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Are 3N Veneers Better Than Lumineers?

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I have read some of your information about Lumineers, and other expert cosmetic dentists seem in alignment with your thoughts. My question is about 3N Veneers. I live in Europe and quite a few cosmetic dentists here say that 3N is better than Lumineers. What are your thoughts on them?

Marie

Dear Marie,

An image of a porcelain veneer being held up to a tooth.

I’m glad you wrote. I want to redirect your line of thinking. While great that you are trying to do research before investing in your smile makeover, I think you are looking at the wrong thing. Let’s look at it from an art point of view, and cosmetic dentistry is definitely an art. If you were trying to commission a sculpture to be done, would you look into the brands of clay or marble the sculptors use or the artistry of the sculptor? My guess is the artistry of the sculptor. That is how you need to approach this.

Why? Because while 3N porcelain veneers could be better than Lumineers, that would completely depend on the skill and artistry of the dentist placing them. An expert cosmetic dentist could provide you with a stunning smile no matter what brand they used. An average cosmetic dentist will give you an average smile no matter how great the brand. Plus, each brand has different strengths and qualities. A dentist who does a lot of smile makeovers will know the pros and cons of each brand.

I would focus your attention in finding the best cosmetic dentist you can. I am going to recommend that you look for a dentist accredited by the American Academy of Cosmetic Dentistry (AACD). Accreditation with the AACD is different than just membership. These dentists have passed stringent exams and demonstrated their artistry before an examination board. They’re in the top 1-3% of cosmetic dentists in the country.

One thing you can do to protect yourself is to make sure the dentist is willing to do a provisional try-in for your porcelain veneers. That means he or she will put them on with a temporary try-in paste. Then, you get to look at them in several different type of lightings. If you don’t absolutely love them, then your dentist should be willing to send them back to the lab as many times as is necessary to give you the beautiful result YOU want. They should not get permanently bonded until you are thrilled with them.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Stain on the Edge of a Porcelain Veneer

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I have four porcelain veneers. They have stayed very white and I have been pleased with them. However, there was a change after my most recent dental cleaning. There is a small gray stain at the top of one of the veneers at the margin. I am not sure if it is damaged, but do find the timing suspect. Is there a way to fix this?

Miranda

Dear Miranda,

a porcelain veneer being placed on teeth

I am at a disadavantage here of not being able to examine your porcelain veneers. However, I can give you some generalities. Porcelain veneers are both very stain resistant as well as color stable. When they do stain, it is only because of a handful of reasons. In some cases, a porcelain veneer will pick up stains on the edges where the bonding is. These can be polished out and should be considered a regular part of maintenance. Your dentist can do it quickly with special polishing strips at your checkups about once a year or so. This does not sound like what you are talking about.

Another reason for stains on porcelain veneers is on the surface if the glaze that protects the veneers is damaged. This can happen if your hygienist uses something like a power prophy jet or acidulated fluoride during your appointment. This can also happen if you use over the counter whitening toothpaste for an extended period of time. Most people don’t realize that these type of toothpastes use abrasives to whiten the teeth. If this were the type of stains you were having, it would stain over the entire surface of the tooth. If you want a whitening toothpaste that is safe for porcelain veneers, I recommend Supersmile Toothpaste.

If your porcelain veneers are older, say about ten or twenty years, you could be dealing with microleakage. In this case, stain starts right at the edge of the porcelain veneer and involves one to two millimeters of the veneer. It would confine itself to the edge of the porcelain veneer. It this is not addressed it can turn into decay. Unfortunately, the way of repairing this is to replace the porcelain veneer.

In your place, I would go to an expert cosmetic dentist who is experienced in smile makeovers, like someone who is AACD accredited, and have them look at the stain to give you a precise diagnosis.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Dealing with a Chipped Lower Incisor

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I have a lower incisor that is chipped. It is a bit irritating and I’m worried people can see the chip when I am talking. My dentist tried to repair it with dental bonding but that fell off after a few days. Is there a way to just regrow the broken part?

Olivia

Dear Olivia,

A porcelain veneer being held up with a dental tool

With a lower incisor there is always the problem with the upper teeth causing an issue with the dental bonding. This is because the incisal edges hit the insides of the upper incisors every time you close your mouth. Dental bonding is more susceptible to those type of stresses. You would need an expert dentist to who has studied occlusion to know how to avoid those type of stresses. Otherwise, the bonding will break.

Another option for fixing this is with a porcelain veneer. These are a bit stronger and last longer than dental bonding. While bonding will last a few years, veneers can last for decades if well cared for.

With either one of these procedures you will want a dentist with significant post-doctoral training and expertise in both occlusial studies as well as cosmetic dentistry.

In your position, I would look for a dentist who is AACD accredited. These are the top cosmetic dentists in the country and they will have the skills to give you not only a repair that will last, but that will also blend seamlessly with the rest of your smile.

If you can’t find a skilled cosmetic dentist in your area, then a last resort would be to have the dentist smooth out the chip. That would only be a last resort. You may have to travel to a nearby city, but I’m sure you can find a skilled cosmetic dentist.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Dental Crown Disaster

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I needed a crown on a front tooth. My dentist suggested a CEREC crown because it could be done in one day, but I’d heard that they don’t look good on front teeth, so I asked for a traditional crown. The temporary crown didn’t really match, but he assured me that the temporary crowns would always be worse than the permanent crowns and when they came in it would be a perfect match. When the crown came in, I never really got to see it before it was bonded in. Once I got to look at it I realized (to my horror) that it didn’t really match the tooth next to it. I mentioned that and he said it “looked fine to him” plus it was already bonded so it couldn’t be removed. Then, a few weeks later the permanent crown, that “couldn’t be removed” fell out. I went back to my dentist suggesting that this would be a good time to improve the appearance. He then said that, “While he could redo it, he would have to charge me for it because I have a functional crown.” Otherwise, he could just bond this back on for free. I was so frustrated. Now it has fallen out again. I’m sure he is going to give me the same choice again. Do you have any recommendations for me?

Greta

Dear Greta,

Porcealin crown being placed on a tooth

The one good thing you have going for you is that the dental crown is not staying in. The dental board considers the standard of care functional. While you, unfortunately, would not have any recourse because the crown does not match your teeth, you do have the right to ask for a refund when it does not stay in. Despite what your dentist said, you do not have a functioning crown if it does not stay in your mouth. That is exactly what I think you should do.

Not only has this dentist shown himself to be unethical in how he misinformed you about the temporary versus permanent crown, he also cannot get the dental crown to stay. Do not allow them to do any more work on you. Instead, tell him you want a complete refund. Your crown is not functional. This is the second time it has fallen out.

When you go to get your crown replaced, I want you to go to an expert cosmetic dentist. Matching a tooth to a front tooth is more challenging than for other teeth because the light hits them directly which reveals all the nuances of the teeth. A truly skilled cosmetic dentist would do a temporary try-in to make sure it perfectly matches the adjacent teeth. If not, they would make notes about what changes need to be made and then send them back to the lab to be redone. He or she would not be satisfied, nor would they bond the crown in, until you are completely satisfied.

My suggestion is that you go to an AACD accredited dentist. These are the top cosemtic dentists in the country. They will give you a gorgeous crown that completely blends in with its adjacent teeth.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Crowns or Veneers for Tetracycline Stains

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I have severe tetracycline stains that I am ready to get cosmetically treated. I’ve seen two dentists about this. The first suggested porcelain veneers, the second dentist suggested porcelain crowns. The price quoted to me for the veneers is almost double that for the crowns. Can I acheive the same beautiful result with either porcedure? I like the idea of saving money, but don’t want subpar results.

Avery

Dear Avery,

a porcelain veneer being placed on teeth

It is an exciting time when you are getting to plan your smile makeover. I am glad you wrote. The single biggest factor that detrmines the beauty of your case is not necessarily which procedure, but which dentist. Think of cosmetic dentistry as an art form. If I commissioned two painters to do the same portrait with the exact same materials, the portraits would not be exactly the same. This is because the skill and artistry varies from painter to painter. The same is true of cosmetic dentists.

Now factor in that you are dealing with severe tetracycline stains and the dentist becomes even more important. Tetracycline stains are one of the most advanced cases in cosmetic dentistry and quite difficult to do.

The standard treatment for this would be to have porcelain veneers placed. Usually, dentist who suggest porcealin crowns do so because they do not have the skill to cover the stains with the thin wafers of porcelain that make up veneers and think that using dental crowns will make that easier. This is not the case.

With dental crowns, you also want to consider that there is significantly more grinding of the teeth for preparation. This weakens the teeth and puts them at greater risk down the road. Plus, you can never backtrack from dental crowns. Once the tooth structure is gone, it’s gone. There is not a way to get it back.

Just because the first dentist suggested veneers instead of crowns, does not necessarily make him an expert cosmetic dentist. The easiest way for you to find an expert, artistic cosmetic dentist is to go to the AACD.com website. They have a find a cosmetic dentist link. However, it is important that you check that you want an accredited dentist. AACD accredited dentists are the top cosmetic dentists in the country. Any one of them can ensure you get a beautiful smile, even with severe tetracycline stains.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Are Same Day Crowns as Good as Traditional Ones?

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I need a crown on a front tooth and my dentist is suggesting that I use his new CEREC machine, which will allow me to get my dental crown the same day as my appointment. There is something appealing in that, but I want to make certain that they are just as good as the traditional crowns. This is a front tooth so I don’t want to have something that doesn’t fit right and makes my smile look weird.

Beverly

Dear Beverly,

CEREC crown block

 

The CEREC machine can produce a well fit crown. However, front teeth are a bit trickier. It’s not tricky to make them fit. The difficult part comes in getting them to look both natural and beautiful. It takes a great deal of artistry.

With CEREC, the crowns are produced from a single block of porcelain. If you look at your front teeth, you will notice that there are many variations to the opacity. Parts of your tooth are lighter and have more translucency than other parts of the teeth. Because CEREC uses a single block of porcelain the results will be uniform, which will make front teeth look rather flat. Your dentist would have to know how to use different types of stains and tints in order to produce the variations needed to look natural.

If your dentist is not a highly skilled cosmetic dentist, I would not use CEREC for a front tooth. In fact, even with tradtional crowns, you need to make certain the dentist uses a temporary try-in paste to make sure the crowns not only look natural and beautiful, but that they blend seamlessly with the remainder of your teeth, especially the adjacent front tooth. It will probably take a few tries to get it perfect.

This is above the skill level of most dentists. I would either look for a dentist who is recommended on the mynewsmile.com website or someone who has reached accreditation with the American Academy of Cosmetic Dentistry. These are the top cosmetic dentists in the country. If it were any other tooth than a front tooth, it would be an easy assignment.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

30K Cosmetic Dentistry Disaster

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Can you help me find a different dentist. I just had a total smile makeover that included both dental crowns and porcelain veneers. This was done to fix both the damage done from my teeth grinding as well as cover my tetracycline stains. They look really opaque, which does give them a fake appearance. However, the thing I’m worried about is my jaw has been hurting. It didn’t hurt like this before the crowns and veneers were placed. I did have some low level aching because of the teeth grinding. However, now my jaw really hurts all the time. So much so that it is distracting. My dentist insists not only does everything look great but that he has passed all the check marks for proper placement. I’m at my wits end and have already spent $30,000 on this.

Laurie

Dear Laurie,

Woman Holding her jaw in pain

Under normal circumstances, it would be very hard for you to get this repaired without paying for the whole thing all over again. If the only problem is the appearance it is nearly impossible for you to get a refund. You’d think that wouldn’t be the case when you are talking about cosmetic work, but that is currently where it stands. However, you seem to be dealing with some functional issues. I don’t know how he thinks the markers for proper placement would not include your patient not being in pain.

It sounds like your bite may be thrown off a bit, which could be leading to complicating issues such as TMJ Disorder. This can work in your favor because it means that the case isn’t truly functional. We’ll go over how to get this diagnosed in a moment. First, I want to go over the difference between a general dentist and a true cosmetic dentist. Even though there is not a recognized specialty in cosmetic dentistry, there are some distinct differences.

One of those differences is the amount of training they get. Smile makeovers are not taught in dental school. In order for a dentist to truly learn the techniques and artistry required, they would need post doctoral training. Another important difference is how they treat the patient. A true cosmetic dentist would not be satisfied with the work if you weren’t. They would first do a temporary try in and allow you to look at it in several different lights and make sure you are completely thrilled with the results. Even a little hesitation would cause them to ask, “What do you wish was different?” and it would go back to the lab to make the changes.

The easiest way for you to find one of these dentists would be to go to the American Academy of Cosmetic Dentistry’s (AACD) website. They have a “find a cosmetic dentist” link. Make sure you check the box that says you want an Accredited Cosmetic Dentist. These are among the top 1% of cosmetic dentist’s in the country. Have one of them examine your case. It will be helpful if they also have TMJ training. They can tell you if your current dentist’s work threw off your bite. If that is the case, then they can help you secure a refund so you can get this done properly by a qualified dentist.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

A Single Porcelain Veneer Turning Dark

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I have eight porcelain veneers on the top arch and six on the bottom. A few months after they were placed, I chipped one in a fall. The dentist buffed the tooth down so it would be even. Then he had to buffer down the partner tooth on the other side so they would be even. Fast forward a few months and now one of her teeth has turned bluish and has a darker spot underneath. I went back to the dentist and he said that he had no idea what I was talking about. He was pretty put out and said he was “excellent with color design.” His professional opinion is that I’m being too picky. However, I assure you that the color has changed. I don’t know what to do and I am worried that this veneer will fall off. Do you have any recommendations?

Carolyn

Dear Carolyn,

a porcelain veneer being placed on teeth

First, I am going to tell you that your dentist does not sound like a true cosmetic dentist. A dentist who has done a significant amount of post-doctoral training would never tell a patient they are being too picky. Their goal is to make sure the patient has the smile of their dreams.

Bear in mind that I haven’t examined you or even seen images. However, going solely on your description it sounds like you have a leaky veneer. This means that the bond between your tooth and your porcelain veneer is failing. The changing color is debris getting caught between your porcelain veneer and your tooth.

This needs to be fixed or you can end up with severe decay on that tooth. My suggestion is to go back to your dentist and have him fix this tooth. You may need to show him this blog post. If that doesn’t work, get a second opinion from an expert cosmetic dentist that examines you. One way to find an expert cosmetic dentist is to go to the American Academy of Cosmetic Dentistry Website (aacd.com). In their “Find a Dentist” link make sure you check that you want a dentist who is accredited. AACD accredited dentists are among the top 1% of cosmetic dentists in the country with proven skill and artistry.

When you get that second opinion, make sure it is a blind one. They should not know who your dentist is or what he said about the veneer that you are concerned about. If it turns out that it is a leaky veneer and needs to be replaced/rebonded, then he or she can give that recommendation to your dentist. Peer pressure is a thing, even in professional circles.

This blog is brought to you by Philadelphia Dentist Dr. Michael Weiss.

Am I Too Young for Porcelain Veneers?

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I am 21 years old and want to get a smile makeover. I had braces years ago, but some of the gaps are back. Plus, I was a bit of what my parents dubbed a tom-boy so I’ve chipped quite a few teeth. Now, I’m graduating from college soon and want to start thinking about a professional look. I want a nice smile. Am I too young to get porcelain veneers? If so, would bonding be a good substitute? As for the dentist, my general dentist doesn’t do porcelain veneers but said he’s willing to learn if it is important to me. I’m not sure I want to wait for him to learn so do I just look for one who already does them?

Phoebe

Dear Phoebe,

a porcelain veneer being placed on teeth

I am glad you wrote. You have some great questions. Let’s jump right in. First, you are not too young for porcelain veneers. The important factor is that all your teeth are fully developed. This generally happens around 18 years of age, so you should be fine. I don’t recommend dental bonding for full smile makeovers. They are not as useful over large surfaces. Instead, their sweet spots are small gaps or chips. You mentioned those, but if you have a lot of them and/or want to change other things about your smile, you are still better off with porcelain veneers. They are more durable, as well as beautiful.

You are wise not to go with your general dentist. It takes years of post-doctoral training, as well some natural artistry to be skilled with doing smile makeovers. It is not something taught in dental school, nor is it a recognized specialty. As a result, it is up to the patient to figure out the best dentist to do their smile makeover.

I am going to suggest that you use a dentist who has reached accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists are proven in both their technical knowledge as well as their artistry. You will get a stunning smile.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Dental Bonding Staining After Two Weeks

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I had dental bonding placed just two weeks ago. It has already started staining, which surprised me. I did some research and realized it could be my coffee drinking. It was also suggested that I purchase Supersmile Toothpaste. Do you know if this will allow me to continue drinking coffee or if I will have to give it up? My dentist never told me to stay away from anything in particular.

Carol

Dear Carol,

before and after dental bonding

While it is true that dental bonding will pick up stains after a while, a few weeks is way too soon. I have a supicion your dentist is just a bread and butter general dentist and not one who does any significant amount of cosmetic work in his practice.

Dental bonding is made with a blend of composite and inorganic fillers. There are a variety of fillers and sizes. Some examples of this are silica, quartz, and glass. Hybrid composites are strong, but because their particles are larger they cannot be glossed to a high shine. Microfills, because they are very small, can be polished to a luster as shiny as natural tooth enamel but are not as strong. There is a newer nanofill composite which claims to have both strength and polishability. Because it is new, we have to see how that pans out.

Most general dentists, who don’t do a lot of cosmetic work, will just keep hybrid composites on hand because they are looking for durability. But, when you are talking about appearance, you need a combination. A skilled cosmetic dentist will use the hybrid on the inner part of the tooth and then use the microfills on the surface on the teeth which allows them to get the high shine you need to protect your teeth from staining.

My suggestion is that you return to your dentist and share what you’ve learned here. He should be willing to improve the shine. If he is incapable, then you will have to go to an expert cosmetic dentist.

Whenever we are talking about aethetic dentistry of any kind, I recommend you see an AACD accredited dentist. These are the top cosmetic dentists in the country and can give you stunning results.

I don’t know what your dental bonding was for, whether it was to repair a chip, close a tooth gap, or purely to give you a smile makeover. If you were doing a smile makeover, you will get longer lasting, more beautiful results with porcelain veneers.

As for Supersmile toothpaste, it does an excellent job removing surface stains from dental work. However, if yours has lost its shine, it won’t be helpful there. Save the toothpaste for when your bonding is repaired.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.