Tag Archives: porcelain veneers

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.

Dental Horror Story

I need some help and advice. I had 20-year-old porcelain veneers I wanted to replace. My dentist decided my bite needed to be opened up as well so people could see my teeth so in addition to 8 veneers he added two dental bridges to the mix. The whole time I was in temporaries I was miserable. I would literally call every couple of days to tell them how much pain I was in. I felt like they weren’t taking me seriously. Then the day came for the permanent ones and he placed them in under an hour. They felt as bad as the temporaries. All the dentist will say is all his checkpoints are textbook and it is just a matter of me adjusting to the open bite. Aside from the pain, my mouth is so dry my lips are sticking to my teeth. I’ve been sucking on popsicles and drinking water and soda all day long just to keep my mouth moist. I’m miserable. What do I do?

Lydia

Dear Lydia,

This is an absolute disaster and none of it is your fault. Let’s start with the fact that he wanted to open your bite. The only way to properly do that is to crown at least every tooth on one arch, so he’s already going about it wrong. While he did do temporaries, which is good and necessary, the purpose of them is to make sure the teeth occlude properly and the patient is comfortable, which by definition includes pain-free.

He didn’t pay attention to one of your complaints and based on your description, you brought your pain to their attention quite a bit and he plowed right onto the permanent restorations without any regard to what you were experiencing.

It is obvious that he opened your bite too much, which is why you are facing all these issues with dry mouth. All his guff about meeting the checkpoints is nonsense. A key checkpoint is that your mouth closes naturally when at rest. If yours were doing that you wouldn’t be having these dry mouth issues. So he’s not being honest there.

On the note of your dry mouth. Please don’t eat popsicles and drink soda to keep your mouth moist. This is decay waiting to happen. The water is okay.

What to Do Next

He’s caused serious damage to your bite. While bad news, it is also good news. Because your case lacks proper form and function, you are entitled to a refund. However, what I’d like you to do is ask for him to pay for the repairs with a dentist of your choosing.

You need a highly skilled dentist in both occlusion and cosmetics to make this right, especially with the damage he did. The top cosmetic dentists are AACD accredited. For the occlusion of your teeth, I’d look at someone with significant TMJ training.

This blog is brought to you by Salem, MA 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.

Her Dentist is Incompetent or Dishonest

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

Katherine

Dear Katherine,

image advising she stop with this dentist

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

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

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

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

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

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

A Collapsed Bite

I need some help and advice. My “smile” is a disaster. When my mouth is relaxed, you can’t see my teeth at all. When I’m smiling, it takes an extraordinary effort to get my teeth to show. I am a grinder and have jaw pain. To help with that, I wear a nightguard. When I’m wearing that, it helps. Would investing in porcelain veneers help with this situation?

Ben

Dear Ben,

A man in pain needs to see a Salem Emergency Dentist

I am glad you are writing before making any decisions. What you are dealing with requires a dentist with advanced training. The wrong, inexperienced dentist can absolutely destroy your bite. I haven’t examined you, but based on what you’re describing you are dealing with both a collapsed bite and TMJ Disorder.

Opening your bite would be the solution. Porcelain veneers aren’t going to help without doing that first. Once that is done, you may not even need the veneers. However, this has to be done very carefully. You’ll need a dentist with extensive experience in doing a full-mouth reconstruction.

The thing which is most important for you to know is that it needs to be done first with temporaries. Before any permanent restorations are placed. Do not allow anyone to permanently bond anything onto your teeth until the provisionals are successful. So, what will successful mean?

  • You are completely out of pain.
  • You can see your upper teeth normally.
  • You absolutely LOVE how your smile looks.
  • You have no speech problems.

To get that combination will require a very special dentist, but they are out there. First, look for their restorative dentistry training. This has to be post-doctoral training. You want them to have had training in one of these schools: L.D. Pankey Institute and the Dawson Academy in Florida, and the Las Vegas Institute for Advanced Dental Studies.

Additionally, we want to make certain they can create a beautiful smile. I would look for an AACD accredited dentist. These dentists are proven in both their technical skill and as well as their artistic ability. Finding a dentist with these combined qualifications, you’ll go from having a smile you can’t show to one you are thrilled to share.

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