Hope Restorative & Cosmetic Dentistry

Help Picking the Right Dentist

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I need some advice on picking a new dentist. I haven’t been happy with the last few I’ve tried. Then, every time I want to try another one it means more x-rays and a whole new charge for a visit. I’m just not having much success in finding a practice where I’m happy. Do you have any tips for me?

Elana

Dear Elana,

A woman smiling with her dentist behind her also smiling

Each person has a different dentist who is the best one for them.

There are some hacks to picking the best dentist for your particular needs. First, decide if you need any special type of treatments. For instance, needing a dentist with expertise in cosmetic work is very different than looking for a general dentist. The same is true if you prefer dental sedation because of any level of dental anxiety or have other needs such as TMJ Disorder.

When it comes to a general dentist, the first thing I’d like you to do is check their reviews. You can get a good idea about a dentist from reading about those who’ve already visited the office. That alone can help you eliminate some duds right off the bat saving you both time and money.

Some good review sites are:

  • Google Reviews
  • Yelp!
  • Facebook

The second thing you can do is ask for a complimentary visit. This is where you get to go in and meet the staff and possibly even sit with the dentist for a few minutes and ask some questions. This should give you some idea of whether or not they have the services you need. Not every practice will accommodate you on a complimentary visit, but they’re likely not a practice you’d want anyway.

If You’re Looking for the Best Cosmetic Dentist

This is a little different. Doing a smile makeover isn’t taught in general dental school. Dentists have to invest in time and training post-doctorally. Then, you’d also need to know if this particular dentist has an artistic eye. Two dentists can do the exact same smile makeover and the cases will turn out completely differently.

Fortunately, there is an easy button in these cases. The American Academy of Cosmetic Dentistry has an accreditation program to test both the technical knowledge and artistry of cosmetic dentists. They have to pass stringent oral and written exams. If they pass those, they’ll then have to provide visual evidence of a large number of cases they’ve performed to show they have the artistic skill required to reach accreditation.

Any AACD accredited dentist can give you a stunning smile. Check out their website (aacd.com)and they have a link for you to find a cosmetic dentist. Just make sure you check the box for accredited.

This blog is brought to you by Tulsa 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.

Do Professional Teeth Whitening Kits Expire?

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I received a teeth whitening kit from my new dentist when I moved to town. I didn’t really need my teeth whitened at the time as I’d had it done a couple of years ago in my old town. I popped it in my dresser and forgot about it. I was changing out clothes for the season and saw it there. Is it still good? I’ve taken up coffee again and now really do need some whitening done. Why do I drink that wretched stuff?! I don’t want to pay for a new kit if I don’t need one.

Joyce

Dear Joyce,

Teeth Whitening Trays

The custom fitted teeth whitening trays will be fine, especially since they’ve been in your dresser this whole time. The only thing that could really damage those would be heat. We’ve had patients leave them in their car and put them in the dryer. Unfortunately, this warps the trays and they won’t fit properly. Yours weren’t exposed to heat, so that won’t be an issue.

The gel could be a different story. It’s generally good for a year, possibly a little longer if your dentist kept it refrigerated. You could look on the tube to see if there’s an expiration date. It’s unlikely. There’s probably a batch number on it from the manufacturer. You could contact them. But, honestly, it would be easier just to open a tube and see what the gel looks like. If it’s cloudy or white, it’s lost its potency.

The teeth whitening will definitely clear up your coffee stains. Most coffee drinkers find they need a touch up every year. If you keep your trays, your dentist can provide you with a new tube of gel every year. Some dentists will do that free of charge for as long as you keep up with your regular cleanings. Even if they charge, the gel won’t be much money at all.

I hope this helps.

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.

Can Dentures Look Nice?

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I’m 39 years old and the victim of a bad gene pool with teeth. Because I couldn’t keep up with all the work I needed, my dentist suggested I just get dentures. While I was happy to be out of pain all the time, they don’t look very natural so I find it a little awkward to smile. I realize they are fake teeth, but can they be made to look natural, maybe even pretty?

Evelyn

Dear Evelyn,

Woman with beautiful smile
The key to a beautiful smile is going to the best dentist

I’m very sorry you are facing this. It’s amazing how much genetics plays a factor in how our teeth end up. You can do everything right and still struggle with your oral health.

I don’t think your dentist is serving you well. Not only did he create unattractive dentures for you, from what I can tell he didn’t warn you about the side effects. Some of them are a danger at your age.

Dentures and Facial Collapse

An image of a woman before and after facial collapse
If dentures are worn too long it can lead to facial collapse

The biggest thing you’ll have to deal with is facial collapse. Now that your teeth are removed, your body thinks you no longer need the minerals in your jawbone, so it will slowly resorb the minerals in it to use elsewhere in your body. This will cause your jaw bone to shrink. Not only does that make you appear years older, but you’ll no longer even be able to keep your dentures in your mouth because there is nothing to support them.

The solution to that is implant overdentures. This uses four to six dental implants and anchors a pair of dentures to them. The implants prevent your jaw from shrinking. You’ll no longer be in danger of facial collapse.

Additionally, you’ll find that they fit so much better. They will be completely secure. You can eat and drink whatever you want as well as brush and floss normally. It will improve your standard of living to what it was like when you had healthy, natural teeth.

Getting Beautiful Dentures

The key to beautiful dentures is going to be the dentist. Your current dentist will NOT be able to do this. I’m even doubting that he is minimally competent. You will need another dentist.

What you want to look for first is a dentist skilled in dental implants. Ask how many cases they’ve done. What their post-doctoral training is in dental implants. What their success rate is. It should be 98% minimally.

After you find that, ideally, you’d want a dentist who is AACD accredited. Those are the dentists who create beautiful smiles. You’ll be thrilled with the results.

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

Whitening Toothpastes While Pregnant

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I wanted to get my teeth whitened but my dentist said it isn’t approved for use during pregnancy. I totally get that and don’t want to do anything to harm my baby. I was wondering if I could use a whitening toothpaste instead?

Cammie

Pregnant Woman in Dental Chair
Taking care of your teeth is as important as taking care of your baby when you’re pregnant.

Dear Cammie,

It’s great that you are looking out for your little one and double checking before you move forward. While whitening toothpaste won’t harm your baby, as long as you use it as directed, it will harm your teeth.

Whitening toothpastes are more abrasive than other types of toothpastes. Yes, that characteristic does help scrub off superficial stains, but it also makes micro-scratches on your tooth enamel. This will cause them to pick up more stains. This means you’ll keep using the whitening toothpaste to remove them.

Continued scratching of your enamel weakens it. Making you more susceptible to decay. Your best bet is to just continue with good oral habits and get professional teeth whitening after your baby is born.

Dental Care While Pregnant

You don’t need to avoid the dentist altogether though. In fact, it is healthier for you and your child if you continue with checkups and cleanings. Timed well, you’d only need to have one checkup during your pregnancy.

If possible, time it for during your second trimester. The reason for this is you’ll tend to be more prone to nausea during your first trimester and in your third trimester you are much larger leading to discomfort with long stints in one position. The second trimester is like the dream comfort zone.

What If a Problem Develops?

Let’s say you develop a dental infection during your pregnancy. Is it safe to get it treated or do you need to wait until after birth? Unless you are in a special high risk category, it is always better to get dental infections dealt with. There are two reasons for this:

  1. Dental Infections are considered dental emergencies. Dental infections spread. That could mean passing the bacteria to your baby, or even having the infection to spread into your heart or brain.
  2. Bacteria from infections has a connection to low birth rate. This puts your baby at risk.

It is much more important for you and your special one to get that infection taken care of. Your dentist will know any precautions which need to be taken.

This blog is brought to you by Tulsa 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.

Avoiding Disappointing smile makeovers

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One common theme the best cosmetic dentists see in their practice is patients who come from other practices because they received a disappointing smile makeover. It’s not awful. It’s just average. When you spend that much money for a smile makeover, average is the worst. Why? It’s not bad enough to get your money back, but it’s absolutely nowhere close to the dream smile you’d been saving up for all this time. While patients who leave Dr. Cha’s chair are thrilled with their stunning new smile, it would have been better if they could have received that the first time around and not had to come to him to fix what their dentist couldn’t.

Woman with beautiful smile

The key to a beautiful smile is going to the best dentist

The #1 Factor in Avoiding a Disappointing Smile Makeover

The most important decision you make isn’t the type of porcelain veneers you get. We often see the debate of Lumineers versus Other brands of porcelain veneers. It’s not whether you get ultra-thin versus traditional. It’s not the brand.

Simply put, the wrong dentist can ruin all of it. He or she can have the best materials and a patient with an idea facial structure, yet his output is mediocre at best. Why?

Smile Makeovers aren’t Taught in Dental School

When dentists go to school, they are taught how to clean, examine, and repair teeth. Cosmetic dentistry is something completely separate. Things like smile makeovers, color theory, smile esthetics, etc. aren’t taught.

Instead, a dentist has to make the effort to get the training they need post-doctorally. They’ll need to go to schools like The Las Vegas Institute for Advanced Dental Studies, among a few others to learn these procedures and the art form that makes them stunning.

Smile Makeovers are an Artform

Like any art form, some artists have more skill and a naturally artistic eye than others. Two sculptors can have the same subject model for them. Both will likely get the form of the subject. Yet, somehow, one is able to capture the spirit of the subject more than the other.

This takes training, experience, and a willingness to understand what the end result should be before even starting.

How Do Patients Locate the Best Cosmetic Dentists

While patients used to be left to flounder and evaluate the training and artistry of dentists on their own, that is no longer the case. The American Academy of Cosmetic Dentistry (AACD) began an accreditation program. This tests the dentist’s technical knowledge with both oral and written exams.

It also tests their artistry by requiring them to present a large number of cases they’ve recently done themselves. Dentists which are awarded accreditation are among the top 1% of cosmetic dentists in the world. They’ll give you an absolutely stunning smile. If you want the best dentist, choose an accredited one.

Most of them even have a beautiful smile guarantee.

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

Husband Can’t Wear His Dentures

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I’m worried about my husband. He got dentures, but he can’t wear them. We’ve been back several times for refittings, yet nothing seems to work. I don’t know how to help him. He’s miserable and can barely eat without his bottom teeth. Do you have any advice?

Carolyn

Dear Carolyn,

illustration of dentures beside a dental implant

It sounds like your husband is really suffering. It is not uncommon for patients to have an adjustment period to dentures. For some, it’s quite difficult. Usually making adjustments helps. Others never adjust. This is a chance to evaluate what his next steps are.

If he’s determined to stick with dentures, he could go to a different dentist to try someone else’s hand at refitting his dentures. Another option is a prosthodontist. They have more experience than some of your local dentists, depending on where you live.

An Alternative to Dentures

If he just can’t adjust, he has another option. Dental implants are a fantastic tooth replacement option. These put prosthetic tooth roots into his teeth. He will no longer be in pain. It’s more like having healthy, natural teeth back.

However, there is an even better reason to get them. When his teeth were removed, his body started slowly leeching the minerals out of his jawbone to use elsewhere in his body. It does that to be efficient. This is causing his jawbone to slowly shrink. Eventually, there won’t be enough jawbone left for his denture to stay in place. Dentists call this facial collapse.

Getting dental implants prevents this from happening. Because the prosthetic root is placed in his jawbone, his body interprets this as him having teeth and needing his jawbone. This will change his life. He’ll be able to eat again. In fact, he can eat anything he wants, even steak.

If you decide to go the implant route, make sure your husband sees an experienced and qualified implant dentist. It’s an advanced procedure and requires significant post-doctoral training. For instance, Dr. Cha took every course on it the Misch Institute offered and is a Fellow at the International Congress of Oral Implantologists (ICOI).

I wish you both the best.
This blog is brought to you by Tulsa Dentist Dr. Jerome Cha.

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