Tag Archives: finding an expert cosmetic dentist

Do You Really Need an Expert Cosmetic Dentist?

I keep hearing how important it is to see an expert cosmetic dentist if you want a smile makeover. What I don’t understand is why. Don’t they just send out the work to be done at a lab? If so, wouldn’t the lab be the most important part of your smile makeover?

Landon

Dear Landon,

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

You’ve asked an important question. A lot of people think of it with the analogy of it doesn’t really matter which gallery you purchase the art if the artist who does great work. That works for art. But, a dentist isn’t a gallery. Think of it more like it’s the doctor who determines your illness and what medicine will cure it, not the pharmacy where he sends the order.

The lab needs the right prescription to do that work. The truth is no matter how good the lab and ceramist are, they cannot work around a bad dentist. The foundation for the beauty of a smile makeover is in the hands of the dentist, not the ceramist. It’s the dentist who has to give the shade map of the final result, the surface texture, the degree of translucency, as well as a mock-up of the final result. The dentist has to approve what the ceramist does to ensure they followed his directions.

Even if a bad dentist uses a good lab, the results won’t be what you were hoping for. Always choose the dentist. Let the dentist choose the lab. The best dentists usually have an almost symbiotic relationship with their ceramist anyway.

Finding the Best Cosmetic Dentist

Because there isn’t a recognized specialty in cosmetic dentistry, it is hard for patients to recognize who has the skills to give them a beautiful smile. The American Academy of Cosmetic Dentistry recognized that problem. As a result, they started an accreditation program with a two-fold purpose. One is to help train dentists in the art of cosmetic work. The other is to have a recognition system to help patients know who has what it takes.

The best dentists have reached accreditation. These are the top 1% of dentists in the country. Any one of them can give you a stunning smile. Most smile makeovers are done using porcelain veneers. You’ll find these dentists will often have a beautiful smile guarantee.

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

Best Brand of Porcelain Veneers

I just had my teeth whitened and then got in an accident which has caused me to need repairs on several teeth. I’m considering getting porcelain veneers but want to know which brand is the best before I invest. What is the best at this point and time?

Larry

Dear Larry,

A single porcelain veneer being placed

It is great that you want to do research before investing in your smile makeover. You never want to go into any dental procedure without understanding what you’re getting into and whether or not your dentist is qualified.

However, I want to change your tactic. There really isn’t a best brand of porcelain veneers. They each have unique properties with different strengths and weaknesses. However, it is the dentist which makes the difference.

Think of it as an art form. If you commissioned an oil painting, you’d research the artist, not the paint. This is the same thing with smile makeovers. Two different dentists can do the same smile makeover with the same materials and come up with totally different results.

Finding the Best Cosmetic Dentist

Cosmetic dentistry isn’t a recognized specialty. That means any general dentist can call themselves a cosmetic dentist regardless of their skill level. This makes it hard for patients to know whether or not they’re getting an artistic dentist or a dabbler.

Because of that, the American Academy of Cosmetic Dentistry began an accreditation program. This process tests dentists for both their technical knowledge as well as their artistic ability. They have to pass exams as well as demonstrate their artistry by providing visual evidence on a large number of cases they’ve done.

Becoming accredited takes years of training. Those who attain accreditation are among the top 1% of dentists in the country. They can give you a stunning smile makeover. In fact, most of them have a beautiful smile guarantee.

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.

What If Dentures are my Only Option?

I’m in a pickle. I’ve had four pregnancies in six years which kept me vomiting every day, multiple times a day. Then, when I was done with that, I was diagnosed with cancer. My teeth are an absolute wreck as a result. Many of them are literally crumbling. I think the only thing I can afford is dentures. I’m about to completely lose it. I keep hearing dentists say dentures are the worst thing I can do but I’m not sure I have a choice. I’ve no money left and am still paying off tens of thousands of dollars for my treatments.

Emily

Dear Emily,

An illustration of both a denture and a dental implant

You have been through a lot and I don’t want you to beat yourself up. Sometimes, our health (even the health of our teeth) are beyond our control. In your case, I’m going to make a couple of suggestions to see if we can help you get the health you need for your jaw as well as a beautiful smile.

You mentioned dentists have warned you against dentures. The reason for that is the danger of facial collapse. Your jawbone slowly shrinks. Eventually, there is not enough money to even keep your dentures in place. The upper dentures are held in by suction, so those are a bit safer. The bottom ones just sit on the ridge of your jawbone.

If at all possible, I am going to suggest you get snap-on dentures on your bottom arch. This can place as few as two dental implants into your jawbone and keep your dentures from falling out. Plus, it will preserve the bone where ever you have an implant. From there, you can save up for other implants as you are able.

Getting Beautiful Dentures

Regardless of the type of your tooth replacement option, you want to make certain, the dentist who prepares them will create a beautiful smile for you. This is one of the few upsides for your particular situation. After years of damage to your teeth, you can now have the smile of your dreams.

Not all cosmetic dentists are equal in skill. It’s not a recognized specialty by the American Dental Association, so it is up to the dentist how much time and training he or she invests in learning how to make beautiful smile makeovers. There are two sources where you can find dentists capable of giving you a gorgeous smile.

The first is the American Academy of Cosmetic Dentistry website. They have a link where you can find a cosmetic dentist. When you list your area, make sure you check that you’re looking for an accredited dentist. These are the ones with expertise and artistry. The second source is mynewsmile.com. They also have a “Find a Cosmetic Dentist” link. Not all of them are accredited. However, each one of them has been screened for their technical and artistic skill.

This blog is brought to you by Salem, MA 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.

Is it Too Late to Get a Pretty Smile?

I’ve had dentures for years. They have always looked fake but I knew they would be because they were dentures. Last week a friend of mine I hadn’t seen in a few years came to town and we had lunch together. Her smile was gorgeous. I couldn’t believe it. She said she got dental implants. I didn’t even know those existed. Is it too late for me to get them?

Mandy

Dear Mandy,

Mature couple smiling
You can have a gorgeous smile that feels good no matter what your age!

It’s never too late for a pretty smile. You should know that, with a great cosmetic dentist, you could have had a beautiful smile with dentures as well. It’s not the procedure in this case. It’s the dentist. However, you can’t change the past.

Dentures or Dental Implants

Truthfully, dental implants are by far the best choice when it comes to replacing their teeth. First, they’re permanently implanted so they’re completely secure. It’s like having healthy, natural teeth back in your mouth. You can eat whatever you want and brush and floss like you do with natural teeth.

They have a more important function, though. You’ve probably noticed your dentures don’t fit the same way they used to when you first received them. That’s because your jaw is shrinking. When your teeth were removed, your body recognized that and started resorbing the minerals in your jawbone to use elsewhere.

It won’t be long before you won’t be able to keep your dentures in place. This is known as facial collapse. Dental implants prevent that. The prosthetic roots placed into your jawbone tricks your body into thinking your natural teeth are still there and, as a result, leaves your jawbone intact.

If you decide to get dental implants, you’ll likely find you no longer have enough jawbone left to support them. However, that doesn’t mean you can’t get them. It means you’ll have to have an additional procedure first, called bone grafting.

Bone grafting is a simple, outpatient procedure. This will build up the bone structure so that your jawbone will be able to retain the implants.

Getting Beautiful Results No Matter What Procedure You Choose

As I mentioned above, the most important decision is to find a highly skilled and artistic cosmetic dentist. They can create something stunning that you’ll be proud to share with the world. You’ll never feel like you have an ugly smile again.

The easiest way to find one of those is to go to the website of the American Academy of Cosmetic Dentistry (aacd.com). They have a “find a cosmetic dentist” link. However, to get one with the expertise you need, you need to check that you want an accredited dentist, not just a member.

After you find a great cosmetic dentist, see which of them have experience with dental implants. You’ll want one with post-doctoral training in restorative dentistry.

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

Blade Implant Not Healing?

I don’t know what’s going on. I had a blade implant placed over 12 months ago and it still isn’t healed. Is something wrong or is this normal? Do I just wait it out?

Catherine

Dear Catherine,

Illustration of a dental implant

I’m curious as to why your dentist decided on a blade implant. While they have been in use for many years, there are better options in current practice. It’s generally used for people who don’t have a thick enough jawbone to retain a traditional screw implant but don’t want to do bone grafting.

Unfortunately, while traditional dental implants (pictured above) have a 98% success rate, blade implants only have around a 50% success rate. This should have healed within twelve months. At this point, something is wrong. You need to return to your implant surgeon and have them look and advice you.

Dental Implant Options

A woman's profile twice, one with facial collapse, one after
Wearing Dentures Leads to Facial Collapse

Bone loss in your jaw is usually the result of having missing teeth with no replaced root. For instance, if you removed your teeth but didn’t replace them or replaced them with removable dentures, the minerals in your bone start to resorb into your body. The result not only ages your appearance years, but it will also make you a denture cripple, forced onto a liquid diet the remainder of your days. This is known as facial collapse.

If you want to replace those teeth with an option which provides a prosthetic root, thereby preventing facial collapse, you need to have enough jaw bone. If you don’t, you have two great alternatives to blade implants.

Bone Grafting

This is a simple outpatient procedure which adds bone structure back into your jaw. The biggest benefit to this is it allows you to get screw implants which have a significantly higher success rate to the blade option.

All-on-4 Dental Implants

This doesn’t require grafting. Instead, the all-on-4 implant procedure places the implants at an angle helping them retain with less bone structure.

Cosmetic Considerations with Dental Implants

While it is wonderful to have a full mouth of teeth. If they’re not attractive teeth, you might not smile nearly as much as you would if you were provided with a stunning smile. Whether you are getting all new “teeth” or just a couple of implants, you’ll want a dentist who can make them match your teeth. You don’t want natural teeth next to obviously fake teeth.

One or Two Implants

I recommend before your implant crowns are made, you whiten the rest of your teeth. It’s an inexpensive way to drastically improve the aesthetics of your smile. But, the real reason for doing it before getting your crowns is the permanence of your crown color. Even professional teeth whitening only works on natural tooth structure. That means if you get the crowns first and then decide to whiten your teeth, your natural teeth will whiten. Your tooth replacements will not. Doing the whitening first means your implant crowns can be made to match the beautiful new color of your teeth.

A New Smile with Implant Overdentures

If you are getting a new smile with your implants, you want an expert cosmetic dentist to do the work. You are talking about a complete smile makeover made from dental crowns. Finding an expert cosmetic dentist is a lot easier than it used to be. The American Academy of Cosmetic Dentistry has an accreditation program which helps patients to know who can give them a stunning smile.

Just go to aacd.com and click on find a dentist. Just make sure you put a check by “accredited dentist”. This way you get a list of those who are experts in their field.

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

Why Your Cosmetic Dentist Matters

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

I recently read on Dr. Hall’s blog about a woman who was having a full-mouth reconstruction. Yes, this is mostly for function, however, it’s important it looks good as well. This poor woman had so many problems. Her dentist made the top teeth darker than the bottom, they weren’t the color she wanted (he told her she picked the wrong color), then one of the teeth were sharp.

When she mentioned that, he essentially said she’s too demanding and he can’t help her. She had the choice between having horrible teeth bonded on or leaving without teeth. She asked him to use a temporary bonding and he refused.

This is a horrific situation. If you want to read her complete post, you can here. However, the more important thing is knowing how to not end up in that type of situation to begin with.

Getting an Expert Cosmetic Dentist

This man wasn’t a true cosmetic dentist. I know that not just by his obvious lack of skill, but also by the manner in which he responded to her about the color as well as her dissatisfaction.

A true cosmetic dentist would have always deferred to the patient’s desires. Not only that, a temporary try-in paste is an automatic given.

If you’re looking for a great cosmetic dentist, your best bet would be to go the American Academy of Cosmetic Dentistry website (aacd.com). They have a “find a cosmetic dentist” link. Now, here’s the thing. Any dentist can become a member of the AACD. What you want is someone who is accredited by them.

Accreditation is only achieved after passing both oral and written exams, as well as proving the artistry of their work. They have to turn in photographic evidence of a large number of cosmetic cases they’ve done.

If you want to avoid a situation like the one I mentioned, make sure you get an accredited dentist. Dentists who are accredited are the top cosmetic dentists in the country. They could give you a gorgeous smile makeover.

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