Hope Restorative & Cosmetic Dentistry

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.

Cracked Porcelain Veneer

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I received a substantial amount of money (at least to me) in an inheritance. I decided to spend it to finally get a smile I am not ashamed of. I decided to do it right and found the best cosmetic dentist I could, even though they were more expensive. I LOVE the porcelain veneers. Not only are they gorgeous, but they lengthened my teeth, which are normally pretty short. Now you can see much more of my teeth when I smile, which I’ve been doing all the time since getting this smile makeover seven months ago. My only problem is one of the veneers has developed a horizontal crack. I want to fix it but can’t keep going back to this dentist. I’ve not even picked up the phone when they call to schedule my cleaning and checkup because I can’t afford them. Do you think they will try to blame me for the crack? I’ve been so careful with these veneers because I’ve been so proud of them. I’m really worried this will fall off, otherwise I’d just ignore the crack.

Stephanie

Dear Stephanie,

porcelain veneer being placed on a tooth

I don’t think you have to be worried about them blaming you for the crack. When someone abuses their teeth, it usually results in chips, not cracks. In most cases, a cracked porcelain veneer will stay on just fine because of the bonding. However, you expressed they lengthened your teeth I am worried there isn’t much bonding there. Of course, that depends on the location of the crack, which I don’t know.

I would call them and tell them what’s going on. Don’t worry about the fact that you can’t afford them regularly. Most top cosmetic dentists are used to patients coming to them just for their cosmetic work. Some even have patients fly in from other countries to have their work done. If you tell them your financial situation they won’t continue to pester you for your regular cleanings.

The repair for this is to replace the porcelain veneer. I’m sure they didn’t give you any guarantees about how long they would last. That being said, seven months is definitely not long. I think they will repair it for you free of charge.

Tips For Follow Up Care with Porcelain Veneers

When you have to stay with your family dentist for cleanings instead of the cosmetic dentist there are some things you may need to make them aware of, especially if they’re not used to dealing with veneers. First, make sure the hygienist doesn’t use either a Power Prophy Jet or acidulated fluoride during your appointments. Both of these tools, while fine on natural tooth structure, will damage the glazing on your porcelain veneers. This will cause you veneers to pick up stains, essentially ruining them.

Second, while by no means required, I always suggest using Supersmile toothpaste when you have porcelain dental work. This safely removes stains using a special formula that collects and rinses the stains while keeping the glazing perfectly intact.

Some patients use traditional whitening toothpaste without realizing these use abrasives. While it will scrape and scratch off stains, it will also scratch the surface of your veneers causing them to pick up stains. So you are aware, teeth whitening will not fix stained veneers. It only works on natural tooth structure. Maintenance is the key to their longevity.

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

Crowns for Teeth Whitening? NO!

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I have two porcelain veneers on my front teeth. One of them chipped and needs replacing. My dentist says it is because I grind my teeth. The adjacent teeth are yellowing so my dentist wants to do dental crowns on eight of the upper teeth, which would pretty much be all of them when I smile. One of the things I’m wondering about is if I chipped my porcelain veneer would I also damage my dental crowns?

Marie

Dear Marie,

Woman covering her mouth with her hand

I’m appalled by what I’m hearing and am truly hoping there something else to this story. Putting dental crowns on all your upper teeth is a massive overtreatment unless there is something else going on. Based on what you’ve said he’s doing it because one of your porcelain veneers needs replacing and your natural teeth need to be whitened. That’s insane! When you need to whiten teeth, you do just that. You have teeth whitening done. I can see where it would benefit him to suggest otherwise. Teeth whitening will bring him in a few hundred dollars. What he’s suggesting, which is a full-mouth reconstruction, will bring in a minimum of $30,000. I hope that is not his motive.

Another concern I have is replacing your porcelain veneers with dental crowns. Whenever a dentist suggests that, it brings up massive warning bells. This tells me your dentist doesn’t know how to do porcelain veneers. Therefore, he’s telling you to do dental crowns. No dentist in his right mind would remove healthy tooth structure if he didn’t need to. Your dentist would rather do that than admit his lack of skill and send you to another cosmetic dentist with more expertise.

Now, there is a third thing that concerns me and gets to the heart of your question — your teeth grinding. I cannot believe your dentist would know you grind your teeth and not provide a way for you to protect them. A simple nightguard would have kept your porcelain veneer from chipping. As to whether you will damage your dental crowns, yes, if you don’t have the nightguard.

Bottom Line—You Need a Different Dentist

I don’t think you are being well served by your dentist. Here’s what I want you to do. Spend this time during the COVID-19 to research some dentists in your area. Ideally, you’ll want one who is AACD accredited. If you can’t find one, look on mynewsmile.com and go over the websites of their recommended dentists in your area. Check their reviews and pick one.

Once the quarantine is over, do the following. Get your teeth whitened. If you choose Zoom Whitening, give two weeks for the color to settle, then have that single chipped porcelain veneer replaced and have a nightguard made.

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

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.

Dental Bonding Done Wrong

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I’m a little annoyed. We got my granddaughter’s teeth whitened and then dental bonding done to build up . The lateral incisors don’t match at all. They’re darker than the rest of her teeth. The dentist blew us off and said he matched it to the canines. They don’t match those either so I don’t know what he’s talking about. When I brought that up he said it’s just the lighting. It’s not. Finally, he suggested we try a whitening toothpaste. Really? Is there anything we can do about this?

Brenda

Dear Brenda,

before and after a chipped tooth is repaired with dental bonding

When dental bonding is done right, it blends in perfectly.

It doesn’t sound like your dentist is willing to take responsibility for his work. A true cosmetic dentist would never work this way. They know you paid for a beautiful smile and that is what you should get. He knows whitening toothpaste won’t work and is just saying that to get you off his back.

I’m going to suggest you see an expert cosmetic dentist to get a second opinion on his work. Sometimes having the opinion of a peer saying this was poorly done will help him take responsibility simply because he doesn’t want to look bad to a peer.

How to Find a True Cosmetic Dentist

There isn’t a recognized specialty in cosmetic dentistry. Any general dentist can call themselves a cosmetic dentist, regardless of their skill level or artistic ability. It’s hard for patients to know who is truly qualified. Fortunately, there are two great resources for patients.

The first one is the American Academy of Cosmetic Dentistry. They have an accreditation program. In order for a dentist to get accredited, they have to pass an oral and written exam which shows their technical knowledge. Then, they have to provide visual evidence for a large number of cases that demonstrates their artistic ability. It takes years and a great deal of time and skill to become accredited.

The second is mynewsmile.com. There are some great cosmetic dentists out there who are on their way to becoming accredited. This site screens dentists for their skill and artistry.

A dentist recommended on either one of these sites are the top cosmetic dentists in the country. They’ll do a great job for you, both in helping you get a refund and repairing the work.

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

Dentist Stained my Lumineers

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I’m so upset. I spent a fortune on these Lumineers and they are an absolute disaster. First, I told him I wanted a very white smile. He said they could do that. When he bonded them on, though, they weren’t nearly as white as I asked for. When I mentioned that he said in order for them to look natural they have to add a slight stain. If I wanted my natural looking teeth, I wouldn’t have paid a fortune to have whiter ones made. I insisted that he make them whiter. He told me they couldn’t be whitened but he could remove the stain. I agreed to that not knowing he was going to essentially drill the top layer off. Now I’ve got misshapen, dull looking teeth. What do I do?

Caryn

Dear Caryn,

A porcelain veneer being placed on a tooth

The dentist is more important than the brand of porcelain veneers

The first thing you need to know if your dentist isn’t a true cosmetic dentist. Cosmetic dentistry isn’t a recognized specialty. Every cosmetic dentist is just a general dentist who enjoys doing cosmetic work. Unfortunately, skill and training vary. I don’t think your dentist truly sought expert training in cosmetic work.

A few things make me think this. First, he thought a stain was necessary. True cosmetic dentists understand patients want very white smiles. As you said, they’re not looking for natural color. They want clean and white. He didn’t understand that. Second, he thought he knew better than you. In general dental school we are taught dentists know best. However, when we study cosmetics, we know it’s what the patient wants that rules. It’s not repair we’re going for but beauty. That beauty is in the eye of the patient.

Finally, he didn’t understand what he was doing would ruin them. Or worse, he did and didn’t care.

You need a refund. Your dentist has ruined your smile makeover. Not that you were pleased with it anyway. In a small way, his drilling off the top layer is a blessing in disguise. Before he ruined them, it would have been hard to get a refund. The standard for dental work is functional, not beauty.

However, now, without their glazed layer, he’s ruined them and they are not functional. Tell him you want a refund. Your next step is to find a true cosmetic dentist.

Getting Gorgeous Porcelain Veneers

I’ll say one other thing first. If all you wanted was a whiter smile, your dentist would have better served you by offering you teeth whitening. Professional teeth whitening can get your teeth brilliantly white and is much less expensive than Lumineers. He didn’t, which makes me feel he was taking advantage of you.

I could be completely wrong about that. Maybe you wanted some other things changed about your teeth, such as their shape or size in addition to the color. In that case, a smile makeover with porcelain veneers would be the right course of action.

If you want a stunning smile, you should go the website of the American Academy of Cosmetic Dentistry. They have a link to find a cosmetic dentist. Make sure you check you’re looking for an accredited cosmetic dentist. These are the ones with the training and artistry to give you a smile you’ll be proud to share.

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

Dentist Yelled Because I Didn’t Like My Crowns

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I’m having to replace four crowns which are aging. Originally, my crowns were a beautiful white color. My new dentist has made me temporaries but they’re yellowy and don’t feel or look like they have the right shape. He wants to make the permanent ones and I’m not wanting to. I told him my concerns and he actually yelled at me saying they “were perfect” and I’m unreasonable. I left telling him not to even order the permanent ones. However, now I have these hideous temporaries and I don’t know what to do. These are my front teeth.

Penny

Dear Penny,

Beautiful brunette woman with gorgeous smile
To get beautiful dental work requires the right cosmetic dentist

This “I know better than you” attitude is what dentists learn in dental school. However, those who invest the time after they graduate to learn that when it comes to creating gorgeous smiles it is what the patient thinks which matters.

A true cosmetic dentist would never have behaved the way your dentist did. You were wise not to allow him to move on to the permanent crowns. You would have been miserable every time you saw them.

Plus, if the shape is off, it can throw your bite off. Then, you risk getting TMJ Disorder.

Finding a Cosmetic Dentist

Especially because you’re talking about your front teeth, you need an expert cosmetic dentist. In your place, I’d look for a dentist who is accredited with the American Academy of Cosmetic Dentistry.

Accredited Dentists are among the top in the world. They’ll give you a stunning smile. If you’re not satisfied, neither are they.

I’m going to suggest, because you are about to get new crowns and you said you like them to be white, make sure you teeth are the level of whiteness you’ll be happy with for a long time.

If they’re not, it is important you get your teeth whitened before getting your permanent crowns. This way they’ll match your permanent tooth color and you won’t have to re-do anything.

This blog is brought to you by Tulsa Cosmetic Dentist 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.

Avoiding a Dental Implant Horror Story

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I keep hearing you have to be careful with who does your dental implants or it can be a complete disaster. I’ve read countless horror stories online. How do I find the best dentist to do my dental implants? I don’t want to end up another story on the internet.

Celina Y.

Dear Celina,

Illustration of dental implants in three parts

You’re wise to check ahead of time. I don’t know if you’ve already talked to your dentist about this. It could be that your dentist will be the best dentist for you, but let’s go through a few things first.

The Best Implant Dentist Will Have Extensive Post Graduate Training

There are several very reputable schools for dental implant study. General Dental school does not give enough training in such an advanced procedure. Never hesitate to ask a dentist where he received his (or her) implant training. Here are some of the best programs for that study:

  • The Misch International Implant Institute
  • The Las Vegas Institute for Advanced Dental Studies (LVI)
  • Dawson Academy

The Best Implant Dentist Can Do Both the Surgery and the Restorative Crown

Many mistakes are made regarding dental implants because of simple miscommunication between the dentist and the surgeon. If the surgeon places the implant in the wrong place, then what? You’ll have to have the implant completely re-done, which would mean the additional procedure of bone grafting and then a second surgery. Believe it or not, this happens more often than you’d think.

When the dentist and the surgeon are the same, there isn’t that danger. The dentist knows exactly where the implant needs to be placed for optimum security and aesthetic value.

The Best Implant Dentist Can Give You a Beautiful Restoration

You don’t want to just have a secure implant. You’ll also want a beautiful restoration. Check out your dentist’s smile gallery to make sure the dental crowns they craft are natural looking.

If your implant is being placed in a visible spot, and you’re not completely satisfied with the color of your teeth you’ll want to get them whitened before you have the implant crown made. Once the crowns completed, the color cannot be changed.

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

Please Tell Me I Have Options Other Than Dentures?

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I’ve stopped crying long enough to write you. I’m 28 years old. My parents never took me to the dentist. I didn’t really think about it much until last week when my new job told me I had dental insurance. That was kind of exciting. So, I was thrilled to get to go to the dentist for the first time. That feeling quickly turned from elation to despair. He told me that my teeth were a wreck and he should pull them all and replace them with dentures. He really pressured me to do it right then. I was in shock. Dentures! At my age! I burst into tears. That’s when he grew impatient and said, “What did I expect when I neglected my teeth my entire life.” I got angry and walked out. I haven’t neglected my teeth. I brush AND floss everyday, which people who have been to the dentist don’t do. Also, how was it my fault my parents couldn’t afford to take us to the dentist? Is there any chance he’s wrong? I’d think if my teeth were in that bad of shape, I’d know somehow. Wouldn’t I be in pain or even see cavities? If he’s not wrong, are dentures my only option. Please help me!

Annabelle P.

Dear Annabelle,

Tulsa Dentures

Wow! I’m not sure what to say. Mostly, I feel sorrowful that your first experience with the dentist was this negative. Not all dentists are as grumpy as the one you experienced. And they certainly would not have such a pessimistic attitude about your dental health.

You may not feel this way right now, but there is hope. In fact, I’m pretty sure you won’t need dentures at your age. I have no idea why your dentist just jumped right to dentures. That’s generally an absolute last resort, even if you do have to remove all of your teeth.

The first step for you is to get a second opinion and see what the true condition of your teeth is. Most dentists will make it their first priority to save as many teeth as absolutely possible. If you do need to have some teeth removed, dentures won’t be their top recommendation.

Alternatives to Dentures

There are several alternatives to dentures. Most of which are a better option.

Dental Implants

Tulsa Dental implant

This is the ideal tooth replacement. As you can see from the image on the left, this puts a prosthetic tooth root into your jawbone to stabilize a dental crown. The crown serves as the visible part of your teeth. The stability of the implant allows you to eat, drink, and care for your teeth as you normally would.

A Dental Bridge

Tulsa Dental Bridge

Another good option is a dental bridge. It uses the teeth on either side of the extracted tooth to anchor your new false tooth. These are especially useful when the adjacent teeth are needing crowns to begin with. It’s a little less expensive than dental implants as well.

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

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