Tag Archives: finding an expert cosmetic dentist

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

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

Lizzie

Dear Lizzie,

Wallace & Grommit

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

The Bad News

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

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

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

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

The Good News

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

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

Getting Your Smile Makeover Re-Done

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

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

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

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

Worried This Dentist Can’t Do Porcelain Veneers

I had some dental bonding on my front teeth that needed to be replaced. I had since moved and am going to a new dentist. I thought the new bonding would look like the original, but they actually looked awful. The dentist felt she could do a prettier smile if we did porcelain veneers. I thought that would be okay. I’m in the temporaries right now. They have a hump on the top which worries me. Is it supposed to be like that? I saw a picture of some Dura-Thin veneers and they didn’t seem to have that hump. What do you think?

Olivia

Dear Olivia,

A single porcelain veneer being placed

I can understand your concern. To answer you question bluntly, no it is not good for your porcelain veneers to have a hump. It is not just visually unattractive , but it is hygienically dangerous. The hump will trap bacteria and plaque. That will lead to gum inflammation, decay, or even gum disease. Your dentist should know that.

Another thing which worries me is that she couldn’t get the dental bonding to look good. An artistic cosmetic dentist could get DuraThin, bonding, or any other brand of porcelain veneers to give you a gorgeous smile makeover.

You’ve got two choices here. You can tell her you’d like to transfer your case to another dentist and then have a cosmetic dentist with more expertise and artistry. Your second option to give her a chance to get it right.

If you decide to give her a chance, here is wha tyou need to make sure happens. First, she needs to let you see the permanent porcelain veneers in your mouth BEFORE permanently bonding them on. She can do that using a temporary try-in paste. If you don’t love them, and I mean really love them, then she shouldn’t bond them in.

Don’t let her try to tell you they will look better after they are bonded on. They won’t. Also, don’t let her tell you they can be adjusted after they are bonded on. They can’t. If she can’t get it right, then you really do need to switch.

Finding an Expert Cosmetic Dentist

There isn’t a recognized cosmetic dentistry specialty, which makes it hard for patients to know which dentists have done post-doctoral training and which haven’t. Additionally, not every dentist has the artistry necessary.

One way to be certain you can find a great cosmetic dentist is to look for one who is AACD accredited. These dentists have passed stringent exams as well as having to submit a large number of cases they’ve done for visual inspection of both their technical expertise and artistry.

Any dentist who passes accreditation has years of experience and can create stunning smiles. That’s who I would go to if you switched.

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

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.

Cure for Fluorosis

I used to catch my daughter in the bathroom sucking down whole tubes of toothpaste. We eventually had to lock them up and then supervise her while brushing. Now she has white spots on her teeth and they look a bit splotchy. I did some reading and I bet it is something called fluorosis. Is there anything I can do to help with this? I’m sure as she gets older it will bother her. I was thinking of teeth whitening. What are your thoughts?

Dennie

Dear Dennie,

white spots on teeth

It looks like you are trying hard to stay on top of your daughter’s oral health as well as her cosmetic appearance. You are right that it could be fluorosis. Teeth whitening, while it sounds like a good idea, will actually not help. It will whiten the surface of the teeth evenly. This means the uneven color will still be there only more evident.

You have a couple of options in the treatment of white spots. In some cases, using a treatment called Icon can work. That would be my first try because it doesn’t require any detailed cosmetic work.

If that doesn’t remove the spots, your other options are cosmetic. She’s too young for porcelain veneers. That will be an option after her teeth are fully developed. I would go with dental bonding. This uses a composite resin the dentist will hand sculpt onto her teeth and cover the white spots. However, this isn’t the type of procedure your average dentist can do. You will need an expert cosmetic dentist.

Finding a Great Cosmetic Dentist

Many people do not realize that cosmetic dentistry isn’t a recognized specialty. Any general dentist can call themselves a cosmetic dentist regardless of the amount of training they have put into developing their cosmetic skills. This is not something dentists learn in dental school. They have to invest time and training post-doctorally.

The best cosmetic dentists have reached accreditation with the American Academy of Cosmetic Dentistry. They are among the top 1% of cosmetic dentists in the country. However, it is not always easy to find one near you. If you run into that problem, an equally good option is to go to mynewsmile.com. They pre-screen cosmetic dentists for their training and artistic ability. They can also do a fine job for your daughter. Most of them are accredited or almost accredited (a process that takes years).

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

Problem Speaking After Porcelain Veneers

I had ten porcelain veneers put on ten teeth. Ever since then, I have had trouble speaking. I’m not sure what to do. It feels like the backs of my teeth are too thick and my tongue is pushed. It’s making me talk weird. My dentist has no idea what is wrong. Have you heard of this?

Brooke

Dear Brooke,

A single porcelain veneer being held up by a dental instrument

Looking at the image of porcelain veneers above, you can see that it doesn’t have any part of it that goes on the back of your teeth. It won’t affect your speech there. However, there are some dentists who place porcelain crowns and tell their patients it is porcelain veneers. If they surround your teeth, they’re crowns. If they just go on the front of your teeth, they’re porcelain veneers. Sometimes the length of porcelain veneers can affect your speech, but you said it was bothering you from the back. That’s not the same.

If it turns out he place crowns, then he’s not only been dishonest, he’s also thrown off your bite. If that’s what happened, you can get him to pay for these to be re-done by a dentist who has both cosmetic dentistry training (preferably someone who is an AACD accredited dentist) as well has having done post-doctoral TMJ training. That’s the kind of dentist who will know how to repair the bite’s position as well as give you a beautiful smile.

Another possibility is your dentist did place porcelain veneers and the thick feeling in your tongue is completely unrelated. You could have had an allergic reaction to something and that is why you’re having trouble speaking.

How Can You Get Help

The first thing I would do is get a second opinion. I again suggest going to a skilled cosmetic dentist. There is a trick to this, though. Dentists know each other. They are one another’s peer group. So one dentist might hesitate to say something unkind about work their friend did.

This is why you won’t tell them who did the work. First, ask him if you received porcelain veneers or dental crowns. Then, ask him if he knows why you’re having trouble speaking. If he asks for the name of the dentist tell him, you want a blind, unbiased second opinion so you won’t be sharing any names.

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

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.