Category Archives: Porcelain Veneers

Porcelain Veneers With an Overbite

I am finally in a position where I can get a beautiful smile. I’ve had tetracycline stains on my teeth for years, which always left me self-conscious about my smile. I wanted to get porcelain veneers but my dentist said my overbite will prevent that because my top teeth pretty much completely cover my bottom teeth. Instead, he is suggesting four porcelain crowns. I have some questions though. First, have you heard of my type of bite being an issue with porcelain veneers. Second, Do I whiten my bottom teeth to come close to matching the top?

Melissa M.

Dear Melissa,

Porcelain Veneers require real expertise.

I am glad you wrote before going through with this procedure. I have some concerns about your dentist’s qualifications to give you a beautiful result. Let’s start with his choice of treatment–porcelain crowns. When dentists suggest porcelain crowns when a patient asks for porcelain veneers, it is most often because they are not comfortable doing porcelain veneers but don’t want to admit that to their patient.

I will give your dentist credit for his creative excuse, even if it is totally invalid. When you have an overbite, porcelain veneers actually make more sense. Veneers only cover the front of your teeth and hug the sides a smidge. Dental crowns have to go around the whole tooth. If your top teeth are covering your bottom teeth, that will be a challenge.

A second issue is your dentist suggesting four dental crowns. Unless you have an unusally narrow smile, this means your adjacent teeth, with their tetraycycline stains, will be visible when you smile. Most smiles need somewhere between eight to ten veneers to get all their visible teeth.

For the bottom arch, it is possible to have some teeth whitneing done, but tetracycline stains can be pretty resistant to most whitening methods. Kor Whitening has had the best results with these type of stains.

The Key to a Beautiful Smile Makeover

The one constant in beautiful results will be tied to the dentist you choose to do your porcelain veneers. Smile makeovers are not taught in dental school. On top of that, cosmetic dentistry is not a recognized specialty. A dentist has to decide to get the post-doctoral training necessary to produce beautiful results.

In your place, you need an expecially well-trained dentist. Tetracycline stains are one of the most challenging cases. Your dentist will have to get the veneers opaque enough to cover the stains but still look translucent to give it that natural reflective shine. To get this result, I would look for an AACD accredited dentist. These are the top 1 % of cosmetic dentists in the country.

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

Staining on Porcelain Veneers only one year later

I had porcelain veneers done just a year ago. I was told these would last for many years. I’m actually still paying them off. Yet, they’ve already started staining. Should I be worried?

Carol

Dear Carol,

I wish I had a picture of your porcelain veneers. That would help me have a more precise idea of what went wrong. Without that, I can give you some generalities which should be helpful.

If the staining seems to be over the surface of the entire veneer, there are two possibilities. The first is that the glazing on your veneers was removed. This can happen if your dental hygienist used something like a power prophy jet or acidulated fluoride during your appointment. Both of these will damage the glazing, which does not only give your veneers their shine but protects them from stains.

A second possibility is that there is a gap between your porcelain veneers. This allows food and other bacteria to get underneath. Not only does that make your veneers look darker because of all the stuff caught underneath, but it pretty much guarantees you’ll end up with the tooth underneath becoming severely decayed.

Both of these issues are the fault of your dentist, and they should take responsibility for repairing it, which will mean replacing them.

If the staining is not all over, but rather at the top or the sides these are completely separate issues. The first problem can occur if there is a gap at the top of your veneers between that and your gumline. Like the other gap, it will cause both staining and decay. Your dentist will need to replace them.

The staining around the sides is much easier to deal with and is generally part of regular maintenance. There is usually a minimal amount of composite bonding around the edges of your teeth. The composite needs to be periodically polished. This is easily done and I would plan on doing it once a year. This is especially true if you smoke or drink staining beverages such as coffee or tea.

If the problem is one of the more serious issues that require replacement, but your dentist is uncooperative you may have to get a second opinion dentist to help you.

Sometimes a dentist is more willing to listen to a peer than a patient. I would make certain you go to an expert cosmetic dentist to tell you what is wrong with them, though. See if you can find a nearby dentist who is AACD accredited. These are the best cosmetic dentists in the country.

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

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.

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.

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?

Madison

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?

Dinah

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.

Porcelain Veneers & Mouthwash

I have porcelain veneers that I love. I’m mixing up a homemade mouthwash to help care for them, but wanted to run the ingredients by you first:

8 oz. Boiled water (I also filter my water)
8 oz. Hydrogen Peroxide
1 T. Sea Salt

Do you see anything harmful about this?

Carmella

Dear Carmella,

porcelain veneer being placed on a tooth

I am glad that you love your porcelain veneers and want to take good care of them. While nothing in the DIY mouthwash you listed will harm the porcelain veneers directly, there will be a separate issue.

Hydrogen peroxide releases oxygen. This will kill bad bacteria that leads to gum disease, but it will also kill good bacteria that helps your mouth. If you use this regularly, it will lead to candida growth and an oral yeast infection. Using a peroxide rinse every once in a while is fine, though.

In most cases, you don’t need a mouthwash to take care of your porcelain veneers. Regular brushing and flossing should do it. If you want a special toothpaste to help keep them white, then I would recommend Supersmile Toothpaste. This is specially designed for cosmetic dental work.

Some patients, however, really feel they need a mouthwash. If you are in that category, the most important thing is making sure that there is NO alcohol in the ingredients.

If there is, the alcohol will soften the bonding and cause ditching and staining around the edges. Using an alcohol-free mouthwash will prevent that.

This blog is brought to you by Boston Cosmetic Dentist Dr. Randall Burba, an AACD Accredited Dentist.

5 Ways to Avoid Regrets about Getting Porcelain Veneers

Are you thinking about getting porcelain veneers but concerned about what can be done if you don’t like them? Consider four things you can do to avoid disappointment.

Ways to Get Porcelain Veneers Right the First Time

1. Find a few cosmetic dentists

Photo of a single porcelain veneer held by dental forceps.
Porcelain veneer

A true cosmetic dentist has received post-graduate training in dental aesthetics. Advanced training helps dentists learn which techniques and tools will produce the results you want. An accredited cosmetic dentist has proven his or her skill by passing exams and submitting multiple patient cases that demonstrate artistic talent and understanding of what’s required to create a beautiful smile.

2. View the dentist’s smile gallery

A smile gallery features before-and-after photos of the dentist’s own patients. Take note of photos of patients who have received porcelain veneers. Do the patients’ teeth look natural, or do they look pasty, bulky, off-centered, too short, or too long?

3. Schedule consultations

Most dentists offer complimentary consultations for smile makeovers. You can schedule consultations with two or three dentists. You’ll have time to talk with each dentist about your smile goals and the options he or she recommends for achieving your perfect smile.

4. Learn about the dentist’s process

The dentist should readily explain to you what he or she does to design a smile with porcelain veneers that you will love. Some common processes include:

  • Discussing your goals for you smile
  • Showing you photos of smile designs to help you make decisions about the look of your own smile
  • Providing a digital model of your smile
  • Using a variety of high-quality veneers
  • Making a wax model of your smile designs
  • Providing temporary veneers for you to wear and see how they will look and feel
  • Temporarily bonding the porcelain veneers on your teeth so you can examine them before they are permanently bonded

5. Don’t rush

The success of your smile makeover with porcelain veneers is impacted by the skill and artistic talent of the cosmetic dentist you choose. Take time in the selection process. After the veneers are bonded to teeth, if you are unhappy with the results, you will have the start the process all over again.

But if you follow the steps for finding a good cosmetic dentist, you’re highly likely to get results that you’ll love.

This post is sponsored by the Salem, MA dentists at Burba Dental. Dr. Randall Burba is one of a few Massachusetts dentists who are accredited by the American Academy of Cosmetic Dentistry.

I Can’t Afford The Repair for my Chipped Tooth

`I chipped a front left tooth. My dentist suggested two Lumineers to ensure they match but they cost so much money. I would literally have to take out a loan. I’m hoping there may be another cheaper solution and my dentist was just trying to give me the Porsche type of solution.

Jenna

Dear Jenna,

Your dentist certainly suggested the most expensive treatment, but I wouldn’t exactly call it the Porsche. Lumineers is a brand of porcelain veneers that are often marketed to inexperienced cosmetic dentists as being easy to place. I’m afraid your dentist likely falls into this category for a couple of reasons. The first is the treatment he is suggesting for this repair. The second is the fact that he needs to do two veneers to get them to match. A skilled cosmetic dentist can match a single tooth with a single veneer.

The one good thing working in his favor is he didn’t suggest a dental crown as a solution, which would require healthy tooth structure to be ground down. I have actually seen some suggest this.

The Best Solution for a Chipped Tooth

If you have a chipped tooth, the standard solution is dental bonding. However, I wouldn’t try to force or pressure your dentist into doing this. Tooth bonding is an advanced cosmetic procedure that has to be done freehand.

My suggestion is you find a dentist who already has cosmetic expertise to do this repair for you. The best cosmetic dentists are AACD accredited.

This doesn’t mean you have to switch dentists permanently. You can just go to the cosmetic dentist for the bonding and stay with your dentist for everything else.

Teeth Whitening and Dental Bonding

Dental bonding can blend in perfectly with the remainder of your teeth when done well. However, once it is bonded on, no changes can be made. If you are considering getting your teeth whitened in the near future, it will save you money to do it before your bonding is done.

If you wait and do it after, your natural tooth structure will whiten, but the bonding will stay the same color. To get it to match, you will need to replace the bonding.

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

Gum Inflammation after Porcelain Veneers

I recently had a smile makeover done. The results improved my smile, so I’ve been very careful to be diligent with my oral health care. Since then, my gums have become inflamed. I went back to the dentist after a month and the hygienist tried to blame me for not brushing enough. When the dentist came in he did remove some excess cement which helped a bit. Should I ask for a recommendation for a periodontist?

Liza

Dear Liza,

It is infuriating when dentists blame the patient. We have always found when we do a smile makeover with porcelain veneers, the patients love their new smiles so much they are even more diligent with their care than they were before. It is much more likely that the dentist did something wrong. In fact, I know yours did.

Inflammed gums with porcelain veneers would fail an AACD accreditation review.

If a dentist is trying to obtain accreditation through the American Academy of Cosmetic Dentistry, one of the things the review committee will look for, in addition to the beauty of the results, is the health of the gums. For instance, if the picture above would have been submitted, it would have failed because the two lateral incisors are inflamed.

You mentioned that your dentist removed some dental cement at a one-month follow-up appointment. This should have been done at the initial appointment. A skilled cosmetic dentist will cure the cement in the center of the porcelain veneers and then remove the excess cement while it is still soft and cannot irritate the patient’s gums.

One issue, if your gums are still irritated after he removed some cement, that means there is still some there that needs to be removed. If that isn’t the issue, it could be that the margins of the veneers are off. This means the veneers aren’t flush the way they should be.

When the margins aren’t properly set, then things can get trapped there causing both irritation to the gums as well as decay underneath the veneers.

Getting to the Bottom of the Problem

You mentioned going to a periodontist. While they are gum disease specialists, they will be unlikely to be able to tell you what is the root cause of the problem. If it is the margins, the porcelain veneers will need to be re-done in order to protect your teeth.

I’m going to suggest that you have an expert cosmetic dentist look at this. Either go to an AACD accredited dentist or one recommended by mynewsmile.com. These dentists are all pre-screened for their technical knowledge as well as their artistry. They will know exactly what is wrong with the veneers and can advise you on what your next step should be.

If it turns out the margins are the problem and the dentist needs to re-do them, it should be done at your dentist’s expense, not yours.

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