Hope Restorative & Cosmetic Dentistry

Category: Porcelain Veneers

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.

Porcelain Veneers and Root Canal Treatments

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Is it safe to get a root canal treatment when you have porcelain veneers? I’m hoping it won’t damage them. I really like my smile now. I don’t know for sure, I just know there’s been some pain in one of my teeth. The last time I had a tooth feel like this it required a root canal treatment. I’m not sure what to do.

Kelly

Dear Kelly,

a porcelain veneer wafer being placed on a tooth

The first thing I’d like you to do is to see your dentist and have the tooth in pain evaluated. It may be nothing, but if it is you don’t want to leave it until it becomes a dental emergency. It is always much easier to treat something early on.

A root canal treatment can be done, even with porcelain veneers. It’s fairly simple to open a path to the canal of the tooth at the back of the tooth. This won’t affect the veneer at all. What you have to beware of is whether or not the tooth behind the veneer will turn dark, which can sometimes happen after a root canal treatment.

Fortunately, there is a way to prevent this. You just have to find a dentist who understands the right procedure.

Keeping a Tooth White After a Root Canal

Before agreeing to a root canal treatment, you’re going to test the dentist by following these instructions.
1. First, ask your dentist if the darkening of the tooth can be prevented. If he says yes, you can move on to the next part of the test. If he says no, he’s already failed.
2. Once you find a dentist who says the darkening can be prevented, ask him how. He or she should answer they will make sure any gutta percha and other root canal filling materials are cleaned out of the inside of the crown of the tooth.
3. If they say that, you’re in good shape and the dentist has a good knowledge of keeping this a true color for you. If they don’t say that, consider them failed. Whatever you do, don’t try to teach them about what you were listening for.

You want a dentist who cares enough about his or her patients to keep up with their continuing education and learn these developed techniques.

A dentist may try to insist on a dental crown to keep it from breaking. If it is a front tooth, either incisor or canine, a crown will actually weaken your tooth, not strengthen it. What you need instead, is a dental post. They’ll need to provide you with a flexible whitish post.

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

Dentist Stained my Lumineers

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I’m so upset. I spent a fortune on these Lumineers and they are an absolute disaster. First, I told him I wanted a very white smile. He said they could do that. When he bonded them on, though, they weren’t nearly as white as I asked for. When I mentioned that he said in order for them to look natural they have to add a slight stain. If I wanted my natural looking teeth, I wouldn’t have paid a fortune to have whiter ones made. I insisted that he make them whiter. He told me they couldn’t be whitened but he could remove the stain. I agreed to that not knowing he was going to essentially drill the top layer off. Now I’ve got misshapen, dull looking teeth. What do I do?

Caryn

Dear Caryn,

A porcelain veneer being placed on a tooth

The dentist is more important than the brand of porcelain veneers

The first thing you need to know if your dentist isn’t a true cosmetic dentist. Cosmetic dentistry isn’t a recognized specialty. Every cosmetic dentist is just a general dentist who enjoys doing cosmetic work. Unfortunately, skill and training vary. I don’t think your dentist truly sought expert training in cosmetic work.

A few things make me think this. First, he thought a stain was necessary. True cosmetic dentists understand patients want very white smiles. As you said, they’re not looking for natural color. They want clean and white. He didn’t understand that. Second, he thought he knew better than you. In general dental school we are taught dentists know best. However, when we study cosmetics, we know it’s what the patient wants that rules. It’s not repair we’re going for but beauty. That beauty is in the eye of the patient.

Finally, he didn’t understand what he was doing would ruin them. Or worse, he did and didn’t care.

You need a refund. Your dentist has ruined your smile makeover. Not that you were pleased with it anyway. In a small way, his drilling off the top layer is a blessing in disguise. Before he ruined them, it would have been hard to get a refund. The standard for dental work is functional, not beauty.

However, now, without their glazed layer, he’s ruined them and they are not functional. Tell him you want a refund. Your next step is to find a true cosmetic dentist.

Getting Gorgeous Porcelain Veneers

I’ll say one other thing first. If all you wanted was a whiter smile, your dentist would have better served you by offering you teeth whitening. Professional teeth whitening can get your teeth brilliantly white and is much less expensive than Lumineers. He didn’t, which makes me feel he was taking advantage of you.

I could be completely wrong about that. Maybe you wanted some other things changed about your teeth, such as their shape or size in addition to the color. In that case, a smile makeover with porcelain veneers would be the right course of action.

If you want a stunning smile, you should go the website of the American Academy of Cosmetic Dentistry. They have a link to find a cosmetic dentist. Make sure you check you’re looking for an accredited cosmetic dentist. These are the ones with the training and artistry to give you a smile you’ll be proud to share.

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

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