Hope Restorative & Cosmetic Dentistry

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.

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.

Botox and TMJ

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My wife said her dentist suggested she get Botox for her TMJ. Is that legit or is she just trying to find a way for me to pay for her to get Botox treatments?

Cliff

Dear Cliff,

Illustration of the TMJ joint

Hopefully, your wife won’t see this post and think you don’t trust her. But, we’ll certainly answer your question. There are times when the muscles are causing TMJ problems. When that happens, Botox can be of assistance. It relaxes the muscles around the temporomandibular joint, easing the pain. It can even assist when a patient is suffering from limitation of opening. It’s not a permanent solution but can bring some relief while the dentist works toward pinpointing the cause and developing a more permanent solution.

There are quite a few causes for TMJ disorder, so it can take some time to figure out what’s the actual trigger. For some patients, it’s a misaligned bite. A wise dentist will start with the least invasive treatments. It may be a simple mandibular device can gently move your jaw into proper alignment.

Don’t trust a dentist who wants to immediately jump to a full-mouth reconstruction.

What Type of Dentist Can Treat TMJ?

There isn’t a recognized specialty in TMJ. Because of that, you want a dentist who has applied themselves to post-doctoral training and who has experience treating TMJ disorder.

If you have a dentist tell you a full-mouth reconstruction is necessary, it’s important you get a second opinion from a dentist with some expertise. This is a very advanced procedure and requires both training in occlusion as well as cosmetic work.

You don’t only want a dentist who understands how your bite should come together, but who can create a gorgeous smile for you at the same time. Ideally, you’d want a dentist who’s reached accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists are among the top in the world. You’ll be pleased to share any smile they create. In fact, most of them have a beautiful smile guarantee.

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.

Cosmetic Dental Disaster! Can it be Fixed?

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

Ingrid

Dear Ingrid,

Beautiful brunette woman with gorgeous smile

Getting a Gorgeous Smile Requires Finding the Best Cosmetic Dentist in Your Area

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

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

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

Finding the Best Dentist for a Smile Makeover

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

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

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

Can Your Smile Be Fixed?

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

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

Solution for Tetracycline Stains

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

Corrine

Dear Corrine,

A single porcelain veneer being held by a dental tool

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

Porcelain Crowns Versus Porcelain Veneers

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

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

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

Choosing a Cosmetic Dentist

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

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

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

My Dentist Lied about Porcelain Veneers

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

Marianna

Dear Marianna,

A single porcelain veneer being held by a dental tool

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

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

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

How to Find an Expert Cosmetic Dentist

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

  • The American Academy of Cosmetic Detnistry

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

  • mynewsmile.com

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

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

Why Would Porcelain Veneers be the Price of a Home?

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

Cora L.

Dear Cora,

A single porcelain veneer being held by a dental tool

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

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

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

A Tale of Two Dentists Who do Porcelain Veneers

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

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

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

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

What Do I Look For in the Best Cosmetic Dentist?

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

Thank you,
LeeAnne

Dear LeeAnne,

A single porcelain veneer being held by a dental tool

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

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

  • Technical Skill
  • An Artistic Eye
  • Empathy

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

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

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

How Do You Find the Best Cosmetic Dentist?

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

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

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

I hope this helps!

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

My Dentist Says I’m Being Unreasonable

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I saved up for years to get a smile makeover. My dentist and I decided on Lumineers so that we wouldn’t have to grind my teeth. I did read that you should ask a dentist to try the Lumineers on first to make sure you like them before he bonds them on completely. I told him that’s what I wanted. He said okay. But, when the time came he didn’t try them on. He just bonded them onto my teeth without me even looking at them. I didn’t realize that’s what he was doing. I thought it was the try-in. When I first saw them I burst into tears. They’re so bulky they look like horse teeth and the color looks chalky, not natural. It’s so obvious these aren’t my teeth. I told him I didn’t want them and he said they’re already bonded. What?? Now I can’t fix this and I want my money back, but he’s refusing and saying I’m being unreasonable. Am I?

Miranda D.

Dear Miranda,

A Woman Giving a Thumbs up in the dental chair

Not only are you not being unreasonable, but your dentist has behaved unethically. He completed a procedure without your permission. If you turned him into the dental board, he’d get in a lot of trouble. You have a fantastic case for a full refund.

The biggest problem you’re facing at this point is your dentist is likely a decent general dentist but is in over his head with cosmetic procedures. There are a few things that lead me to believe this. He made several mistakes that the best cosmetic dentists would never make.

How Do You Know if You Have the Best Cosmetic Dentist?

First, his dependence on Lumineers is an error. Lumineers are highly marketed to inexperienced cosmetic dentists as being easy to place because they don’t require tooth preparation. Unfortunately, the result will often end up like you’ve experienced with bulky teeth.

It’s a common misconception that your teeth have to be ground down for porcelain veneers. That’s not true. Dental crowns require grinding. Veneers usually require mild tooth shaving.

Second, he didn’t use a try-in paste. Even without you requesting him to let you approve the veneers before they’re permanently bonded he should have done that. Good cosmetic dentists ALWAYS do that. In fact, most of them have a beautiful smile guarantee.

Third, he didn’t care that you weren’t satisfied. A true cosmetic dentist would be horrified if a patient was so dissatisfied with their work it caused them to cry. They would instantly offer to do them over.

You need to get a little forceful about your refund. Remind him he bonded them on without your approval and you’ll be taking it to the dental board. That should be enough to light a fire under him. Then, go to a dentist who’s accredited by the American Academy of Cosmetic Dentistry. If they’ve reached accreditation level, you’ll get a stunning smile.

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

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