Hope Restorative & Cosmetic Dentistry

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.

Matching Whitened Teeth to Dental Work

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I whiten my teeth regularly. My old dentist whitened them and would give me a whitening gel to touch them up every year. I’ve since moved and have a new dentist. I decided to get porcelain veneers. He did four of them, but they are noticeably darker than the rest of my teeth. He says it is the whitest shade. How is that possible? Can I do anything to fix this?

Lacey

Dear Lacey,

tooth shade guide

I think I know what happened here. The above is a tooth shade guide. This is the old standard one which dentists would use to match a dental crown to their patient’s natural tooth color. Then, as teeth whitening grew in popularity this became problematic. We could no longer find a shade white enough to match their teeth.

This is because teeth whitening doesn’t just remove stains which have built up over the years. It will also whiten the natural pigment of the teeth making your teeth whiter than “natural” shades. My guess is your teeth are whiter than what he has available on his shade guide. That also tells me your dentist hasn’t kept up with his field very much.

ivolclar shade guide for bleached teethIn the 90s, as teeth whitening grew in popularity, dental companies knew they had to expand the pallet. Here is an additional guide the Ivoclar company came out with for dentists to use when their patients had very white teeth. Your dentist should have based the color of your new porcelain veneers from something like this guide.

Getting Bad Porcelain Veneers Fixed

Show your dentist this post and ask him to re-do your porcelain veneers at his cost. They don’t match your natural teeth, so it is not the beautiful smile you paid to get.

This time, before you allow your dentist to bond them on permanently, tell him you will want to see them on first. He can use a temporary try-in paste. This will allow you to look at them carefully on your teeth. You get to approve them before they are bonded. If you’re not happy with how they look, it is a simple thing for your dentist to send them back to the lab and make changes. This has to be done before they’re bonded.

This blog is brought to you by Tulsa 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.

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.

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.

Dental Crowns for a Tooth Gap? Run Away From This Dentist!

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I need some advice. I have a tooth gap which I finally decided to take action on it. I spoke to my dentist about repairing. The gap is between my two front teeth. It’s not huge, but it is always on my mind when I smile. I want to feel confident. My dentist suggested I get two dental crowns put on my front teeth. I’m not keen on that because the teeth are healthy. Grinding them down to nubs means I’ll always have to wear dental crowns, right? Are there any other options that are less invasive?

Jill R.

Dear Jill,

I’m really relieved you wrote and asked before moving forward with your dentist’s disastrous treatment plan. It’s incredible to me that you recognize the fallacy in this type of “solution”. Yes, you’d be stuck with dental crowns for the rest of your life. Why get rid of all that healthy tooth structure when there are much simpler solutions. However, because your dentist didn’t suggest them it likely means he’s not comfortable doing them. Dentists are proud creatures. If you pressure him into it, he’ll do it rather than admit he’s not good at it. The results will be disastrous. This is not the best dentist for you. I’d really plan on you finding a new one.

So, planning on getting a new dentist for this treatment, what options are available to you?

First, you could close the gap with orthodontics. It used to be that even adults were stuck with a mouth full of metal if they wanted to straighten their teeth. That’s no longer true. In fact, you can straighten your teeth without anyone even knowing that you’re doing it. The aligners truly are invisible, even at a conversational distance.

However, if the only thing wrong with your teeth is that small gap, then you may feel that full blown orthodontics is a bit of an overtreatment. In that case, you can just do dental bonding to close the gap. It uses a white composite filling material to match the color of your teeth. It takes an artistic cosmetic dentist to do this procedure because he will sculpt it by hand.

This next option only should be considered if you’re interested in a complete smile makeover. Using porcelain veneers, you can completely change the shape and character of your smile. It can change not just the shape, but the size and color, as well as cover things like chips and gaps. Like dental bonding, this procedure also requires an expert cosmetic dentist. Ideally, you’d want a dentist who’s reached accreditation level with the American Academy of Cosmetic Dentistry (AACD). Accredited Cosmetic Dentists are among the top 1% in the world in both skill and artistry. Any smile they create for you will be stunning. In fact, most of them even have a beautiful smile guarantee.

I hope this helps you in your decision making. This blog is brought to you by Dr. Jerome Cha.

My Porcelain Veneer Is Turning Dark at the Top

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I need some advice. I had a large chip that my dentist repaired with a porcelain veneer. It always looked okay, but for some reason it’s turning dark at the top near the gumline. I don’t know why. I’ve only had it for two years. The dark line is really visible and is making me feel awkward about smiling. Do you know if this is normal? My dentist never mentioned this as a possibility.

Serena A.

Dear Serena,

I can think of a couple of possibilities for what is happening. If you truly have a porcelain veneer (and I’ll explain why I’m not positive that’s what you have in a moment), then it means it’s not bonded on properly. A porcelain veneer should sit flush against your gums so that nothing can become trapped there. If it’s not properly placed there can be a ledge. This will attract food and bacteria. If it’s not dealt with it will lead to decay. Poor bonding can also leave a space between the veneer and your tooth which will allow things to seep between them. Not only will this also lead to decay, but your veneer will turn dark from the things gathering beneath it.

However, if you had a very large chip it’s possible you were given a dental crown instead. Porcelain veneers are used for smile makeovers and only cover the front of your teeth. Dental crowns are used to cover the whole tooth when there are large chips or decay over a majority of the tooth.

If you were given a porcelain-fused-to-metal crown, it would explain the dark line as well. These will begin to show the metal at the top of your gums eventually. However, it generally takes more than two years for that to happen. There are a couple exceptions to that time rule. One is if you have gum disease. Another is if you brush hard. That can cause your gums to recede.

Either way, the only way to fix this is to have either the crown or the veneer re-done. If it is a crown, be sure to have them give you an all-porcelain crown this time, so you don’t have to worry about a dark line eventually showing up. However, if there is gum disease you’ll want to address that as well. If it’s a veneer, the problem resulted in an error on the dentist’s part. They should repair it for free.

I hope this helps.
This blog is brought to you by Dr. Jerome Cha.

I Want to Find the Best Cosmetic Dentist

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I have always hated my smile.  Always. I’ve never had the money to do anything about it–until now. I’ve just inherited a ton of money and the very first thing I want to do is feel pretty.  Shallow? Maybe. But, you don’t understand how embarrassed my smile has always made me.  Now that I can do something about it, I want the BEST cosmetic dentist there is.  How do I find him or her?

Dana P. – Ohio

Dana,

You are not alone in being embarrassed about your smile.  One poll showed that over 50% of Americans were unhappy with some aspect of their smile. It’s great that you’ve been given the resources to do something. You’ll find that not only will a smile makeover improve your smile, but your confidence will soar as well.

You’re wise to ask questions before just jumping in. There isn’t a recognized specialty in cosmetic dentistry, so any general dentist can claim to have the skills required to do a smile makeover. While they might be able to give you a basic makeover, there’s no guarantee that it will be beautiful.

If you want a gorgeous smile, your safest bet is to go to a dentist who is accredited with the American Academy of Cosmetic Dentistry (AACD).  There is a difference between a member of AACD and someone accredited with the AACD.  Any dentist can join and become a member. To be accredited, you have to pass stringent exams as well as demonstrate your artistic skill with cosmetic procedures.  Many accredited dentists also have a beautiful smile guarantee.

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

Can You Get A Pretty Smile Without Porcelain Veneers?

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I’ve been unhappy with my smile for years. They’re stained. I have a gap in my front teeth and a chip on two of them. I’ve always wanted porcelain veneers, but just can’t afford them. Is there a way to get a pretty smile without veneers?

Jullian S. – Arkansas

Jullian,

Yes! There are great ways to give you a gorgeous smile–even without using porcelain veneers. I’ll list them in the order they’d need to be done for best results.

The very first thing I’d do is teeth whitening. It’s inexpensive, it makes you look years younger, and depending on which teeth whitening procedure you decide on, you can have complete control of the level of whitening.

If you just want them as absolutely white as you can get them and you want it done quickly, KöR® Deep Bleaching™ is an in-office system that will give your teeth a blast of whitening. Although many dentists use Zoom Whitening, Dr. Cha prefers KöR because unlike Zoom, it doesn’t use a gel-activation light that dries out your teeth and make them sensitive.

If you want to control how white they get, take-home whitening is a fantastic option. You simply wear the take-home trays for a period of time every day and when you’ve reached the whitening you’d envisioned, you stop.  It’s that simple.

After you whiten, it’s time to address the gaps and chips.  The simplest thing to do is dental bonding. Though you want to make sure you go to a good cosmetic dentist for the procedure. It has to be done freehand.

It’s important that the whitening gets done first so you can match the dental bonding to your new sparkling, white teeth.

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

Ways to make teeth more attractive if you can’t afford veneers

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I just cannot afford porcelain veneers, but want to do something to make my teeth more attractive. Do you have any suggestions?

Elizabeth C. – Boston

Elizabeth,

Teeth whitening is an excellent way to improve your smile.  Just whitening your teeth will take years off your appearance and give your teeth a healthy, clean look.

It’s quite a bit less money than porcelain veneers. It’s limitation is it will only affect the color of your teeth, not the shape and size, like porcelain veneers .

It will give you a beautiful improvement for your smile. One that you’ll be proud to show off when you smile.

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

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