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My Smile Makeover Is Turning Yellow

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I spent a good amount of money hoping to get my dream smile makeover. It’s been a disaster from the beginning. I selected a very white color because my natural teeth were very white. I just didn’t like their shape. My dentist gave me six porcelain crowns. However, when the came in they didn’t look as white as I expected. He assured me it is the color I asked for. Now, to make matters worse, the crowns seem to stain every time I even drink something. I am going in for a consultation with another dentist and I have no idea what to even ask him. Do you have any recommendations?

Dinah

Dear Dinah,

a porcelain veneer being placed on a tooth

Porcelain Veneers

I am sorry this happened to you. The first thing I’d like to ask is why dental crowns? Typically, a smile makeover is done with porcelain veneers. Was there some decay on the teeth that required crowns or were there already crowns there? Either way, it is water under the bridge. Those teeth will always need dental crowns from now on because the structure of the tooth has been ground down to fit the crowns over them.

One other thing that bothers me is why the crowns are picking up stains. If he truly gave you porcelain crowns, they would be very stain resistant. In fact, they’d be even more stain resistant than your natural teeth. I’m prone to wonder if he just said they were porcelain but used some other type of material. That is the first thing I’d have the dentist you are going to for a consultation look at.

However, let’s back up a bit. What makes you think this dentist you are going to get the consultation from is any better than the one who provided your disappointing results to begin with? I would make sure you are going to an expert cosmetic dentist. Look for someone who is AACD accredited. Then you’ll be certain to have an expert with both technical and artistic skill to work on your smile.

By the way, if it turns out your dentist gave you something other than porcelain crowns, you can get your money back because of misrepresentation.

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

My 11-Year-Old’s Dental Bonding Looks Terrible

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I need some advice. My eleven-year-old daughter fell in such a way that it knocked a giant portion of the middle of her two front teeth out. She has some on the sides and top and that is it. Our dentist said the best solution would be to fill in the empty space with dental bonding. We agreed, but in all honesty, it looks awful. Her two front teeth are now lumpy looking and the color doesn’t exactly match the remainder of her natural teeth. This is a very tricky age for kids and she has been in tears since we returned. I don’t know what to do. Can this be fixed? Did he need to do a different procedure?

Avalon

Dear Avalon,

before and after dental bonding

While your dentist was correct about the type of repair that would be the best solution, he doesn’t appear to have the cosmetic training necessary to do the actual work. Cosmetic dentistry is not a recognized specialty. As such, any general dentist can “do” cosmetic work, but very few of them have the actual training necessary to do it right.

Dental bonding is particularly difficult because it has to be done freehand. It also requires special materials in order to match the colors exactly to the remaining tooth structure. On top of that, your daughter’s type of repair is more difficult than most. It’s even on the list of cases dentists have to show proficiency and artistry in for them to pass the AACD Accreditation Exam, which is the one “guarantee”  for knowing that you have an expert cosmetic dentist.

My suggestion is you ask for a refund from your dentist. It doesn’t sound like he even came close to doing this in an acceptable fashion. Then, look for an AACD accredited dentist in your area. They will make certain your daughter has gorgeous front teeth as she returns to school.

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

Teeth Whitening Before a Dental Crown

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I am getting a dental crown on a white tooth and I want to do a touch-up on my teeth whitening before I get it. I asked my dentist how long I would have to whiten my teeth each day and for how many days to get them back to their original color when I first whitened them three years ago. He couldn’t tell me so I am wondering if there are some tips you have.

Bethany

Dear Bethany,

teeth whitening trays

 

I am going to help you with this, but before I do I want to let you know that I am concerned that your dentist was unable to answer these type of questions. Teeth whitening is a fairly straightforward procedure. If he can’t deal with that I would not trust him to place a dental crown on your front teeth. We’ll go over how to find a dentist who can in a moment.

The Basic Principles of Teeth Whitening

The main idea behind whitening your teeth is the longer you wear the whitening gel, the faster your teeth will whiten. You can wear them one hour a day, but they whiten faster than if you wear them several hours a day or overnight. Because each person’s teeth are different in the amount of staining and how white they want them, there is no way to quantify a number of days/hours. The one constant is you want to leave a week between when you stop your teeth whitening and when you begin the procedure for your dental crown. This is because the teeth will continue to whiten during that time period.

Getting a Crown on a Front Tooth

Crowns on back teeth are no big deal. The color doesn’t have to match exactly. However, matching a single crown to a front tooth is a completely different story. All the light hits your front teeth making all the differences much more visible. Even the best cosmetic dentists will do a couple of try-ins before settling on it being just so.

Ideally, you would want an expert cosmetic dentist to do this. Look for a dentist who is AACD accredited. Then you can be certain they will get it right. If your dentist cannot tell you about teeth whitening, I would not let him near this crown.

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

 

Fixing a Gummy Smile

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I have a gummy smile and wondered if there is something my dentist can do to change that and give me one of those smile makeovers I keep seeing online?

Penny

Dear Penny,

before and after a gummy smile makeover

It is possible to have a beautiful smile makeover done for someone with a gummy smile. However, one word of caution. this is very advanced and way beyond the capabilities of your typical dentist. You will need an expert cosmetic dentist for this. Beware of dentists who want to send you to an oral surgeon and cut your upper jaw. Not only is this invasive and expensive, but unnecessary and dangerous. It will likely lead you to TMJ Disorder.

Instead, you want a cosmetic dentist to do what is known as a gum lift. This removes a small amount of gum tissue, which will expose the bone beneath. Then, they can place porcelain veneers, which will cover the bone and completely make-over your smile.

Porcelain veneers can change anything you want about your smile, including the shape, size, and color. Please only go to an expert cosmetic dentist with this. I would look for someone who is AACD accredited. These are among the top 1% of cosmetic dentists in the country.

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

Smile Makeover Disaster with Tetracycline Stains

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I have tetracycline-stained teeth. I went to my dentist who is very reputable and has done a great job for me over the years. I was considering porcelain veneers, but my dentist talked me into porcelain crowns saying that they would help cover the stains better. This did not turn out to be the case. The gray is visible with each of the crowned teeth AND the crowns look fake, so it’s obvious I have fake teeth. But, not even pretty fake teeth. He said he can send them back to the lab. I’m so confused. I looked online and there is a woman from a different dentist who has beautiful teeth after getting her tetracycline teeth made over and she used porcelain veneers! What has gone wrong with my teeth? Will doing them again with crowns make a difference? I don’t think I can get porcelain veneers after I have crowns, right?

Leslie

Dear Leslie,

a porcelain veneer being placed on a tooth

You are correct that you will always have to have crowns now that you have them. This is because the teeth have been ground down to little nubs. That tooth structure is gone. In a way you have answered your other question already. You said, “…a woman from a different dentist.” The key to any smile makeover is the dentist who does it. One warning sign is when a dentist suggests porcelain crowns over porcelain veneers when the tooth is healthy and does not need a crown. These dentists are either not comfortable doing porcelain veneers to begin with or do not have enough skill in them and think that the added structure of dental crowns will make it easier to cover the stains.

Sending it back to the lab will only help if he can give them good directions. A lab is more like a pharmacy who fills the prescription of the doctor. It is the doctor that has to come up with the right diagnosis and the appropriate medicine for it. I am not convinced he can write the correct directions. However, there is no harm in allowing him to try. If you do that, do it on the condition that he uses a temporary try-in paste and if you don’t love them the second time then you get a refund. You should get to see them in several lights before making a decision.

If you end up needing a refund, you will want to look for an expert cosmetic dentist. The easiest way for you to do this is to look for a dentist who is accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists have proven skill and artistry. They can give you a beautiful smile whether using porcelain veneers or porcelain crowns.

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

How Long Do Composite Veneers Last?

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I’ve been looking at options for smile makeovers. Most people suggest getting porcelain veneers, but I am just curious about composite veneers. Would they be less expensive? How long will they last?

Carol

Dear Carol,

before and after dental bonding

In most cases, composite bonding is better used for small repairs, like a tooth gap or chipped tooth. The procedure has to be done freehand, which would take much longer in the dental chair than porcelain veneers will. In fact, many dentists will not do a smile makeover with composite resin for that reason. It would end up costing you more because of the tedious nature of the smile development.  On top of that, the composite bonding will only keep their luster a few years before they begin to pick up stains. On the other hand, well-cared for porcelain veneers can last upwards of twenty years.

My suggestion would be to look for an excellent cosmetic dentist. This is not a skill taught in dental school, nor is it a recognized specialty. If a dentist wants to become skilled, they would need to invest in post-doctoral training. It would be easiest for you to just look for an AACD accredited dentist. These dentists have proven skill and artistry. It will keep you from having to investigate the training of each dentist you look at. Any one of them can give you an extraordinary smile makeover.

Let them look at your teeth and talk to them about the look you want. They will be able to determine what procedure can give you the best outcome.

I hope this helps.

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

Fixing a Gap Between a Crown and a Dental Bridge

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I have a gap between my front teeth I would really like to fix. Unfortunately, the tooth on the right is a dental crown and the left is a crown attached to a dental bridge. Is there a way for me to close this gap without having the fixtures replaced? Maybe by putting something like Lumineers on top of them?

Peggy

Dear Peggy,

Advertisement for Lumineers over dental crowns

Years ago, Lumineers would advertise something like you mentioned. They told patients that old crowns can be restored by placing Lumineers on them, but it ended up not working out as well as they hoped. First, porcelain does not bond to porcelain as well as it does to the natural tooth structure. Second, it takes as much work to place them over crowns as it would to just make a new crown. Finally, you have double the risk of failure because now there are two things bonded.

I am curious why your dentist didn’t place the crown and the bridge in a way where there was not a gap to begin with. That makes me wonder about his skills. In reality, because of that you will likely have to have these two procedures re-done. You don’t want to re-do just one of them because the porcelain would be “lopsided”.

There is a possibility you could have someone do a repair by bonding composite to porcelain, but they would need to have some experience with dental bonding and some special equipment. Your dentist would need to use a micro-etcher on the areas of porcelain near the gap. After that, they’d need to etch the area with a hydrofluoric acid gel. Then it would need to be primed with a silane coupling agent. Finally, a bonding resin and then a composite bonding applied to match the color of your crown and bridge. As you can see this would take some specialty skill. I’m not sure your dentist has it if he or she was not able to apply your procedures without a gap to begin with. If you want to try this repair method before resorting to replacing everything, I suggest you see an AACD accredited dentist.

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

Dental Work in Costa Rica

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I need twelve dental crowns done. After doing some calling around, I learned I can get this done for just $6000 in Costa Rica. I would have to stay two weeks, but that’s like a vacation and it is still cheaper than what I can do in the states. My sister is freaking out saying this is a huge mistake. She asked me to at least call my dentist and get his opinion on this plan, but of course he’s going to say don’t do it because then he gets my money. I came across your website. You are across the country from me and have no chance of getting my money, so what do you think of my plan?

Mason

Dear Mason,

map of costa rica

Should you get dental work done in Costa Rica?

 

I’m glad you wrote. I think I can save you a lot of grief. The dental industry is a real risk in Costa Rica. Because of the way their legal system is set up you have no recourse if something goes wrong. And let me tell you, a LOT can go wrong. Here are just a handful that come to mind:

  • A tooth can be broken off or lost
  • Overdrilling could take place causing nerve or root damage
  • You could end up needing a root canal treatment
  • Your bite can get thrown off leading to painful TMJ Disorder
  • Once you return home, the crowns can fall off
  • The crowns could look terrible, pasty, fake, and the wrong color
  • Poor placement of the crowns can impact your speech

Believe me, I am not exaggerating here. I recently read a case that you can read about in total here, but I will sum it up. A woman went to Costa Rica to save money on her dental care. The job was so badly done that she was in terrible pain. A dentist in the states called it criminal negligence and it would cost her around $35,000 to get the needed repairs done. Of course, she didn’t have that kind of money. She tried to get her money back from the Costa Rican dentist, even hiring a lawyer from the area, who was on her side. However, the law in that area is very corrupt and she ended up getting in trouble for complaining about a Costa Rican dentist publicly who had not been convicted of any crime and they put a warrant out for her arrest. She ended up having to flee the country.

You are at particular risk because of the number of dental crowns you need. There is a lot that could go wrong with that type of bite placement. My advice is to find a dentist here in the states with good qualifications and let him or her do the work. You may even be able to work out payment arrangements. Leave the Costa Rica trip for a true vacation, where you are not putting yourself at risk.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss, an AACD accredited dentist.

Does the Dentist Matter If They Outsource Their Porcelain Work?

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I am getting a smile makeover, which will include porcelain veneers on the top arch and some dental bonding for some broken teeth on the bottom arch. I understand that they outsource their porcelain work, so I don’t have to worry about that as much, but the dental bonding is done by the dentist in the office. How do I know if they can do quality bonding work or not?

Billy

Dear Billy,

before and after dental bonding

 

You are correct that dental bonding is tricky and that the dentist really needs to know what he or she is doing. Not only is it done in the office, but it is done freehand. However, be careful about thinking the dentist won’t matter for the porcelain veneers. That is like saying it doesn’t matter what doctor you go to because it is the pharmacist who gives you the medicine. The reality is the pharmacist can only do what is precribed. If the doctor makes the wrong diagnosis and prescribes the wrong medicine, the result will be a disaster even if the pharmacist fills it perfectly.

With porcelain veneers, the cosmetic dentist prescribes the map for the ceramist to follow. He can do the work perfectly according to the dentist’s instructions, but unless the dentist is skilled and artistic the results will be disappointing. So, I would say you will need to find an expert cosmetic dentist for every part of the smile makeover.

How to Find an Expert Cosmetic Dentist

The hands down easiest way to guarantee you will have one of the best cosmetic dentists in the country is to look for a dentist who is AACD accredited. In order for a dentist to reach accreditation with the American Academy of Cosmetic Dentistry. They have to pass oral and written exams as well as have a large number of cases they’re required to do examined in front of a board to ensure they have artistry. You can be assured that they will give you both stunning porcelain veneers and dental bonding. It will be the complete package.

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

What Do You Think of GlamSmile?

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I want to get a smile makeover and recently read about something called GlamSmile. It is supposed to be less expensive and the dentist can place them in just one hour. Have you looked into these? If so, what do you think of them?

Brooke

Dear Brooke,

a porcelain veneer being placed on a tooth

 

I’m glad you wrote. I think I can help you and save you a major disappointment. Here are some things to consider with GlamSmile:

First, similarly to Lumineers, they are marketed to inexperienced cosmetic dentists as being super easy to place. GlamSmile tells them that the lab does all the work so they don’t need extensive post-doctoral training to place these. There are countless examples of cosmetic dentistry horror stories of patients from both Lumineers and GlamSmile, and even other brands of traditional porcelain veneers. where patients were distraught because they spent a fortune on a smile makeover that actually made their smile look worse. This is because the brand does not matter nearly as much as the technical and artistic skill of the dentist doing the makeover.

Second, they have another marketing push that is telling dentists that they can make five times their normal means in the same amount of time they normally would spend with a patient in the chair. Whenever you push how much you’ll make to dentists, it stops becoming “which is best for the patient” and tempts dentists to push certain procedures which can increase their profit.

Finally, I am quite skeptical about their suggestion that this can be done in one hour. In fact, even they say the dentist may need to schedule a second appointment to finish up removing excess cement. Generally, to do this well, would take around three or more hours.

So, what should you do? Instead of looking for a specific brand, I am going to suggest you change your thought process to looking for the right dentist. You need someone with extensive post-doctoral training, as well as technical skill and artistry. The easiest way to find a dentist like this is to go to an AACD accredited dentist. These have proven skills.

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