Tag Archives: AACD accredited dentist

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.

Dental Implants After Ten Years?

I’ve had full removable dentures for a little over ten years. I really don’t like how they feel or look, plus I haven’t been able to eat normally since getting them. Is it too late for me to get dental implants? Will they look better than my dentures?

Andrea

Dear Andrea,

side by side comparison of dentures and a dental implant

You can get dental implants after any period of time, with one caveat, which we will talk about in a moment. In fact, it is actually important that you do. As you can see from the image above, your lower dentures just rest on the ridge of your jawbone.

You have already experienced that it makes it harder for you to eat. Even the best fitting dentures reduce your chewing capacity by 50%. However, there is an even bigger issue.

When you first removed your teeth, your body recognized that and began to resorb the minerals in your jawbone. Everntually, there isn’t enough of your jawbone left to retain your dentures. This is known as facial collapse. You are probably already starting to experience some of this.

Dental implants are different. They serve as prosthetic tooth roots, which signal to your body that you still have teeth. As a result, it leaves your jawbone completely intact.

Bone Grafting

Without enough bone, you won’t have a way to retain the implants. They’ll simply fail and fall out. Depending on how much jawbone you’ve already lost, you may need some bone grafting done first. This will add the missing bone and enable you to have the implants placed in a way that will be successful.

When you’ve lost all your teeth, it is more financially feasible to do implant overdentures. With these, you have 4 to 6 dental implants placed and anchor dentures to them. They will be completely secure.

Getting Beautiful Dental Implants

Whether or not they are beautiful will depend on the dentist who creates your new dentures. Creating beautiful smiles isn’t taught in dental school. Instead, a dentist has to invest in cosmetic dentistry training in a post-doctoral setting.

The best cosmetic dentists have reached accreditation with the American Academy of Cosmetic Dentistry. Any one of them will be able to create a stunning smile for you. You’ll be getting new teeth and a smile makeover at the same time.

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

Dentist Feels I’m Too Picky

I had to get a dental implant on a front tooth. The implant itself has done fine but I’ve had the crown replaced three different times. My dentist hasn’t been able to get it to match the adjacent teeth. She said it’s because my teeth are between two shades and I’m being too picky. She also said if I keep having her remove it, I risk losing the implant itself. That scares me. Am I being too picky? Should I just accept that false teeth can’t match perfectly?

Lanie

Dear Lanie,

Woman covering her mouth
Your dental crowns can match

One thing I want to tell you right up front is that you are not being too picky and it is possible for your implant crown to match the adjacent teeth. That being said, it may be above the skill set of your current dentist.

Matching a single front tooth is challenging even for the most expert of cosmetic dentists. They often have to do several try-ins before they are satisfied it matches properly. Notice I said “try-ins”. There is a temporary try-in paste your dentist could have been using this entire time instead of permanently bonding it on and then having to pry it off.

Don’t buy into the fear your dentist hinted at. Your dental implant will be safe having the crown replaced. However, you may have to go somewhere else to have it done.

Matching Your Dental Implant Crown

It’s very possible the color of your teeth is between two standard shades. That happens a lot. However, the tooth can still be made to match. While using one of the standard shades is fine for a back tooth, front teeth need some artistry. Below is a color map a dentist would provide for a ceramist to show them what tints to place and where in order to shade the tooth properly and get it to match seamlessly with the teeth beside it.

color map for a cosmetic tooth
Color Map

Your best bet at this point is to ask for a refund on the crown portion of your dental implant procedure. Then, find an AACD accredited dentist. They’ll be able to provide you with a beautiful, natural-looking porcelain crown that matches perfectly.

This blog is brought to you by Salem, MA Cosmetic 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.

Her Dentist is Incompetent or Dishonest

I need some advice. I have horrible dry mouth which is wreaking havoc on my daily life. I’m constantly drinking water, which means I’m also constantly in the bathroom. In addition to that, my teeth are getting super yellow. I have one crown and two porcelain veneers. When I talked to my dentist, he suggested replacing all those teeth, plus the remainder of them with crowns. He said a full-mouth reconstruction will take care of my aging restorations as well as whiten my smile. This seems pretty aggressive and I have no idea if it will also fix my dry mouth. What do you think?

Katherine

Dear Katherine,

image advising she stop with this dentist

I do not want you to see this dentist again. Either he is either incompetent or dishonest. This is a massive overtreatment. A full-mouth reconstruction is for the most severe of cases. This is not the treatment you need. So, why is he recommending it? Let’s start with the whitening of your teeth. This would bring your dentist a few hundred dollars. With a full-mouth reconstruction, he can bring in between 30-60 thousand. Which one do you think is the better moneymaker for him? To me, this speaks to dishonesty.

Now let’s talk about those two porcelain veneers. He wants to replace these with dental crowns? That can only be because he doesn’t know how to do veneers well enough. So, instead of sending you to a dentist who knows what they’re doing, he hides the fact he doesn’t do that particular procedure and suggests something more aggressive. The best dentists try to save as much tooth structure as possible. Your dentist is more interested in his reputation and his bottom line.

Now, let’s talk about that full-mouth reconstruction. This is one of the most advanced procedures a dentist can do. My gut tells me your dentist doesn’t have the training or skills to pull this off. Not only can it give you permanent dry mouth, but he could also throw off your bite so significantly you are in constant pain with TMJ disorder.

My very strong recommendation is you find a different dentist. In your case, one with great skills and cosmetic dentistry. Look for an AACD accredited dentist. They will whiten your teeth and replace your porcelain veneers and dental crown in a way that is beautiful and blends seamlessly.

About the dry mouth. This will be detrimental to your oral health, which you already know. I’d like you to talk to your medical doctor. It’s possible he has you on some medication which is causing this. If that’s not it, he or she can do some investigating to figure out what is the true cause and hopefully get you some relief.

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

A Dentist Who Disagrees with Me

I’m a little tired of you saying that a patient has to see an accredited cosmetic dentist if they want a beautiful smile. First of all, cosmetic dentistry isn’t a recognized specialty. It’s an area of interest. Being AACD accredited doesn’t make you better than a dentist who isn’t. You also act like anyone who uses Lumineers doesn’t know what they’re doing. Why does using a specific brand make you less of an expert? All you are doing are scaring patients. You’re probably just doing it to drive them to you. There are other good dentists.

Dr. H.

Dear H.,

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

You are right that there isn’t a recognized specialty. That’s part of the problem. Any dentist no matter how much or little training they have in cosmetic dentistry can call themselves a cosmetic dentist and do a smile makeover. When they don’t have the artistry necessary, it is the patient who suffers.

What I did NOT say is that only an AACD accredited cosmetic dentist can do a beautiful smile. I’m sure there are dentists on their way to accreditation who create beautiful smiles. However, my blog is here to help patients, not dentists. It is too hard for a patient to investigate each dentist to know which ones will give them a stunning smile and which ones will make them into the next cosmetic dentistry horror story.

How are they to know which post-doctoral schools to look for in their training? Or how to tell from the smile gallery photos whether the gums are healthy?

Accredited dentists have already proven their technical knowledge and artistry. It is an easy way for the patients to know they are getting the best dentist to do their smile makeover.

I’m not saying you have to get accredited to be good. I’m saying being accredited shows you are and gives the patient some measure of security.

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.

Dentist Insisting I Get Invisalign

I feel horrible about my teeth and now my dentist has made me feel even worse about both that and my finances. I have two crowns on my front teeth. They’re 16 years old so they are in definite need of replacing. When I went to see my dentist about that, he insisted I have Invisalign done first before he would replace the crowns. The front teeth do stick out a little, not a ton. I”m ashamed to say I don’t have the money to do both procedures. If I do the Invisalign, I won’t be able to replace the crowns, but my dentist won’t replace them without straightening my teeth first. What do I do?

Miriam

Dear Miriam,

Clear Invisalgin Aligner
Invisalign’s aligners are invisible, even at a conversational distance.

I’m very sorry your dentist has placed you in this position. It is unfair of him to insist on perfect cases or nothing. I am going to tell you now that this isn’t the best dentist for you. I’d like you to look for another one. In your case, I’d like you to look for an expert cosmetic dentist.

Your crowns can be replaced with or without you doing Invisalign. In fact, you can get your crowns replaced and then do Invisalign later if you’d like. It’s completely up to you. It is obvious to anyone with a brain the teeth can have dental crowns, even with their slight overbite, because you already have them.

What Type of Dentist Should you Get

crowned front teeth without all-porcelain crowns and then with

You are replacing your front teeth which is one of the first things people notice about you. You’ll want a dentist who understands both the technical aspects of your procedure but also has an artistic eye. This way you may get a beautiful smile. Plus, you can be assured a dentist with the right skills and training will know to only place all-porcelain crowns on your front teeth.

The image above, on the left side, shows teeth with metal-based crowns on the front teeth. The right side shows that same patient who had their dental crowns replaced with all-porcelain crowns. You can see what a beautiful smile a great cosmetic dentist is able to create.

I’d look for an AACD accredited dentist in your area. If you can’t find one. Try mynewsmile.com. Any dentist they recommend is excellent.

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

Best Way to Fix My Nephews Teeth

My nephew wants to be an actor but his teeth are pretty crooked, at least in my opinion. He is about to graduate from high school. I want to get his teeth repaired for him as his graduation present so he can pursue his dream of being an actor. I spoke to one dentist who suggested Lumineers, but I’m a little concerned about this option. It doesn’t have the best reviews. Plus, from what I hear they will only last about 15 years. Should I look for something more permanent?

Aunt Mary

Dear Aunt Mary,

Clear Invisalgin Aligner
Invisalign’s aligners are invisible, even at a conversational distance.

If only everyone had an aunt like you! What a great way to help your nephew. I’m actually very glad you wrote because I want to make sure your money is well spent and not wasted on such a kind gift.

With how you described your concerns with your nephew’s smile, you have two options. Let’s start with the one your dentist recommended— Lumineers.

Option One: Porcelain Veneers

Lumineers is one brand of porcelain veneers and you’re wise to be concerned about the reviews you’ve read. It is highly marketed to inexperienced cosmetic dentists as being easy to place. The company claims it doesn’t require any tooth preparation (which is what they say makes it easy). In most cases, that makes the teeth look bulky.

A secondary problem is the company which makes Lumineers requires dentists to use their lab, which isn’t known for its beautiful work. Because of that, most expert cosmetic dentists prefer other brands of porcelain veneers.

If you decide to go the route of porcelain veneers, make sure you take your nephew to an AACD accredited dentist. These are the top cosmetic dentists in the country. They’ll know which brand will work best for your nephew’s smile goals and will create a gorgeous smile for him.

As far as the longevity of porcelain veneers. A lot of that depends on how well cared for they are. If they are not taken care of, they will only last around five years. If they are cared for diligently, they can last 20+ years.

However, you have a second option, which costs significantly less.

Option Two: Invisalign and Teeth Whitening

If all he really needs is orthodontics, I would suggest you go this route. With Invisalign, he can straighten his teeth without anyone knowing in half the time of traditional braces. Instead of metal wires and brackets, these use clear aligners. A sophisticated software program plans out his treatment then produces the aligners which he’ll switch out every two weeks.

Additionally, if his teeth need whitening, the aligners can double as teeth whitening trays which will allow him to straighten and whiten his teeth at the same time.

I hope this helps.
This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.

Root Canal or Dental Bonding

I went to an endodontist for what I thought was a dental emergency. My tooth is darker. He said the tooth is still viable and likely doesn’t have to a root canal treatment. In that case, I think I could just get dental bonding done to make it look better. My endodontist said I’d have to get several teeth bonded for it to match. I’m not sure I want to do that if I will need a root canal in the near future. What do you think?

Trisha

Dear Trisha,

Illustration of an abscessed tooth

If he’s telling you the tooth is viable and saying you don’t “have to” have a root canal treatment, then you don’t have a tooth infection and don’t require a root canal. You either need one or you don’t. Saying you don’t have to have one is misleading. My guess is you have a cracked tooth. Doing a root canal treatment won’t help that.

If you want to treat the color, dental bonding or a porcelain veneer can do that. As to your dentist’s suggestion that you’d have to have several teeth done in order for them to match, that is only true if you go to an inexperienced cosmetic dentist. An expert cosmetic dentist can match a single tooth.

Finding that Expert Cosmetic Dentist

Very few dentists are skilled in cosmetic dentistry. The best have reached accreditation with the American Academy of Cosmetic Dentistry. To reach that level, they have to pass stringent exams as well provide visual evidence of their artistry in a large number of cases they’ve completed.

If I needed cosmetic work done on a visible tooth, I would go to an AACD accredited dentist. You are assured a beautiful result.

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