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Cosmetic Dental Disaster! Can it be Fixed?

I’ve had a cosmetic dentistry disaster. I asked my dentist about finding a cosmetic dentist so I could get a makeover. He said there isn’t a cosmetic dentistry specialty and they’re just general dentists who do cosmetic work. I didn’t realize that, so when he offered to do my smile makeover I figured I was safe. I think that was a huge mistake. My smile seems bulky and opaque. It’s very obvious they’re fake. They don’t look at all beautiful. Can this be fixed? If so, how?

Ingrid

Dear Ingrid,

Beautiful brunette woman with gorgeous smile
Getting a Gorgeous Smile Requires Finding the Best Cosmetic Dentist in Your Area

I’m very sorry this happened to you. While your dentist is technically right about there not being a cosmetic dentistry specialty, that doesn’t mean any general dentist can give you a gorgeous smile. Think about it in terms are art. Yes, many people graduate from art school, but aren’t some artists better than others? That’s what you’re facing.

You said the smile makeover you received is opaque and bulky. Is there any chance your dentist gave you Lumineers? That would explain both of those issues. There are many different brands of porcelain veneers, but Lumineers are often marketed to inexperienced cosmetic dentists as being easy to place. All that’s required for being certified in them is to watch a simple seminar. That’s it. Nothing which determines if they can do a good job or not.

Also, the Lumineers brand insists dentists use their lab, which isn’t thought to be that great among the cosmetic dentists who really know what they’re doing.

Finding the Best Dentist for a Smile Makeover

When you want a gorgeous smile, you need to find the best cosmetic dentist you can. But, as you’ve learned, it can be tricky. How can a patient know who is an artist and who isn’t? Fortunately, the American Academy of Cosmetic Dentistry (AACD) realized this was going to be a problem for patients. Because of that they began an accreditation program so patients would have a way of gauging the artistic and technical skill of dentists.

If a cosmetic dentist wants to be accredited they have to pass both an oral and written exam that clearly demonstrates they have advanced technical knowledge about the procedures, color theory, etc. In addition to that, there is a long list of cases where they have to submit photos of work they’ve actually done to demonstrate they’re not just knowledgeable but artistic.

An AACD accredited dentist can give you a gorgeous smile. In fact, most of them have a beautiful smile guarantee.

Can Your Smile Be Fixed?

The short answer is yes. But…. You were waiting for that “but” weren’t you? In order to get it fixed you’ll have to completely start over. I’d start by getting a refund from your current dentist. If he knows how unhappy you are with his results, he shouldn’t mind refunding the money. Though, he may not refund the lab fees, because he had to eat those.

This blog is brought to you by Dr. Jerome Cha.

Are Dentures of the Devil?

I have chronic kidney disease. For some reason, which not even my dentist understands, since I’ve been diagnosed my oral health has taken a nose dive. I haven’t changed my habits, so I don’t exactly know what’s going on. Regardless, I’m now in the untenable situation of losing my teeth. My dentist tried valiantly to save them, especially because I’m only in my thirties, but we lost. I was horribly upset at first, especially with everything else tanking with my health, but have sort of resigned myself at this point. My dentist wants me to get dental implants. I’ve had so many medical procedures and surgeries, I am kind of surgeried out. So, I suggested dentures. He acted like I told him I’d like to worship the devil. But dentures have been used for years. Surely they can’t be that bad.

Linda

Dear Linda,

An image of a woman before and after facial collapse
If dentures are worn too long it can lead to facial collapse

First, let me express my compassion for what you’ve been going through. I have a friend with chronic health problems and it’s been a painful and helpless experience watching her suffer. I’m sure you’re suffering too. That being said, and especially because of your other health issues, I want to make sure you get the best treatment possible.

Just because something has been used for years doesn’t always mean it’s your ideal solution. Look at leeches. Yes, they can remove blood, but we have much better means of doing that now. Yes, dentures were used for years and are still in use. In the past, that’s because it was all we had available.

Now we have a much better solution. Your dentist suggested dental implants for a very good reason.

Dental Implants over Dentures

The upper arch of dentures is held in by suction. The lower arch just kind of rests on the ridge of your jawbone. While many people adjust to wearing removable dentures, others find them intolerable. They’re never secure, food gets underneath them while you eat, and even the best fitting dentures reduce your chewing capacity by 50%.

Though those things can be adjusted to, there is something much more serious in your particular case because of your age. You’re just in your 30s, which means you’ll have to wear these for many years. When you remove your teeth your body begins to reabsorb the minerals in your jawbone to use elsewhere.

After about 10-20 years, you won’t have enough jawbone left to support your dentures. You’ll be a dental cripple, barely able to eat. Look at the picture at the top of the page and it will give you some idea of what to expect.

Getting Beautiful Dentures or Dental Implants

Regardless of which procedure you get, you’ll want the results to look both natural and beautiful. Every dentist has a different skill level when it comes to cosmetic work. It’s hard for patients to know ahead of time which ones do beautiful, artistic work and which just barely get by.

To be safe, you’ll want a dentist who’s reached accreditation level with the American Academy of Cosmetic Dentistry (AACD). They’re among the top cosmetic dentists in the country and are sure to give you a gorgeous smile. In fact, most of them have a beautiful smile guarantee.

This blog is brought to you by Dr. Jerome Cha.

Solution for Tetracycline Stains

I have tetracycline stains. I’m finally in a financial position where I can do something about them. I’ve seen two dentists thus far. Both gave me vastly different suggestions. I’m hoping you’ll break the tie. First, I went to my family dentist. He recommended I get porcelain crowns to cover the stains. He’s done a crown for me in the past and I liked it. Though, this one was made to match the stains. Next, I saw a cosmetic dentist. He suggested I get porcelain veneers. They’re much more expensive, but I assume are more likely to give a pretty smile. Do you know which procedure would be a better solution?

Corrine

Dear Corrine,

A single porcelain veneer being held by a dental tool

I’m glad you wrote. Tetracycline stains are some of the more difficult things to treat. I’m going to have you switch gears just a smidge. While I think porcelain veneers will be a better idea than porcelain crowns for reasons I’ll explain in a moment, more important than what procedure is what dentist.

Porcelain Crowns Versus Porcelain Veneers

Porcelain crowns require a much more aggressive treatment than veneers. They require the dentist to grind down a great deal of healthy tooth structure. Plus, let’s say a few years from now you meet a top-of-the-line cosmetic dentist. It will be too late to get porcelain veneers. Once your teeth are ground down, you can’t undo that and switch to porcelain veneers. You will always have to have crowns.

A good thing to consider is why your dentist is suggesting a much more aggressive treatment than is necessary. Most dentists will suggest the least invasive treatment so as to preserve as much healthy tooth structure as possible. The one obvious reason he’d do that is he is more comfortable with crowns, which translates to not a lot of cosmetic dentistry training. I think even if you went with the porcelain crowns you wouldn’t be happy with the results.

Now, let’s discuss the cosmetic dentist who suggested porcelain veneers. While he’s suggested a good procedure, how do you know if he’s a skilled and artistic cosmetic dentist? Cosmetic dentistry isn’t a recognized specialty so every general dentist can just call themselves a cosmetic dentist regardless of their skill level.

Choosing a Cosmetic Dentist

The American Academy of Cosmetic Dentistry recognized the problem which patients face in finding legitimately skilled practitioners. To help, they started an accreditation program. This tests both the technical skill and artistry. They have to pass stringent exams, both oral and written. In addition to that, they have to show a series of cosmetic procedures they’ve completed in order to demonstrate their artistry.

Those who pass reach what is known as accreditation level. Only about 1% of dentists in the world reach this level. This is the type of dentist you want to take care of your tetracycline stains. Not only are they incredibly skilled, but almost all of them have a beautiful smile guarantee.

This blog is brought to you by Dr. Jerome Cha.

DIY Teeth Whitening

My dentist refused to whiten my teeth until I got my teeth cleaned. It kind of ticked me off so I’ve been looking into DIY Teeth Whitening options. The one which seems to be the most legit is charcoal whitening. Is there anything I need to know about it to make it the most effective?

Dan

Dear Dan,

An image of charcoal

First, let me explain why your dentist was insisting on a cleaning. If you haven’t had a cleaning in a while and your dentist whitened your teeth anyway, the results would end up splotchy. You will end up embarrassed by how your teeth look. But, when you start with professionally cleaned teeth, the results are smooth and amazing. So, don’t get too annoyed at your dentist. He’s just trying to make sure you end up with results you’ll be happy with.

Charcoal and Teeth Whitening

The type of charcoal they’re talking about when it comes to DIY whitening isn’t the kind you’d use in a grill. They’re referring to activated charcoal, which is completely different.

The theory behind activated charcoal is it’s natural, non-toxic, and absorbent. All of that is true. You can ingest it and you’ll be perfectly safe. Unfortunately, it’s not safe for your teeth. Charcoal has quite a high abrasiveness rating. The upside is it will whiten your teeth— temporarily. The downside is because of its abrasiveness it will also scratch the enamel on your teeth, causing it to pick up stains much more readily. That lost enamel doesn’t grow back. You’re stuck with teeth that look duller because their shiny glazing is damaged and pick up stains so often you need to whiten your teeth much more than you’d ever need to under normal, healthy tooth circumstances.

If you truly want beautiful, white teeth you’re better off having professional teeth whitening done. Or, if there are other things you want to change about your smile, you could go all out and get a total smile makeover with porcelain veneers.

Professional Teeth Whitening Options

Most cosmetic dentists offer two types of teeth whitening:

  • In-office Whitening
  • Take-home Whitening

How do you know which option is better for you? It really depends on the level of whitening you want. If you just want to get your teeth as white as they possibly can get, then I’d suggest in-office whitening, such as you’d get with Zoom Whitening. The benefit is you can get it done in just one appointment. The downside is you have no real control over the level. Your teeth will be as white as they can get. It also costs just a little more than take-home whitening.

IF you want to whiten your teeth, but gradually with control over just how white they’ll get, then take-home whitening is for you. It costs a little less, but if you want them very white, it could take several weeks.

Getting a Total Smile Makeover

I mentioned porcelain veneers earlier. This is the top of the line for cosmetic dental procedures. These tiny wafers of porcelain can remake every aspect of your smile. They can change the shape, size, and color of your teeth all in one fell swoop.

This blog is brought to you by Dr. Jerome Cha.

My Dentist Lied about Porcelain Veneers

My dentist made me four porcelain veneers. When they came in, he held them up for me to look at. I told them they looked bulky but he assured me that’s because they weren’t bonded on yet and that once they were bonded on I’d see they were perfect. He’s the cosmetic dentist so I thought he knew what he was talking about. When they were bonded, they looked even worse than I imagined. Even worse, you could see the teeth next to them which didn’t match in color. It makes it very obvious my other teeth have had work done. I told him I didn’t like them but he said nothing could be done now that they’re bonded on. Is there anything I can do or am I stuck with these?

Marianna

Dear Marianna,

A single porcelain veneer being held by a dental tool

Calling your dentist a cosmetic dentist is a little generous at this point. He’s made so many fundamental mistakes I don’t know where to begin. First, let’s start with the mismatched teeth. At a minimum, your dentist should have suggested you whiten your teeth before getting porcelain veneers. That way they’d have a better chance of blending in with the veneered teeth. Ideally, your dentist should have suggested you get the number of veneers necessary to cover the teeth which are visible when you smile. Most cosmetic dentists do six for narrow smiles and 8-10 for wide smiles.

Secondly, he didn’t bother to use a try-in paste, so you could see the veneers on your teeth without the restriction of permanently bonding them. Either he didn’t bother learning the basics of his craft or he doesn’t care.

Here’s what I want you to do. First, give him a chance to make this right by giving you a refund. If he refuses, I want you go to an expert cosmetic dentist and have him look at your case. If he agrees with you, he can call your dentist and put some pressure on him. Sometimes a dentist is more willing to listen to a peer.

How to Find an Expert Cosmetic Dentist

It’s hard for patients to know who is qualified and artistic enough to create a beautiful smile for them. Even if you could interview them ahead of time about their training and technique, you likely wouldn’t know what was a good answer. Fortunately, there are two great resources for patients in your position.

  • The American Academy of Cosmetic Detnistry

The AACD has an accreditation program which vigorously tests dentists in both their technical skills and artistry. Anyone can be a member, but accredited members are the cream of the crop. You will get a beautiful smile. In fact, many of them even have a beautiful smile guarantee.

  • mynewsmile.com

If there isn’t an AACD accredited dentist in your area, there’s still hope. I’d look on the mynewsmile.com website. You can input your zip code and the number of miles you’re willing to travel and they’ll recommend expert cosmetic dentists in that radius.

Best of luck to you.
This blog is brought to you by Dr. Jerome Cha.

Avoiding a Dental Implant Horror Story

I keep hearing you have to be careful with who does your dental implants or it can be a complete disaster. I’ve read countless horror stories online. How do I find the best dentist to do my dental implants? I don’t want to end up another story on the internet.

Celina Y.

Dear Celina,

Illustration of dental implants in three parts

You’re wise to check ahead of time. I don’t know if you’ve already talked to your dentist about this. It could be that your dentist will be the best dentist for you, but let’s go through a few things first.

The Best Implant Dentist Will Have Extensive Post Graduate Training

There are several very reputable schools for dental implant study. General Dental school does not give enough training in such an advanced procedure. Never hesitate to ask a dentist where he received his (or her) implant training. Here are some of the best programs for that study:

  • The Misch International Implant Institute
  • The Las Vegas Institute for Advanced Dental Studies (LVI)
  • Dawson Academy

The Best Implant Dentist Can Do Both the Surgery and the Restorative Crown

Many mistakes are made regarding dental implants because of simple miscommunication between the dentist and the surgeon. If the surgeon places the implant in the wrong place, then what? You’ll have to have the implant completely re-done, which would mean the additional procedure of bone grafting and then a second surgery. Believe it or not, this happens more often than you’d think.

When the dentist and the surgeon are the same, there isn’t that danger. The dentist knows exactly where the implant needs to be placed for optimum security and aesthetic value.

The Best Implant Dentist Can Give You a Beautiful Restoration

You don’t want to just have a secure implant. You’ll also want a beautiful restoration. Check out your dentist’s smile gallery to make sure the dental crowns they craft are natural looking.

If your implant is being placed in a visible spot, and you’re not completely satisfied with the color of your teeth you’ll want to get them whitened before you have the implant crown made. Once the crowns completed, the color cannot be changed.

This blog is brought to you by Dr. Jerome Cha.

30 Years of Dentures – Can My Smile Be Pretty?

I’ve had dentures for over thirty years. I’ve spent my life embarrassed by my smile. The other day I read something that reminded me I’ve never tried to do anything about it. Instead, I accepted it as a fate I couldn’t change. Now I’m wondering. After all this time, is it too late for me to have a pretty smile?

Miranda

Dear Miranda,

You’ve got a few issues going on here. But, first let me tell you before we go into what to do that yes, you can absolutely have a beautiful smile again.

Sadly, your dentures could have been gorgeous from the beginning. Many patients feel like what their dentist gives them is as good as it gets, especially when dentures are concerned. Maybe it’s because they remembered their grandmother’s dentures looked similar. It no longer has to be that way.

It would have taken a better cosmetic dentist than you obviously had. But, gorgeous dentures are done every day by expert cosmetic dentists. Looking at Dr. Cha’s smile gallery, there are a few patients there who had partial dentures placed. You can see they are stunningly gorgeous. When it comes to beauty, it’s not the procedure nearly as much as it is the dentist.

But how do you find such a dentist? When it comes to finding the most artistic and skilled cosmetic dentists, I recommend getting a dentist who’s reached accreditation level with the American Academy of Cosmetic Dentistry (AACD).

Problems with Dentures

However, your bigger issue is not just how it looks. The downside of dentures is far greater over the long term. When your teeth were removed, your body wanted to preserve the minerals which are no longer necessary to retain your teeth. Unfortunately, that means you’ll start losing jawbone. Eventually, you won’t have enough jawbone to retain your dentures, leaving you a dental cripple.

Solution to the Problems with Dentures

Illustration of dental implants in three partsFirst, you’ll need to build up your jawbone again. This can be done with a procedure called bone grafting. This will provide you with bone again. From there, you have two choices. You can get your dentures re-done. You will have similar problems with losing jawbone all over again, along with the other types of problems which go along with dentures.

You have another option, though. My suggestion would be for you to instead of replacing your dentures to get dental implants instead. You’ll find that your quality of life goes up significantly, especially your chewing capacity.

This blog is brought to you by Dr. Jerome Cha.

Why Would Porcelain Veneers be the Price of a Home?

I had a disastrous first smile makeover. Even the dentist who created it knew it was awful and offered me a full refund without me even asking. That should tell you how bad it was. So, now I’m off to get this fixed. You can imagine I’m not too willing to smile at this moment. The “makeover” is humiliatingly bad. I made a list of cosmetic dentists in my area. I’ve tried one who was highly recommended in fact, I heard that people fly in from other countries to have him do their makeovers. Unfortunately, he quoted me the price of my home. Is that what I’m looking at if I want this fixed?

Cora L.

Dear Cora,

A single porcelain veneer being held by a dental tool

I’m going on the assumption that your house is worth more than $100,000. That’s pricey even for the best of the best cosmetic dentists. Is it possible he quoted you a full mouth reconstruction? Did he say anything about your bite being off?

Some dentists only want to work on the “ideal” treatment, but a great cosmetic dentist can give you a gorgeous smile even if your bite is a bit off. Though, if it’s very off, you may want to look into TMJ disorder because you don’t want an additional problem.

What you were quoted isn’t a typical cost of getting porcelain veneers. I wouldn’t panic that you’ll have to mortgage your house to get this fixed. In fact, cost isn’t the biggest factor in determining who’s a better dentist. I know a couple of dentists in the area who might be able to illustrate this for you.

A Tale of Two Dentists Who do Porcelain Veneers

Dentist “A” costs a fortune. He gives gorgeous smile makeovers. Dentist “B” isn’t the cheapest but is less than dentist “A”. He gives gorgeous smile makeovers. It’s more about the skill of the dentist than it is the price.

In your place, because you’re already repairing a disaster, I’d say you need a highly skilled and artistic cosmetic dentist. See if there’s an AACD accredited dentist in your area. Most of them even have a beautiful smile guarantee.

If there’s not one within a reasonable distance, then look on the mynewsmile.com website. They list artistic cosmetic dentists by area. A dentist can’t buy their way onto the site. Either way you’ll get great results.

This blog is brought to you by Dr. Jerome Cha.

Teeth Whitening and Pot Stains

Can you tell me if teeth whitening can get rid of pot stains? If so would someone use the tray teeth whitening or the Zoom? Asking for a friend….

Dan S.

Dear Dan,

an attractive white smile
After Teeth Whitening

Here’s what you can tell your friend…

You can imagine there haven’t been any clinical studies done on this to date. Not only is a brand unwilling to give patients marijuana, they’re not likely to align their brand with it either. Though, my guess would be this will change because more states are legalizing its use.

Even without the studies, I can tell you that teeth whitening can remove marijuana stains because of the nature of THC stains that have been observed in patients. That being said, there are some things you should know first.

Any teeth whitening needs be done on clean teeth. If you haven’t had your teeth recently cleaned, the whitening gel will not distribute evenly which will give you blotchy teeth. Not an attractive look.

As to whether to use take-home whitening or Zoom whitening depends on how quickly you need results. Zoom will completely whiten your teeth in one appointment. Take home does it gradually so the results can be as brilliant but will happen over a period of weeks instead of the same day.

Before You Whiten Your Teeth

Are you certain your friend’s stains are from marijuana? THC stains are usually very easy to remove so if your friend regularly brushes his teeth and gets check-ups there really shouldn’t be that much staining, at least not from that.

It could be that he’s assuming it’s from that but they’re actually stained from things like cigarettes or coffee/tea, etc. Those will need professional whitening as they are harder to remove and get into the pores of the teeth more readily.

Pot Smoking and Oral Health

Something else to be aware of. People who smoke marijuana have a much higher rate of gum disease and decay. Most of that has to do with the effects of THC on the gums. I would also venture to guess that when someone is high, they’re binging on lots of food because of the “munchies”. That’s more likely to be things like carbs, sugary snacks, and sodas than it is to be carrot sticks and other healthy snacks. Plus, it’s highly unlikely brushing and flossing after snacking like that is going to be high on their priority list if they happen at all.

Let your friend know how important it is he brush carefully afterward, and also see a dentist regularly. Otherwise, he will develop gum disease which leads to tooth loss. Then he’s looking at expensive tooth replacement options such as dental implants.

Some recreational users avoid the dentist out of fear of being turned in. That’s really not a legitimate fear. They won’t turn him in, with the possible exception of if he came to the office high and was trying to drive himself home. That would make him a public danger.

This blog is brought to you by Dr. Jerome Cha.

What Do I Look For in the Best Cosmetic Dentist?

I want to get drop dead gorgeous porcelain veneers. My aunt, who’s filthy rich, asked me what I dream about. I told her having a smile which doesn’t embarrass me. Then she handed me a blank check and said. “Go go it.” She was serious, too. I burst into tears. Now that I have this dream as a possibility, I want to do it right. How do I go about finding the best cosmetic dentist?

Thank you,
LeeAnne

Dear LeeAnne,

A single porcelain veneer being held by a dental tool

How exciting! You have a very generous aunt. You’re also wise to be doing research before investing in a permanent smile. I’m sorry you’ve spent your life feeling embarrassed about your smile. If it’s any consolation about half of all Americans feel the same way.

When it comes to finding the best cosmetic dentist, there are three skills that are of equal importance.

  • Technical Skill
  • An Artistic Eye
  • Empathy

The first one always makes sense to patients. Of course you want a dentist with the skill to do the procedure, but what do artistry and empathy have to do with it?

Creating a beautiful smile is like creating a work of art. Two artists can have the same subject and their painting will turn out completely different depending on their level of artistry. The same is true with porcelain veneers. The dentist has to understand how facial shape, smile width, subtleties of color, and shape of the teeth all work together to create a portrait of sorts.

Empathy is equally important. You sort of explained why during your question. You have lived with a smile that you’ve been ashamed of your whole life. You want one to be proud of. You need a cosmetic dentist who understands this is about how YOU feel about the results. Not how he feels. You don’t want a dentist who lets pride in his “creation” get in the way of giving you your dream smile.

How Do You Find the Best Cosmetic Dentist?

The easiest way to locate a skilled, artistic cosmetic dentist is through the American Academy of Cosmetic Dentistry (aacd.com). They have an accreditation program to separate the sheep from the goats. With no offense intended to goats. They have to pass stringent oral and written exams as well as demonstrate artistry in a list of recent cases they’ve completed. Bear in mind that being a member and being an accredited member are different.

Not everyone has an accredited dentist near them and there are some fantastic dentists on their way toward accreditation that just haven’t finished yet. It’s a long process. In that case, check out the mynewsmile.com website. They recommend skilled artistic dentists by zip code and the distance you’re willing to travel.

But what about empathy? How do you measure that ahead of time? I’d suggest two things. First, check their reviews. What type of experience have other patients had with them. Second, make sure they have some sort of beautiful smile guarantee. By that I don’t mean a smile they think is beautiful, but one YOU love. Check out Dr. Cha’s guarantee to see what I mean.

I hope this helps!

This blog is brought to you by Dr. Jerome Cha.