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Dentist Says I Can’t Whiten My Teeth

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I have really ugly teeth and wanted to get them whitened. However, my dentist said my teeth are endogenous and because of that, I cannot get them whitened. Is that true? If so, is there anything I can do to make them look better? I am so embarrassed by my smile.

Kelly Anne

Dear Kelly Anne,

teeth whitening trays

There is always something you can do to make your teeth look better. I’m sorry your dentist was zero help to you. I am not crazy about it when dentists use clinical words with patients without explaining what it means. That doesn’t help you at all.

What he is trying to say is the stains on your teeth are endogenous, not your teeth themselves. Endogenous stains are simply stains that were acquired while your tooth was developing. There are two categories of this that dentists see most often.

The first is tetracycline stains. These are the result of taking the tetracycline medication during childhood while your teeth were still developing. Even professional teeth whitening does not make much headway with these type of stains. They are just too deep and dark.

The second is fluorosis stains. These are the result of consuming too much fluoride during your teeth’s development. While they are more superficial, teeth whitening is still not a good solution because the fluorosis stains usually result is splotched teeth. Because teeth whitening bleaches the teeth uniformly, the teeth will be whiter but still splotchy. That’s not an attractive look.

The Solution for Endogenous Teeth Stains

The best solution in both of these cases is to have porcelain veneers placed. These tiny wafers of porcelain that cover your teeth are the go-to procedure for celebrity smile makeovers. They can change anything you want about your smile, including the shape, size, and color.

The only real catch with these is it requires an advanced cosmetic dentist to give you beautiful results. Smile makeovers are not taught in dental school. It is up to the dentist how much training they invest in to do this type of work. Tetracycline stains, especially, are among the most difficult cases for a dentist to do. In your place, I would only go to an AACD accredited dentist.

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

Brown Spots on Teeth

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My teeth are very healthy. I’ve never even had a cavity. However, I have these ugly brown spots on several teeth, including my very front teeth. My dentist and I have been trying all the over the counter teeth whitening brands, but they all seem to make it look worse. My dentist is wondering if she should grind the brown spots off, but admitted she doesn’t know if it would work or how far she’d have to grind. That sort of makes me nervous. Would professional teeth whitening work any better?

Mazie

Dear Mazie,

teeth whitening trays

 

I am very glad you wrote. It sounds like you have a dentist who cares about you, but she is in way over her head. Please don’t let her experiment on you any longer. She will end up doing inadvertent permanent damage to your teeth.  Cosmetic dentistry isn’t taught in dental school. In order for dentists to learn these procedures, they have to take post-doctoral classes. To do it well they need a lot of time invested in the training. Your dentist hasn’t done that yet. That’s okay. Some dentists just prefer to be a general dentist and help people have healthy teeth. Obviously, together the two of you have accomplished that.

Teeth whitening, even professional strength, will not work on the type of stains you are dealing with. As you have discovered with the over-the-counter brands, it makes them look worse. This is because the whitening gel bleaches the teeth evenly. It doesn’t change the unevenness in the color.

Solution for Brown Spots

You have two good options available to you. The first is dental bonding. The second is porcelain veneers. If there are just a few brown spots and you are happy with every other aspect of your teeth, I’d recommend the dental bonding. It’s less expensive.

However, if the brown spots are extensive or if there are other things about your teeth you’d like to change then I’d recommend porcelain veneers. These are the go-to for total smile makeovers and can change the shape, size, and color of your teeth simultaneously. They are more expensive but do more and last years longer.

Finding a Qualified Cosmetic Dentist

Even though smile makeovers aren’t taught in dental school, there isn’t a recognized specialty for cosmetic dentistry either. That means it is up to the dentist how much, if any, cosmetic training they get before treating patients.  This makes it tricky for patients to know who can create beautiful smiles and who can’t.

I always suggest patients pick their dentist from the mynewsmile.com website. This site is run by a retired cosmetic dentist. He prescreens any dentist who wants to be listed to ensure they have not only the right technical knowledge but the artistry required to create a beautiful smile as well. Any dentists he lists will be able to give you the stunning smile you’ve always wanted.

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

Covering Tetracycline Stains

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My twin sister and I both have tetracycline stains. Several years ago, she had porcelain veneers placed on her teeth, but they looked a bit fake. The dentist said the only way to adequately cover the stains was to make them opaque. I am hoping the technology has improved some since then and I can get a beautiful, natural-looking smile.  I really do hate my smile.

Avery

Dear Avery,

A single porcelain veneer being placed

I am not sure if you will want to tell your sister this or not, but the technology has been around for a long time to make porcelain veneers look beautiful on tetracycline stains. While your sister chose the right procedure, it sounds like she likely picked the wrong dentist.

Cosmetic dentistry is not a recognized specialty. That means any general dentist can call themselves a cosmetic dentist. To make matters even more challenging for the patient, smile makeovers aren’t taught in dental school. It is up to the dentist to invest in the post-doctoral training necessary to do the work properly.

While choosing your cosmetic dentist carefully is important for any smile makeover, tetracycline stains are among the most difficult type of cosmetic cases there are. You can tell by your sister’s case that it is a challenge to get the porcelain veneers opaque enough to cover the stains, but still translucent enough to look natural.

If I were in your position, I would only go to a dentist who is accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the country. They’ve passed stringent exams as well as an examination board that has examined a large number of cases the dentist completed for both technical skill and artistry.

You find an AACD accredited dentist, you’ll find a dentist that can give you a stunning smile.

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

Smile Makeover Gone Wrong

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I went to a dentist because I was finally in a position to fix my teeth. My four front teeth are overcrowded and misaligned. My dentist told me using smile makeover techniques with cosmetic dentistry I could fix my teeth without braces. In total, he did dental bonding, two porcelain veneers, and some tooth shaping. He also said he shaped some lower teeth, which we never actually discussed. I wish he hadn’t done that because it added to the price. I paid a total cost of $9.3K. When it was “finsihed”, there really wasn’t much of a difference. My teeth were still misaligned and I didn’t feel like it was prettier in any way. I asked how it was possible to get the teeth to look like he said they would. He told me I’d need to do four root canals and dental crowns, of course, there is a significant additional cost. I wasn’t too keen on that so I went to see another dentist to see what they thought. Their solution was to just whiten my teeth and then do four porcelain veneers. There cost for that was only $7K. I like that idea. Is there any way for me to recoup my original $9.3K?

Camille

Dear Camille

a porcelain veneer being placed on a tooth

 

I am sorry for what you have been through. We are going to file this in one of the many cosmetic dentistry horror stories people write to us seeking advice. One of the problems you are facing is that there isn’t a recognized specialty in cosmetic dentistry. On top of that, dentists are not taught much in dental school about doing smile makeovers.

The dentist who did your smile makeover obviously hasn’t invested much in his cosmetic dentistry training. Nor has he given you the smile he told you that he would provide. I think you have a good case for a refund. Before we get into that, I want to make sure the next dentist you see to repair this is qualified.

My suggestion is that you look on the mynewsmile.com website. They prescreen cosmetic dentists who wish to be listed. They cannot purchase their way on. Instead, they have to demonstrate their technical skills, training, and artistry.  Anyone they list will give you a stunning smile.

The second dentist was on the right track. You do not need root canals or dental crowns. Please don’t let anyone do that to your teeth. Porcelain veneers are sufficient and will give you a beautiful result with an artistic dentist. The teeth whitening makes sense too if your smile is wider than the number of veneers you are getting. It also helps your bottom arch to blend.

Tips for Getting a Dental Refund

With some dentists, who care about patient satisfaction, you can simply ask for a refund when the work done wasn’t what was promised. However, some dentists are more stubborn than others. While I always recommend simply asking first in order to give them an opportunity to do the right thing, you do need some tips in case they don’t.

First, let them know you are doing them a favor. Often, a dentist will not know that written requests for a refund have to get reported to the National Practitioner Data Bank. It helps to educate them and give them an out by saying something like the following.

“I don’t want to make things difficult for you. This is why I am making an oral request, instead of a written one which would have to be reported to the National Practitioner Data Bank.”

If he still doesn’t comply, here are my recommendations:

  • Make a written request, explaining your reasons so it is on record.
  • Write a negative online review, which puts them in a position of needing to respond in order to save their reputation.
  • Complain to the dental board. With a legitimate complaint, the dental board can make life quite difficult for dentists. He’ll want to avoid this, so let him know it is your next step. That may spur him on.
  • Go to a lawyer. Often just the letter from the lawyer will be enough. With a legitimate complaint, the dentist’s malpractice insurance will encourage him to settle.

Best of luck. Make sure you get an expert cosmetic dentist to fix this.

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

Ugly Porcelain Veneers

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My girlfriend has what I think is a pretty smile but she’s always been uncomfortable with it. I understand it’s not perfect, but I like it. However, she’s determined to get porcelain veneers. Here is my concern. My sister got these several years ago and I actually thought her smile looked worse after the procedure. While they were whiter, they were so bulky to me it looked like she had horse teeth. I mentioned this to my girlfriend and she just shrugged her shoulders and said my sister probably had a bad dentist and we’ll need to do some research. How do we find the dentist that can give her the beautiful smile she wants?

Kevin

Dear Kevin,

a porcelain veneer being placed on a tooth

It is so refreshing to see a young man caring about his girlfriend. What I love the most about this is you’ve tried to make her feel good about her natural smile and haven’t pressured her to “improve it”. You’ve also recognized that she has to feel as good about her smile as you do. This may mean some cosmetic dental work, but she’ll be happier with her smile, which in turn will make her more confident.

Let’s talk about your sister’s case first. Your girlfriend is correct that an ugly cosmetic case has more to do with the dentist than the procedure. However, I feel there is a combo effect going on with your sister’s case. You mentioned they looked bulky and described them as horse teeth. This is a fairly common complaint with a brand of porcelain veneers known as Lumineers. One of the reasons for this is they are typically marketed to inexperienced cosmetic dentists as being easy to place because they don’t need the tooth to be prepared, as they are thinner than some other brands.

However, as you saw with your sister’s smile makeover, this doesn’t always work out as advertised. Yet, the dentist doing the case doesn’t have enough training to know when or why the teeth need preparation.

Finding an Expert Cosmetic Dentist

Porcelain veneers can look stunning. Celebrities know that as it is their go-to procedures. However, one of the problems patients face is there isn’t a recognized specialty in cosmetic dentistry which allows patients to know who has had the training and who hasn’t. Any general dentist can call themselves a cosmetic dentist regardless of the amount or quality of the training they’ve received.

To makes things even harder, doing smile makeovers isn’t taught in general dentist school. That means to get really good at it, dentists have to invest time and money in post-doctoral training.

One thing I suggest to patients looking for a great smile makeover is to go to an AACD accredited dentist. These cosmetic dentists are proven for both their technical knowledge and their artistry. In fact, they make up the top 1% of cosmetic dentists in the country because the accreditation process is such a high achievement, requiring the dentists to pass rigorous oral and written exams as well as provide visual evidence for a large number of cosmetic cases they have done proving their technique and artistry.

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

Will These CEREC Veneers Look Good?

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I am going to a new dentist because of a job relocation. Before moving, I’d been saving up for porcelain veneers and now have the sufficient funds. However, my new dentist wants to do CEREC veneers which are 1.5mm thick. I’m worried that is too thick and he doesn’t have any before and after pictures to show me of cases he’s done in the past. My last dentist had something called a smile gallery. Should I be worried?

Elaine

Dear Elaine,

A woman smiling with a beauttiful smile

The most important factor in a smile makeover is the skill of the cosmetic dentist.

The materials and thickness of any smile makeover are not nearly as important as having the right cosmetic dentist do the work. Of course, a great dentist will choose the best materials, but it is their skill and artistry which matters. Doing smile makeovers are not taught in dental school. Instead, a dentist interested in doing cosmetic work must invest in post-doctoral training.

I’m a little concerned about the fact this dentist does not have any visual evidence for you. Any dentist who wants to be taken seriously as a cosmetic dentist will have what is known as a smile gallery. This should show before and after pictures of various cosmetic procedures which they have done.

Can CEREC Veneers be Beautiful?

You can get a beautiful smile with CEREC veneers as opposed to porcelain veneers, however, it is more challenging. I would say only about 1-2% of cosmetic dentists could do it well. Some dentists try to do this to save on fees with a ceramist which isn’t a great reason.

So how would you know if your dentist can pull this off before investing all your hard-earned (and saved) money? There are two great resources to tell you about skilled cosmetic dentists. The first is aacd.com. This is the website for the American Academy of Cosmetic Dentistry. They offer an accreditation program. In order for dentists to get accredited, they have to pass stringent exams as well as provide visual evidence of their artistry with a large number of specific cases. AACD accredited dentists are in the top 1-2% of cosmetic dentists in the world. When you use their search feature, make sure you check the box for an accredited dentist.

Your second resource is mynewsmile.com. They don’t allow dentists to just pay to be listed. Instead, they check their educational qualifications for cosmetic work as well as require evidence of cases they’ve done to ensure they have an artistic eye. Many of their listed dentists are either accredited or on their way to accreditation. Any of them can create a beautiful smile for you.

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

Porcelain Veneers During Pregnancy

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I’ve been saving up for a smile makeover for years. Now, when I finally have the full amount I needed I find out I’m pregnant. Is it safe for me to go forward with this or do I need to wait until after delivery?

Madison

Dear Madison,

A single porcelain veneer being placed

While there are some procedures which are not recommended in the first trimester, such as teeth whitening, porcelain veneers should be quite safe. The concern is about introducing chemicals to the baby. With porcelain veneers, the only thing you have to worry about is the anesthetic used. Fortunately, lidocaine has been tested and proved safe for use during pregnancy and even delivery. You and your baby should be fine.

Who Should Do Your Porcelain Veneers?

There is another important consideration— who should do your smile makeover. This isn’t a skill taught in dental school, nor is there a recognized specialty where dentists become graduates in the field. Instead, dentists with an interest in cosmetic dentistry have to take the initiative to get the proper training post-doctorally.

This makes it a little challenging for patients. How can they separate the sheep from the goats, so to speak? The easiest way to handle this is to find an AACD accredited dentist in a reasonable distance to you. These dentists have been tested vigorously for both their technical knowledge and their artistic ability and are among the top 1% of cosmetic dentists in the country.

They will give you a stunning smile.

If you can’t find an accredited dentist without a significant amount of travel, which you’re probably not keen on while pregnant, you still have options.

The mynewsmile.com website also recommends excellent cosmetic dentists. Not all of them have reached accreditation, but they’ve all been carefully screened for their ability to do beautiful smile makeovers. Most are on their way to accreditation.

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

Advice on Picking Dental Implant and Crown Materials

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I’m about to get my smile completely made over with dental implants and crowns. I want it done right so I have some questions.
1. Is Staumann or Nobel Biocare better for implants?
2. Is zirconium or porcelain better for the dental crowns?
3. My dentist said a white porcelain fused to metal crown will not show a black line at the gumline. Is this true?

I am spending a lot of money so want this to end up beautiful.

Laurie

Dear Laurie,

A woman smiling with a beauttiful smile

Getting a beautiful smile makeover requires an artist

I want to refocus your question using an analogy. If you were to commission someone to do a painting to be the centerpiece of your living room, would you spend time investigating paints or the artist? It’s the artist who makes the difference. They have the knowledge and skill to know which paints are good for which situation. Maybe a particular scene look does better with one brand, but for something else another is preferred for its pigment. The artist who works with the materials every day will know their strengths and weaknesses.

So, instead of researching which dental implant or crowns to use, research the dentist. You have a two-fold requirement. They have to be skilled in placing dental implants, including implant overdentures. But, they also have to be skilled cosmetic dentists.

Finding a Dentist Who Can Give You a Beautiful Smile Makeover

Doing smile makeovers aren’t taught in dental school. Instead, dentists who are interested in the art of cosmetic dentistry have to invest time in training for it post-doctorally. Even with that, there is no recognized specialty in cosmetic work. Because of that, patients often find it hard to know who is skilled and who isn’t.

Fortunately, the American Academy of Cosmetic Dentistry offers an accreditation program which gives patients a way to know who they can trust to give them a stunning smile makeover. In order for a dentist to reach accreditation, they have to pass stringent oral and written exams, as well as provide visual evidence of a large number of cosmetic cases they’ve done to show they are not just technically skilled, but artistic as well.

Any AACD accredited cosmetic dentist can give you a celebrity smile you’ll be proud to share. In fact, most of them have a beautiful smile guarantee.

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

Best Dentist for a Recovered Bulimic

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I’m looking for a dentist for my daughter. She’s a recovered bulimic. I’m super proud of all the steps she’s taken to get a healthy mindset again. She’s been out of recovery for six months and has done spectacularly. I thought it was time to reward her new habits with a smile makeover. When she was purging it did tremendous damage to her teeth. I want her smile to reflect her beautiful spirit. I am just not sure how to find the right dentist for this type of situation. Any advice?

Kaylee,

Dear Kaylee,

A woman smiling with a beauttiful smile

It is great that your daughter has such wonderful support from you. That will help her go far for the remainder of her life. It’s also great you are doing some research ahead of time. I can’t tell you how many cosmetic dentistry horror stories there are of patients who went to an inexperienced cosmetic dentist. This would be the last thing your daughter needs.

Most cosmetic dentists have experience with bulimic patients. They are sensitive to how they’re affected by their smile and will not be judgmental, which is important. Equally important is their skill in creating beautiful smiles. Sometimes porcelain veneers are sufficient, but depending on the severity of the damage, she may need some dental crowns as well.

Because of that, you’ll want a dentist who understands not only how to create beauty but knows how her bite should come together if a lot of crowns are necessary.

Finding the Best Cosmetic Dentist

There isn’t a recognized specialty in cosmetic dentistry. This leaves patients in the quandary of figuring out who is skilled and artistic and who isn’t. The American Academy of Cosmetic Dentistry recognized that issue and started an accreditation program to serve both patients and dentists interested in cosmetic work.

Dentists can take classes to improve their skills. Plus, they can strive for accreditation. To get accredited, dentists have to pass stringent oral and written exams. In addition, they have to provide visual evidence of a large number of cases they’ve personally done in order to show their artistry in their work.

In your place, I would look for an AACD accredited dentist. They are the best cosmetic dentists in the country and will give your daughter a smile she’ll be proud to share with the world.

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

Which Brand of Porcelain Veneers

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I’m going to be getting a smile makeover and am trying to decide between brands. I can’t decide if I should get Lumineers or the regular porcelain veneers. I hear with the regular ones you have to get your teeth shaved down. I’m not sure I like that idea. But, Lumineers have mixed reviews. Do you have a recommendation?

Kaleigh H.

Dear Kaleigh,

a single porcelain veneer being placed

Congrats on the fact that you’re getting a new smile. It’s an exciting time filled with possibilities. You will love the confidence it brings. While it is great that you’re doing research, you are asking the wrong question. While brands of porcelain veneers have different qualities, the biggest difference comes from the skill and artistry of the dentist.

A Tale of Two Dentists

You could have two dentists work on the same smile using the same material and they will end up with completely different results. One may create a stunning smile. The other, an average one… or worse.

There are way too many cosmetic dentistry horror stories. We’ve had quite a few people come to our office hoping we could fix the damage done by their cosmetic dentist. You don’t want to invest money in a smile makeover you end up disappointed in. Cosmetic Dentistry is an art form and requires an artist to bring you beautiful results.

Finding a Great Cosmetic Dentist

When it comes to getting a stunning smile, you want to make sure you find the right dentist. Be sure to check out their smile gallery. This is usually a page on their website which shows examples of cases they’ve done. Always ask if it is their actual work or if they are showing stock photos instead.

If you like their work, then you can check their reviews to see what type of experiences other patinets have had with them. Additionally, you want to make sure they are willing to stand behind their work with some form of a beautiful smile guarantee.

You’ll find the best dentists are accredited by the American Academy of Cosmetic Dentistry, as Dr. Weiss is. AACD Accredited Dentists are in the top 1% of cosmetic dentists in the country.

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