Hope Restorative & Cosmetic Dentistry

Category: Porcelain Veneers

Will Porcelain Veneers Turn Dark Around My Gums Like Crowns?

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I have five porcelain crowns with the metal framework. I think they’ve been on for about 12 years now. I want to know what type of metal is used, although I guess I should have asked that before I got these crowns, and I want to know if the metal is causing the black line at my gums. I’m thinking about getting the crowns replaced, and I want to know what kind of metal to ask for so this won’t happen again. I am also getting three veneers on my upper teeth and want to see if I could experience the same problems with dark gums. Thank you. Lenny from TN

Lenny,

Thank you for your question.

Why Do Porcelain-Fused-to-Metal Crowns Turn Dark?

Porcelain-fused-to-metal (PFM) crowns form a dark line near your gumline eventually because of their foundation. PFM crowns have a foundation made from base metals or noble metals. Nickel and chromium are the base metals; gold, platinum, and palladium are noble metals.

A noble metal framework fits better, causes less sensitivity, and is less likely to corrode.

Although a dentist might try to hide the metal framework under the gum, after several years, the gums recede, and the black line is visible anyway. When a ceramist cuts the metal back near the gumline, the black gumline will be less visible. Partially masking the metal requires the crowns to be opaque, which will give them a pasty look rather than looking like natural teeth.

All-porcelain crowns don’t have a metal foundation. So, you do not have to worry about developing the black gumline. An artistic cosmetic dentist will give you beautiful crowns that match the color and translucence of your natural teeth. If you select a cosmetic dentist for your new crowns, people will not notice that you have crowns on your teeth.

Will Your Porcelain Veneers Turn Dark at the Gumline?

Porcelain veneers are all-ceramic and do not contain metals. Your veneers will not turn dark around your gumline.

Choose a skilled cosmetic dentist to replace your crowns and give you veneers. You will get natural-looking results.

Dr. Jerome Cha of Tulsa, Oklahoma, sponsors this post.

Porcelain veneer being placed on a tooth

Porcelain veneers do not dark at your gumline

Should I Be Able to Floss Between My Porcelain Veneers?

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Before I got porcelain veneers in February, I was able to floss with no problem. I’m trying to take care of my veneers, but I worry about not being able to floss. Earlier this month, I had my six-month checkup and cleaning. I told my dentist about the flossing issue, but he didn’t seem to be concerned. I use a water flosser instead, but I’m not sure it is effective since the veneers are so tight. Should I be able to floss between my veneers? – Thank you. Rhea from Arkansas

Rhea,

Thank you for your question. We are concerned that you cannot floss between your veneers, and you should be concerned, too. After you get veneers, floss you easily glide between your tooth without catching or snagging.

What If You Cannot Floss Between Porcelain Veneers?

If you cannot floss between porcelain veneers, the result is the same as not being able to floss between natural teeth. Plaque buildup can promote gum irritation, inflammation, and disease.

Flossing is a vital part of oral hygiene because it is an effective way to remove plaque. The American Academy of Periodontology confirms that without flossing between your teeth, dental plaque causes inflammation. And advanced gum disease is associated with an increased risk of diabetes and heart disease. So, flossing between your porcelain veneers is essential.

Why Can’t You Floss Between Your Porcelain Veneers?

If you cannot floss between your porcelain veneers, your dentist’s bonding technique may be at fault. When bonding veneers on, a skilled cosmetic dentist takes these precautions:

  • Prime each tooth with etching and bonding agents
  • Place bonding composite in each veneer and press the veneer onto each tooth
  • Removes excess composite (bonding material) before hardening it
  • Use an ultra-small light curing tip only on the center of the composite of each tooth
  • Floss between teeth to remove excess composite and ensure surfaces between teeth are smooth
  • Curing remaining composite with a larger curing tip to ensure a solid attachment
  • Use fine polishing strips between teeth to smooth them

We recommend that you ask your dentist to correct your veneers so that you can floss between them with ease. If your dentist does not readily help you, schedule an appointment for a second opinion with an advanced cosmetic dentist who is concerned about helping you achieve healthy teeth and gums.

 

Dr. Jerome Cha, a Tulsa, OK accredited cosmetic dentist (American Academy of Cosmetic Dentistry), sponsors this post.

A Cavity on a Veneered Tooth

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I have porcelain veneers and one of the teeth got a cavity under one of the veneers. My dentist wants to take off the veneer and replace it with a dental crown. I’m not very keen on this idea. Is it completely necessary or is there something else I can do to preserve the veneer?

Alana

Dear Alana,

A porcelain veneer being held up with a dental tool

My gut reaction here is for you to get a second opinion. Here is why.

First, for a tooth to need a dental crown, the cavity would have to be pretty substantial. In general, a crown isn’t necessary until a cavity consumes over 1/3 of the tooth. I find it hard to believe a tooth with a porcelain veneer would be that far gone. If he is suggesting a crown on a tooth that doesn’t need it, that tells me he is not comfortable replacing the veneer and is falling back on a dental crown, that he does feel comfortable with. This could be because he does not know how to bond the composite filling to the veneer. Do not try to push him into this. You don’t want to push a dentist out of their comfort zone. The results are rarely good.

At the same time, you wouldn’t want him placing a crown on your tooth either. First, it is a much more aggressive treatment. He would have to grind that tooth down to a nub. I don’t think you want to do that unless it was completely necessary. Secondly, if he is pushing you toward a crown when it isn’t necessary it does mean that he does not have much cosmetic skill. This will make it nearly impossible for him to match the crown to the remainder of your teeth. I would not let him try.

When you go to get this second opinion, I want you to make sure it is with a dentist that has the cosmetic expertise you need. My suggestion is you look for a dentist who has reached accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the world. It takes passing stringent exams as well as a board of examiners who look at a large number of specific cases cases they’ve done to make sure their artistry is worthy. Their work has to be stunning to pass.

One precaution. When you go, make certain it is a blind second opinion. That means you don’t tell him who the dentist was that you go to or what his recommendation is. If he asks, just tell him you want a blind second opinion. He should be fine with that.

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

Porcelain Veneers While Pregnant

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I am super worried about something. I just had porcelain veneers done but did not know I was pregnant at the time. I was told afterward this is a bad idea. Did I hurt the baby? If so, is there any way to fix it?

Aimee

Dear Aimee,

pregnant woman in the dental chair near her dentist and hygienist

First, congratulations on your baby! That is an exciting time and I can already tell by your concern that you are going to be a great mother. Next, I want you to take a deep breath. It is going to be okay. I’m sorry someone worried you by telling you that you’d done something wrong here.

Dentists are told not to schedule dental work with expectant mothers until the second trimester. This is because your new baby is particularly susceptible to foreign substances during their early stages of development. There is good news here, though.

The only real substance introduced into your body during the porcelain veneers procedure is the local anesthetic lidocaine. This has been proven to be safe for use during pregnancy and is often used during the delivery process. There will have been no harm to your child by your smile makeover. I hope that helps you feel less stressed.

Dental Work During Pregnancy

The general rule of thumb for dental care during a pregnancy is to schedule your routine maintenance and checkup during the second trimester. This is because the baby is more vulnerable during the first trimester and mommas are often uncomfortable sitting in the dental chair during the third trimester. Hitting between those two times seems to be the magic window.

There is an exception to this. If you have a tooth infection it is considered a dental emergency and it is important you seek treatment. An infection enters your body and can have an effect on your child as well. Untreated tooth infections, as well as gum disease, have been linked with low birth weight in newborn children. So definitely keep up with your oral health care.

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

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.

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