Hope Restorative & Cosmetic Dentistry

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.

Peroxide Mouthwash for Porcelain Veneers

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I just received porcelain veneers and want to take great care of them. I’m afraid to use over-the-counter mouthwash. I came up with my own concoction which I think will be safe for porcelain veneers, but wanted to run it by you first.

My mouthwash is made up of filtered water, hydrogen peroxide, and kosher salt. Will that be safe for the veneers?

Amber

Dear Amber,

Woman with beautiful smile
A beautiful smile is worth taking care of

I’ll say right off the bat that I’m thrilled you are taking the care of your porcelain veneers so seriously. Your smile was a huge investment and you certainly want it to last and look its best for many years.

While the mouthwash solution you’ve come up with will not harm your porcelain veneers, it will do some damage to your mouth.

Hydrogen peroxide does a good job killing bacteria. Unfortunately, it does such a good job it kills both the bad and the good bacteria. If done in the short term, periodically, you shouldn’t have a problem. However, if you did it regularly (say a couple of weeks) you will likely develop a yeast infection.

Caring for Your Porcelain Veneers

Cosmetic Toothpaste:

When it comes to any type of cosmetic work, such as porcelain crowns or porcelain veneers, you’ll want to use a toothpaste especially designed for them. Most cosmetic dentists will recommend Supersmile. If you feel that you just want a regular toothpaste, that is fine. Just be certain you don’t use a whitening toothpaste. These leave micro-scratches in your veneers which permanently damage them and cause them to pick up stains.

Mouthwash:

You can use over-the-counter mouthwash. The one ingredient you want to avoid is ANY mouthwash which contains alcohol. Be certain to check the ingredients. Alcohol will eat away at the bond which holds your porcelain veneers in place.

This blog is brought to you by Tulsa 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.

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.

Bleaching a Gray Tooth

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I have a tooth which is turning gray at the moment. I’ve tried teeth whitening strips. They’re whitening my other teeth but not the gray one. I tried just cutting the strip to fit that tooth but it’s not making a difference. Would getting it bleached by a dentist help?

Melody

Dear Melody,

Teeth Whitening Trays

A gray tooth means that the tooth is either dead or dying. Is it possible you’ve had some trauma to that tooth recently? That would explain the tooth turning gray. Bleaching your teeth isn’t going to fix the color. Not even professional teeth whitening.

What you’ll need to do instead is get a root canal treatment and dental crown. The dental crown is to protect your tooth. They often become brittle after a root canal.

I’m guessing the tooth is visible or you wouldn’t be worried about whitening it. Because of that, make sure your dentist gives you an all-porcelain crown. These are much more natural and beautiful looking when done by a skilled cosmetic dentist.

Why Whiten Your Teeth Before Getting a Crown?

When your dental crown is created, the color it’s made with is permanent. If you decide to whiten your teeth later, your teeth will still whiten, but the crown will not. It stays the same color. To get them to match you’ll have to change the color.

If you’re happy with the whitening you received from your whitening strips, you can stick with that and match your crown to them. Otherwise, I’d recommend going ahead and seeing your dentist to whiten your teeth thoroughly before getting the crown.

Types of Professional Teeth Whitening

You can get two types of whitening through your dentist.

In-office

Although Dr. Cha previously used Zoom® to whiten teeth, he switched to KöR™.  Unlike Zoom, KöR doesn’t use an activation light for the bleaching gel. The light dries out teeth and makes them sensitive. KöR conditions and hydrates teeth. Read more about the switch on his Zoom whitening page.

At-home

If you’re looking for whitening where you get more control over the level of whitening, then at-home whitening is a better option for you. This is different from the white strips you were using. Your dentist makes custom fitted trays, like in the picture above. They’ll provide professional strength gel for you to wear in the trays.

Once you reach the level of whitening you want, you’re done.

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

Do I Need a Special Dentist for Implants?

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My husband wants to get two dental implants. I think he needs a specialist and he said regular dentists do it. Because we’re talking about surgery, I just want to make sure he gets the best care possible. What’s the right type of caregiver for this?

Cindy

Dear Cindy,

Illustration of dental implants in three parts

I don’t blame you for wanting the best dentist possible for your husband’s care. In fact, it’s not just the sign of a loving wife, but a wise one as well. To answer your question, there isn’t a dental implant specialty, but there is a distinction in what type of dentist your husband should see for his implant procedure.

Finding the Best Dentist for Dental Implants

The first thing you want to look for is a dentist who is well-trained in the dental implant procedure. When I say well-trained, I’m not referring to a good dental school. This procedure is so advanced it requires significant post-doctoral training.

For instance, Dr. Cha completed every course at the famed Misch International Implant Institute. Not only that, he’s done so many successful implant cases he’s now a fellow at the International Congress of Oral Implantologists (ICOI). This puts him among the top implant dentists in the world.

The second thing you’ll look for is a dentist who can do the surgery himself. Many dentists who say they do dental implants actually only do the crown portion and farm out the surgery to another practice. While that can work, often communication issues arise which means the dental implant isn’t placed in the exact position the dentist needs.

Oral surgeons may be good at surgery, but they don’t always understand the science behind how teeth should properly meet with each other. This can lead to biting or aesthetic issues. If you have a dentist trained in the surgery, there’s no chance of bad placement through miscommunication.

Finally, you’ll want a dentist who is skilled in cosmetic work. You want the porcelain crown used for the tooth to look both beautiful and natural, blending in perfectly with your natural teeth. Ideally, you’d find a dentist who is not only highly qualified in dental implants but is also accredited with the American Academy of Cosmetic Dentistry (AACD).

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

Avoiding My Sister’s Porcelain Veneers Disaster

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My sister and I were both planning on getting a smile makeover. She beat me to the punch and I’m feeling glad she did because I’m hoping to learn from her disaster. I don’t want to sound mean but her teeth look like horse teeth. Is there a way I can make sure my teeth won’t look bulky? She said hers were no-prep. Is that the problem or is it something else? She’s pretty disappointed in her smile.

Elaine

Dear Elaine,

A porcelain veneer being placed on a tooth

I wonder if your sister’s dentist placed Lumineers on her teeth. They’re a brand of porcelain veneers which are highly marketed as being no-prep. The problem is some smiles do need prep even with an ultra-thin brand of porcelain veneers. Otherwise, they look bulky. Your sister’s smile sounds like one of those.

Sadly, these are marketed to inexperienced cosmetic dentists as being easy to place. Being easy to place is completely different than making them look stunning. There’s much more to porcelain veneers than just the prep of the teeth.

The key to a beautiful smile makeover is choosing the right dentist to design your smile. Cosmetic dentistry is an art form. If you were commissioning a portrait you wouldn’t just hire the first artist that popped up on your internet search. You’d do research to see if you like the type of work they do.

Getting Gorgeous Porcelain Veneers

You’ll want a dentist who’s passed accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the world. They’ve passed stringent oral and written exams. Additionally, they had to demonstrate their artistry by providing a large sample of specific cases they’ve completed.

Any accredited dentist can give you a truly stunning smile. In fact, most of them have a beautiful smile guarantee. You’ll find your smile makeover gives you increased confidence.

As for your sister, you can’t really “improve” veneers once they’ve been permanently bonded on. Her best bet is to have her case completely re-done. If her dentist cares about the quality of his work, he won’t want a patient to be disappointed in their smile. Hopefully, he’ll be willing to do it over or give her a refund.

If he does it over, make sure he allows her to look at her porcelain veneers carefully with a try-in paste before he bonds them on. She should give complete approval before allowing them to be permanently bonded.

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

Two Popular Natural Teeth Whitening Methods Which Can Ruin Your Teeth

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Beautiful brunette woman with gorgeous smile

Everyone wants a gorgeous white smile

We often get questions about “Natural Teeth Whitening”. Let’s face it, natural sounds better. Healthier. Plus, it’s free. And we all love a bargain. There are two methods which get brought up consistently, which can do severe damage to your teeth. So, I thought I’d address them here.

Whitening Your Teeth with Lemons

Lemons

Lemons are great for cleaning things. They have a dual ability to cut through stains and kill bacteria. Because of this, it will brighten your teeth. But, it will do so at a cost. Its power is derived from citric acid. This is a powerful cleanser. In fact, it can be used to cut through grease and grime on a stovetop. But, that power will also eat through your tooth enamel.

This weakens your teeth and makes them much more vulnerable to decay. You’ll have whiter teeth, but you’ll also have quite a bit more fillings than you’re used to.

In fact, citrus is so powerful that we recommend not brushing your teeth for 30 minutes after drinking a beverage with lemons in it so you don’t grind the acid into your teeth. If you must brush your teeth right away, take a second to swish some water around your mouth to neutralize the acid.

The same is recommended for any citrus drink, including orange juice. Do the same with apple cider vinegar as well, which contains acetic acid.

Whitening Your Teeth with Charcoal

charcoal

This method is gaining in popularity because of a number of internet celebrities touting its benefits. You should know right up front this isn’t referring to the type of charcoal you use when you light up for your 4th of July cookout. Instead, they’re talking about activated charcoal.

This is brushed onto your teeth and the absorbent qualities of the charcoal will remove some surface stains. But (you knew there’d be a but), activated charcoal has a very high abrasiveness level. This will scratch your tooth enamel, which won’t heal. Again, you’re talking about added decay from missing enamel and vulnerable teeth.

Safely Whitening Your Teeth

There may very well be a safe, natural teeth whitening method. Unfortunately, we haven’t yet discovered it. Until then, the safest way to whiten your teeth while still keeping them safe and healthy is through a dental professional.

You have options on the method though. You can do it gradually, with at-home trays that are custom fit to your teeth. This allows you to control the level of whitening you get.

A second option is in-office teeth whitening. Many dentists prefer Zoom Whitening. Although Dr. Cha is familiar with Zoom, he prefers KöR® Deep Bleaching™ for several reasons:

  • KöR doesn’t use an activating light, which dries out teeth and makes them sensitive.
  • It conditions and hydrates it.
  • It is the most effective treatment for tetracycline and fluorosis stains.

It still allows you to get your teeth as white as possible in just one appointment. It’s fast and convenient. Though, they will get very white. If that isn’t what you’re after, go with the at-home method.

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

For Dentures: Dentist or Oral Surgeon First?

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I’m almost 50 years old. I have avoided the dentist my entire life because of a bad experience in my teen years. Now I’m paying the price for that. If I could turn back the clock and make better choices I would. Now, I’ll just have to move on from here. I’ve lost most of my teeth and the rest aren’t going to last much longer. I need to have them removed and get dentures. My question is do I need to go to an oral surgeon before getting the dentures or does a dentist do both?

Cal

Dear Cal,

implant overdentures

To prevent facial collapse you need implant overdentures

In your place, I’d go to a dentist who can do the pre-denture surgery and the dentures. There’s much less of a chance for communication errors. Plus, there are immediate dentures which can be placed that keep you from having to wait six weeks for teeth.

Even if you decide to get dentures which do require the six-week wait, the surgeon can do stuff to prepare you gums for that to make a better fit. An oral surgeon won’t be as familiar with that.

The pre-denture surgery isn’t a difficult one and any dentist who does that will be skilled at it.

Because of your dental anxiety, it’s going to be important that you see a sleep dentist. This way you don’t have to deal with your anxiety while being treated.

An Important Consideration with Dentures

You mentioned wishing you could go back and do things over correctly. I’m hoping to keep you from making another decision you’ll regret. Once you remove your teeth, your jawbone starts to shrink. That happens because your body recognizes you don’t have teeth anymore and reassigns your minerals in the jaw to be used where they’re more useful.

After about ten years, you won’t have enough jawbone left to retain your dentures any longer. This will leave you with no way to chew food. You won’t even be 60-years-old and you’ll be on a liquid diet. This is known as facial collapse.

If you want to prevent that, it’s important you place implants in your jawbone to trick your body into thinking you still have teeth in your jaw. The best way to do this is with implant overdentures, pictured above.

This has many other benefits too. Your dentures will be fixed, which will keep them from slipping or falling out. It will also increase your chewing efficiency.

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

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