Hope Restorative & Cosmetic Dentistry

Category: Porcelain Veneers

Multi-Colored Teeth After Porcelain Veneers

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I had four porcelain veneers placed and my teeth have ended up multi-colored. First, I have the color of my natural teeth that are next to the four veneers. Then, there is one that is the white color I wanted. The other two are varying shades of gray. One of the teeth was grayer to begin with. The dentist told me that wouldn’t be a problem because they could just make that porcelain veneer thicker. It is thicker, but the colors are still different. Plus, you can tell the one is thicker. What worries me the most are the gray ones because one of them started off white. Is there a way to make this look normal?

Cindy

Dear Cindy,

Porcelain veneer being placed on a tooth

Your dentist may have been well-intentioned, but he or she was in way over his head. Many patients do not realize that cosmetic dentistry is not a recognized specialty. Any general dentist can do cosmetic procedures. In addition, smile makeovers are not taught in dental school. Instead, it is dependent upon the dentist to decide if and how much training they pursue.

A second issue in regard to cosmetic dentistry is that doing a smile makeover is actually an art form. Like any art, some artists are more skilled than others. Two artists can have the same canvas, paints, and subject yet produce vastly different results.

Your dentist does not appear to have invested much in cosmetic training, neglecting even the most basic detail. For instance, you mentioned your natural tooth color doesn’t match your porcelain veneers. It would be rare if they did. Most people want a whiter smile than their current natural one. Because of that, when a smile is wider than the number of veneers a patient is getting, a dentist will have you whiten your teeth first. This is so your adjacent teeth will be in a similar shade to your makeover.

I would love to have an image of the tooth that started white but turned gray. However, I can give you some general ideas. If the discoloration is over the entire tooth, it could either be that the glazing has been damaged, which is causing the veneer to pick up stains or possibly it wasn’t porcelain at all.

On the other hand, if the discoloration is splotchy, it is more likely that you have microleakage going on. That happens when the bonding isn’t done properly. Food and other bacteria can get underneath the veneers. This will not only result in staining, but can seriously damage the tooth underneath causing decay.

Your only option in order to get them to look natural and beautiful, will be to have these re-done. I don’t think you will get any better results from your dentist the second time around. My suggestion is you simply ask for a refund and then have a skilled cosmetic dentist re-do your smile makeover properly. The best cosmetic dentists are AACD accredited. You’ll receive a stunning smile.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.

Disastrous Smile Makeover

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I went to my dentist in the hopes of having my top four front teeth fixed. They are overcrowded and misaligned. My dentist said if we did cosmetic dentistry, it could make the teeth appear aligned and not overcrowded and I wouldn’t have to deal with two years of braces. That sounded great to me, so I agreed. His assessment was to do dental bonding on the #10 tooth, a porcelain veneer on the #7 tooth, and shaping of the other visible upper teeth. He told me that would take care of all the appearance issues. By the time he finished, the teeth were still overcrowded and misaligned and he charged me a little over 9K, which included some shaping of the lower teeth, which I never signed on for. I asked him about the results he promised me and he said in order to achieve that I would need four dental crowns on the top teeth, including root canals. All of this additional work would cost me another 7K. I decided it was time for a second opinion. The next dentist said that all this smile makeover would have required would be some teeth whitening and four porcelain veneers on the upper teeth with no root canal treatments and no crowns. I am going to get this done with the second dentist. My question is, is there a way for me to get back the money I poured into this with my original dentist?

Matthew

Dear Matthew,

Porcelain veneer being placed on a tooth

We are gathering together a large number of cosmetic dentistry horror stories, such as yours, in order to warn patients about the importance of choosing the right dentist when it comes to cosmetic dental work. You have certainly been taken advantage of by this dentist. First, he promised results he did not deliver. Secondly, he charged you for work you didn’t agree to (which is illegal). Finally, he changed the treatment plan once you weren’t happy with the results. If that was the right course of action, why didn’t he suggest that to begin with?

I am glad you sought a second opinion, and porcelain veneers are definitely a better option for the type of smile you’ll like. The word of this second dentist should help you secure the refund I believe you are entitled to. However, before you do that, I want you to make sure this second dentist is any more qualified to give you a better result than the first dentist. Many patients don’t realize that not only are smile makeovers not taught in dental school, but there isn’t a recognized specialty in cosmetic dentistry. This means any dentist can do the work regardless of the training they invested in (or didn’t).

In your place, I would seek out an AACD accredited dentist. These are the top cosmetic dentists in the country with proven technical skills and artistry. Then, have that dentist help you secure your refund and do the follow-up work.

With regard to your refund, under most circumstances, most dentists would care enough about the opinion of their peers to give you that refund. However, it sounds to me like your dentist may be less interested in the opinions of his patients and peers than in his pocketbook. In that case, you may have to get tough and threaten to sue him. I am fairly certain his insurance company will tell him to settle.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jeomre Cha.

I Hate My Porcelain Veneers

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I had a full set of porcelain veneers done (six in total). The whole thing feels like a disaster. I wish I’d have got my teeth whitened ahead of time because you can still see teeth that don’t have veneers on them when I smile and they are much more yellow than my new veneers. Even if I had though, this smile looks ridiculous. There are gaps on top between the veneers and the gum as well as between some of the teeth. They also aren’t as white as I asked for. When he first did the wax model, I mentioned all these issues and he told me it was because it was the wax. Once the real ones were made, none of that would be an issue. Then, when he did the try-in of the real ones, everything seemed exactly like the wax ones. I mentioned that and he said we should bond them on and we’d see what I thought then. I agreed, but I’m not sure why. He did appear frustrated with me so I felt a bit like I was being a “problem patient”. I didn’t like them after they were bonded on. He told me to give it some time and see if I’m just not used to the new look. I did, and still didn’t like them. Now he is saying I agreed to bond them on. Is there anything I can do?

Miriam

Dear Miriam,

Porcelain veneer being placed on a tooth

Thank you for writing. You have been through quite a bit with this dentist. You are facing one of the big problems with cosmetic dentistry these days. It isn’t a recognized specialty. That means any general dentist can do cosmetic dentistry. There are cosmetic dentists who have invested their time and money in training to do smile makeover, which is not taught in dental school. Then, there are general dentists who just call themselves cosmetic dentists.

It sounds like your dentist was going through some motions he’s heard about without understanding what they were for. Both the wax mock-up and the try-in are for YOU to decide what you think of them. If you don’t like them in either step, they should go back to the lab to be re-done until they are done to your satisfaction.

Under normal circumstances, because you had given approval for him to bond them on, you would have no recourse. You aren’t able to get a refund simply because you don’t like how they look. However, there is something you mentioned that could work in your favor. You said there are gaps between the top of your porcelain veneers and your gumline. This isn’t an issue of them being unattractive. It is a functional issue. Those gaps will trap food and other bacteria. This will cause you both gum disease and decay. So…yay you! Now you can get a refund.

My suggestion is that you have a dentist with real expertise look at your case. If they agree about that gap, they can help you secure your refund. Just make sure you don’t tell them who did your porcelain veneers until after they give their opinion. The dental world is a small one. It is better for you if they do not feel conflicted because it would mean saying something negative about a friend.

The best cosmetic dentists are AACD accredited. This is different from membership. It means they have proven their cosmetic skill and are capable of creating beautiful smiles. This is who you should get to give your second opinion and to re-do your porcelain veneers.

As to the teeth whitening, go ahead and get that done. It won’t hurt your porcelain veneers and it will even up your smile somewhat.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.

Gums Inflamed after Porcelain Veneers

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I had some porcelain veneers placed on my teeth. Since then, my gums around the porcelain veneers have been inflamed. The hygienist insists she’s never seen this before and is blaming me, essentially accusing me of not brushing my teeth well. Aside from how insulting this is, it is profoundly not true. At 42 years old, I know how to brush my teeth. When the dentist came in a little bit later, he removed some excess cement. Since then, it has been slightly better, but they are still red and inflamed. Now it hurts when I brush. I have never had problems with my gums before and don’t know how to handle the situation. My dentist sees no issues so I am not going to get any help there. Do you have any recommendations for me?

Laura

Dear Laura,

I am frustrated by the experience you are having. Whenever a patient has a smile makeover, it has been our experience that they take better care of their teeth. The fact that they are trying to pass whatever type of mistake they made on you is infuriating.
Gums inflamed from poorly done porcelain veneersIf you look at this image, you will see this patient is also suffering from inflamed gums. If a dentist were to submit this case to the American Academy of Cosmetic Dentistry, the board would reject them from accreditation.

AACD accredited dentists have to prove that they can not only produce beautiful results but that they do it in a technically proficient way so the patient suffers no problems as a result of the work. Your dentist didn’t do that.

Possible Problems with Your Porcelain Veneers

Left Behind Cement

Though your dentist did make this error, I think it is only part of your problem. However, it will cause issues with gums. This is a mistake often made by dentists who do not do a lot of porcelain veneers. Skilled cosmetic dentists have a system to prevent this from happening. The best way is to tack on the veneer by curing the cement in the middle of the tooth. Then, while the remainder of the cement is still soft, the excess is removed. Your dentist should have done this the day your porcelain veneers were seated. Doing it at your follow-up visit tells me he didn’t even realize his error until you complained.

Improperly Done Margins

You likely wouldn’t have a way of recognizing this and I doubt your dentist will either. Or maybe he will but does not want to own up to another mistake. My recommendation is for you to get a second opinion on these veneers by an expert cosmetic dentist. Look for one that is recommended on the mynewsmile.com website. All of them have artistic and technical expertise. Make sure it is a blind second opinion. That just means you don’t tell him who the dentist is that did your veneers. You don’t want him influenced by whether or not he’s friends with the dentist.

This is a huge mistake because it can not only cause gum disease but will also lead to decay because food and other bacteria will get trapped.

If it is just a matter of more cement being left, that will be an easy fix. If the margins are the problem, this dentist can help you get a refund from your dentist and can get them re-done by an expert cosmetic dentist.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha. An AACD Accredited Dentist.

Porcelain Veneers with an Overbite

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I wanted to get porcelain veneers to cover my tetracycline stains. My dentist said because I have an overbite, I will need to get porcelain crowns instead. Will this still give me a beautiful result?

Caitlyn

Dear Caitlyn,

porcelain veneer being placed on a tooth

I want you to run away from this dentist as fast as you can. He may be a great family dentist, but he is lacking in cosmetic dentistry skills. Rather than being honest with you, he is trying to steer you toward a procedure he feels comfortable with. If he does the work, the results will not be beautiful no matter which procedure he used.

This is because to do truly beautiful cosmetic dental work requires advanced post-doctoral training. Unfortunately for patients, cosmetic dentistry isn’t a recognized specialty this means any general dentist can call themselves a cosmetic dentist regardless of the amount of training they’ve acquired.

To get porcelain crowns on your teeth would require you to grind your teeth down to little stubs. That is not what you want. Why grind away healthy tooth structure? Nope. In your case, with an overbite, porcelain veneers actually make more sense. This is because they don’t require anything to be placed on the backs of your teeth the way crowns do.

Where Should You Go for Beautiful Cosmetic Work?

You want a dentist who is a true artist with great technical knowledge and skill. This is especially important for you because of your tetracycline cases. These are the most difficult cosmetic cases around. The veneers will need to be opaque enough to cover the dark stains but still have a natural light and translucency to them.

I want you to look for a dentist who has attained accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists had to pass stringent exams as well as demonstrate their artistry to an examination board. They are the best cosmetic dentists in the country and will provide you with a stunning smile. In fact, most of them have a beautiful smile guarantee.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.

Cracked Porcelain Veneer

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I received a substantial amount of money (at least to me) in an inheritance. I decided to spend it to finally get a smile I am not ashamed of. I decided to do it right and found the best cosmetic dentist I could, even though they were more expensive. I LOVE the porcelain veneers. Not only are they gorgeous, but they lengthened my teeth, which are normally pretty short. Now you can see much more of my teeth when I smile, which I’ve been doing all the time since getting this smile makeover seven months ago. My only problem is one of the veneers has developed a horizontal crack. I want to fix it but can’t keep going back to this dentist. I’ve not even picked up the phone when they call to schedule my cleaning and checkup because I can’t afford them. Do you think they will try to blame me for the crack? I’ve been so careful with these veneers because I’ve been so proud of them. I’m really worried this will fall off, otherwise I’d just ignore the crack.

Stephanie

Dear Stephanie,

porcelain veneer being placed on a tooth

I don’t think you have to be worried about them blaming you for the crack. When someone abuses their teeth, it usually results in chips, not cracks. In most cases, a cracked porcelain veneer will stay on just fine because of the bonding. However, you expressed they lengthened your teeth I am worried there isn’t much bonding there. Of course, that depends on the location of the crack, which I don’t know.

I would call them and tell them what’s going on. Don’t worry about the fact that you can’t afford them regularly. Most top cosmetic dentists are used to patients coming to them just for their cosmetic work. Some even have patients fly in from other countries to have their work done. If you tell them your financial situation they won’t continue to pester you for your regular cleanings.

The repair for this is to replace the porcelain veneer. I’m sure they didn’t give you any guarantees about how long they would last. That being said, seven months is definitely not long. I think they will repair it for you free of charge.

Tips For Follow Up Care with Porcelain Veneers

When you have to stay with your family dentist for cleanings instead of the cosmetic dentist there are some things you may need to make them aware of, especially if they’re not used to dealing with veneers. First, make sure the hygienist doesn’t use either a Power Prophy Jet or acidulated fluoride during your appointments. Both of these tools, while fine on natural tooth structure, will damage the glazing on your porcelain veneers. This will cause you veneers to pick up stains, essentially ruining them.

Second, while by no means required, I always suggest using Supersmile toothpaste when you have porcelain dental work. This safely removes stains using a special formula that collects and rinses the stains while keeping the glazing perfectly intact.

Some patients use traditional whitening toothpaste without realizing these use abrasives. While it will scrape and scratch off stains, it will also scratch the surface of your veneers causing them to pick up stains. So you are aware, teeth whitening will not fix stained veneers. It only works on natural tooth structure. Maintenance is the key to their longevity.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.

Is It Possible to Have too Much Shine?

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I have a smile makeover with porcelain veneers. I know in most cases people like their porcelain veneers to shine, but is it possible for them to have too much shine on them? My veneers are so shiny, they look fake. Is there a way to take the shine off of them?

Belinda

Dear Belinda,

There is a way to get the shine off of your porcelain veneers, but I don’t think you will want to do that. The shine comes from the glaze put on them, which is what protects your porcelain veneers from picking up stains. If you take the glaze off, it won’t be long before they begin to stain. However, you still may be able to get the porcelain veneers to look the way you want. Here is what I think the problem stems from.

Close up image of teeth.

If you look at the image of these teeth you will notice that there is texture to them. Though they are shiny, the shine still looks natural because of that texture. In fact, I bet you can’t even guess which one of those is not a natural tooth. My guess is your dentist didn’t add the necessary texture. Without that, the teeth will be flat and have too much light reflecting which is what is making them look too bright.

My suggestion would be to simply talk to your dentist and ask him to re-do them. If he cares about the quality of his work, he shouldn’t have a problem with that. After all, you paid to get a beautiful smile and that is what you should get. An expert cosmetic dentist wouldn’t even bond on your porcelain veneers until you had an opportunity to see them with a temporary try-in paste and look at them in different lights. Only when you are absolutely satisfied would they be permanently bonded.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.
AACD Accredited Dentist

Crowns for Teeth Whitening? NO!

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I have two porcelain veneers on my front teeth. One of them chipped and needs replacing. My dentist says it is because I grind my teeth. The adjacent teeth are yellowing so my dentist wants to do dental crowns on eight of the upper teeth, which would pretty much be all of them when I smile. One of the things I’m wondering about is if I chipped my porcelain veneer would I also damage my dental crowns?

Marie

Dear Marie,

Woman covering her mouth with her hand

I’m appalled by what I’m hearing and am truly hoping there something else to this story. Putting dental crowns on all your upper teeth is a massive overtreatment unless there is something else going on. Based on what you’ve said he’s doing it because one of your porcelain veneers needs replacing and your natural teeth need to be whitened. That’s insane! When you need to whiten teeth, you do just that. You have teeth whitening done. I can see where it would benefit him to suggest otherwise. Teeth whitening will bring him in a few hundred dollars. What he’s suggesting, which is a full-mouth reconstruction, will bring in a minimum of $30,000. I hope that is not his motive.

Another concern I have is replacing your porcelain veneers with dental crowns. Whenever a dentist suggests that, it brings up massive warning bells. This tells me your dentist doesn’t know how to do porcelain veneers. Therefore, he’s telling you to do dental crowns. No dentist in his right mind would remove healthy tooth structure if he didn’t need to. Your dentist would rather do that than admit his lack of skill and send you to another cosmetic dentist with more expertise.

Now, there is a third thing that concerns me and gets to the heart of your question — your teeth grinding. I cannot believe your dentist would know you grind your teeth and not provide a way for you to protect them. A simple nightguard would have kept your porcelain veneer from chipping. As to whether you will damage your dental crowns, yes, if you don’t have the nightguard.

Bottom Line—You Need a Different Dentist

I don’t think you are being well served by your dentist. Here’s what I want you to do. Spend this time during the COVID-19 to research some dentists in your area. Ideally, you’ll want one who is AACD accredited. If you can’t find one, look on mynewsmile.com and go over the websites of their recommended dentists in your area. Check their reviews and pick one.

Once the quarantine is over, do the following. Get your teeth whitened. If you choose Zoom Whitening, give two weeks for the color to settle, then have that single chipped porcelain veneer replaced and have a nightguard made.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.

Figuring Out My Smile Makeover

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I want to get a smile makeover with porcelain veneers. My dentist said he wants me to get my teeth whitened first. I thought the porcelain veneers would change the color of my teeth. Why both procedures? I’m worried this dentist is doubling up procedures.

Cathy

Dear Cathy,

a porcelain veneer wafer being placed on a tooth

Believe it or not, your dentist is trying to save you money. Yes, porcelain veneers will change the color of your teeth, but unless you are willing to place porcelain veneers on every single tooth, teeth whitening is a better option for you. Of course, if you prefer to put a veneer on every tooth, I’m sure your dentist wouldn’t mind that.

The idea is to whiten your teeth to the color you’d want your porcelain veneers. It’s it is easier to match the porcelain veneers to the whitened tooth than it is to match whitened teeth to the color of veneers.

Additionally, unless there is something structurally wrong with your bottom arch of teeth, then teeth whitening is all you’d really want there. What shows when you are smiling is your upper teeth. Your bottom teeth are briefly visible while you talk, but as long as they match the color of your upper teeth, they look fine.

The Most Important Consideration with Porcelain Veneers

When you are considering getting a smile makeover, the most important factor is who does the smile makeover. You can have two dentists use the exact same materials and the smiles will turn out very differently. This is because cosmetic dentistry is actually an art form. One artist is bound to be better than another. So how are you to find the dentist with the right artistry who can give you a gorgeous smile?

If I were in your place, I’d look for someone who is proven. See if you can find an AACD accredited dentist in your area. They are among the top 1% of cosmetic dentists in the country. It is worth it even if you have to travel to see them.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.

Two Things She Needs to Know Before Her Smile Makeover

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I’ve been wanting to get a smile makeover. I decided for monetary reasons to go with bonding instead of veneers. I want to do six teeth and am having trouble choosing the color. Is that something I do or the dentist? On that matter, I’m having trouble choosing between two cosmetic dentists who have great ratings on YELP. Is there anything else I should look for?

Catrina

Dear Catrina,

a porcelain veneer wafer being placed on a tooth

I think I can help. Let’s start with choosing your cosmetic dentist. First, while YELP is a great tool for checking reviews and getting information, it isn’t a great way to choose a cosmetic dentist. One of the reasons for that is its algorithm in listing the best is in the reviews. However, it doesn’t distinguish in what they reviewed. They could be giving the good review for being nice while filling cavities. That isn’t going to help you with whether or not he does beautiful cosmetic work. There are a couple of ways to find a great cosmetic dentist. YELP just doesn’t happen to work in this instance.

Porcelain Veneers Versus Dental Bonding

First, most cosmetic dentists won’t do a smile makeover with composite bonding. There are a couple of reasons for that. It takes longer to do a smile makeover with bonding because of the method used. Because of that, if you find a dentist who will do it, you may find it costs more.

Secondly, bonding doesn’t last very long. It will begin to pick up stains in around three years. You may think, “Well, then I can just whiten them.” Nope. Teeth Whitening doesn’t work on dental work. It will only work on natural tooth structure. The only way to get dental bonding white again is to have it redone. Now you’re paying twice the amount you originally planned.

Porcelain veneers, on the other hand, are more stain-resistant than even your natural teeth. They do not really stain unless the glazing is damaged on them. They can last for a many, many years when well cared for.

Finding That Great Cosmetic Dentist

One very easy way to find an expert cosmetic dentist is to check one of two sites. The first is the American Academy of Cosmetic Dentistry (AACD). The AACD has an accreditation program which tests a dentist’s technical knowledge and requires visual evidence of their artistry. An AACD accredited dentist is skilled and artistic.

Another site which does something similar is mynewsmile.com. The dentists who are recommended on there aren’t necessarily accredited. However, it is run by an accredited dentist who verifies both their training and their artistry. Either one of these sites can help you find someone who can give you a stunning smile.

Without those options, you could always check the dentist’s smile gallery to see if you love the results they get. Just be sure they’re putting actual cases they’ve done and not just stock photos.

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

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