Hope Restorative & Cosmetic Dentistry

DuraThin or Lumineers

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Will you please advise me. I am going to get a smile makeover and am trying to decide between DuraThin or Lumineers. The pictures I’ve seen with the DuraThin look a little better than some of the Lumineers pictures. Is there a huge difference in price?

KellyAnne

Dear KellyAnne,

Porcelain veneer being placed on a tooth

I would like to change the way you are thinking about your smile makeover. You are looking at the brand of porcelain veneers. This is a good strategy with some things, such as cars or jewelry. However, it would not be as useful with any type of art form and that is really what a smile makeover is.

It requires a dentist to fashion a smile for you. Think about it like a painting. You can commission two painters to paint a painting. They could use the exact same materials, including the model, and produce two very different type of paintings.

What you should be looking at is the dentist. Smile makeovers are not taught in dental school. Instead, a dentist has to invest in post-doctoral training. Even then, it takes a great deal of practice as well as some natural artistic talent. That is what you need to be researching. The artist– not the materials.

Think of Lumineers and DuraThin as just different brands of paint an artist will use. One dentist will create a masterpiece and one a disaster, both using the same materials. So, now you are probably wondering how you go about finding this wonderful artist?

While cosmetic dentistry is not a recognized specialty, there is an accreditation program with the American Academy of Cosmetic Dentistry. AACD accredited dentists have to pass stringent exams as well as demonstrate their artistry with a large number of cases. It takes years to accomplish. You will find these dentists to be in the top 1-3% of cosmetic dentists in the world.

My advice is to find an accredited dentist, go over what type of smile design you are looking for, and let him or her choose the right materials and brand of porcelain veneers that will create a stunning smile for you.

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

Implant Crown Can’t Match Other Teeth

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I’m trying to figure out why my dental flipper, that I wore while my dental implant was healing, was better able to match my other teeth than my implant crown is. I’m on crown number three and none of them have matched the adjacent teeth. This last visit my dentist told me I should be grateful for what I have and stop trying to get everything perfect. Some teeth are complicated and don’t match. She said my teeth are between the two shades she can choose from and I’ll never be satisfied. She also warned that if I kept having her mess with the crown, I could end up losing the dental implant. I was thinking of going to a different dentist to have the crown down, but don’t want to risk losing the implant due to further manipulation. What should I do? The flipper matched better. Can’t she just use the same material as that?

Pam

Dear Pam,

It really burns me up when medical professionals blame patients for their own lack of knowledge. Obviously, the teeth can be matched or the dental flipper wouldn’t have done it. Plus, you are NOT asking too much to have your teeth match. Everyone wants their teeth to be uniform in color.

In truth, even the best cosmetic dentists will take a couple of try-ins before they can match a front tooth perfectly. Knowing that, they will use a temporary try-in paste so that it is easy to remove. Only once the porcelain crown matches your adjacent teeth will it be permanently bonded. Based on what you’ve said above, your dentist is permanently bonding it each time and then having to grind it off. This is another clue to me that she is not experienced with cosmetic work. Even with that, it will be okay for you to go to another dentist and get this matched without harm to your dental implant. That is a scare tactic on her part to get you to leave her alone.

color map for a tooth

As for how to match a tooth, what your dentist is doing by just using the basic shade for a crown, works fine on back teeth, but our front teeth need some help from the dentist to match it perfectly. Going by your dentist’s feedback, let’s say A1 was too grey/white and A2 was too yellow. That’s okay. What she’d do is take notes on what she’s seeing on the tooth then add different tints, drawing a “map” of sorts (as you see above) to show the ceramist where to add these shades to obtain the right visual effect needed to match your adjacent teeth.

Even without all that work, your dentist could have at least told the ceramist to go halfway between A1 and A2. Yet, she doesn’t seem to want to bother with even the basics. Bottom line, you’re with the wrong dentist. The best dentists work to give their patients the best result. Her comment about “Stop wanting everything perfect.” is very telling. She’s happy with sloppy effort and doesn’t seem to take any real pride in her work.

If you have an AACD accredited dentist in your area, that would be the ideal. These are the top cosmetic dentists in the country. If you don’t, there may still be a highly skilled cosmetic dentist near you who just hasn’t finished the accreditation process. In that case, try mynewsmile.com. They have a “find a cosmetic dentist” link. They only list skilled cosmetic dentists, so you should be able to find someone in a reasonable distance to you.

Don’t give up. You can have a smile that matches.
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.

Can I Switch from Dentures to Dental Implants

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I’ve been in dentures for 25 years. I don’t like them and am having a hard time keeping them in. Is it possible for me to switch to dental implants at this point?

Ken

Dear Ken,

illustration of dentures beside a dental implant

One of the biggest problems with dentures is the shrinking of your jawbone. This is what you’re experiencing right now. When your teeth were removed your body recognizes that. In an effort to be efficient with its resources, it will resorb the minerals in your jawbone where it perceives they will be more useful. That is why your dentures are no longer fitting.

Dental implants prevent that. Your dentist, or oral surgeon, will surgically place the implants into your jawbone. This tells your body that you still have teeth and it preserves your jawbone, preventing facial collapse.

It is possible for you to switch to dental implants. However, because of the amount of bone loss you’ve experience, it will require an additional procedure.

Getting Dental Implants after Dentures

You’ll need to have bone grafting done. This is an outpatient procedure which will build up your bone structure. Once that is healed, then it will be time to start the dental implant procedure. Without that bone, there will be nothing to hold the dental implants in place. They will come loose and fall out.

This is an advanced procedure, so you’ll want to make certain you’re going to a dentist which has the post-doctoral training in that procedure. With an experienced dentist, there is about a 98% success rate. But, you don’t want to go to an inexperienced dentist for this. There are too many things which can go wrong.

The good news is, this is also a chance for you to really update your smile. A dentist who has advanced training in both dental implants and cosmetic dental work can give you a stunning smile. This is the chance for you to get your dream smile. One you’ll be proud to share with the world. The best cosmetic dentists are AACD accredited. So, see if you can find an accredited dentist who does dental implants.

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.

Cosmetic Dentistry Malpractice

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I need help. I’ve spent over $25,000 to get my smile makeover. I had teeth which had composite bonding on them but they were old and needed to be replaced. I was told the best thing to do would be crowns on the top teeth, with whitening on the bottom. I was nervous about this because I had healthy teeth and wasn’t keen on grinding them down to nubs only to have a smile I don’t like. They assured me over and over they wouldn’t be bonded on unless I liked them. That’s not what happened.

We went over extensively the smile design I wanted along with the color. When the temporary crowns were ready they were okay. When the permanent ones came in, I wasn’t too happy. They were too dark. I said that before they put them in, but they insisted once I saw them in, I’d like them. They were still too dark. I still told them I didn’t like them but they insisted they were exactly what I requested and bonded them in.

Not only are they ugly, but uncomfortable. I am not getting anywhere with this practice. Even when I told them they hurt they suggested I give it a couple of weeks first. What do I do? I’m out quite a bit of money and am worse off than I was before agreeing to this debacle.

Katherine

Dear Katherine,

A Woman Giving a Thumbs up in the dental chair
The Best Dentists Listen to their Patients

First, you did not agree to this debacle. You agreed to get a beautiful smile makeover. They didn’t do that. In fact, you have a good case for malpractice. One of the tenents of dentistry is informed consent.

Though they promised you’d love your smile or it wouldn’t be bonded, they seemed to have had no intention of keeping their word. They bonded those crowns on without your approval.

Another thing I will bring up, though there is nothing that can be done about this particular bit, is they shouldn’t have used crowns for a smile makeover on healthy teeth. Smile makeovers are most often done with porcelain veneers which don’t require the teeth be ground down.

If you want to get your money back, you are going to have to get tough. This doesn’t sound like the kind of practice that cares about what their patient thinks. They likely won’t just give you a refund, though do ask.

If they say no, tell them you are willing to go to a lawyer and follow through. You may also show him this post as well. That should get them moving a bit.

They may offer to just do the case over for you. That’s up to you. Personally, I wouldn’t let them near my teeth. Instead, I’d like you to have your dentist pay for a better cosmetic dentist to re-do the smile makeover properly.

Finding the Best Cosmetic Dentist

What you’ll want to do is get the best cosmetic dentist in your area to do this. It will even be worth it if you have to drive to a nearby city. With true cosmetic dentists, your smile will be stunning.

In your place, I would look for an AACD accredited dentist to re-do your crowns. They are the top cosmetic dentists in the country. In fact, I don’t think you’d find one of them who’d be satisfied if you weren’t. Most of them have a beautiful smile guarantee. You can find them by doing a search on aacd.com. Just be certain you check that you’re looking for an accredited dentist. That makes all the difference.

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

Dentist Yelled Because I Didn’t Like My Crowns

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I’m having to replace four crowns which are aging. Originally, my crowns were a beautiful white color. My new dentist has made me temporaries but they’re yellowy and don’t feel or look like they have the right shape. He wants to make the permanent ones and I’m not wanting to. I told him my concerns and he actually yelled at me saying they “were perfect” and I’m unreasonable. I left telling him not to even order the permanent ones. However, now I have these hideous temporaries and I don’t know what to do. These are my front teeth.

Penny

Dear Penny,

Beautiful brunette woman with gorgeous smile
To get beautiful dental work requires the right cosmetic dentist

This “I know better than you” attitude is what dentists learn in dental school. However, those who invest the time after they graduate to learn that when it comes to creating gorgeous smiles it is what the patient thinks which matters.

A true cosmetic dentist would never have behaved the way your dentist did. You were wise not to allow him to move on to the permanent crowns. You would have been miserable every time you saw them.

Plus, if the shape is off, it can throw your bite off. Then, you risk getting TMJ Disorder.

Finding a Cosmetic Dentist

Especially because you’re talking about your front teeth, you need an expert cosmetic dentist. In your place, I’d look for a dentist who is accredited with the American Academy of Cosmetic Dentistry.

Accredited Dentists are among the top in the world. They’ll give you a stunning smile. If you’re not satisfied, neither are they.

I’m going to suggest, because you are about to get new crowns and you said you like them to be white, make sure you teeth are the level of whiteness you’ll be happy with for a long time.

If they’re not, it is important you get your teeth whitened before getting your permanent crowns. This way they’ll match your permanent tooth color and you won’t have to re-do anything.

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

Avoiding Disappointing smile makeovers

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One common theme the best cosmetic dentists see in their practice is patients who come from other practices because they received a disappointing smile makeover. It’s not awful. It’s just average. When you spend that much money for a smile makeover, average is the worst. Why? It’s not bad enough to get your money back, but it’s absolutely nowhere close to the dream smile you’d been saving up for all this time. While patients who leave Dr. Cha’s chair are thrilled with their stunning new smile, it would have been better if they could have received that the first time around and not had to come to him to fix what their dentist couldn’t.

Woman with beautiful smile

The key to a beautiful smile is going to the best dentist

The #1 Factor in Avoiding a Disappointing Smile Makeover

The most important decision you make isn’t the type of porcelain veneers you get. We often see the debate of Lumineers versus Other brands of porcelain veneers. It’s not whether you get ultra-thin versus traditional. It’s not the brand.

Simply put, the wrong dentist can ruin all of it. He or she can have the best materials and a patient with an idea facial structure, yet his output is mediocre at best. Why?

Smile Makeovers aren’t Taught in Dental School

When dentists go to school, they are taught how to clean, examine, and repair teeth. Cosmetic dentistry is something completely separate. Things like smile makeovers, color theory, smile esthetics, etc. aren’t taught.

Instead, a dentist has to make the effort to get the training they need post-doctorally. They’ll need to go to schools like The Las Vegas Institute for Advanced Dental Studies, among a few others to learn these procedures and the art form that makes them stunning.

Smile Makeovers are an Artform

Like any art form, some artists have more skill and a naturally artistic eye than others. Two sculptors can have the same subject model for them. Both will likely get the form of the subject. Yet, somehow, one is able to capture the spirit of the subject more than the other.

This takes training, experience, and a willingness to understand what the end result should be before even starting.

How Do Patients Locate the Best Cosmetic Dentists

While patients used to be left to flounder and evaluate the training and artistry of dentists on their own, that is no longer the case. The American Academy of Cosmetic Dentistry (AACD) began an accreditation program. This tests the dentist’s technical knowledge with both oral and written exams.

It also tests their artistry by requiring them to present a large number of cases they’ve recently done themselves. Dentists which are awarded accreditation are among the top 1% of cosmetic dentists in the world. They’ll give you an absolutely stunning smile. If you want the best dentist, choose an accredited one.

Most of them even have a beautiful smile guarantee.

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

Do I Need a Special Dentist for Implants?

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My husband wants to get two dental implants. I think he needs a specialist and he said regular dentists do it. Because we’re talking about surgery, I just want to make sure he gets the best care possible. What’s the right type of caregiver for this?

Cindy

Dear Cindy,

Illustration of dental implants in three parts

I don’t blame you for wanting the best dentist possible for your husband’s care. In fact, it’s not just the sign of a loving wife, but a wise one as well. To answer your question, there isn’t a dental implant specialty, but there is a distinction in what type of dentist your husband should see for his implant procedure.

Finding the Best Dentist for Dental Implants

The first thing you want to look for is a dentist who is well-trained in the dental implant procedure. When I say well-trained, I’m not referring to a good dental school. This procedure is so advanced it requires significant post-doctoral training.

For instance, Dr. Cha completed every course at the famed Misch International Implant Institute. Not only that, he’s done so many successful implant cases he’s now a fellow at the International Congress of Oral Implantologists (ICOI). This puts him among the top implant dentists in the world.

The second thing you’ll look for is a dentist who can do the surgery himself. Many dentists who say they do dental implants actually only do the crown portion and farm out the surgery to another practice. While that can work, often communication issues arise which means the dental implant isn’t placed in the exact position the dentist needs.

Oral surgeons may be good at surgery, but they don’t always understand the science behind how teeth should properly meet with each other. This can lead to biting or aesthetic issues. If you have a dentist trained in the surgery, there’s no chance of bad placement through miscommunication.

Finally, you’ll want a dentist who is skilled in cosmetic work. You want the porcelain crown used for the tooth to look both beautiful and natural, blending in perfectly with your natural teeth. Ideally, you’d find a dentist who is not only highly qualified in dental implants but is also accredited with the American Academy of Cosmetic Dentistry (AACD).

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

Avoiding My Sister’s Porcelain Veneers Disaster

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My sister and I were both planning on getting a smile makeover. She beat me to the punch and I’m feeling glad she did because I’m hoping to learn from her disaster. I don’t want to sound mean but her teeth look like horse teeth. Is there a way I can make sure my teeth won’t look bulky? She said hers were no-prep. Is that the problem or is it something else? She’s pretty disappointed in her smile.

Elaine

Dear Elaine,

A porcelain veneer being placed on a tooth

I wonder if your sister’s dentist placed Lumineers on her teeth. They’re a brand of porcelain veneers which are highly marketed as being no-prep. The problem is some smiles do need prep even with an ultra-thin brand of porcelain veneers. Otherwise, they look bulky. Your sister’s smile sounds like one of those.

Sadly, these are marketed to inexperienced cosmetic dentists as being easy to place. Being easy to place is completely different than making them look stunning. There’s much more to porcelain veneers than just the prep of the teeth.

The key to a beautiful smile makeover is choosing the right dentist to design your smile. Cosmetic dentistry is an art form. If you were commissioning a portrait you wouldn’t just hire the first artist that popped up on your internet search. You’d do research to see if you like the type of work they do.

Getting Gorgeous Porcelain Veneers

You’ll want a dentist who’s passed accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the world. They’ve passed stringent oral and written exams. Additionally, they had to demonstrate their artistry by providing a large sample of specific cases they’ve completed.

Any accredited dentist can give you a truly stunning smile. In fact, most of them have a beautiful smile guarantee. You’ll find your smile makeover gives you increased confidence.

As for your sister, you can’t really “improve” veneers once they’ve been permanently bonded on. Her best bet is to have her case completely re-done. If her dentist cares about the quality of his work, he won’t want a patient to be disappointed in their smile. Hopefully, he’ll be willing to do it over or give her a refund.

If he does it over, make sure he allows her to look at her porcelain veneers carefully with a try-in paste before he bonds them on. She should give complete approval before allowing them to be permanently bonded.

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

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