Category Archives: Porcelain Veneers

My $30K smile Makeover Makes Me Look Like Wallace & Grommit

I am devastated. I had teeth that were a bit small and hard to notice when I smiled. I wanted to get porcelain veneers, but my dentist said getting porcelain crowns instead could make my smile look bigger. As that was what I was going for, I agreed. He placed a dental crown on every tooth . The best way I can describe it is I look like Wallace from Wallace & Grommit. I can’t even close my mouth anymore and it is making my mouth so dry it is painful. Is there anything that can be done? I spent my life savings on this.

Lizzie

Dear Lizzie,

Wallace & Grommit

I placed an image of Wallace and Grommit here for the benefit of those who may not be aware of who they are. I can see why you are so devastated. Based on some things you said, I have a strong suspicion your dentist was in over his head.

The Bad News

The porcelain veneers you originally requested would have done the job of making your teeth look bigger without having to damage so much healthy tooth structure.

Many inexperienced cosmetic dentists will discourage a patient from porcelain veneers and suggest porcelain crowns instead because it is a procedure they are used to doing. Unfortunately, even doing something familiar, like porcelain crowns, requires extra training to do beautifully.

Even worse (for patients especially), doing smile makeovers isn’t something taught in dental school. Instead, a dentist has to invest in a significant amount or post-doctoral training. It doesn’t sound like your dentist invested in this.

In addition to his lack of training, he didn’t just try a smile makeover. Crowning every tooth is known as a full mouth reconstruction. It is one of the most advanced things a dentist can attempt. Getting the bite to come together properly (known as occlusion) requires bringing together a lot of factors. He seems to have missed the boat.

The Good News

If the only thing wrong with your smile makeover was the appearance and the function of your smile was okay, you would be completely out of luck. I hate to say it, but the fact that you can’t quite close your mouth and are now suffering from severe dry mouth works in your favor.

Your teeth depend on the saliva in your mouth to keep them healthy. It is a little known fact that there are minerals in our saliva that help to fight decay. When you have dry mouth, it puts your teeth at risk. Because your dry mouth is a direct result of your full-mouth reconstruction, it will have to be re-done.

Getting Your Smile Makeover Re-Done

Your current dentist is in over his head. This leads me to believe he is unable to fix this properly. Instead of asking for him to re-do it or even a refund, I want you to have him pay for it to be re-done by the dentist of your choosing.

The downside is, you are stuck with dental crowns. There is no way to grow back that tooth structure he removed for the crowns so you can have porcelain veneers. However, a skilled and artistic cosmetic dentist can create a stunning smile with porcelain crowns.

In your place, I’d look for a dentist who is accredited with the American Academy of Cosmetic Dentistry. These are the top 1% of cosmetic dentists in the country. You are pretty much guaranteed to get a smile you can’t wait to share. In fact, some of them even have a beautiful smile guarantee.

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

Finding a Cosmetic Dentist on YELP!

Dentists in my state are opened back up so it is finally time for me to get my smile makeover. I’ve been doing some research and think I’ll save money by getting dental bonding done instead of porcelain veneers, esspecially since I am planning on getting six teeth done. I’m having a bit of trouble deciding between three cosmetic detnists. All of them are rated high on YELP! is there anything in particular I can ask that will set one of them apart from the other two?

Misty.

Dear Misty,

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

It is fantastic that you’re doing research before you invest your money. There are a couple of things I want to address that should help you tremendously.

First, is your method of finding a great cosmetic dentist may land you in some trouble. YELP! is a very useful resource, but this is one area where their algorithm isn’t helpful. They don’t seem to distinguish between the types of services a dentist is being rated for.

For instance, a dentist may get a lot of 5-star ratings but it has more to do with their chairside manner than their cosmetic skills. I did an experiment in a large city, by doing a YELP search of my own. Two dentists who were rated in the top 3 cosmetic dentists, don’t even do cosmetic work.

Because cosmetic dentistry isn’t a recognized specialty, it can make it difficult for patients to know who has the skills and training and who hasn’t. Smile makeovers aren’t taught in dental school. Any dentist who is interested in developing that aspect of their practice have to invest a significant amount of time in post-doctoral training.

The American Academy of Cosmetic Dentistry (AACD) realized the conundrum facing patients looking for someone to do their smile makeover. That is just one of the reasons they began an accreditation program. For a dentist to become accredited, they have to pass stringent exams and provide visual evidence of specific cases they did themselves in order to demonstrate their artistry. You will find that AACD accredited dentists are the best cosmetic dentists in the country.

Porcelain Veneers verses Dental Bonding

Dental bonding is best done on small surfaces, such as a chipped or gapped tooth. This is because it is done completely freehand and is quiet time-consuming.

For this reason, you won’t find many good cosmetic dentists willing to do a complete smile makeover with them. If they did, it would end up actually costing you more, simply because of how much time in the chair it would require as compared to porcelain veneers, which are made out of tiny wafers of porcelain constructed in lab.

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

Porcelain Veneers While Pregnant

I didn’t realize I was pregnant when I had my porcelain veneers done. I just found out today. Now I’m worried I did something that could have harmed my baby. Any experience with this?

Karen

Dear Karen,

A single porcelain veneer being placed

Generally, when someone is pregnant, we suggest only doing dental work during the second trimester, when the mother is most comfortable. This is because in the first trimester we want to avoid any harmful chemicals to the baby and the poor sweet mama is usually very sick during that time with hormones in constant flux.

In the third trimester, the mother usually finds it difficult to stay comfortable and sitting for long periods of time isn’t easy.

Porcelain Veneers and Safety to Babies

The only medication introduced during the porcelain veneers process is lidocaine. This is a local anesthetic. It will put your mind at ease to know it has been used many times during pregnancy and even during labor. There have never been any adverse effects on either mother or child.

The Exception to the Rule

While we generally tell pregnant women to schedule any dental care in their second trimester, the exception to that is when you have a tooth infection. This is considered urgent dental care.

If you don’t get treated, you will be carrying harmful bacteria which not only will make you feel worse, but can transfer to your child. Additionally, a dental infection will continue to spread until a dentist physically removes the infected pulp. That is done with either a root canal treatment or a tooth extraction.

You don’t want to allow the infection to spread. Your jaw is quite close to your heart, lungs, and brain. If it spreads to one of those, it can become life-threatening quickly. Your dentist will know how to take appropriate precautions for you and baby during any necessary treatment.

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

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.