Tag Archives: teeth whitening

Porcelain Veneers With an Overbite

I am finally in a position where I can get a beautiful smile. I’ve had tetracycline stains on my teeth for years, which always left me self-conscious about my smile. I wanted to get porcelain veneers but my dentist said my overbite will prevent that because my top teeth pretty much completely cover my bottom teeth. Instead, he is suggesting four porcelain crowns. I have some questions though. First, have you heard of my type of bite being an issue with porcelain veneers. Second, Do I whiten my bottom teeth to come close to matching the top?

Melissa M.

Dear Melissa,

Porcelain Veneers require real expertise.

I am glad you wrote before going through with this procedure. I have some concerns about your dentist’s qualifications to give you a beautiful result. Let’s start with his choice of treatment–porcelain crowns. When dentists suggest porcelain crowns when a patient asks for porcelain veneers, it is most often because they are not comfortable doing porcelain veneers but don’t want to admit that to their patient.

I will give your dentist credit for his creative excuse, even if it is totally invalid. When you have an overbite, porcelain veneers actually make more sense. Veneers only cover the front of your teeth and hug the sides a smidge. Dental crowns have to go around the whole tooth. If your top teeth are covering your bottom teeth, that will be a challenge.

A second issue is your dentist suggesting four dental crowns. Unless you have an unusally narrow smile, this means your adjacent teeth, with their tetraycycline stains, will be visible when you smile. Most smiles need somewhere between eight to ten veneers to get all their visible teeth.

For the bottom arch, it is possible to have some teeth whitneing done, but tetracycline stains can be pretty resistant to most whitening methods. Kor Whitening has had the best results with these type of stains.

The Key to a Beautiful Smile Makeover

The one constant in beautiful results will be tied to the dentist you choose to do your porcelain veneers. Smile makeovers are not taught in dental school. On top of that, cosmetic dentistry is not a recognized specialty. A dentist has to decide to get the post-doctoral training necessary to produce beautiful results.

In your place, you need an expecially well-trained dentist. Tetracycline stains are one of the most challenging cases. Your dentist will have to get the veneers opaque enough to cover the stains but still look translucent to give it that natural reflective shine. To get this result, I would look for an AACD accredited dentist. These are the top 1 % of cosmetic dentists in the country.

This blog is brought to you by Boston Cosmetic Dentist Dr. RAndall Burba.

Can I Switch Dentists During Invisalign Treatment?

I am in the middle of my Invisalign treatment. I do love my Invisalign treatment. It is comfortable and I am can see the results. However, the dentist I am using is intolerable. He’s rude and always talks about controversial issues. He’s angry all the time. Plus, he’s got bad breath. I could live with the latter, though it isn’t pleasant. I just don’t want to spend the rest of this time dreading my appointments because of all his rants. It’s like getting Invisalign from Stalin. Is it possible to switch Invisalign dentists during treatment? He isn’t my normal dentist. I love my regular dentist and have checkups with him on schedule, but he doesn’t offer any orthodontics. I had a Groupon for this guy. but it has been too difficult.

Help.

Laura

Dear Laura,

Invisalign Aligner

I am sorry you have had such a horrible experience. I was surprised to hear you had a Groupon for Invisalign. My guess is this dentist has a hard time keeping patients so this was a way to draw new ones in.

Your happiness with your Invisalign itself doesn’t surprise me, though. It has one of the highest patient satisfaction rates of any dental treatment. The good news is you can definitely switch dentists in the middle of your treatment. Additionally, your dentist is under an ethical obligation to provide your new Invisalign dentist with all your diagnostics and treatment notes.

The only downside may be that because you did this through Groupon with Dr. Stalin, you may have to pay a little more with the second dentist who may not offer this same price. From what you have described, it will be worth it though to be rid of this dentist, though.

A Bonus Benefit with Invisalign

There is a way you can get a little bonus treat, however. I doubt your current Invisalign dentist mentioned it. Because the Invisalign aligners are custom-fit to correct your bite into proper alignment, they can also double as teeth whitening trays.

This means you can just get the professional-strength teeth whitening gel from your dentist without the expense of having to have bleaching trays made. Between that and Invisalign, it is like getting a mini smile makeover at a fraction of the cost.

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

Porcelain Veneers are Too Shiny

I have the weirdest problem with my porcelain veneers. They look at bit off and I think it is because they are too shiny. It’s more of an unnatural shine. I wish I had gotten to see them before they were bonded on because maybe I would have noticed it. My dentist says they’re fine and I’m just used to stained teeth. However, I do know the difference between color and shine. Is there anyway to take away some of the shine?

Amanda

Dear Amanda,

Based on some things you said, I think the biggest thing that went wrong with your case has more to do with the skill of the dentist you choose. Most patients don’t realize that cosmetic dentistry isn’t a recognized specialty. Unfortunately, smile makeovers aren’t really taught in dental school so it is up to the dentist to invest in the training that will enable them to create stunning smiles.

Teeth with a natural shine

If you look at the teeth above, you can see that they are not uniform in either color or texture. There are ridges and bumps, as well as difference in opacity from the top to tip.

Your description makes me think your dentist did not add that texture that is necessary to make it look natural. The result will be flat teeth that look excessively shiny.

The only way to remove the shine is to have your hygienist use something like a power prophy jet or acidulated fluoride on your porcelain veneers. However, I am not going to recommend that. It damages the protective glaze on the veneers. This does more than give your veneers their shine. It also protects them from picking up stains.

Once that glaze is removed, your teeth will quickly start to pick up stains. Teeth whitening won’t work on this.

My suggestion is to ask your dentist to re-do the veneers. You paid for a beautiful smile and didn’t get one. An expert cosmetic dentist will not be satisfied if you are not.

When he re-does the veneers, make certain he uses a temporary try-in paste so you can see them in your mouth in several different lights. If you don’t love them, they need to go back to the lab. He should not permanently bond them on until you are thrilled with them.

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

New Lumineers Over Old

I had Lumineers placed quite a few years ago. I’ve never been happy with the color. My dentist knew I wanted whiter ones, but his tech guy told him it wasn’t possible to get them that white. In recent years, I think that has changed because I see a lot of people with really white teeth. I’ve been told that I can’t whiten them, but my dentist suggested we place new Lumineers on top of old Lumineers to make them look better. Have you heard about that being done before?

Madison

Dear Madison,

porcelain veneer being placed on a tooth

The one thing I agree with your dentist about is that using teeth whitening will not help with dingy Lumineers. Teeth whitening only works on natural tooth structure. Everything else he’s either done or suggested in regard to this case, I have serious concerns about.

Let’s start with the original color. Even several years ago, you would have been able to get your smile as white as you wanted. One thing you should know is that Lumineers is just one brand of porcelain veneers. This brand is highly marketed to inexperienced cosmetic dentists. However, most expert cosmetic dentists do not prefer that particular brand. The main reason for that is the company that owns Lumineers insist dentists use their lab, which isn’t known for its artistry or skill. This may be why that particular technician didn’t get them white the first time.

The second issue I have is his suggestion of new Lumineers over old. This is a really bad idea for a few reasons. First, it is just as difficult to place the Lumineers on top of the old ones as it is to just replace them.

Second, the Lumineers will not bond as well to porcelain as it will to your natural tooth structure. This puts it at risk of bonding failure. Finally, the chance of bonding failure doubles because both the new ones and the old ones are at risk.

Getting the Smile Makeover You Want

If you truly want a smile you will be proud of, you will need to go to a different dentist to get it. If you are happy with him as your general dentist, you can still use him in that capacity. Many patients have one dentist for general work and one for cosmetic work.

While there isn’t a recognized specialty in cosmetic dentistry, there is a way to ensure you have a skilled and artistic cosmetic dentist. I recommend that you see an AACD accredited cosmetic dentist. These dentists are in the top 1% of cosmetic dentists in the country. They can create a stunning smile for you. In fact, most of them even have a beautiful smile guarantee.

Don’t be surprised if whichever dentist you end up with suggests a different brand of porcelain veneers. They will know the strength and weaknesses of each and based on what type of smile you want, they will pick the brand whose strengths will give you the most benefit.

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

A Healthy Smile with Lupus

Ever since my lupus has gone active, my teeth have become a mess. I have had to have several fillings and a dental crown. The crown is on my front tooth and I read whenever you have dental work Supersmile toothpaste is the right toothpaste. Will it also help my regular teeth are do I need to brush wtih two different types of toothpaste?

Diana

Dear Diana,

I am sorry you are having to go through this. For those who are unfamiliar with this, Lupus is a horrible disease that effects every system in your body. Essentially your immune system goes haywire and your body starts to fight itself.

Your oral health is greatly impacted along with the rest of your body. According to Lupus.org, oral lesions occur in 40% of people with Lupus. These mouth ulcers can lead to oral cancer. If that weren’t enough, 100% of patients with Lupus have tooth decay and they are more likley to develop TMJ Disorder. Fun, right?

This means regular dental care is essential if you want any shot at healhty teeth and gums. The good news for you is that you seem to be staying on top of things. It is great that you are using Supersmile toothpaste. This removes stains without using any abrasives, that will destroy the protective glaze on your dental work.

There is no need to use more than one toothpaste. It is equally able to clean your natural tooth structure and even contains an appropriate amount of fluoride, which will help prevent decay.

One thing you will want to be aware of to protect your dental crown along with any other dental work you have is actually your dental cleaning appointments.

You do not want your hygienist to use anything like acidulated fluoride or a power prophy jet during the cleaning process. Both of these, while excellent tools for natural teeth, will damage or completely remove the glazing on your dental crown. As mentioned above, the glazing is what protects them from picking up stains.

Unfortunately, if your dental work does pick up stains, they will have to be replaced. Some patients are under the mistaken impression that they can just have teeth whitening done, but that isn’t the case. Even professional teeth whitening will only work on natural tooth structure.

One other bit of counsel. Make sure your fillings are mercury-free composite fillings. Your immune system has enough going on and is already in overdrive. You don’t want it reacting to the mercury, which it may perceive as an enemy to your body because of its toxic properties. Having white fillings placed should prevent that.

This blog is brought to you by Salem, MA 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.

Can I Get Dental Implants if I’m Allergic to Some Metals?

I have some metal allergies, but I am losing a couple of teeth, in different places. I could get a dental bridge, but that would mean crowning four healthy teeth. I’d really like to get dental implants for those two teeth but don’t know if that is possible with them being made of metal. What do you think?

Benny

Dear Benny,

The Type of Metal Allergy Makes a Difference.

illustraition of a dental implant next to natural teeth

When you said you had a metal allergy, you didn’t mention which metal or metals you are allergic to. That will make a difference in which way you go. Some metal allergies are common, like an allergy to nickel.

Dental implants are made from titanium unless otherwise specified. We’ll get to the non-titanium implants in a moment. Titanium is highly biocompatible and serving in various prosthetics for decades. Very few people are allergic to this particular metal. If your allergy is not specific to titanium, you can just get dental implants without any worries. But, what if your allergy is to titanium?

Zirconia Dental Implants

Metal-free Dental Implants

If it does turn out that you have a titanium allergy, boy do I have good news for you! There are now metal-free zirconia implants. Zirconia is dubbed ceramic steel. They are well witin the requirements to be strong enough to serve as a prosthetic tooth root.

It’s a little trickier to find a dentist who provides these, not because they are sub-par, but because they are newer. Many dentists like to wait until something has been around a LONG time to start incorporating them into their practice. However, it will be worth it to you to find a dentist who does provide them so you don’t have to get those dental bridges. It’s rarely a good idea to place porcelain crowns on healthy teeth. I always recommend keeping as much healthy tooth structure as possible.

Planning Ahead Saves You Money

Another thing I always recommend to someone needing dental work such as a dental crown, whether for an implant, stand-alone, or dental bridge, is they think long term.

If you are ever going to whiten your teeth, the time to do it is before your crown is made. Because the color you choose for your crown is permanent, if you choose to do teeth whitening later, your natural tooth struture will whiten but not the crown. The only way to get your teeth to match then is to replace the crown and have it made the newer color.

This blog is brought to you by Salem, MA 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.

Best Way to Fix My Nephews Teeth

My nephew wants to be an actor but his teeth are pretty crooked, at least in my opinion. He is about to graduate from high school. I want to get his teeth repaired for him as his graduation present so he can pursue his dream of being an actor. I spoke to one dentist who suggested Lumineers, but I’m a little concerned about this option. It doesn’t have the best reviews. Plus, from what I hear they will only last about 15 years. Should I look for something more permanent?

Aunt Mary

Dear Aunt Mary,

Clear Invisalgin Aligner
Invisalign’s aligners are invisible, even at a conversational distance.

If only everyone had an aunt like you! What a great way to help your nephew. I’m actually very glad you wrote because I want to make sure your money is well spent and not wasted on such a kind gift.

With how you described your concerns with your nephew’s smile, you have two options. Let’s start with the one your dentist recommended— Lumineers.

Option One: Porcelain Veneers

Lumineers is one brand of porcelain veneers and you’re wise to be concerned about the reviews you’ve read. It is highly marketed to inexperienced cosmetic dentists as being easy to place. The company claims it doesn’t require any tooth preparation (which is what they say makes it easy). In most cases, that makes the teeth look bulky.

A secondary problem is the company which makes Lumineers requires dentists to use their lab, which isn’t known for its beautiful work. Because of that, most expert cosmetic dentists prefer other brands of porcelain veneers.

If you decide to go the route of porcelain veneers, make sure you take your nephew to an AACD accredited dentist. These are the top cosmetic dentists in the country. They’ll know which brand will work best for your nephew’s smile goals and will create a gorgeous smile for him.

As far as the longevity of porcelain veneers. A lot of that depends on how well cared for they are. If they are not taken care of, they will only last around five years. If they are cared for diligently, they can last 20+ years.

However, you have a second option, which costs significantly less.

Option Two: Invisalign and Teeth Whitening

If all he really needs is orthodontics, I would suggest you go this route. With Invisalign, he can straighten his teeth without anyone knowing in half the time of traditional braces. Instead of metal wires and brackets, these use clear aligners. A sophisticated software program plans out his treatment then produces the aligners which he’ll switch out every two weeks.

Additionally, if his teeth need whitening, the aligners can double as teeth whitening trays which will allow him to straighten and whiten his teeth at the same time.

I hope this helps.
This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.