Hope Restorative & Cosmetic Dentistry

Luster Premium Teeth Whitening

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I recently saw an advertisement for Luster Premium Teeth Whitening. It does have some good reviews, but I would like to get a professional opinion before using something over the counter. Have you ever examined this? If so, is it safe? I’ve never been happy with my smile and am looking for ways to improve it.

Emily

Dear Emily,

Teeth Whitening Trays

I am glad you wrote. I have looked into this. Lets talk about the light first. It does not have the strength to do anything. I think it is there just to make you think it is helping. The second issue is the whitening ingredient itself. This is not a true teeth whitening ingredient, such as you would find with a dentist or even some legitimate over the counter products. Instead, it uses a pigment found in one of their ingredients, Zinc Oxide. This will temporarily make the teeth look whiter without actually whitening them. My guess is this is why there are some positive reviews. They likely wrote the review before the pigment wore off.

I think this would be a waste of your money. If you are looking to improve your smile, this will not be the best way.

Improving Your Smile

If you are looking for a top of the line smile makeover, then porcelain veneers is the way to go. It is the go-to for Hollywood celebrities and can change anything you want, including the shape, size, and color. However, this is not cheap, so it will depend on your budget. One word of caution here. You don’t want to let any dentist do this. It requires an expert cosmetic dentist. Smile makeovers are not taught in dental school, so it requires a lot of post-doctoral training to develop the skill as well as artistry. If you go this route, I would look for an AACD accredited dentist to do this procedure.

If you need something less expensive and are just wanting to whiten them, it will improve your smile. In fact, it is the least expensive way to significantly to make your smile look better, while making you look years younger. Unlike the porcelain veneers procedure, pretty much any dentist can do it. It’s the most basic of cosmetic procedures.

There are two types of whitening procedures. The first is in-office whitening. Many offices who do this use Zoom Whitening. It allows you to whiten your teeth in just one appointment. Another method is at-home teeth whitening. It will use bleaching trays, such as the ones pictured above. This whitens your teeth over a period of weeks, but allows you to control the level of whitening.

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

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.

Porcelain Veneers While Pregnant

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I am super worried about something. I just had porcelain veneers done but did not know I was pregnant at the time. I was told afterward this is a bad idea. Did I hurt the baby? If so, is there any way to fix it?

Aimee

Dear Aimee,

pregnant woman in the dental chair near her dentist and hygienist

First, congratulations on your baby! That is an exciting time and I can already tell by your concern that you are going to be a great mother. Next, I want you to take a deep breath. It is going to be okay. I’m sorry someone worried you by telling you that you’d done something wrong here.

Dentists are told not to schedule dental work with expectant mothers until the second trimester. This is because your new baby is particularly susceptible to foreign substances during their early stages of development. There is good news here, though.

The only real substance introduced into your body during the porcelain veneers procedure is the local anesthetic lidocaine. This has been proven to be safe for use during pregnancy and is often used during the delivery process. There will have been no harm to your child by your smile makeover. I hope that helps you feel less stressed.

Dental Work During Pregnancy

The general rule of thumb for dental care during a pregnancy is to schedule your routine maintenance and checkup during the second trimester. This is because the baby is more vulnerable during the first trimester and mommas are often uncomfortable sitting in the dental chair during the third trimester. Hitting between those two times seems to be the magic window.

There is an exception to this. If you have a tooth infection it is considered a dental emergency and it is important you seek treatment. An infection enters your body and can have an effect on your child as well. Untreated tooth infections, as well as gum disease, have been linked with low birth weight in newborn children. So definitely keep up with your oral health care.

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

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.

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.

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