Hope Restorative & Cosmetic Dentistry

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.

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.

How Can You Offer a Beautiful Smile Guarantee?

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I saw on your website that you offer a beautiful smile guarantee. How is it possible to do that? Isn’t everyone’s smile different? Some people just have an ugly smile.

Justine M. – Oklahoma City

Justine,

You’re right that everyone’s smile is different. You’re also right that some people have had unfortunate experiences with their smile, such as tetracycline stains or trauma to their teeth that causes chips or breaks. There are also those who are just born with less than ideal smiles. When Dr. Cha offers a beautiful smile guarantee, he’s referring to those who are getting a smile makeover.

Generally, that is done with porcelain veneers, though occasionally a patient will also require a crown or implant. He can offer that guarantee because he won’t stop with their restorations until they are absolutely astounded and thrilled with the results. Dr. Cha places their porcelain veneers with a try-in paste and gives them time to look at them from every angle with several types of light.
If they’re ecstatic with their new smile, he’ll bond the veneers. If they’re not thrilled, he will start over.

One of the reasons he does that is because of the number of smile makeover disasters other dentists have done. He’s had more patients than you could imagine come to his office in tears begging him to fix the fiasco done to their smile by another dentist. That is because not all cosmetic dentists are created equal. They might know the technical procedure, but not have an artistic eye.

In fact, two cosmetic dentists can do the exact same smile makeover on the same person and end up with completely different results. Many patients are not aware that cosmetic dentistry isn’t an official recognized specialty with the American Dental Association (ADA). So anyone who calls themselves a cosmetic dentist is just a general dentist who enjoys doing cosmetic procedures. Their skills vary widely. So how is a patient able to tell an artistic dentist from a less skilled one? That’s where the American Academy of Cosmetic Dentistry (AACD) comes in. They started an accreditation program to award dentists who’ve reached the highest level of technical and artistic skill. So, if you’re looking for a stunning smile, an AACD accredited dentist would be the way to go. I’d be willing to guess many of them offer a beautiful smile guarantee.

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

I’m depressed about my veneers

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I don’t think there is anything you can do to help.  I just want to see if I’m wrong. I saved up for years, and I mean years, to get my smile re-done. I have been embarassed about my smile since forth grade when the a group of boys made fun of me in front of the class.  I got a full smile makeover with porcelain veneers. While me teeth are better than they were, they’re not the “beautiful” I expected.  My dentist thinks they’re beautiful and I’m over reacting, but he’s given me the day to decide before cementing them. He said he can’t give me all my money back. Only half.  That’s a lot of money to give up for nothing.  It is likely he’s right because he’s the professional.  Is it normal to be depressed after a smile makeover? Maybe a better smile is better than my old one, even if it’s not what I wanted.

Mary R. – Rhode Island

Mary,

I’m sorry for what you are going through. I don’t think there is such a thing as normal or not normal when it comes to navigating our feelings.  However, I will say, you shouldn’t have to be depressed after a smile makeover. It should be the happiest feeling in the world. You should be so in love with your new smile that you’re smiling from ear to ear and showing off your porcelain veneers to everyone.  The reasons you’re not isn’t your fault, but rather your dentists.

Many patients don’t realize that cosmetic dentistry is not a recognized specialty. Any general dentist can claim to be a cosmetic dentist. But, to do the job well takes a lot of post graduate training, artistry, and experience.  I know your dentist does not have this training and can tell you why.

In dental school dentists are taught that they know best, not the patient.  However, in post-graduate cosmetic training, we’re taught that it is the patient who determines the beauty of our work.  A great cosmetic dentist would not be satisfied if you weren’t. In fact, he would re-do the veneers until you were satisfied.

Now, as your dentist doesn’t seem to have any artistry or an understanding of that concept. I recommend you don’t get them cemented. Get half of your money back.  Hopefully, when we find  you a real cosmetic dentist he can help you get the rest of your money back, by applying some pressure to your dentist, but there is no guarantee.  At the very least, you’ll have a gorgeous smile.

Ideally, what you want is a dentist who is accredited with the American Academy of Cosmetic Dentistry (AACD). Those of the top cosmetic dentists in the country.  There are none in Rhode Island. However, there are two in Connecticut and four in Massachussets.  Go to whichever of those dentists is closest to you.  Print out this post and have them read it, so they have a quick summary of your situation.

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

 

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