Category Archives: Porcelain Veneers

Is My Dentist’s Recommendation for a Cavity too Aggressive?

My dentist recommends a treatment that I think is aggressive, but I need another opinion. If a porcelain veneer tooth has a cavity, is removing the veneer, fixing the cavity, and replacing the veneer with a crown the right thing to do?  I asked my dentist to give me some time to think about it, but something about this doesn’t seem right. – Thanks for your help. Gabrielle from GA

Gabrielle,

Thank you for your question.

Although one of our dentists would need to examine your tooth and x-rays for an accurate diagnosis, we can provide general information.

Matching crowns and veneers

Few dentists can achieve a perfect match with crowns and veneers. Advanced cosmetic dentistry training is required to get natural-looking results.

Cavity size can affect treatment options

A crown might be necessary if a cavity is so large that much of the tooth structure would be lost when preparing the tooth. A dentist may not preserve enough tooth structure to create a secure bond between a porcelain veneer and the tooth. Other dentists might find ways to build up the tooth and restore it.

Porcelain veneer

If you have porcelain veneers and want to keep them, it is essential to understand the skill level between a general or family dentist and a cosmetic dentist. Family dentists are skilled at regular maintenance. But cosmetic dentists have advanced training and artistic talent. It is unreasonable to expect a family dentist to achieve beautiful results and restore your veneer if they lack the training.

We recommend scheduling a second opinion with an advanced cosmetic dentist to examine your porcelain veneer tooth and x-rays.

The cosmetic dentist at Burba Dental Partners of Salem, Massachusetts, sponsor this post. Please read what our doctors do to provide some of the best dental care in the Boston area.

Porcelain Veneers or Bonding for Chipped Teeth?

I asked my dentist for porcelain veneers in June because my old bonding on two chipped front teeth was worn out. My dentist said she preferred to replace the dental bonding rather than grind my teeth down for porcelain veneers. It made sense to me at the time. So I agreed to the bonding, and when my dentist finished, I could see that it did not match my teeth, which she.

My dentist assured me that she would correct the bonding color and gap, so I returned two weeks later. I did not notice any improvement. I talked to my dentist about my disappointment, and again, she promised to correct it. But I have not rescheduled the appointment because I do not trust her, and I am thinking about finding a dentist for porcelain veneers. Is switching dentists the right thing to do? Also, is there anything wrong with asking for veneers, or should I let another dentist try bonding again? Thanks in advance for your suggestions. Toni from Maine

Toni,

Thank you for your question. Your experience shows that it is unlikely that your dentist can match your bonding to your tooth color. Dentists who use bonding must understand how to manipulate color to achieve a perfect match for your teeth. And hand application of the material makes bonding even more challenging. Still, a trained cosmetic dentist with an artistic eye can achieve beautiful results.

Dental Bonding vs. Porcelain Veneers

Both dental bonding and porcelain veneers will conceal chipped teeth. How do they compare?

Dental bonding

  • Material – Composite can beautifully match tooth color, translucence, and gloss.
  • Application – A cosmetic dentist applies bonding by hand directly on your teeth and layers and sculpts them to achieve natural-looking results.
  • Longevity – If you take good care of it, bonding can last about five years. But it will stain over time.

Porcelain veneers

A dental tool holding up a porcelain veneer
  • Material – Porcelain is more durable than tooth enamel, and like dental bonding, beautifully matches natural teeth. Cosmetic dentists work with artistic ceramists to produce natural-looking veneers.
  • Application – After conservative tooth preparation, a dentist will bond a veneer to each affected tooth.
  • Longevity – Veneers can last eight to twenty years, depending on their quality and how well you take care of them.

Your dentist explained that she prefers bonding over grinding down your teeth for porcelain veneers. But porcelain veneers only require light tooth preparation—if any. So, it seems that your dentist also does not understand the porcelain veneers process. We recommend scheduling an appointment with a trained cosmetic dentist to discuss your options for concealing your chipped front teeth.

The cosmetic dentist at Burba Dental Partners of Salem, Massachusetts, sponsor this post. Please read what our doctors do to provide some of the best dental care in the Boston area.

Getting crowns & Veneers to Match

Can you tell me how difficult it is to get a crown to match your porcelain veneers? I have several porcelain veneers but one tooth that needs a crown. I love my dentist but when he did this crown, it is whiter than my veneers. That actually surprised me because the stub underneath it is pretty dark. Before this, I was worried about the opposite problem. Is this a problem with the lab? Can it be fixed?

MaryEllen

Dear Mary Ellen,

It is possible to match a crown to porcelain veneers exactly; however, it takes an expert cosmetic dentist to do so. There is not much emphasis on cosmetic work in dental school. Truthfully, if a dentist wants to know how to do it well, they have to invest a lot of time and money in post-doctoral training. It takes years. Your dentist may be trying to do that, but it looks like he isn’t quite there yet.

This is a tricky thing to do, especially when the underlying tooth is darker than the rest of them, but it can be done. It sounds like he overcompensated knowing he would need to put some extra effort into that tooth. What he may not have factored in is the difference in thickness between a porcelain veneer and a porcelain crown.

You didn’t mention if you were given the opportunity to approve this crown before it was permanently bonded on. Typically, a dentist should put on dental work with a temporary try-in paste and allow you to look at it in several types of lighting to make sure you are happy with the results before bonding it on.

If your dentist did not do that, I would simply ask him to re-do the crown making it a bit lighter and then let you approve it first. If he can’t get the color to match, you could always go to a more advanced cosmetic dentist. You have a right to have your dental work match.

The best cosmetic dentists are AACD accredited. If you need to switch dentists for this procedure, that is who I would go to. They have proven skill and artistry and have trained for years to do this with excellence.

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

Dentist Said My Tooth Moved with My Porcelain Veneer

I need some advice. I had a chipped tooth that had some dental bonding on it, but the bonding was old and discolored and needed to be replaced. I went to my family dentist and she said you can’t replace dental bonding that we’ll need to do a dental crown instead. I didn’t want to grind away an entire tooth, so I suggested she do a porcelain veneer instead. In anticipation that I would whiten my teeth afterward, we had the shade made a little whiter than my other teeth. When it came in, it looked fine and then she put it on my tooth. She said everything looked great, but I didn’t get to see it. When I got to the car, I looked in the mirror. I was a bit concerned because it looked like it was a millimeter or two too long and there is a gap between the back of the veneer and my actual tooth. I’m afraid that will get decay. I thought maybe it just looked that way because of the angle of my rearview mirror and went home to look at my bigger, magnified mirror. It was the same. When I called her she said that they can close up the gap, but nothing can be done about the length. She tried to say my tooth must have moved. Really? From the distance of her office to my car? I have a feeling I am not going to like the fix. What should I do?

Mazie

Dear Mazie,

It is sad how often we hear stories like this. Not many family dentists actually know what they are doing when it comes to cosmetic dentistry. One of the problems patients face is there is not a recognized specialty in cosmetic dentistry, so they are left guessing which dentists invested in the training and which did not. Yours obviously did not.

There were several mistakes made here. First, dental bonding can, in fact, be replaced. She likely just said that because she did not know how. Second, if you were anticipating doing teeth whitening, she should have had you do it before having the porcelain veneer done so you could get a more accurate match. Porcelain veneers are much more precise than teeth whitening. Finally, her bonding was off. In my opinion, she must have known that, otherwise why didn’t she show off the result to you when she finished? A dental office without mirrors? I doubt it.

It is much easier to seat a crown on a tooth. You just slip it on. A porcelain veneer has to be carefully positioned and then cured into place. Somewhere there, she messed up. Rather than admit it, she tells you it looks great. That is not cool. Not cool at all. An ethical dentist would have admitted their mistake. But, no, she was willing to let you go on with a protruded veneer that makes you look weird and puts you at risk of decay.

Now, every dentist has probably seated a veneer incorrectly at one point or another. The problem is not the mistake, it is how she responded to it. If the only thing wrong with the veneer was the length, then she could just have trimmed it. She didn’t even offer that, because she knew the problems here were more substantial and the entire veneer needed to be re-done.

In cases where a skilled, ethical cosmetic dentist has this problem, they would tell you what happened, show you the result, then schedule for you to come back at your earliest convenience to have it redone.

Getting this Porcelain Veneer Done Right

What you will need to do is go to an expert cosmetic dentist and have them document with photographs the problems with this tooth. Look for either an AACD accredited dentist or one recommended on the mynewsmile.com website. Both sets are expert cosmetic dentists. They can arm you with what you need to secure a refund. Then, have the true cosmetic dentist fix this tooth in a way that is beautiful.

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

How to Find Someone Who Does Beautiful Lumineers

I want to get Lumineers. I saw an advertisement I liked and they had good images. I went to see two dentists in my area who place Lumineers. As a precaution, that I learned about from a friend, I asked to see before and after images of cases they did themselves, but all of them looked bulky or chalky, or both. How do I find someone who does beautiful Lumineers?

Kelly

Dear Kelly,

You are up against three things here. First, cosmetic dentistry is not a recognized specialty. Any general dentist can do it regardless of the amount of training they received (or even the lack thereof). The second issue is that Lumineers are actively marketed to inexperienced cosmetic dentists as being easy to place. The truth is while they may be easy to bond, they are not easy to design beautifully, which is what you’ve seen in the dentists you have met with so far.

The third issue you will face is the lab. The DenMat company owns the Lumineers brand. They insist that dentists use their lab for the work, which does bring the company more money. Unfortunately, their lab is not known for their beautiful results.

I want to shift the way you are going about this. Instead of looking for a dentist who can do a certain brand well, I suggest you look for an expert cosmetic dentist and let them decide which brand will be the best to achieve the results you are looking for.

Lumineers is simply one brand of porcelain veneers. A skilled and artistic cosmetic dentist will know the pros and cons of each brand. They will also have a ceramist they prefer to to work with because they like the results they get.

A couple of things to bear in mind as you move forward. The number of porcelain veneers you get matters. Look in the mirror and smile. How many of your upper teeth are visible?

As an example, let’s pretend you have ten teeth visible when you smile. You will either need to get that many porcelain veneers, or you will need to whiten your teeth before getting your porcelain veneers so there is not a color difference between your veneered and non-veneered teeth.

So, how do you go about finding this expert cosmetic dentists? My suggestion would be to have an AACD Accredited Dentist do your porcelain veneers. These are the best cosmetic dentists in the world.

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

Porcelain Veneer Scam

I need some advice. I had some slightly misaligned teeth and they were also showing their age with their color. I went to someone who advertised as a cosmetic dental specialist who was having a new patient sale of 15% off. He told me he could fix both of those things with porcelain veneers. I was super excited about the idea of having a nice smile again. By the time he was “finished” nothing looked like he said they would. The teeth are still misaligned and the color looks chalky and fake. To top it off he told me he reshaped some of the bottom teeth, which we didn’t agree to or even discuss, yet he charged me$2k extra for it. Now he’s saying I have unrealistic expectations and the only way to get my teeth to look the way I want is with dental crowns and of course, he wants to charge me more for the crowns. He’s the one who suggested veneers in the first place. What do I do?

Carly

Dear Carly,

Wow! I absolutely hate hearing stories like this. He has been so unethical and it makes the rest of the legitimate dentists look bad. Your first thing to do is try to secure a refund. Here are the things going for you that will help you procure one.

  • First, he misrepresented himself by calling himself a specialist. There is not a recognized specialty in cosmetic dentistry. For him to call himself a true specialist is unethical. That being said, there are dentists who are more qualified than others. I’ll discuss below how to find a truly skilled cosmetic dentist.
  • Second, he promised you results he did not follow through on and then blamed you for your expectations. Telling you he can do something is a verbal contract. He did not fulfill his part of the deal.
  • Thirdly, he did work by shaping teeth you did not even discuss. That is a big no-no. A patient must consent to work before it is done.

I’d start by gently asking for a refund. If he gives you trouble, and I suspect he will, point out the things mentioned above. If he still gives you trouble, let him know you’ll be talking to the dental board and contacting an attorney if need be.

I also recommend, for the benefit of other potential victims that you leave a review documenting your experience with this dentist.

Finding an Expert Cosmetic Dentist

So you are aware, porcelain veneers CAN actually do everything he said and more. You just have to have a skilled and artistic cosmetic dentist to do the work. Smile makeovers are not taught in dental school so it is up to the dentist how much training they invest in this skill.

The best cosmetic dentists have reached accreditation with the American Academy of Cosmetic Dentistry. It’s more than just being a member of the AACD. In order to get accredited, they have to pass stringent exams as well as have a large number of cases they’ve done examined by a board to make sure it meets the highest technical and artistic standards.

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

Porcelain Veneer Disaster

I had four dental veneers placed. Nothing seems to be going right with these. When I first got them, I was a little uncomfortable with how yellow my natural teeth looked next to them. My dentist said that people will only notice the veneers, but I noticed the other teeth every time I smiled. Now the two front teeth seem to be turning gray so those are now a different color than when I first got them, just a few months ago. All totaled that makes me smile three different colors. My dentist thinks the teeth under the graying ones are darker so we need to make the veneers thicker. I’m having my doubts. What do you think?

Barry

Dear Barry,

porcelain veneer being placed on a tooth

I am very glad you wrote. This is one I am going to place in our cosmetic dentistry horror story file, which is growing by the day. The biggest problem you are facing with your smile makeover is your dentist. He or she is in over their head and at this point is just experimenting on you. Do not let them do any more work on your porcelain veneers. Let’s go through everything that was done wrong on this case and then I’ll tell you where to go from there.

First was the number of veneers. While it is fine to get just four veneers, most smiles (like yours) are much wider than that. Saying that people will only be looking at your veneers is a joke. They’re going to notice you have four very white teeth and then yellow teeth, which will instantly signal those four teeth are fake. To have a uniform smile color, a patient either needs to get enough veneers to cover the whole smile, which is usually 8-10 teeth wide, or have their teeth whitened before getting the veneers. The latter option is much less expensive if you are on a tight budget.

As to the graying, do not allow the dentist to make the veneers any thicker. You said the veneers have started turning gray, not that they were gray to begin with. That means it has nothing to do with the shade of your teeth underneath. It is more likely a bonding issues.

If the porcelain veneers weren’t bonded on properly, then you will have food, debris, and other bacteria getting caught between your natural tooth structure and your veneers. This puts you at serious risk of both decay and gum disease. The good news is, you can use this to get at least a partial refund, possibly a full one. Here is how to go about this. There are other possibilities as well, but you need someone who is looking at the veneers to tell you which. Here’s what I recommend.

Look for either an AACD accredited dentist or one listed on the mynewsmile.com website. Dentists in both these groups are experts in cosmetic dentistry. They’ve invested in post dental school training and have real artistry. Most of them even have a beautiful smile guarantee. Have them look at your veneers and tell you what is wrong. Don’t just have them look at the two that are turning gray, but the other two as well. If the bonding is off on two, it is probably off and all of them and they’ll eventually start having the same problem.

From there I would tell your dentist what the verdict was and simply ask for a refund. If he or she refuses, then the second dentist should be willing to help you. Sadly, sometimes dentists are more willing to listen to their peers than their patients.

Once your refund is secured have the case done again properly. One world of caution. When you go to get this second opinion. Do not tell him who did the work before they’ve given their opinion. You want it to be a blind second opinion in case they are friends with one another.

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

I Need Root Canals after Porcelain Veneers

I had twelve upper and ten lower veneer crowns. My dentist told me there weren’t any risks in getting a smile makeover. I was fine during the temporaries, but when the permanent veneer crowns were placed, I started having pain. My dentist adjusted it at least five times before it stopped hurting. But, then a few weeks later I ended up with one of them abscessed. I had to have a root canal on the tooth. I asked him about this and he said that he doesn’t know what happened and I am just an unlucky one. Since then, this unlucky one has had to have five more root canal treatments on these teeth. What do I do? I am in complete agony.

Melissa

Dear Melissa,

I am glad you wrote. I want to clarify something first. There are porcelain veneers and there are porcelain crowns, but there is not something called veneer crowns. Unfortunately, there are some unethical dentists who place dental crowns and just call them veneers. One way to tell which one you received is by the tooth preparation your dentist did.

Tooth Preparation for Porcelain Veneers

When your teeth are prepared for porcelain veneers, there is very little tooth preparation necessary. Generally, your dentist will just remove the depth of a fingernail. The veneers themselves only cover the front of the tooth. It would be extremely rare for teeth prepared for veneers to need a root canal treatment, let alone the number you have had to have. My suspicion is that you have had dental crowns placed.

Tooth preparation for dental crowns

On the other hand, when a tooth is prepared for a dental crown, there is a great deal more tooth structure that is removed, as you can see from the image directly above. The crown will surround the entire tooth. It sounds like your dentist went even deeper than this based on your experiences.

If he told you that you received porcelain veneers but gave you porcelain crowns, he either lied or does not know his field well enough. Neither of those are great choices.

When a dentist is overly aggressive with tooth preparation it can lead to problems such as you are having. He needs to pay for the damage he caused. This is especially true because he told her there weren’t risks, when obviously there were.

Whenever possible, a smile makeover should be done with porcelain veneers instead of crowns because of the very risks you encountered, plus it is always better to save as much natural tooth structure as possible.

You’ll have to get any root canals done that are necessary in order to save your teeth.

I’m sorry this happened to you.

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

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.