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tri-colored porcelain veneers

I’ve got a smile makeover disaster. I have three different colored teeth right now. First, my ugly natural yellow teeth, then I had four porcelain veneers placed. Three of them look okay, but one of them is an uneven gray color. I paid a lot of money hoping to get a beautiful smile, but now I feel ridiculous with three different colors of teeth. I don’t even smile. My dentist said she’d make the gray one thicker to even out the colors, but I’m not sure how that will look and I’m losing confidence in her. What do you recommend?

Laurie

Dear Laurie,

A single porcelain veneer being placed on a tooth

Yikes! I can understand why you are unhappy. It sounds like you went to your family dentist who was in over her head. First, don’t let her make the graying veneer thicker. In fact, I think you need to ask for a refund and start over.

If I’m right about the graying veneer you have a good case for one. Because it is a splotchy gray, I think there isn’t a good bond between the porcelain veneer and the tooth. This is bad for your teeth. It allows things to get between the two, leaving you vulnerable for decay.

When you have this re-done, the first thing the dentist will have you do is whiten your teeth. This will keep your adjacent teeth from being an obviously different color. This is why your natural teeth look so obviously different from your four porcelain veneers.

Finding the Right Cosmetic Dentist to do Your Porcelain Veneers

It is imperative you have an excellent cosmetic dentist to re-do your porcelain veneers. Unfortunately, doing beautiful smile makeovers aren’t taught in dental school. Dentists have to invest time in getting the training they need.

Even with training, as with every art, some dentists have a more artistic eye than others. If you want the best cosmetic dentist, I’d go to aacd.com and look up an accredited cosmetic dentist in your area.

AACD accredited cosmetic dentists are the top cosmetic dentists in the country. They’ve passed stringent oral and written exams. Additionally, they have to provide visual evidence of a large number of cases they’ve done in order to show they are both technically skilled and artistic.

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

3 traits of a great cosmetic dentist

I plan on getting a smile makeover. I keep hearing the dentist is the key, but how in the world do you know if you’ve got the right key?

Amanda

Dear Amanda,

Brunette woman with beautiful smile
Beautiful smiles require great dentists !

You’ve asked a great question and doing so will save you a great deal of agony. There have been countless cosmetic dentistry horror stories of patients from another practice who came to us in tears needing their “smile makeover” fixed.

The problem most patients run up against is there is not a recognized specialty in cosmetic dentistry. That means any general dentist can call themselves a cosmetic dentist if they dabble in one or two cosmetic procedures.

Unfortunately, to get great results in cosmetic dentistry, it takes a lot more than dabbling. Here are three important things to look for in a cosmetic dentist.

Trait One: Empathy

This one is hard to quantify, but you can quickly tell if a dentist has it or doesn’t. Dr. Hall calls this trait, “The root of a good cosmetic dentist.” They know you want a beautiful smile and they will make sure you get one you can be proud to share.

In general dental school, dentists are taught they know better than the patient. Cosmetic dentistry is different. It’s the way the patient sees their smile that matters. They’d never let a patient leave unhappy and will make any changes necessary to make sure it is the smile of your dreams.

Trait Two: Training

How to do stunning smile makeovers isn’t taught in dental school. It requires a dentist’s willingness to invest in extensive post-doctoral training. They’d invest time and money in continuing education at reputable institutions.

Trait Three: Artistry

Smile makeovers are a type of art form. As with any art, some artists are better than others. The evidence isn’t necessarily in the art school they went to but the results of their work. Never hesitate to look at a cosmetic dentists smile gallery to see what type of results they get.

Especially look for specific examples of the procedure you’re getting. if you want porcelain veneers, ask to see those pictures. If you have tetracycline stains, see what type of success they’ve had covering those.

Where to Locate Dentists with these Traits

The American Academy of Cosmetic Dentistry realized the predicament patients were in locating a great cosmetic dentist. Because of that, they began an accreditation program so dentists with the right skills could have a way of letting patients know.

They have to pass stringent oral and written exams as well as provide visual evidence and a large and varied number of cases demonstrating their artistry.

If you’re really looking for the best, go to aacd.com and do a search for an accredited cosmetic dentist.

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

Dental crown looks fake

I’ve had dental crowns before but they’ve always been on back teeth. This is my first one on a front tooth. My dentist did a CEREC crown which was very convenient. I liked that, but for some reason it looks really fake compared to the tooth next to it. It almsot has a painted, dull appearance. Is this typical of crowns? Is there a way to get them to look natural?

Dana

Dear Dana,

CEREC Crown being placed on a tooth
Whether or Not a Crown Looks Natural Depends on Two Things

A crown on a front tooth can look natural and blend in naturally. Whether or not that happens depends on two things:

  • The cosmetic skill of the dentist
  • The materials used

Getting a Beautiful Dental CEREC Crown

CEREC crowns are made of all-porcelain, which is great. Porcelain mimics the appearance of natural teeth by reflecting light. When you get traditional porcelain veneers, they are milled from several different blocks of porcelain.

Our natural teeth aren’t the same all the way down. If you look closely at your front teeth the bottom parts of your upper front teeth are more translucent than the middle parts of your teeth.

Even though it still requires an expert cosmetic dentist to place a dental crown on your front teeth, traditional all porcelain crowns are a little easier simply because they’re milled from several block of porcelain making it easier to get the different levels of opacity versus translucency.

With CEREC crowns, this is more challenging. They are milled from a single block of porcelain. That makes it harder to show the subtle differences in color. Dentists have to be very familiar with color theory and stains to get a front CEREC crown to look natural.

Without that, you end up with a flat looking front tooth as you’re experiencing.

Which Dentists Can Place a Crown on a Front Tooth?

Front teeth are more exposed, making it imperative the dentist has the right skills to match and blend the crown with the adjacent teeth exactly. In your place, I’d only use an AACD accredited cosmetic dentist. Dentists who’ve reached accreditation are the top cosmetic dentists in the world. You can go to aacd.com to find one in a reasonable distance to you.

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

Problems with invisalign

I’ve been considering getting Invisalign, but decided to talk to an acquaintance who’d already used them. She said she’d never had worse breath than when she wore them. I decided to do some online research about that issue and it seems some people have had that same problem, but others absolutely love them. Does that mean that particular issue is preventable?

Marcia

Dear Marcia,

A woman placing in her Invisalign aligners

Absolutely that one is preventable. Invisalign is removable. As such, it allows you to eat whatever you want. Then, you simply pop them back in when you are done. However, your dentist will strongly recommend you brush and floss your teeth after each meal before you put them back on.

There is a good reason for that. Every time you eat, you get some food and bacteria on and between your teeth. If you don’t remove that before you place the aligners back on, they’re going to fester there. That will lead to some seriously bad breath. It would also leave a nasty taste in your mouth. Simply brushing before replacing them completely fixes this problem.

Two Other Common Invisalign Issues

So you are completely prepared for Invisalign treatment, I want to tell you about two other common issues.

The first is some minor aches when you switch aligners. With Invisalign, you wear a pair of aligners which you will switch out every two weeks. Each pair gently moves your teeth into another position.

The first couple of days, the aligners will feel a bit snug. That’s because it is new position. By the third day, they should feel like a perfect fit. The remainder of the two week is to allow the bone time to form around the new root position.

Many patients don’t feel any discomfort. However, if you are one who does, most often some mild over the counter pain relievers is enough to make a difference.

The second common issue is excess saliva. For some patients, when they first start Invisalign, their body thinks of it as a foreign substance in their mouth which needs to be digested. It responds by producing excess saliva. Fortunately, this fades quite quickly.

An Unexpected Invisalign Benefit

While everyone expects to have a straighter smile by the end of their Invisalign treatment, did you know you could also have a whiter smile as well? Invisalign aligners can double as teeth whitening trays.

All you have to do is ask your dentist for some teeth whitening gel, which doesn’t cost much at all. Then, you simply place the gel in your aligners and you’ll have a mini smile makeover at a fraction of the cost.

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

3 Unexpected facts about CEREC crowns

If you’re considering same day crowns, that’s great. They’re useful and convenient. Here are three things your dentist may not have told you yet.

Block of porcelain for CEREC crowns

They are Not Billed Any Differently

When dentists bill your insurance, they use codes. The codes for crowns, whether you are using traditional crowns or same-day crowns, they’re billed by the material used, not the brand.

While your dentist spent a small fortune on the machine, he is making up on lab fees by having it milled right in the office. This means you shouldn’t have to pay more for a CEREC crown than a traditional crown.

Only the BEST Cosmetic Dentists Can Place Them on Front Teeth

Because they’re milled from a single block of porcelain, they don’t have all the subtleties your natural teeth have. A dentist has to be very versed in color theory and have exceptional skills.

If your dentist is recommending a CEREC crown on an anterior (front) tooth, you need to check their qualifications. Ask to see samples of CEREC work they’ve done on front teeth.

If it’s important to you to have the crown done on the same day, you’ll want to take the precaution of going to a dentist who has achieved accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top of their field.

They Don’t Whiten

Often patients decide they want their teeth whiter at a certain point. However, the color made on your dental crowns (CEREC or traditional) is meant to be permanent.

The whitening gel used even in professional teeth whitening only works on natural tooth structure. It saves you money in the long run to whiten your teeth beforeĀ having your dental crown made. This way when the dentist does do it, you’ll have it match the color you’ll be proud of.

It’s not required, of course. You can whiten later. It just means you’ll have to have your crown re-made to match.

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

Does smile direct work?

I keep seeing advertisements on Facebook for smile direct club. They’re offering a free start on their program and it’s much less expensive than Invisalign. Does it really work?

Sadie

Dear Sadie,

The Smile Direct Club is an company which has been in business since about 2013. They’ll mail you your aligners which you’ll wear for three weeks. With Invisalign, you switch the aligners every two weeks.

Their biggest benefit is the money savings. It does cost less than working through a dentist with Invisalign. It appears to work out fine for many patients. But (you knew there would be a but), there are risks.

Dangers with Smile Direct

  • Gum Disease

While you submit a photo and a dentist reviews it, only certain cases of gum disease are able to be diagnosed this way. Dentists will also do x-rays and probe the tissue.

If you do this treatment and have gum disease it will quickly get worse. As it progresses, your teeth can become loose. Combine that with shifting of tooth movements for your orthodontic treatment and you could end up losing teeth.

  • Complications

While for most patients things will go fine, there are exceptions. Sometimes a tooth his supposed to rotate which doesn’t. This affects the entire treatment process.

Another, more common issue, is when there’s crowding. When that is an issue, some of the sides of the teeth have to be shaved down to make room for the correct alignment.

This is something you’ll have to do at a dental office. However, removing the right amount of enamel is tricky. You’d really want a dentist who’s invested in the case to do the work on it. Without that, It might not go as well as you’d like.

So, could it work? Possibly. In many cases it does. The thing to be aware of is what to do if something doesn’t. At the very least, I’d recommend you get a good check up with a dentist ahead of time and make sure you don’t have any signs of gum disease before proceeding.

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

Dental bridge before implant?

I’m a little concerned about what my dentist is recommending for a missing tooth on my 15-year-old daughter. We’re planning on getting her a dental implant when her jaw is developed enough for one. I was looking at some temporary replacements. I thought a flipper would be a good option, but my dentist wants to give her a dental bridge. I think that’s a bad idea, but he said flippers are too temporary. What do you think?

Mandy

Dear Mandy,

woman smiling with a dentist
It’s always okay to get a second opinion from another dentist

I’m glad you wrote about this. While a dental bridge is a more secure fit, I don’t think it is a good fit for a teen aged girl. There are two reasons for this.

First, just like her jaw is still developing for her dental implant, she will need new bridges. That is too expensive to keep replacing as she grows.

Even though the flippers are meant to be temporary, you can replace those in a much more affordable way than the bridge.

There is another reason too which has nothing to do with cost. A dental bridge requires her adjacent teeth to be crowned in order to support and suspend the false tooth. That will mean those teeth will always have to be crowned for the remainder of her life.

If those teeth are healthy, you won’t want to grind down the healthy structure.

It’s Okay to Get a Second Opinion from Another Dentist

A good dentist will give you all of your options. Even then, they will make a recommendation. if you don’t like their recommendation and they’re pressuring you to go with their option, I recommend getting a second opinion.

If your dentist refuses to do the treatment you want you can go to another dentist for that procedure. That means you could get your daughter a dental flipper elsewhere. You don’t have to switch dentists to do that, unless you want to.

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

Porcelain veneers staining between teeth

I had porcelain veneers placed almost two years ago. I’ve been happy with them, but recently have noticed staining between my teeth. I do smoke, but I was pretty sure these were supposed to be pretty resistant to change. Is something going bad on them?

Marianna

Dear Marianna,

A single porcelain veneer being placed on a tooth

You are correct that porcelain veneers are quite stain resistant. I wish I had a picture of your particular case. It would help to make a more certain suggestion.

Often, when people are talking about stains on their porcelain veneers, it is because their hygienist used some type of power prophy jet, which takes the glaze off. When that happens, the staining ends up covering the entire veneer However, you said it is just between the teeth.

I can think of two possibilities for that. The first possibility is the porcelain veneers aren’t flush with your teeth in the edges there. That will be tricky to fix. If that ends up being your issue, I’d seek an AACD accredited dentist (not just a member) to do the work.

The second possibility is that there is some composite bonding there which needs polishing up. Your dentist may even have recommended this as part of your regular maintenance. Most do. With you being a smoker, it will be even more important.

However, go back to the dentist who did you porcelain veneers, don’t expect your family dentist to know how to do this.

Porcelain Veneer Upkeep

In addition to periodically having the polishing done for their longevity, it’s helpful if you use a toothpaste which is specifically designed for cosmetic work. Supersmile is the one most cosmetic dentists recommend.

If you like using a mouthwash, you don’t need to get anything special. Just be certain you don’t use one which contains alcohol. That will eat away at the bonding that holds them onto your teeth.

And don’t forget to floss…

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

Porcelain Veneers Look Unnaturally Shiny

I’m curious if you can reduce the shine on porcelain veneers. Mine are unnaturally shiny looking. There’s so much shine on them they don’t look anything like regular teeth, more like a overly waxed marble floor. Is there anything I can do about this?

Martha

Dear Martha,

A single porcelain veneer being placed on a tooth

When you pay money for a beautiful smile, this is what you should get. I’m very sorry you didn’t. I’m going to make a very good guess that your dentist isn’t an expert cosmetic dentist. Those who are create stunning smiles. In fact, most of them have a beautiful smile guarantee.

While the shine on porcelain veneers is an important part of what gives it their beauty, they have to be done properly to achieve that result. Even more importantly, the glaze is what protects the veneers from picking up stains. However, in your case it sounds like the glazing wasn’t properly done.

Here’s what can create a fake looking shine. Look at the picture directly below. Notice that although these teeth have a beautiful shine, there’s texture. This makes the shine look natural. In fact, one of those teeth are fake. You probably can’t tell which one.

close up of teeth

The likely reason your shine looks unnatural is it is flat. It wasn’t given the texture of natural teeth, which makes the teeth look fake. You can remove the glaze by allowing your hygienist to clean your teeth with a prophy jet. However, doing that will actually cause your teeth to pick up stains rather quickly.

Getting Your Porcelain Veneers to Look Beautiful

I would not recommend removing the glazing. Instead, I’d ask your dentist to re-do them properly. If your dentist hesitates, it may help you to get a second opinion from an expert cosmetic dentist. Look on mynewsmile.com. All the dentists they list are expert cosmetic dentists.

They’ll be able to let you know what’s wrong with the smile and help your dentist to understand that as well. If your dentist doesn’t think he can follow through. He may be able to give you at least a partial refund.

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

Cosmetic Dentistry Tourism Disaster

I had porcelain veneers placed on my top teeth and a dental implant and crown on my bottom arch. In the U.S. it would have cost me over $60,0000 but I was able to get it done overseas for around $11,000. At first, I was pleased as punch, but now I’m four months out and the veneers are falling off. I’ve been cutting up the food the way he showed me and not eating with my front teeth at all. In fact, the last one fell off while eating spaghetti. That’s hardly anything to stress about. Three of the veneers have fallen off. They’re all intact. Do I need to have these re-done or can another dentist put them back on?

Catrina

A single porcelain veneer being held up by a dental tool

So, here’s the thing. Those instructions your dentist gave you about eating are a huge red flag to me. There is absolutely no reason why you should have any restrictions at all on what or how you eat. When properly bonded on, porcelain veneers will allow you to eat anything.

This dentist doesn’t know proper bonding technique. That alone, makes me question the skill of the rest of his work. For health and safety reasons, I’d like you to get a second opinion on the dental implant and crown you had done. This is especially important about the implant. If an infection develops it can lead to serious consequences.

Regarding your fallen porcelain veneers. You mentioned they’re still intact. In that case, it is possible an expert cosmetic dentist could clean them up and get them bonded back on properly. However, this is beyond the skill of almost all cosmetic dentists. You will need someone in the top 2%.

Finding an Expert Cosmetic Dentist

Cosmetic dentistry isn’t really taught in dental school so you’ll need to look for someone who invested the time and training into doing it well. In your place, I’d look for a dentist who has reached accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists are in the top 1% of dentists. You can find them listed on aacd.com. Just make sure they’re accredited. They will know the right procedure to help you with your porcelain veneers.

The cost to get them bonded back on properly shouldn’t be too bad, if they can be saved. If they can’t be, these dentists will give you a list of options and let you determine which way you want to go.

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