Tag Archives: Boston porcelain veneers

Invisalign or Braces?

I want to get my smile beautiful once and for all. Invisalign appeals to me, but I didn’t know if there was an advantage to braces. Are they better? If not, why would anyone use them when Invisalign is available?

Marcy

Dear Marcy,

Clear Invisalgin Aligner

You raise a good question. If Invisalign is more comfortable and invisible why would anyone use any other orthodontic option?

Here are three reasons some people might choose traditional braces over Invisalign.

  • Cost: Braces can, depending on the particular case, be less expensive than Invisalign
  • Complications: It used to be that Invisalign only worked on certain ideal cases. That is no longer the case. It can now handle most cases. However, there are still a few highly complex cases which would require traditional braces.
  • Compliance: With traditional braces, the orthodontics are bonded directly onto your teeth. Invisalign is removable therefore it requires patient compliance. If you don’t keep the aligners in, the treatment won’t work. Some parents don’t feel their child is responsible enough to not lose them.

If none of those issues are a problem for you, then Invisalign would be the better choice.

Getting a Beautiful Smile Without Orthodontics

If you’re wanting a total smile makeover, you may feel happier with porcelain veneers. These can change the shape, size, and color of your teeth. They can even make crooked teeth appear straight. In fact, they are the go-to procedure for celebrities wanting a stunning smile.

There’s one precaution with this. With Invisalign, any dentist can do the procedure. When it comes to porcelain veneers it takes an expert cosmetic dentist. Smile makeovers aren’t taught in dental school. A dentist has to invest in post-doctoral training in order to do them well.

It takes both technical training and an artistic eye to do them well. If you want a gorgeous smile, look for a dentist who has reached accreditation. These are the best cosmetic dentists in the country and any one of them can give you a smile you’re proud to share with the world.

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

Will This Smile Makeover Be Bad?

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

Missy

Dear Missy,

A single porcelain veneer being placed

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

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

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

Protecting Yourself From a Bad Smile Makeover

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

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

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

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

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

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

Notches & Erosion at gumline

I have notches on my teeth at the gumline a type of erosion from brushing too hard. I’m thinking of getting porcelain veneers as a means of covering it. As long as I don’t brush too hard, they should be fine, right?

Lisa

Dear Lisa,

A pretty blonde with a pretty smile.
The best cosmetic dentists create beautiful smiles

I’m glad you wrote. It’s true that we used to think the kind of erosion of teeth you’re dealing with was caused by brushing too hard. We no longer believe that to be the case.

While it is still believed to wear away your gums, the notches and erosion on your teeth are now believed to be caused by bruxism. This is when you clench and grind your teeth. So, let’s see if I can’t help you with both issues.

Porcelain Veneers

Yes, you could get porcelain veneers and it will cover those notches. Whether or not you get a gorgeous smile with those veneers depends on the dentist who creates the smile.

Smile makeovers aren’t taught in dental school. It’s something a dentist will choose to study afterward if they’re interested. Some invest more in time and training than others. Some have an artistic eye and some don’t.

If you want a gorgeous smile, you need to look for an expert cosmetic dentist. Go to the website of the American Academy of Cosmetic Dentistry (aacd.com) and do a search for an accredited dentist in a realistic distance from you. AACD accredited dentists are of the highest caliber.

Bruxism and TMJ

Bruxism is biting stress on your teeth. When you grind your teeth or even clench them, it causes stress at the neck of the tooth leading to the problems you currently have, as well as weakening and cracking them. It will also lead to problems with your temporomandibular joint causing TMJ Disorder.

Even if you get porcelain veneers, this will need to be dealt with. You will continue with this habit without realizing it. Most people do it in their sleep. My suggestion is you see a TMJ dentist and get fitted for a nightguard as soon as your porcelain veneers are bonded.

If you’re not getting your smile makeover right away, be sure to get the nightguard now so you don’t do any further damage to your teeth.

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

Worried dentist damaged porcelain veneer

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

Elaine

Dear Elaine,

A single porcelain veneer being held up by a dental instrument

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

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

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

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

Getting This Porcelain Veneer Fixed

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

There are two ways to repair this:

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

Finding an Expert Cosmetic Dentist

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

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

No-Prep or Traditional Veneers

I’m getting a smile makeover for the start of the new year. It was one of my Christmas presents. I’ve been doing some research and I just can’t make the final decision between Lumineers or traditional porcelain veneers. I like the idea of no-prep, but the reviews have been mixed with some people saying their smile ended up looking bulky. Do you have any advice for me?

Elaina

Dear Elaina,

A single porcelain veneer being held up by a dental instrument

How great that you received such an incredible Christmas gift. You must have been a very good girl this year. It is also nice that you are trying to research ahead of time to get the best option for a beautiful smile.

I’m going to shift your question a bit to give the important answer. A great cosmetic dentist can create a gorgeous smile for you no matter what type of materials he is working with. That is one of the reasons the reviews are so mixed on the Lumineers brand. The ones who’ve had their teeth end up looking bulky are the ones who didn’t go to a top-of-the-line cosmetic dentist.

Whenever you’re talking about creating a piece of art, the artist you choose matters. While porcelain veneers, whether traditional or no-prep, can give you a stunning smile. The right dentist has to be doing it.

So, how do you find this magic dentist?

Finding the Right Dentist for Your Porcelain Veneers

You’ll want a dentist who has not only invested a significant amount of time training in cosmetic dentistry and smile design, but one who has a natural or trained artistic eye as well.

You could spend countless hours researching each cosmetic dentist in your area one by one, or you can utilize one of two great resources. The first is the American Academy of Cosmetic Dentistry (AACD). They have an accreditation program which helps patients find the best of the best.

You’ll simply need to go to their site (aacd.com), click on find a cosmetic dentist, then input your area. Be sure to check the box that says you’re looking for an accredited dentist. That is very important.

Sometimes it’s hard to find an AACD accredited dentist in some areas. These are among the top 1% of cosmetic dentists. The accreditation process takes a long time. If you don’t see one in a reasonable traveling distance to your home, check out mynewsmile.com.

This site screens cosmetic dentists who wish to be listed for both technical skill and artistry in their work. They also have a find a cosmetic dentist button. While many they list are accredited, others are highly skilled cosmetic dentists in the midst of the accreditation process and can give you an equally gorgeous smile.

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

Dentist wants to CROWN a Chipped Tooth!

I fell on some ice and chipped my tooth. I wanted to repair it but my dentist said the best repair would be a crown. I know he’s not big on cosmetic dentistry, but I was hoping for something that wouldn’t grind the whole tooth. Aren’t there┬ásome cosmetic options?

May

Dear May,

before and after a chipped tooth is repaired

I’m sure your dentist is a decent general dentist and is giving you the best service he can provide for you. Unfortunately, he not the best dentist for you in this particular situation. Yes, there are cosmetic solutions to this which are much simpler. The ideal one is much more affordable than a crown too.

However, I don’t recommend you force his hand on this. If he isn’t familiar and experienced in cosmetic dentistry you will not like the results you get. Many people use one dentist for their general dental work and one for their cosmetic work.

Fixing a Chipped Tooth

The standard repair for a chipped tooth is to have dental bonding done on it. This uses a composite resin that the dentist will sculpt onto the tooth freehand. It does require an artistic cosmetic dentist. As you don’t have one, I’m going to tell you how to find the best cosmetic dentist in your area.

I mean if you’re going to do a cosmetic procedure, you may as well go to the person who can not only do it well, they do an awesome job. My suggestion is you get an AACD accredited dentist. These dentists have gone through stringent oral and written exams as well as demonstrated their artistic ability on a large number of cases.

Any of them could not only fix your chipped tooth, but they could also give you a stunning smile makeover with porcelain veneers.

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

Were Porcelain Veneers the Wrong Option?

I have teeth which are too short. I’d recently read an interview about a celebrity who used to have the same problem. She got porcelain veneers on her teeth and now her smile is gorgeous. I told my dentist I wanted him to give me her smile, but it turned out horribly. Did I misunderstand what she had done? Were porcelain veneers the wrong option for me?

Kylie L.

Dear Kylie,

A single porcelain veneer being placed

Porcelain veneers are a great solution for what you were concerned about. They can change just about anything wrong with a smile. They can make short teeth longer, as you needed. In addition to the length of your teeth, they can change the width, the shape, the color, and create a character.

The problem likely lies in the skill set of your dentist. Not every dentist has invested a lot of time into learning how to do smile makeovers. Given that it is not something taught in dental school, the additional post-doctoral training is a must.

Even those who have invested in the training have varying levels of skill and even greater variety in artistry. If you’re unhappy with the results of your case, you can ask him to re-do it. However, even if he is willing, you may not get any better results. He’s limited by his capabilities or lack thereof.

I’d ask for a refund or at least a partial refund and then go to an expert cosmetic dentist to have the case done the way you’d dreamed.

Finding the Right Dentist to Create Your Porcelain Veneers

You want a dentist with more than just technical knowledge. You want an artist; someone who can truly design a stunning smile that blows you away. You should be so thrilled with your smile makeover you can’t stop smiling to show it off. You should feel like a new woman with renewed confidence.

So, where do you find a dentist like this? The easiest way is to go to aacd.com and click on find a cosmetic dentist. Then, make sure you check that you’re looking for an accredited dentist.

AACD accredited dentists are the top cosmetic dentists in the world. They will give you a stunning smile. Additionally, almost every one of them has a beautiful smile guarantee.

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

Does Cosmetic Dentistry have to be a Fortune or a Failure?

Several years ago, I had four dental crowns placed on my front teeth. I decided it was time to upgrade my smile and had a consult with my dentist. I told him I wanted something which would improve my smile but not cost a fortune. He suggested teeth whitening. I went ahead with that. The rest of my teeth look great, but the crowns now look dingy compared to the rest of them. I don’t know what went wrong, but my dentist said it was probably time to replace them anyway. When he did the temporaries, I realized that the crowns would be ugly. I didn’t want that either, it’d be no better than leaving them as is, but without the extra cost. I decided just to get a consult from one of those touted cosmetic dentists. He agreed the crowns needed to be redone, but insists I need work on eight teeth because of the width of my smile. That will be quite a pretty penny. Do I have to spend a fortune or be left with an ugly smile?

Andrea

Dear Andrea,

Woman giving thumbs up in a dental chair
If you want to have a smile in the dental chair you need to choose the best dentist

You’re in a bit of a tough spot and it’s all because your family dentist didn’t know (and apparently still doesn’t) know a thing about cosmetic dentistry. He should have told you that the teeth whitening procedure you had done would bleach your teeth but have zero effect on your crowns.

However, you were smart to not go through with his re-do of your crowns. His cosmetic skills are non-existent and you’re talking about your front teeth. You want the best cosmetic dentist you can find. The dentist who’s telling you that eight crowns are necessary is likely trying to give you a perfect smile. If you have a wide smile, eight porcelain veneers are common. Sometimes, even ten are necessary.

However, you don’t have to have all eight done. If you’re happy with the color and shape of the two teeth adjacent to either side of your four front teeth, then you can just get four all-porcelain crowns to go with them. A great cosmetic dentist can make your smile look stunning even with those limitations.

Finding the Best Cosmetic Dentist

You may have to find a different cosmetic dentist than the one insisting on eight teeth. Some will only do the ideal. However, you can find incredible cosmetic dentists who will work within your desired smile.

My recommendation is for you to look at two different online resources. The first is the American Academy of Cosmetic Dentistry’s website (aacd.com). The second is mynewsmile.com. Both of these will recommend the best of the best cosmetic dentists in your area. If you use the AACD site, make certain you check that you want an accredited dentist or an accredited fellow. Those are the best.

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

Why Are My Gums Bleeding After Porcelain Veneers?

I’m a little concerned. Around six months ago I had porcelain veneers done. My gums were irritated from the beginning. I called the office. They said it is normal to have a little irritation after dental work and it should resolve itself. Then a month or two later the gums started bleeding when I brush. Not every time I brush, but enough that I wondered what’s going on. Now I went in for my six-month check-up and the hygienist said I’m not brushing and flossing well enough because I’m developing gum disease. I was horrified. I always am so careful about my oral care and have never had a problem before. Is this a common side-effect from porcelain veneers? My dentist said no, but I didn’t have any issues until I had them placed.

Carina

Dear Carina,

A single porcelain veneer being placed

It’s not a side-effect of porcelain veneers, but like you said, it’s rather suspicious it started when you had them placed. I have an inkling of what may be going on here. Is it possible your dentist is a family dentist who doesn’t do cosmetic work as a large portion of his practice?

My guess is your dentist isn’t a skilled cosmetic dentist and maybe just dabbles. With your gums being affected, it sounds like your dentist didn’t get the veneers flush against your teeth. When that happens, it’s what’s known as bulky margins.

What this does is create a tiny “shelf” at the top of your veneers, which allows for food and other bacteria to get trapped there. This is what is probably what is irritating your gums and leading to the bleeding and gum disease.

Who Should Replace Your Porcelain Veneers?

Here’s what I’m going to recommend in your place:

First, you have a great case for a full refund. In your case, I wouldn’t consider developing gum disease a functional case, which is the standard for whether or not you’d get a refund. If he gives you a problem about that you can get a second opinion from another dentist. Tell him what’s going on with your gums without making a comment about bulky margins. If he or she gives you that diagnosis as well, then the dentist will be more likely to refund you. Dentists have pride and don’t want to look bad in front of their peers.

One tip. Don’t tell the second opinion dentist who placed them, just in case they’re buddies. If he asks, tell him you just want an unbiased opinion and would prefer he not know. He should be fine with that.

Once you’ve gotten your refund, you need to go to a different dentist to replace them. Ideally, you’d want to go to a dentist who’s reached accreditation level with the American Academy of Cosmetic Dentistry. AACD accredited dentists are in the top 1% of cosmetic dentists in the country.

I wouldn’t be surprised if when you had your new case made that you found the end result to be much more beautiful. In fact, most expert cosmetic dentists have a beautiful smile guarantee.

If there’s not an accredited dentist within a reasonable distance from your home, you can go to the mynewsmile.com website. They recommend expert cosmetic dentists by zip code. Not all of them are accredited, but every one of them are skilled and artistic enough to give you the stunning smile you deserve.

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

What if You Hate Your Smile Makeover?

I’ve always hated my smile and am considering getting a smile makeover. However, my husband mentioned something that gave me pause. He asked me what happens if I spend all that money and hate my smile makeover? It’s a valid question. He’s not just asking because he doesn’t want to spend the money. Do you have an answer for that? Does it vary from dentist to dentist?

Brittany

Dear Brittany,

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

Your husband asks a great question, one I wish more patients would ask before investing in their smile makeover. The answer varies from dentist to dentist. But, that being said, there is a “right” answer your dentist should be giving you. If they don’t give the right answer, go elsewhere.

A smile makeover is a work of art. Therefore, the first thing you should do is make sure you’re getting an artist to do it. If you were going to commission a portrait, I’m sure you’d check out the reputation and skills of the artist first. Please do the same with your cosmetic dentist.

Ideally, you’d want a dentist who’s reached accreditation level with the American Academy of Cosmetic Dentistry. AACD accredited dentists have guaranteed technical skill and artistic prowess. You will get a stunning smile through them.

However, just because something is stunning, doesn’t mean it’s what YOU dreamed of.

What You Should Expect From a Cosmetic Dentist

Your cosmetic dentist should sit down with you and have a consultation about what is your dream smile. You can bring pictures or discuss the character you’re going for. For instance, do you want a sporty smile, an authoritative smile, a youthful smile? All of these are formed with different shapes.

He or she should also let you test drive your porcelain veneers after they’re created using a try in paste. You should get to look at them in several types of lighting and also have your family and/or friends look at them. If you LOVE them (and I mean really love them) great. If not, your cosmetic dentist should be willing to go back to the drawing board.

Most skilled cosmetic dentists call this a beautiful smile guarantee. If they don’t offer one, walk away. Once you’re satisfied, then and only then should you allow him to permanently bond them on.

I hope this helps! Enjoy your new smile. It will bring with it amazing doses of confidence.

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