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What is the lightest shade?

Hi, I just got two Lumineers to fix some chips and other problems with those two teeth.  The problem is they are darker than my other natural teeth. My dentist keeps telling me he gave me the lightest shade and if I’d just stop whitening my other teeth (which I don’t anyway) they would match up.  I see people with teeth whiter than even mine, so what exactly does he mean by the whitest shade?

Breanna N. from Wisconsin

Breanna,

The problem is your dentist is a general dentist who does cosmetic dentistry and not an expert in the field. It takes significant post-graduate training to become really skilled with cosmetic dentistry.

Here is what is happening. It dental school we are taught the whitest “natural” shade for most teeth is a B1. I suspect that is what he ordered from the lab. We can get teeth much whiter than that, but the lab has to be instructed properly.  I’m surprised the only thing you didn’t like about your Lumineers was the color. Many people find that brand of porcelain veneers to be a little bulky.

There is no way to change any brand of veneers once they are permanently bonded on. You can, however, get them removed and have another brand of porcelain veneers placed. However, don’t go to your family dentist again. Look for someone in your area who is accredited with the American Academy of Cosmetic Dentistry (AACD).

This blog is brought to you by Lafayette, Louisiana dentist Dr. Mike Malone.

Problems with my smile makeover

I just spend an unbelievable amount of money on my smile makeover. I got ten porcelain veneers. I know most people get six or eight, but I have a really wide smile, so I wanted to make sure that everything visible was covered. We talked for a long time about what kind of smile I wanted. But, when he put it in, I thought it looked ridiculous. It seems too cloudy. I had some stains on my teeth from some medicine I took when I was a child. My dentist said he had to make it that way to cover the stains and insists it looks better than I think, but I just don’t like it. Plus, my jaw hurts and the veneers feel loose so I’m afraid to bite down too much. I don’t even smile anymore. Is there any way to fix this?

Cindy- Mississippi

Cindy,

I can’t tell you how often we hear these type of stories.  There are very few dentists that can do a beautiful smile makeover, especially in a situation like yours. I’m assuming the stains on your teeth are from tetracycline.  These take a very skilled cosmetic dentist to get right.  For the beginning cosmetic dentist there is generally one of two mistakes. Either they are made normally, which allows the tetracycline stains to show through, or they make them too opaque to cover the stains and they don’t look natural.

If you had gone to an expert cosmetic dentist he would be appalled to hear you don’t want to smile anymore. True cosmetic dentists take steps to insure their patient is thrilled with their new smile. First, they make an acrylic smile for them to try on and see how they like it.  If they don’t like it, then they would go right back to designing the smile. Then, after the smile arrives, your dentist will put it in with a try-in paste.  You would get to look at them in different lights. You could even have a friend or family member come in to look at them and give their opinion. Only when the dentist was sure that you were pleased would they be permanently bonded on. You would never be pressured into liking them.

Generally, if you received a bad smile makeover, there isn’t much recourse. The standard for judging cosmetic dentistry for refunds is whether or not it is functional. Now, here is where you are at an advantage. Your veneers are not loose. I know that because if the veneers were loose they would just fall off. I suspect, based on your jaw pain that your teeth are loose because your bite has been thrown off. This could cause some serious problems for you, including TMJ Disorder. That entitles you to to compensation for getting this repaired.

Here is what I suggest you do. First, go to the AACD (The American Academy of Cosmetic Dentistry) website to see if there is a dentist in your area that is AACD accredited. That is different than just being a member. Any one of them could give you an opinion on the work that has been done and help you get the compensation you need to repair the damage if the porcelain veneers are what threw off your bite.  Then, you can get the smile makeover you had dreamed of.

If there is not an AACD accredited dentist in your area, then you can also find an expert cosmetic dentist by going to the mynewsmile.com website. They recommend expert cosmetic dentists by state. Anyone on their list will be safe. It will be worth it to travel if you have to.

This blog is brought to you by Lafayette Lousiana Cosmetic dentist Dr. Mike Malone.

Smile makeover without spending a fortune

I want to get a smile makeover. My problem is I can’t spend a fortune. My sister just got her smile done, but it cost her $35,000. I don’t have that kind of money. Personally, I think my sister was overcharged. She tends to want to only go to the top of the line for anything. My question is how can I find a highly qualified cosmetic dentist without spending an unreasonable amount of money? Oh, my dentist says I have a problem with grinding. I don’t know if that will affect my makeover. FYI, I don’t trust my dentist for cosmetic work. He’s a good regular dentist though.

Gail B.- New Mexico

Gail,

There are two ways to find a great cosmetic dentist. One is to go on the American Academy of Cosmetic Dentistry (AACD.com) website and look for someone who is accredited with them that practices in your area. There is a difference between accreditation and membership, so make sure you are looking up the right thing. Another avenue is to look on the mynewsmile.com website and see who they recommend in your state.

For a smile makeover you generally do porcelain veneers or porcelain crowns. Sometimes a mix of both.  Because of your grinding issue, I’m guessing the dentist you choose will recommend mostly porcelain crowns.  It is good you are not just going to your family dentist to get your work done, because you would end up out of a lot of money as well as disappointed in the results.  Not all highly qualified cosmetic dentists charge a fortune, but they won’t be cheap either. I would make a list of potential cosmetic dentists from those two sources, then call and ask them how much they charge for porcelain crowns. You’ll probably be able to find one who is both qualified and reasonable in their fees.  I hope this helps.

This blog is brought to you by Lafayette, Louisiana dentist Dr. Mike Malone.

Dens in dente

My dentist said I have a dens in dente. He wants to do a root canal on it. Is that the best option?

Karrie S.- Albany, NY

Karrie,

You didn’t say if your tooth with the dens in dente (a tooth within a tooth) is infected. If so, then a root canal treatment might be a good option. If not, then there is no point in doing the root canal.  The best treatment for this situation is to clean out the pit of the tooth really well, fill it, then cover it with a white composite material, like you’d get with white fillings. There is no reason to do anything else with this tooth unless there is a cavity or infection.

This blog is brought to you by Lafayette, Louisian Dentist Dr. Mike Malone.

Really unhappy with Lumineers

We had some cosmetic issues we wanted to fix with my daughters teeth. They weren’t huge issues, but they really bothered her. I want her to have a good self image, so I talked to my dentist about it, who advertises as a cosmetic dentist.   He said Lumineers would be perfect for my daughter Naia. He also told us that we would get to see them on before they were bonded on permanently. He said she could see them in different types of lights and that she could show them to others. None of that was true. One of the things we were wanting to fix were some small gaps in her teeth. We thought about doing bonding, but he said this would be more permanent. When he put in the temporary  ones, we didn’t get to look at it any of the ways he said we would ahead of time. There were no different lights, no getting up to show them to others. Just sitting in the dental chair and looking in a hand mirror. Yet even with that limited way of looking at them we knew we didn’t like them. It did fix her gaps, but the Lumineers were so bulky she looked ridiculous. We asked if he could make them a little more reasonable in  size, but he insisted they were great. He said if we “lived with them” for a week or so we realize how nice they were. We agreed to try. She was teased unmercifully in school about them. She came home feeling worse about her smile than ever. It turns out my dentist wasn’t a cosmetic dentist, just a general dentist. Is there a way I can get a refund and then go to a real cosmetic dentist?

Azida A.- Tulsa, OK

Azida,

I think you can probably get at least some of your money back if this is handled correctly, but first I want to clear up a common misunderstanding.  There is no recognized specialty is cosmetic dentistry. So every cosmetic dentist is actually a general dentist. What sets apart a dentist as an expert cosmetic dentist is the amount of training they have and artistry they’ve developed. I would not consider your dentist an expert cosmetic dentist for several reasons.

First, cosmetic dentists know that Lumineers tend to appear bulkier than other brands of porcelain veneers, because they are advertised as a no-prep veneer. Most teeth will need some form of preparation to keep that from happening.  Secondly, a true cosmetic dentist won’t try to convince you that the porcelain veneers look great. If you don’t like them, they wouldn’t be satisfied either. Period.

Here is what I recommend. Don’t let him do any more work. You know you’re wanting to get a refund and go elsewhere so it is only fair you don’t use anymore of his time. Next, talk to him about how unhappy you are with how things have gone. Let him know that you weren’t given the procedure you were promised. Also be sure to let him know everything your daughter went through with school as a result of his work. Be upfront with him about your desire to get a refund and be done with this procedure.  That may work on its own.

If not, and you need to enlist some help, go to the mynewsmile.com website and find one of their recommended cosmetic dentists in Oklahoma. Don’t go to another one in Tulsa, but another nearby city. Dentists don’t like to go up against their peers because they have to deal with them on a regular basis. It will be easier to get one from another area. Have him look at the cosmetic dental work and give his opinion.

Generally the standard for refunds on poor dental work is that it is has to be non-functional. That makes it hard to get a refund on poorly done cosmetic work. Ugly doesn’t mean non-functional. However, in this case, your dentist didn’t keep his agreement. You were told your daughter would get to see it in several lights before you agreed on the final bonding and that didn’t happen. With another dentist backing up your claim that the work is poor, you have a chance.

Hopefully, others will learn from your experience to check the qualifications of cosmetic dentists ahead of time. Two of the best ways are seeing if they are accredited with the American Academy of Cosmetic Dentistry (AACD) and if they’re recommended on the mynewsmile.com website.

This blog is brought to you by Lafayette, Louisiana Cosmetic Dentist Dr. Mike Malone.

 

Pain with CEREC crown

I had a CEREC crown put on and am having persistent pain. I’ve been back two times for my dentist to adjust and do a little shaving of it, but it is still hurting quite a bit. I’m afraid to eat food that I have to chew for fear of irritating the nerve. My dentist thinks it might be the way I chew. I don’t think so, becuase I didn’t have this problem beforehand.

Jackson R.- Los Angelos

Jackson,

Generally when there is persistent pain after a crown it is because of one of two reasons. Either the crown is too high or there is an infection. I don’t think it is the bite placement for two reasons. One, you’ve already been back and had it adjusted twice. And second, with CEREC crowns the bite placement is designed by the computer that mills the crown, which makes it easier to place. The next step is to check for an infection with an x-ray. These can sometimes be tricky to find.

If you’re a little suspect of your dentist’s diagnostic skills, you may get an endodontist to look at it. The intensity of your pain along with the amount of time that has passed makes me wonder if that is the real problem.

This blog is brought to you by Lafayette, Louisiana dentist Dr. Mike Malone.

Sonic toothbrush with porcelain veneers

I got porcelain veneers. I wanted  to get a sonic toothbrush, but just read on a website that sonic toothbrushes could damage the bond on porcelain veneers. Is that accurate?

Brooke K.- San Antonio, TX

Brooke,

I’m not sure what website you were reading, but I wouldn’t agree with it. Sonic toothbrushes are not only great for removing plague, but tests have shown that they are perfectly safe for use with porcelain veneers. If you’re interested, you can look up the 1998 survey from University of Missouri at Kansas City, where they tested sonic toothbrushes on porcelain veneers.

This blog is brought to you by Lafayette Louisiana Cosmetic dentist Dr. Mike Malone.

Broken front tooth

My daughter fell and broke off part of her front tooth. She is really embarrassed and I want to get if fixed right away, but my dentist said he can’t see her for six weeks. He told me the root of the tooth needs time to heal, so it is better to wait. Is there anything I can do to make her feel less conspicuous?

Jeanine- San Francisco

Jeanine,

There really isn’t any reason for you to wait to have her treated.  If you have the piece of the tooth the broke off then the dentist can re-attach it. If you don’t have the piece, they can fix it with dental bonding until she is old enough for a permanent porcelain crown.

Be careful not to price shop these procedures. I cannot stress enough how important it is to see an expert cosmetic dentist. You want your daughter to be comfortable with her appearance. Someone who is accredited by the American Academy of Cosmetic Dentistry (AACD) will be able to create a beautiful bonding for your daughter. Be aware that being a member of the AACD and being accredited by them are two very different things. Any dentist can join the AACD, but to become accredited you have to pass a stringent examination and demonstrate your artistic ability.

This blog is brought to you by Lafayette Cosmetic Dentist Dr. Mike Malone.

Options for straightening teeth

I’ve had crooked teeth my whole life. My parents could not afford to get them fixed. I’m now starting my career and have some discretionary money to fix my teeth. Could you list out some ways to fix my teeth at varying expenses. Don’t tell me what is the cheapest or most expensive. I want to just think about what I feel the best option is.

Thanks,

Cynthia F.- Alabama

Cynthia,

Here are three good options for you:

1. Invisalign: Not everyone is a candidate, but any Invisalign dentist can tell you and many dentists do a complimentary consultation so you don’t waste money figuring out if you’re a candidate.  These are aligners that work like braces, except that they are essentially invisible. No one will know you are wearing them. They’ll take about six months to a year to straighten your teeth.  When you’re done, you’ll have a beautiful, straight smile. You might ask your dentist if he’ll allow you to use the aligners as whitening trays. That will allow you to knock out two birds with one stone.

2. Cosmetic Contouring: This is a reshaping of your teeth that takes about one to three office visits. You’ll need x-rays to make sure your teeth are healthy enough for this procedure.  Sometimes just a couple of millimeters of tooth reduction can make your smile completely different. A sanding drill or laser can reshape them. Abrasive strips can shape the sides of your teeth.

3. Porcelain Veneers: In just two appointments, you can change the shape, size, and color of your teeth.

Here is some important advice though, the last two methods need an expert cosmetic dentist.  Don’t settle for the average family dentist who knows some cosmetic procedures. He needs to have the expertise and artistry that only comes from extensive post-graduate training. Your safest avenue is to find someone who is AACD accredited.

This blog is brought to you by Lafayette, LA Cosmetic Dentist Dr. Mike Malone.

Unhappy with porcelain veneers

My daughter had four porcelain veneers placed on her front teeth to help with some crookedness. We couldn’t do orthodontics because of some previous damage. He was afraid the teeth couldn’t take the movement. Unfortunately neither she nor I are happy with the results. They just don’t look as natural as we were led to believe, yet our dentist insists they look gorgeous. We didn’t even get to see them before he bonded them on. Can we get our money back? Why do people rave about porcelain veneers if they look so fake?

Desiree B. from Boston

Desiree,

Actually, porcelain veneers, when done artistically, look fantastic. I suspect your dentist is not a true cosmetic dentist. One of the problems with cosmetic dentistry is that any general dentist can call themselves a cosmetic just by learning a few procedure. Unfortunately, it takes significant post graduate training to become artistic enough to make porcelain veneers not only natural, but beautiful.

A true cosmetic dentist would try on the veneers with a temporary paste and let you look at them in several different lights. They would want to be sure you were absolutely thrilled with them before they bonded them on permanently. Another thing that makes me suspect your dentist isn’t a true cosmetic dentist is that he tried to convince you the veneers were beautiful. In dental school we are taught the dentist knows best. But, when it comes to cosmetic dentistry it is the patient who knows best. We are treating your self esteem. If you don’t love them, it’s not done.

As far as getting your money back, that might be tricky. If the only thing wrong with them is you don’t like their appearance, he has no legal obligation to give you your money back. You could try.  I would also go to a truly qualified cosmetic dentist and get a second opinion. If at all possible, go to a dentist outside of your area and don’t tell him who the dentist was. See if the second dentist thinks the work was done poorly. That may help your case.