Hope Restorative & Cosmetic Dentistry

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.

Save Yourself from a Cosmetic Dentistry Disaster

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I had four porcelain fused to metal crowns done on my front teeth years ago. I wanted to update my smile. I went to see one cosmetic dentist who was voted as one of the best cosmetic dentists in our area, but he was out of my budget. Plus, he wanted to do four crowns and four porcelain veneers covering eight teeth and I really only need the four crowns done. I went to my family dentist who assured me I’d get a smile I’d love. This hasn’t turned out to be the case. The crowns he made are too short and you can’t even see my teeth, which makes me look ancient. I also think the color looks greenish, which he said, “Is the color I picked.” I’ve been back several times trying to get this right. The last time they actually said to me, “You’re expecting perfect teeth, which is unrealistic.” Well… duh. That is why someone does cosmetic dentistry. I don’t know what to do at this point.

Pam

Dear Pam,

Woman giving a thumbs up in a dental chair

You are running up against a philosophy taught in dental school but corrected in post-doctoral institutions that teach cosmetic dentistry. In dental school, we’re taught the dentist always knows best and you don’t want cosmetic work to look perfect. Those dentists who invest in serious cosmetic dental studies know it is about how the patient wants their smile to look.

Another problem you are running up against is that doing smile makeovers isn’t taught in dental school. A dentist has to invest in that post-doctoral training in order to know how to do it well. My guess is your family dentist hasn’t done that. I also don’t think you’re going to get anywhere with him on making this the way you want it. That isn’t just because of the attitude. It’s also an issue of his ability.

You can ask him for a refund. He did assure you that you’d get a smile you love and he hasn’t been able to provide that. What you’ll need to do from there is find a true cosmetic dentist. It isn’t a recognized specialty so it is hard for patients to know who has invested in the training and who hasn’t. The best cosmetic dentists are accredited by the American Academy of Cosmetic Dentistry. That is different than just being a member. To get AACD accredited, the dentists have to not only pass stringent exams, but demonstrate their artistry with visual evidence of a large number of cases they’ve done.

As to the other dentist who is suggesting you also get four porcelain veneers, he is probably doing that so your smile will match. Most smiles are much wider than just four teeth. One other way to accomplish that is to whiten your teeth, which is recommended anyway so your bottom arch will blend well. See if he’ll let you do that instead of getting veneers and crowns.

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

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.

Lumineers or Porcelain Veneers

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I’m FINALLY able to get a smile makeover. I can’t tell you how excited I feel about this. I’m just having a bit of a hard time choosing. I like the idea of the thin ones called Lumineers. Originally, I thought that would look more natural. But, I’m reading a bunch of reviews which seem to be mixed. Am I better off with porcelain veneers?

Karen

Dear Karen,

A porcelain veneer being placed on a tooth

Which is more important the brand of veneer or the dentist who does them?

It’s great that you’re trying to research this. However, I’d like to redirect your question just a bit. The brand isn’t as important as the dentist which does them. A great cosmetic dentist could make any brand look stunning. But, an inexperienced cosmetic dentist could have the best materials and still create a subpar smile.

Lumineers Limitations

You should be aware that most expert cosmetic dentists aren’t extremely fond of the Lumineers brand. Much of that has to do with their lab. The DenMat company owns Lumineers and requires dentists to use their lab. Sadly, that lab isn’t known for its skill and artistry.

True cosmetic dentists will normally have a ceramist they prefer to work with that they feel produces the right results and follows their directions well.

While Lumineers brand does seem to heavily advertise as being no-prep because they’re’ ultra-thin it’s not always best practice to place porcelain veneers without any tooth prep whatsoever. The results can look bulky depending on the smile.

The Most Important Decision for Porcelain Veneers

More important than which brand of porcelain veneers you get is which cosmetic dentist you have design and place them. The artistry and skill of the dentist will make the biggest difference in the beauty of your smile makeover.

To find one of the best cosmetic dentists in your area, I recommend you go to the American Academy of Cosmetic Dentistry website (aacd.com). The AACD has an accreditation program which helps patients looking for a good cosmetic dentist to know which dentists have the skills necessary to give them a gorgeous smile.

On their website, is a link to help find a cosmetic dentist in your area. Just be certain you check that you’re looking for one who is accredited. If there is not one in your immediate area it will be well worth a little bit of travel to get stunning results.

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

Mismatched Front Teeth

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I had a root canal and the tooth needed a dental crown. My dentist has had a very hard time getting it to look natural. The first one looked way too white. Then he redid it. The next one was a more realistic shade, but still doesn’t match my adjacent teeth. He bonded that one on. At first, I thought I could live with it but I’m really uncomfortable having mismatched front teeth. He’s willing to try again. Do you think I’m being too picky? I can tell he’s getting frustrated, even though he hasn’t said anything.

Louisa

Dear Louisa,

Image of a crown being placed on a tooth

You’re not being too picky. You have every right to have matching front teeth, especially when they’re being crafted for you. However, you might be asking too much of your particular dentist. Matching a single front tooth requires cosmetic skills that are likely above his artistic and technical ability at this point.

Even many expert cosmetic dentists, will charge extra for matching a single crown to a front tooth because they know it could take three or four try-ins. A dentist should never permanently bond on the crown until they are 100% sure it matches the adjacent tooth absolutely. There are many subtleties in colors. It’s rare to get it spot on first time out of the box.

You have two choices. The first one is for you to continue to allow your dentist to try and get it right. He may and it won’t cost you any extra. However, there’s no guarantee he will.

Your other option is to find an expert cosmetic dentist and let them do your crown. They’ll be more likely to get the result you’re both hoping for and deserve. But, it will cost you some extra. It’s possible your dentist would be willing to give you a partial refund because you’re having to go elsewhere for the crown.

Finding an Expert Cosmetic Dentist

How is a patient supposed to know which cosmetic dentists have the skills and artistry to create a gorgeous restoration? The American Academy of Cosmetic Dentistry (AACD) realized the quandary many patients found themselves in. Because of that, they began an accreditation program. This requires the dentist to pass stringent oral and written examinations demonstrating their technical knowledge of their craft. In addition to that, they have to provide examples of a large number of specific cosmetic cases they’ve done within a recent time period.

Anyone who reaches accreditation level with the AACD can not only match your crown to your front teeth, but if you ever decided to go all out and get a total smile makeover with porcelain veneers, they’d give you an absolutely stunning smile.

If you were to pick a new dentist to do your cosmetic work, they should be on the top of your choice list. To find one in your area, you simply go to the aacd.com website and choose “find a dentist”. Make sure you click that you’re looking for an accredited dentist.

This blog is brought to you by Tulsa Cosmetic Dentist 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.

Can the Shape of My Bite Really Keep Me from Porcelain Veneers?

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I’ve wanted a smile makeover ever since I was old enough to realize my smile was ugly. I have an overbite, which makes my front teeth practically cover my bottom teeth. They’re misshapen, some of them have small chips, and they’ve all got tetracycline stains. I saved for years to get the top of the line smile makeover. Now, when I finally tell my dentist, he tells me I can’t because of my overbite. Instead, he wants to do four to six crowns on my upper front teeth. To say I’m disappointed is an understatement. I just wanted to double check he had the right idea before I give up my dream.

Hazel L.

Dear Hazel,

Don’t give up your dream. Give up your dentist. I hope I’m not coming across harsh, but I want you to get the best smile possible. It sounds to me like your dentist is in over his head when it comes to cosmetic work so he’s made up some lame excuse to not have to admit he doesn’t know what he’s doing.

If you were to get porcelain crowns, he’d have to grind down your front teeth to nubs! Why get rid of all that healthy tooth structure? Plus, he’s talking about 4-6 crowns. Most smiles are much wider than that. Can you imagine how weird that would look beside tetracycline stained teeth? No. Don’t do this.

Your bite actually makes you a fine candidate for porcelain veneers. Your teeth are covering your bottom teeth. Crowns would have to surround your entire tooth, causing the dentist to have to beware of what he does on the back side, so it doesn’t negatively impact your bottom teeth. Porcelain veneers don’t go on the back of your teeth, just the front.

In your place, I’d look for a top of the line cosmetic dentist. Tetracycline stains are more challenging than most. The dentist will want to get the veneers to look bright, translucent, and natural, but still cover the stains. It will take someone with an advanced skill set and artistic eye to do that. Find a dentist who’s reached accreditation level with the American Academy of Cosmetic Dentistry (AACD). They’ll be your best bet and can certainly give you the gorgeous smile you’ve always dreamed of having. In fact, quite a few of them have a “beautiful smile guarantee“.

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

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