcelain Veneers

I had ten porcelain veneers put on ten teeth. Ever since then, I have had trouble speaking. I’m not sure what to do. It feels like the backs of my teeth are too thick and my tongue is pushed. It’s making me talk weird. My dentist has no idea what is wrong. Have you heard of this?

Brooke

Dear Brooke,

A single porcelain veneer being held up by a dental instrument

Looking at the image of porcelain veneers above, you can see that it doesn’t have any part of it that goes on the back of your teeth. It won’t affect your speech there. However, there are some dentists who place porcelain crowns and tell their patients it is porcelain veneers. If they surround your teeth, they’re crowns. If they just go on the front of your teeth, they’re porcelain veneers. Sometimes the length of porcelain veneers can affect your speech, but you said it was bothering you from the back. That’s not the same.

If it turns out he place crowns, then he’s not only been dishonest, he’s also thrown off your bite. If that’s what happened, you can get him to pay for these to be re-done by a dentist who has both cosmetic dentistry training (preferably someone who is an AACD accredited dentist) as well has having done post-doctoral TMJ training. That’s the kind of dentist who will know how to repair the bite’s position as well as give you a beautiful smile.

Another possibility is your dentist did place porcelain veneers and the thick feeling in your tongue is completely unrelated. You could have had an allergic reaction to something and that is why you’re having trouble speaking.

How Can You Get Help

The first thing I would do is get a second opinion. I again suggest going to a skilled cosmetic dentist. There is a trick to this, though. Dentists know each other. They are one another’s peer group. So one dentist might hesitate to say something unkind about work their friend did.

This is why you won’t tell them who did the work. First, ask him if you received porcelain veneers or dental crowns. Then, ask him if he knows why you’re having trouble speaking. If he asks for the name of the dentist tell him, you want a blind, unbiased second opinion so you won’t be sharing any names.

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

Root Canal with Porcelain Veneers

I have eight porcelain veneers on my upper teeth. Recently I learned I had a periapical abscess and my dentist says I need a root canal treatment. First, how did I end up needing a root canal to begin with? Second, how do I keep this from ruining the look of my porcelain veneers?

Kaleigh

Dear Kaleigh,

I’m sorry this happened. I can understand your concern about needing a root canal treatment. Most expert cosmetic dentists go their entire careers without a porcelain veneer they’ve placed needing a root canal treatment.

teeth being prepared for porcelain veneers

The picture above is the right way to prepare a tooth for porcelain veneers. Using a depth limiting diamond bur, your dentist should place grooves in the teeth only 1/2 millimeter in depth. Then, they’ll go back and prepare the remainder of the surface to even out with the grooves with a traditional diamond bur. When done this way, there is little stress to the tooth causing the need for additional treatment.

Unfortunately, not all dentists understand that.

illustration of a tooth prepared for a dental crown

Some dentists will be too aggressive in their preparation of the teeth and get all the way down to the dentin. Others do a crown preparation, as seen above. They are actually placing porcelain crowns and just call them porcelain veneers.

This type of aggressive preparation is much more likely to stress the tooth and cause problems. This is likely what happened to you.

Protecting a Porcelain Veneers During a Root Canal

There is no way around getting the root canal. If you leave the periapical abscess there, the infection will cause serious problems and could even put your life at risk. Dental infections still lead to death when untreated.

The good news is, there are steps your dentist can take to preserve the color integrity of your veneer. The majority of darkening which takes place after root canals is because of left behind dentin and root canal filling material. Your dentist needs to thoroughly clean out the crown of your tooth.

From there, he’ll need to place a fiberglass post down into the root. The remainder should be filled with a light colored composite resin.

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

Picking the Whiteness of My Porcelain Veneers

I have a highly recognized AACD accredited cosmetic dentist who just did ten porcelain veneers for me. I will say they look beautiful. The only thing that disappoints me is their color. Yes, they are very white, but I was hoping for even whiter. My dentist said he is willing to re-do them and send them back to the lab but said they would have to add an opaqueness to them to get them any whiter. He did tell me many celebrities choose this option but warned some people think they look a tad more fake than the more translucent veneers. Would they be obviously fake? Should I go for the more translucent to sacrifice the whiteness I was hoping for?

Kristin

Dear Kristin,

A single porcelain veneer being placed

From what you’ve described it sounds like you have a very good cosmetic dentist. AACD accredited dentists are the top cosmetic dentists in the country. That is the number one factor in determining how beautiful your smile will turn out. Cosmetic dentists often have patients who want teeth whiter than a natural white. They want that dazzling Hollywood smile. Many cosmetic dentists call this “ballistic white”. Some patients love them and some want a slightly more translucent smile.

So here’s your choice. Do you want a smile that dazzles from across the room but may look slightly more opaque close-up or would you rather have a slightly more translucent natural white? Still beautiful. Still shiny. But, not ballistic white. There’s not a right or wrong answer. It is what appeals more to YOU.

I will say, while some patients who received ballistic white porcelain veneers wish they’d gotten them a little more translucent, most who want a change wish they’d gone whiter.

I can’t answer which one is right for you. The good news is, your dentist should let you try them in with a temporary try-in paste and get a great look at them before the final bonding. So, you’ll have a chance to change your mind.

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

Porcelain Veneer Cracked

I had a set of 10 porcelain veneers done to lengthen my teeth. They are stunning and I’m in love with my smile. I’m not wealthy, but recently received an inheritance which allowed me to get the smile of my dreams. I went to the best cosmetic dentist around. I’m truly thrilled with the results. Here’s my problem. I can’t afford this office regularly. After I had my veneers done I planned on going back to my normal dentist for things like check-ups. I’ve only had the veneers for about 5 months and one of them has cracked. I’m a little embarrassed about going back and worried I won’t be able to afford it. The crack is horizontal about a fifth of the way up my lateral incisor. I’m worried it will fall off. What do you recommend?

Lizzie

Dear Lizzie,

A single porcelain veneer being placed

Normally, a well-bonded porcelain veneer will stay on even if it has a crack. However, because of the location of your crack and the fact your dentist had to add length to your teeth, I’m worried there’s not much bonding in that location to hold it on. Because of that, this needs to be repaired.

While porcelain veneers aren’t guaranteed to last forever, they’re certainly meant to last for more than the amount of time you’ve had them. In fact, when well taken care of, they can last for upwards of 20 years. I think your dentist will likely repair it at no charge or for a very low fee. I wouldn’t let fear of the cost stop you.

You were smart to invest wisely in an expert cosmetic dentist for your work. Don’t feel guilty about not being able to go there for your regular checkups. The best cosmetic dentists realize some patients come to them just for their cosmetic work and have all their general dental work done elsewhere at a more affordable practice.

If they ask you about scheduling your six-month checkup while you’re there, just be politely upfront with them about your financial situation. They shouldn’t be offended.

A Note on Porcelain Veneer Care

The best toothpaste for your porcelain veneers would be Supersmile. This is specially formulated for cosmetic work to keep it stain-free without damaging the glazing.

Because you’re going to your general dental clinic for your checkups, the hygienist might not be familiar with taking care of cosmetic work. Two things to tell her (or him) to avoid are a power prohy jet (or anything similar) and acidulated fluoride. Both of those will take off the glazing from your porcelain veneers. The glazing is what makes them so stain resistant. If that comes off, they’ll quickly start picking up stains and be ruined. Teeth whitening won’t fix them. They’d have to be replaced.

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

Best Brand of Porcelain Veneers

I just had my teeth whitened and then got in an accident which has caused me to need repairs on several teeth. I’m considering getting porcelain veneers but want to know which brand is the best before I invest. What is the best at this point and time?

Larry

Dear Larry,

A single porcelain veneer being placed

It is great that you want to do research before investing in your smile makeover. You never want to go into any dental procedure without understanding what you’re getting into and whether or not your dentist is qualified.

However, I want to change your tactic. There really isn’t a best brand of porcelain veneers. They each have unique properties with different strengths and weaknesses. However, it is the dentist which makes the difference.

Think of it as an art form. If you commissioned an oil painting, you’d research the artist, not the paint. This is the same thing with smile makeovers. Two different dentists can do the same smile makeover with the same materials and come up with totally different results.

Finding the Best Cosmetic Dentist

Cosmetic dentistry isn’t a recognized specialty. That means any general dentist can call themselves a cosmetic dentist regardless of their skill level. This makes it hard for patients to know whether or not they’re getting an artistic dentist or a dabbler.

Because of that, the American Academy of Cosmetic Dentistry began an accreditation program. This process tests dentists for both their technical knowledge as well as their artistic ability. They have to pass exams as well as demonstrate their artistry by providing visual evidence on a large number of cases they’ve done.

Becoming accredited takes years of training. Those who attain accreditation are among the top 1% of dentists in the country. They can give you a stunning smile makeover. In fact, most of them have a beautiful smile guarantee.

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

Will This Smile Makeover Be Bad?

I’m a little concerned. For our 25th anniversary, my husband and I decided to get smile makeovers together. Our dentist is preparing Lumineers for us. We’ve already paid our money and they were designed. She said they’d be back from the lab in two weeks. Two weeks later, she did call us but only to tell us the impressions were bad and we need to re-do them. Are we being taken? She’s already got our money. How can we be certain we’ll actually get our Lumineers?

Missy

Dear Missy,

A single porcelain veneer being placed

Having to re-do impressions is not unheard of. So, that’s okay. However, I do have some concerns. My concern isn’t that you’ll not get your Lumineers. It’s that you’ll get them and be disappointed. I’m reading into some things here, but think I’m on solid ground and want to give you a way to protect yourself.

It seems to me like your dentist may be in over her head. Here is what makes me think that. First, she didn’t notice the impressions weren’t good. Instead, the lab had to call and tell her. The fact that it took the full two-weeks, makes me think that she didn’t want to admit the impressions were bad because it could be embarrassing. She likely asked them to try anyway. At which point they likely did and had to call her back saying they were unworkable. Plus, it wasn’t just one impression, but both were unusable.

Combine those issues with the fact that she is using Lumineers instead of another brand of porcelain veneers has me concerned. The Lumineers brand are heavily marketed to inexperienced cosmetic dentists.

Protecting Yourself From a Bad Smile Makeover

You’ve already paid and had this work done, so let’s see if we can avoid having to switch dentists. When the Lumineers come back, I’d like you to insist, and I do mean insist, she puts them on with a temporary try-in paste first. If she doesn’t have any, tell her to get some and then get back with you.

This is a water-soluble gel which allows the patient to see exactly what the veneers will look like on their teeth. Make sure your husband gets a good look at yours and you at his, as well as both of you getting to see them in various lightings. If you don’t like them, really like them, ask her to send them back and have them re-done. This is a common thing and she shouldn’t balk at it.

Don’t let her try to convince you they’ll look different once they are permanently bonded on. They won’t. This is a common tactic some less skilled cosmetic dentists use to get the case done. If she can’t get them to where you are thrilled, DO NOT allow her to bond them on.

Instead, that would be the time to switch dentists. She is ethically obligated to cooperate and give the new dentist all the impressions, as well as all other information.

If it comes to that, go to see an AACD accredited dentist. These are the top of the line dentists in the cosmetic field. They can give you a stunning smile.

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

Worried dentist damaged porcelain veneer

I had six porcelain veneers placed. They looked great, but noticed on the way home one of them had what felt like a line or divot. I called the dentist from my car and they had me come straight back. I really appreciated that. When I was back in the chair he looked at it and he said he could repair it then and there. He did some kind of sanding of the area and it felt smooth. I left satisfied. However, it’s been a couple of days since and I’m noticing that spot is more dull than the rest of the veneers. Am I being overly critical? I’m kind of worried he damaged it, but if it’s no big deal, let me know.

Elaine

Dear Elaine,

A single porcelain veneer being held up by a dental instrument

First, let me assure you that you’re not being overly critical. You paid for a beautiful smile and that’s exactly what you should get. You especially need to know if something damaged your porcelain veneer.

In this case, I would say they, yes, your dentist likely damaged this veneer. It sounds like in the process of trying to smooth out the divot, he took off the glazing.

The glaze on your porcelain veneers is very important. Not only does it give it that shine your natural teeth have, it is also what makes them stain resistant.

Without that glaze, this veneer will begin to pick up stains very quickly making it unattractive.

Getting This Porcelain Veneer Fixed

You’ll need to show this to your dentist as soon as possible. If you wait, he could try to pass the blame onto you saying you did something to it.

There are two ways to repair this:

  • Using diamond polishing equipment. This is an advanced procedure which not all cosmetic dentists know or have the tools for. However, if he does (which at this point I’m doubting because of how he did the repair) then I’d go this route. Even if he doesn’t, you could seek out the aid of an expert cosmetic dentist to do it for you and have your dentist cover the expense. This would be cheaper for him than the second option.
  • Have him replace the veneer he damaged. This will incur lab fees for him, but if he doesn’t know how to do the repair and isn’t willing to pay another dentist to do it, then….

Finding an Expert Cosmetic Dentist

If you need to get a different dentist to do this repair, your best bet is to find a dentist who is accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are in the top 1% of dentists in the country. Every one of them will know this diamond polishing technique and have the tools on hand.

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