Tag Archives: AACD Accredited Dentist

gums inflamed after porcelain veneers

I had porcelain veneers placed on four teeth almost a month and a half ago. Since they’ve been on, my gums have been inflamed. I went in to see the hygienist and she said it is probably that I’m babying the teeth and not brushing well enough. I can assure you that is not the case. Then, at my one-month follow up the dentist removed some excess cement. That helped a little but it has been a week and a half since then and they are still inflamed. My dentist doesn’t seem concerned but I’m worried, not to mention in pain. What do you recommend?

Kay L.

Dear Kay,

Our experience has been patients love their new smiles so much, after getting porcelain veneers, they tend to take better care of them, not worse. Isn’t it a tad annoying when medical professionals blame the patient when they can’t figure out what is wrong?

Cosmetic dentistry is both an art and a science. The health of the gums is one of many things the American Academy of Cosmetic Dentistry looks at in evaluating cases when dentists are working toward accreditation.

The lateral incisors, in this case, received porcelain veneers. Because of the gum inflammation on these teeth, this case would be rejected as unacceptable by AACD accreditation examiners.

In the case above, the gum inflammation on the lateral incisors would be an indication this dentist did something wrong, causing the case to be rejected by accreditation examiners as a means of demonstrating competency.

While there are several reasons your gums could be inflamed, I’m leaning heavily toward your dentist not removing all the excess cement. You said he removed some at your one-month follow-up appointment. When done properly, all the excess cement would have been removed immediately after they were bonded. There shouldn’t have been any to remove at the follow-up appointment.

A couple of other possibilities would be uneven margins or the porcelain veneers going too far under the gumline. To truly know what is going on, though, you’re going to need to see an expert cosmetic dentist.

Getting a 2nd Opinion from an Expert Cosmetic Dentist

The first thing I want you to do is go to the website of the American Academy of Cosmetic Dentistry. (aacd.com). They have a link to find a cosmetic dentist. However, make sure you check the boxes for an accredited dentist. Membership is easy. AACD accreditation requires real skill.

Pick one which is reasonably close to you and schedule an appointment for a second opinion.

Finally, make sure when you go, you get a “blind” second opinion. This means you won’t tell them which dentist did the work or anything they said could be the problem. You want the accredited dentist to give his unbiased opinion without anything to sway him.

Best of luck.

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

can I fix the color of my cerec crowns?

I had a CEREC crown done on one of my canine teeth about three weeks ago. We never really discussed the shade while I was in the office, but as soon as I got home, I realized that it was a bit lighter than the rest of my teeth. Well, once I saw it, I couldn’t un-see it, and now every time I look at myself, all I see is that darn tooth. It looks fake.

I didn’t want to bother my dentist with this at first, so I started playing around with at-home whitening products to try to get the rest of my teeth to match, but I’m just not getting them as bright as that CEREC crown. This probably sounds crazy, but I’m starting to wonder if he can darken it just a bit, so it’s a better match. Is that even possible?

Thanks,

Stan

Dear Stan,

CEREC crown restorations and materials

There are a couple of things about your case that give away that your dentist isn’t really what I would call a cosmetic dentist. Every dentist who is serious about cosmetic dentistry, when they place a crown on a front tooth, will make sure you get a good look at it before it is permanently bonded on. He didn’t do that.

The other problem is that it is a CEREC crown. The CEREC material is a block of material that is a set shade. Unless the dentist is an advanced cosmetic dentist, he won’t know how to use color theory and stains to match a front tooth.

To match a front tooth, a true cosmetic dentist has the ability to customize the shade. Each tooth in your mouth has differences in color from the neck of the tooth to the tip, and it is quite a process to mix different materials to get a crown to match the surrounding teeth.

Tints and Stains Exist

There are tints and stains that can be applied to the CEREC to customize the shade. But on a ceramic, that has to be baked into the crown, so that has to be done before the crown is put in your mouth, obviously.

Sounds Like You Will Have to Have Your CEREC Crown Replaced

You deserve to be happy with your smile and he biffed the color. Hopefully, your dentist will agree to re-doing the crown. However, this time, make sure you get to look at it BEFORE they cement it. Check it out under various lighting conditions—seriously. Look at it in the chair. Get up and go into the bathroom and check it there. Venture to an outside window and view it in natural sunlight. If it isn’t right, don’t let them cement it.

Request a Lab-Made Restoration if All Else Fails

There are crowns that have a core that is made like a CEREC crown and then have porcelain baked over the top. If you want a natural-looking crown on a front tooth, this is the way to go. Although you’ll have to wait two weeks for the lab to make it, the lab technician will be able to tint the crown to match your existing teeth. But the dentist also needs to have a good eye for color and the ability to describe the color variations in your tooth, and your dentist doesn’t sound like he is that much into that. For the best results, you’d really want to switch to someone who specializes in cosmetic dentistry for these sorts of things, but you’ve already started with him, so as long as you’re keen to continue, give him the chance to fix his work too.

If he can’t, look for a dentist who has been accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the country.

This blog is sponsored by Lafayette, LA Dentist Dr. Mike Malone.

covering tetracycline stains

I have pretty bad tetracycline stains, as did my sister. She had porcelain veneers put on them a number of years ago. While they look better than my teeth, they do not look natural. They told her they had to use an opaquer in order to get them to cover the stains. I was hoping in the last few years or so they’ve made some advancements so that if I had porcelain veneers done, they would look more natural. What are my chances?

Avery

Dear Avery,

A single porcelain veneer being placed on a tooth

When it comes to making natural-looking porcelain veneers, the need isn’t for better advancements; rather, it’s for better cosmetic dentists.

The technology has been around for years, but very few cosmetic dentists have the training and skill required to pull it off. To be fair, tetracycline stains are among the most challenging a dentist can face.

The porcelain veneers have to be opaque enough to cover the stains, yet translucent enough to reflect light and look normal. I would say only the top 1% of dentists in the country are capable of pulling this off.

Finding an Expert Cosmetic Dentist

If you want the best cosmetic dentist, and you will need that for tetracycline stains, you will want an AACD accredited dentist.

The American Academy of Cosmetic Dentistry realized, because cosmetic dentistry isn’t a recognized specialty, patients would have a hard time distinguishing who was actually skilled and who just dabbled.

To reach accreditation, dentist have to pass stringent oral and written exams as well as provide a large number of cases which demonstrate they have artistry in their work as well.

Those who reach this level are in the top 1-2% of dentists in the country. You can locate them at aacd.com. Just make sure you check you want an accredited dentist.

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

porcelain veneers during pregnancy

I’ve been saving up for a smile makeover. I just reached the amount I needed and I found out I was pregnant. Am I able to move forward wtih the porcelain veneers or do I need to wait until after the baby is born?

Melinda

Dear Melinda,

A single porcelain veneer being placed on a tooth

Congratulations on your new little one! While there are so many things you’ll have to protect your new child from, porcelain veneers won’t be one of them.

There are some cosmetic procedures which are not recommended during pregnancy, such as teeth whitening. This is because, especially during the first trimester, when the baby is most vulnerable you don’t want them ingesting any unsafe chemicals.

Fortunately, porcelain veneers do not have anything which could endanger your baby. The only chemical used would be lidocaine which has already been proven safe in pregnancy.

It is up to you at this point. Some women struggle with intense nausea during their first trimester. That may make having your mouth messed with a challenge. Because of that, you may want to wait and see how your body reacts to this new baby first. If you seem to be fine, you can move forward. If not, there is no harm in waiting.

Who Should Do Your Porcelain Veneers?

You don’t want just anyone doing your smile makeover, though. This is a once in a lifetime procedure and you’ll want it done right. Because there isn’t a recognized specialty in cosmetic dentistry, there is no real way to know if the dentist doing your procedure has had enough additional training to do the job well.

In your place, I’d look for a dentist who has attained accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the country.

They’ve passed stringent oral and written exams to prove their technical knowledge. Additionally, they had to provide visual evidence on a large number of cases they’ve done to show they are also artistic.

Any one of them can give you a stunning smile.

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

porcelain veneers & invisalign?

I’m hoping you can help me make a decision. I want to whiten my teeth and I have two crooked front teeth. I was thinking I could fix both getting porcelain veneers. I spoke to my dentist about it and he said that would be fine, but he’d like me to straighten the front teeth first. I was hoping not to have to do orthodontics because they’re so unattractive and take forever. Is it really necessary?

Kathryn

Dear Kathryn,

Invisalign aligner
You can now straighten your teeth invisibly

First, please understand that I haven’t seen your teeth and can only go by your description. Unless there is something your dentist hasn’t explained to you, I’m puzzled why you would need both as well.

Generally, a patient will either do porcelain veneers or orthodontics, not both. There could be an exception if you have either a serious bite problem or overly crowded teeth. In those unusual cases, it would be helpful to have orthodontics first. Other than that, you can just have porcelain veneers placed and it will make your front teeth appear to be straight.

If you are in that position, then I have some helpful news for you. You can completely straighten your teeth without anyone knowing. Invisalign uses clear aligners. You can see an image of one of the aligners above. When you are wearing them, they are completely invisible, even at a conversational distance.

The best part is they have the benefit of being able to whiten your teeth simultaneously. The aligners used to straighten your teeth can also double as teeth whitening trays.

Invisalign or Porcelain Veneers

If you have the choice and all you want to do is whiten and straighten your teeth, you would save a lot of money using Invisalign. However, if there are other things about your smile you want to change, such as the shape or length, then porcelain veneers are the way to go.

These are the go-to for a complete smile makeover. One word of caution. They require technical expertise as well as an artistic eye. Not every dentist can do a smile makeover with porcelain veneers. There are countless cosmetic dentistry horror stories to back this up.

If you decide to go that route, you will want a dentist who has been accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the country.

If you go the Invisalign/teeth whitening route, just about any family dentist can do it.

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

dentist ruined this man’s bite

I’m worried I made a horrible mistake having a gap closed. I had a large gap between my two front teeth. To fix it, my dentist did six dental crowns. Ever since then, I’ve been in a lot of pain, I can’t speak properly, and my mouth is dry all the time. Can I put the gap back? Would that fix this?

Peter

Dear Peter,

CEREC Crown being placed on a tooth
Sometimes a dentist gets in over their head

Your problem isn’t because the gap was closed. These large gaps can be fixed without any negative repercussions. Instead, I think your porcelain crowns were not done properly. This case was probably too challenging for your dentist. As a result, he has inadvertently damaged your bite.

This is rather serious and needs to be addressed right away. My suspicion is your dentist made your dental crowns too thick, which opened your bite too much. This led to the pain you are experiencing as well as lip incompetence.

When your crowns are too thick, it leads to your mouth staying agape. That will cause the dry mouth you are struggling with. It is absolutely imperative your mouth closes naturally. Without that, you won’t have enough saliva in your mouth. Saliva is a key component in fighting decay because of its bacteria fighting minerals.

Pain is also a result of a bite being opened too far. This can lead to problems with TMJ Disorder. Though, pain is enough of a reason to have this fixed.

Your dentist appears to have been in over his head fixing this gap. I want you to see an AACD accredited cosmetic dentist. They’ll have the expertise you need to fix this. They can also help you secure a refund from your dentist.

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

Porcelain veneers with an overbite

I want to get a smile makeover. I asked my dentist about porcelain veneers and he said because my top teeth cover my bottom teeth I’m not a good candidate. Instead, he suggested I have crowns placed on my six front teeth. My teeth have some dark stains because of tetracycline too. Does this mean after the crowns are done, I’d whiten the bottom teeth to match?

Lisa

Dear Lisa,

A single porcelain veneer being placed on a tooth

I want to caution you not to do dental crowns for your smile makeover. I think I know what is going on here. It sounds like your dentist isn’t as comfortable with designing and placing porcelain veneers than he is with dental crowns.

He doesn’t want to tell you this and cause you to think less of him as a practitioner, so instead he suggests the procedure he feels he does better.

Blaming your bite is creative but not valid. Even thinking about it logically, porcelain veneers would be a better fit for your bite. Porcelain crowns surround your entire tooth, but porcelain veneers only are bonded to the front. They would actually be less intrusive.

On top of all of that, with dental crowns, your teeth have to be ground down to nubs. Because of that, you can never have anything but crowns on those teeth for the remainder of your life.

There is another hint to me that your dentist isn’t an advanced cosmetic dentist. He’s suggesting six teeth be treated. Unless you have a narrow smile, that won’t be enough. Most people show between eight to twelve teeth when they smile.

Finding an Advanced Cosmetic Dentist

Your particular case is particularly challenging and requires a top-notch cosmetic dentist. Tetracycline stains are quite tricky to get right. You need the teeth to have the look of natural translucency, but at the same time still be opaque enough to cover the deep stains.

Only the top 2% of dentists can do this well. In your place, I’d look for a dentist who has been accredited by the American Academy of Cosmetic Dentistry. They have both the technical skill and artistry to give you a stunning smile, even with tetracycline stains.

Regarding the teeth whitening you mentioned. Yes, you would whiten the remaining teeth which don’t get veneered. However, you want to do the teeth whitening first. When you get them to the level of whitening you want, it will be time to get your porcelain veneers. The KöR  Teeth Whitening System has been the most effective in whitening tetracycline stains.

This blog is brought to you by Lafayette 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.

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 before 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.