Tag Archives: porcelain veneers

Questions about Cosmetic Work

I want to get porcelain veneers, but have some questions. I can’t afford to get them on all my teeth, so can I just whiten them? If so, do I do it before or after the veneers? Another question I have is about Invisalign. I have a slightly crooked front tooth. When I talked to my dentist, he hinted that I may want to do Invisalign before getting the veneers. I may be wrong about this, but I thought that porcelain veneers could make teeth look straight. Was I wrong about that?

Simone

Dear Simone,

Porcelain veneer being placed on a tooth.

I am a bit concerned about the dentist you are using for this. I will say that up front. We’ll get into that more in a moment. First, let me answer your questions.

You should almost always whiten your teeth when you are getting porcelain veneers, even if it is just for your bottom teeth. Teeth whitening is even more important if you are not getting enough veneers to cover all the visible top teeth when you smile. This should definitely be done before getting any porcelain veneers. It is much easier to match porcelain veneers to the whitened teeth exactly. It’s almost impossible to stop the whitening at the perfect time.

Invisalign and Porcelain Veneers

Invisalign aligner

As for Invisalign, I haven’t seen your case, but in many cases Invisalign can make your teeth look straight when done by a skilled, artistic cosmetic dentist. The way you described your situation I would think porcelain veneers would do a fine job.

My guess is your dentist is not comfortable with that portion of the makeover, so he’s trying to convince you to pay for Invisalign to make his job easier.

How to Get a Beautiful Smile Makeover

You are not going to get the smile makeover you want with this dentist. I get the feeling he has not invested in much post-doctoral training in cosmetic work. Here is the problem you are facing. Cosmetic dentistry is not a recognized specialty. That means any dentist can call themselves a cosmetic dentist.

Even worse, doing smile makeovers is not taught in dental school. It is completely up to the dentist how much training they invest in. So, how will you go about finding a dentist skilled enough to provide you with a beautiful smile?

The easiest way is to find an AACD accredited dentist. This is a program that was started by the American Academy of Cosmetic Dentistry to give patients a way of knowing which dentists have the skills and artistry to provide you with a stunning smile. Dentists who pass accreditation are the best cosmetic dentists in the country.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.
Click here to read about Dr. Burba’s Beautiful Smile Guarantee.

How to Find Someone Who Does Beautiful Lumineers

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

Kelly

Dear Kelly,

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

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

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

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

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

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

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

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

Why didn’t My Bonding Whiten?

I had dental bonding done several years ago. They started picking up stains. The dentist who did my work retired and sold his practice to someone just out of dental school. The dentist suggested we whiten them but that didn’t work. They actually look worse. Now he is talking about re-doing the bonding. I know this sounds petty, but I’m worried if he can’t get teeth whitening right he won’t get the bonding right. What do you recommend I do?

Patty

Dear Patty,

You are right to be concerned. I am not going to recommend that you have this dentist re-do your dental bonding. However, it wasn’t as much that he did the teeth whitening incorrectly as it is that he doesn’t understand how teeth whitening works.

The reason your dental bonding looked worse after he did the teeth whitening is the gel will only work on natural tooth structure. That means your natural teeth whitened, but your dental bonding did not. This is a basic principle of teeth whitening.

So, while your dentist did not do the teeth whitening wrong. he doesn’t understand the easiest of cosmetic principles. Dental bonding on the other hand is one of the most advanced cosmetic procedures a dentist has to do.

He’ll have to blend different textures, colors, and translucencies. He likely doesn’t even have enough of these in supply to do the job well. In addition, it will all have to be done freehand.

Here is my suggestion. I’d like you to look for an AACD accredited dentist. These are the top 1-3% of cosmetic dentists in the country. They will have the training, skill, and artistry to do this not just well, but beautifully.

They would have suggested you whiten first, if you want to whiten at all. This is because (as you’ve learned) the bonding color is permanent so it is better to whiten first so you can match the bonding to the color you want to stick with. You’ve already whitened, so that is one step completed.

Next, you will get the bonding done by someone who knows what they are doing.

This blog is brought to you by Salem, MA Cosmetic Dentist Dr. Randall Burba.
Click here to learn about Porcelain Veneers.

Did My Dentist Give Me TMJ?

I am concerned that something happened during my dental procedure which could have given me TMJ Disorder. I had my upper arch worked on with two dental crowns and eight porcelain veneers. While they look great, my jaw hurts like mad. I called the office to see what to do and they just suggested I take Advil. It’s been three days. Should this still be happening or is there something more serious going on? I’ve read that you can get TMJ with this type of dental work if it isn’t done right.

Avery

Dear Avery,

With the extent of dental work you had done, it is fairly normal for your jaw to feel achy, even for several days. Your jaw had to be propped open for quite a while. Advil is a good choice because it has an anti-inflammatory. You could also put some warm towels on your jaw. Other than that, it will just be a matter of rest and time.

When you are talking about TMJ developing from dental work, it would be a matter of the dentist doing the work incorrectly in a way that threw off your bite. That does not appear to be what you have going on.

Often when we see this happen it is when a dentist had one side of the bite that is occluding before the other, or if they opened your bite too much. You would notice if that were happening. The pain would not just be an ache. You would likely also develop some speech difficulties because your bite was now misaligned.

My advice is take the Advil and give it an other week. If it is still bothering you, go in and have your dentist examine that the teeth are meeting together properly.

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

Botched Tetracycline Case

I’ve had tetracycline stains most of my life. Originally, I had some work done by having dental bonding done over them, but it was time to replace them. I’d since moved to another city and couldn’t see the original dentist. My new dentist suggested we do six dental crowns because it would “hide the stains better.” I did not do adequate research and just trusted what the dentist told me. Now I regret it. The crowns show the stains underneath, especially in fluorescent lighting. Plus, you can tell these are crowns because they look so different from the adjacent teeth.

What do I do here? He’s offered to send them back to the lab, but I’m not sure the results will get any better. Is it okay to ask for a refund?

Lannette

Dear Lannette,

Tetracycline stains are among the most difficlut cosmetic procedures to do. The stains are so dark and so deep, it takes real skill to get the repair opaque enough to cover the stains while still having that natural translucent look. Your dentist likely had good intentions but was in over his head.

Warning Signs He Didn’t Know What He Was Doing

First, he suggested porcelain crowns instead of porcelain veneers. This automatically shows he is not comfortable with cosmetic dentistry. Dental crowns, for this type of procedure, means unnecessarily grinding down healthy tooth structure.

Second, he suggested only six teeth. When we study in dental school we learn about front and back teeth. The first six are considered the front teeth. However, dentists who study cosmetic dentistry, do not divide things into anterior and posterior teeth. Instead, we talk about the aesthetic zone. This is the number of teeth visible when you smile. For most patients, that is eight to ten teeth. Not six.

With those adjacent teeth showing with the dark stains, it makes it obvious your front teeth are crowns.

I agree with you that this dentist is not going to be able to make it any better. I suggest you just ask for a refund. Then go to an experienced cosmetic dentist to do this. The best cosmetic dentists are AACD accredited, so I would look there. Unfortunately, once you have dental crowns placed you are stuck wtih crowns. The good news is an excellent cosmetic dentist can make them look natural and beautiful.

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

She Needs to Leave This “Cosmetic” Dentist

I went to see a dentist who advertises as a cosmetic dentist. I mostly wanted them whiter and brighter. I also have a slightly crooked front tooth, but it really isn’t that crooked, certainly not enough to pay for braces. I wanted to get some porcelain veneers on my upper arch. But, the cosmetic dentist I saw wants me to do Invisalign first and then get the porcelain veneers. If the tooth is only a little crooked, is that really necessary?

Madeline

Dear Madeline,

Invisalign Aligner

I want you to find a different dentist to work on your smile makeover. While I am sure he calls himself a cosmetic dentist, there are a couple of things that bother me here. You should be aware that cosmetic dentistry is not a recognized specialty. Any general dentist can call themselves a cosmetic dentist regardless of the amount training they have invested in.

I have a strong feeling your dentist doesn’t have much training. Under normal circumstances, you would either need porcelain veneers OR orthodontics, not both. Porcelain veneers, done skillfully, can make crooked teeth look straight. He obviously does not know how to do this, so he is setting up the ideal situation for himself. This does not inspire confidence in me with his abilities.

Doing smile makeovers are not taught in dental school. In order to learn how to do them well, a dentist would have to invest in significant post-doctoral training.

If you want a smile makeover done well. You want a dentist with the highest skills.

However, there is something else for you to consider. If the only thing wrong with your teeth is you need them whiter and brighter, plus there is one crooked tooth you could save a significant amount of money by instead doing Invisalign with tooth whitening. In fact, the Invisalign aligners can double as the teeth whitening trays thereby saving you even more money. Unless there is something else you want to change about your smile, that is what I would recommend.

However, if you decide you still want to have porcelain veneers done, perhaps because you want the fastest solution, then I would look for a dentist with more expertise. In fact, I would only go to a dentist who is AACD accredited. These are the best cosmetic dentists because they have the proven skills and artistry.

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

Why Did Her Dentist Stain Her Lumineers?

I recently went to the dentist about a smile makeover after I received an advertisement from him about Lumineers. I spoke with him extensively ahead of time about the type of smile I wanted. One of the requests was to have a very white smile. When the Lumineers were placed on my teeth I realized they were darker than I expected. When I questioned him about that he told me he ordered a stain on them so they’d look like natural teeth. He told me I’d realize he was right in a few days. After a few days, I called him back asking him if he could make them whiter. He had me come in and then he drilled off the outer layer to get to the white underneath, but it looks uneven and dull. What do I do?

Melody

Dear Melody,

I am glad you wrote. You are dealing with a family dentist who is in over his head trying to do cosmetic work he doesn’t have adequate training for. My first hint was when you said he advertised Lumineers.

This particular brand of porcelain veneers is highly marketed to inexperienced cosmetic dentists as being easy to place. They say this because the veneers are thinner than some other brands which in some cases means there doesn’t need to be any tooth preparation. Unfortunately, in most cases, they end up looking bulky.

A second thing that told me he was not an experienced cosmetic dentist was his attitude. In dental school, we are taught that we know better than their patients. This philosophy does not work with cosmetic dentistry. With smile makeovers, we are creating an image the patient has in their head. Their dream smile. He doesn’t get to tell you what you’ll like.

The stain is also something taught in general dentistry. Most people have at least some stained teeth so your dentist thought that to make your smile look natural he’d have to add one to yours. However, patients don’t pay to get a smile makeover that looks like every other smile. They want something that looks exceptional.

Finally, he bonded your Lumineers on before letting you see them on your teeth to approve them. Experienced cosmetic dentists will use a temporary try-in paste for you to see the smile makeover. If you don’t absolutely love it, instead of bonding it on, they will send it back to the lab to make any necessary changes.

Unfortunately, you can’t get a refund on a smile makeover just because it is ugly. The standard is function. In your case, this is good news. When he filed away the stain, he also took the protective glazing with it. Now they have no protection and will pick up stains quickly. You should be entitled to a refund because of this.

If he gives you a hard time, contact us again and I’ll tell you how to get a refund from a dentist.

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

Collapsing Mouth

My dentist is suggesting I get porcelain veneers for an issue I’ve been having. My mouth seems to be collapsing. It is getting harder and harder to see my teeth when I smile and I’ve even been having trouble saying certain letters such as P and T. I want to make sure that porcelain veneers are the right solution before I move forward. It’s a rather expensive procedure.

Elizabeth

Dear Elizabeth,

If your dentist suggested that porcelain veneers would fix your problem, he is mistaken. The only thing it will improve is the appearance of your teeth. Even that will depend on his or her skill as a cosmetic dentist.

You have a bigger issue than just the appearance. Based on your description, it sounds like your teeth are worn down. It’s likely you are grinding your teeth without realizing it. Most patients who grind their teeth do so while they are sleeping.

This grinding wears the teeth down to little nubs and causes your mouth to over close. This can lead to TMJ disorder and will give you a lifetime of jawpain and migraines.

You’ll need a dentist with extensive treatment in TMJ disorder in order to fix this properly. This is especially true with a case like yours which will be more advanced than most.

In your place, I’d look for a dentist who received training in one of the following institutions, which are all highly reputable.

  • The Dawson Academy
  • The Spear Institute
  • The Las Vegas Institute for Advanced Dental Studies
  • The Pankey Institute

A dentist with this type of training will be qualified to provide you with the solution to fix your bite and your appearance.

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

I Can’t Afford The Repair for my Chipped Tooth

`I chipped a front left tooth. My dentist suggested two Lumineers to ensure they match but they cost so much money. I would literally have to take out a loan. I’m hoping there may be another cheaper solution and my dentist was just trying to give me the Porsche type of solution.

Jenna

Dear Jenna,

Your dentist certainly suggested the most expensive treatment, but I wouldn’t exactly call it the Porsche. Lumineers is a brand of porcelain veneers that are often marketed to inexperienced cosmetic dentists as being easy to place. I’m afraid your dentist likely falls into this category for a couple of reasons. The first is the treatment he is suggesting for this repair. The second is the fact that he needs to do two veneers to get them to match. A skilled cosmetic dentist can match a single tooth with a single veneer.

The one good thing working in his favor is he didn’t suggest a dental crown as a solution, which would require healthy tooth structure to be ground down. I have actually seen some suggest this.

The Best Solution for a Chipped Tooth

If you have a chipped tooth, the standard solution is dental bonding. However, I wouldn’t try to force or pressure your dentist into doing this. Tooth bonding is an advanced cosmetic procedure that has to be done freehand.

My suggestion is you find a dentist who already has cosmetic expertise to do this repair for you. The best cosmetic dentists are AACD accredited.

This doesn’t mean you have to switch dentists permanently. You can just go to the cosmetic dentist for the bonding and stay with your dentist for everything else.

Teeth Whitening and Dental Bonding

Dental bonding can blend in perfectly with the remainder of your teeth when done well. However, once it is bonded on, no changes can be made. If you are considering getting your teeth whitened in the near future, it will save you money to do it before your bonding is done.

If you wait and do it after, your natural tooth structure will whiten, but the bonding will stay the same color. To get it to match, you will need to replace the bonding.

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

Durathin or Lumineers?

I plan on getting a smile makeover but am having a hard time deciding between Durathin or Lumineers. So far, I like the images of the Durathin veneers better. Is there a huge price difference between the two?

Evelyn

Dear Evelyn,

A dental tool holding up a porcelain veneer

I want to try and make a course correction about how you are going about this. Instead of thinking about porcelain veneers as an item purchase, you would be closer to reality if you thought about it as commissioning an artist to create a portrait.

In that case, you wouldn’t be deciding between what brands of paint you want for the portrait, you’d be considering the skill of the artist and letting them choose the best paint for the job.

Creating a smile makeover is an art form. Unfortunately, it is an artform that isn’t taught in dental school. A dentist has to choose to get that training post-doctorally. What you need is a dentist who has invested a significant amount of time in training and developing their technique and artistry. They are the ones who can provide you with a stunning smile.

One thing you will find is not many of them like the Lumineers brand. This is because their company, insists you use their lab, which isn’t known for producing beautiful results. This also may be why you like the Durathin images better.

Proven Cosmetic Dentists

When you are looking for an expert cosmetic dentist to do your smile makeover, the best cosmetic dentists are AACD accredited. These dentists have passed stringent exams and have provided visual evidence of a large number of cases they’ve done, which is carefully examined by a panel of experts for both their technical skill and artistry.

Any dentist can join the American Academy of Cosmetic Dentistry, but only the ones who pass this rigorous process can be accredited. You will be pleased with any smile they create for you.

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