Dentist Stained My Lumineers

I am so angry, but don’t know if I can do anything about it. Before getting my “smile makeover” my dentist and I discussed what I wanted it to look like. One thing I specifically said was how white I wanted them. Despite my instructions, he put a stain on my Lumineers. When I asked him about it he said, “I want smiles I do to look natural.” When I let him know I wasn’t thrilled, he said, “Well it’s certainly prettier than your natural smile.” I’m furious. Can anything be done?

Stephanie

Dear Stephanie,

Advertisement with Lumineers including a woman smiling and a single veneer being held by a tool

I understand your anger and have heard these type of stories so often it makes me sad. It’s so hard to get patients the information they truly need before getting their smile makeovers done. Here’s the thing, the only thing which guarantees a great result in your smile makeover is the dentist you choose. Too many patients think their family dentist is qualified.

I don’t blame the patients. They’re supposed to trust their medical and dental providers. However, doing proper smile makeovers aren’t taught in dental school. In order to be a great cosmetic dentist, your dentist would have had to invest in post-doctoral training at a reputable institute which trains in cosmetic dentistry.

It’s not a recognized specialty so it’s completely up to the dentist how much time and money they invest in this type of training. At the same time, there are companies (like the Lumineers company) which heavily markets their products to dentists as being “easy” to place because they’re not required to do tooth prep. While they may be easy to place, that doesn’t make them any easier to get a beautiful result.

Evidence Your Dentist Isn’t a Skilled Cosmetic Dentist

In dental school, dentists are taught that they know better than the patient and should tell them what to do. However, cosmetic dentistry is different. Notice your dentist said, “I want smiles I do to look natural.” What he’s not realizing is cosmetic dentistry is about what you want, not what he wants.

Additionally, he thinks a stain is what makes a smile look natural. But, patients who come for cosmetic work aren’t looking for a “natural” smile. They’re looking for a gorgeous smile.

Finally, he didn’t do a try in. Based on what you described, he didn’t let you see them before he permanently bonded on your porcelain veneers. Any cosmetic dentist worth his salt will use a temporary try-in paste to make sure the patient is satisfied before bonding them.

What to Do About Your Lumineers

You have a reason to get a refund. You gave your dentist specific instructions about the color. He ignored them. That means he didn’t have your permission to place those porcelain veneers. Tell him, either you get a refund or you’ll go to the dental board about him not following your instructions and then bonding them on without giving you an option.

Then, once you get your money back, go see an expert cosmetic dentist to have them redone. My suggestion to find the right dentist is to go to the mynewsmile.com website and use their “Find a Cosmetic Dentist” link. They only recommend expert cosmetic dentists who can create gorgeous smiles and know how to follow a patient’s instructions. In fact, most of them have a beautiful smile guarantee.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

Bleeding Gums with Porcelain Veneers

I got porcelain veneers and am sort of happy with them. However, a few weeks after I received them my gums started bleeding. I don’t know if it’s related to the porcelain veneers or not, but it seems a coincidence they happened about the same time. Then, I just went in for my checkup and they said I’ve developed gum disease. I’m seriously puzzled. I’ve always had very healthy teeth and gums. Is there something I’m doing wrong? I don’t think I’ve changed my habits. Any ideas? I saw on your website that you do porcelain veneers. I’m hoping you’ve encountered this before.

Elaine

Dear Elaine,

A woman getting a porcelain veneer placed on her teeth

Bear in mind I haven’t examined your particular case, so I’m going on intuition. If none of your habits have changed, then my suspicion is you have what’s known as bulky margins. This means your dentist didn’t get your porcelain veneers flush against your teeth and gums.

What this does is cause there to be a little shelf on the top of the porcelain veneers which traps food and bacteria. This will lead to gum disease, which in turn will cause your gums to bleed as it progresses.

Here’s what I recommend to you. I want you to ask your dentist to look at the veneers and check them for bulky margins. If he realizes his error, he should repair it free of charge. If he doesn’t see the problem, it’s okay for you to get a second opinion. However, I want you to see an expert cosmetic dentist for your second opinion. I’ll show you how to find one in a moment.

If it turns out there are bulky margins, then ask your dentist for a refund. This way you can get them re-done properly by a dentist who knows what he or she is doing.

Finding an expert cosmetic dentist

Doing great smile makeovers isn’t something taught in dental school. A dentist interested in cosmetic dentistry will have to invest the time in to learning the skills and developing the necessary artistry after they’ve already received their doctorate. In fact, they should never stop learning.

It’s hard for patients to know which dentists have the skill and artistry they need to give them a gorgeous smile and which don’t. It’s obvious to me your dentist didn’t have what it took. Not just because you’re having gum problems, but also because you were only “sort of” happy with them.

When a smile is done well, a patient will be thrilled. A true cosmetic dentist won’t be satisfied unless the patient is. They often have a beautiful smile guarantee.

To find this type of dentist, I’d go to the mynewsmile.com website. They have a “find a cosmetic dentist” link. You’ll input your zip code and how far you’re willing to travel and they’ll provide a list of dentists which have been vetted for knowledge, skill, and artistry.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

Premedicating with Dental Implants

I’ve got two conflicting opinions and I’m not sure which direction is the right one. I had a hip replacement about ten years ago. Now I need to get some dental implants. One dentist says I’ll have to pre-medicate with antibiotics; the other says that’s nonsense. Who’s right?

Beth

Dear Beth,

dental implant diagram

Oh…the medical community. Don’t you love them? They all claim to be experts and none of them agree with one another. That’s a lot of experts who see things differently. Here’s what is going on in your situation.

It used to be that the standard recommendation was any time someone with a hip replacement had anything invasive done, including a dental cleaning, they were to have antibiotics so there was no risk of any bacteria being introduced which could make its way to the replacement site.

However, that changed in 2012 when both the American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association (ADA) released a new study which said recent studies showed there was no direct evidence to continue to make that recommendation.

That simply means it’s up to the dentist. It sounds like the dentist recommending the pre-medication likes to take every precaution possible. Which you do is up to you. There’s not a right or wrong answer. I would say if you’re a healthy person who doesn’t easily get sick it won’t matter. If you tend to catch things more easily, I’d pre-medicate.

Cosmetic Care and Dental Implants

I want to give you a heads up on a cosmetic issue that recently came up with a patient I know. She’d planned on getting dental implants and teeth whitening. Even though her dentist knew she wanted both procedures, he didn’t warn her that the teeth whitening needed to be done first.

The reason for that is the gel used to whiten teeth only works on natural tooth structure. While her natural teeth were getting whiter, her dental implants stayed the same color they were the day they were placed.

Only then did her dentist tell her to get her smile to match she’d have to replace her implant crowns. If he’d have advised her to get her whitening done first, she wouldn’t be in this situation having to spend unnecessary money. Her crown could have been made to match her new, white color from the beginning.

I don’t know if you were ever going to want teeth whitening, but as this just happened to someone I know, I thought I’d warn you just in case.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

Do I Need a TMJ Specialist?

I told my dentist about a pain in my jaw. He decided I have TMJ and keeps giving me Botox injections. While the injections help, I don’t want to need them for the rest of my life. If I went to a TMJ Specialist would there be a permanent solution?

Gina

Dear Gina,

A woman holding her jaw from TMJ pain

TMJ Disorder can be very complex. Often, there’s more than one factor. If all your dentist is doing is the Botox injections without looking for what could be causing it, then yes, you’ll want to see someone else. Unfortunately, there’s no such thing as a TMJ Specialist as far as a recognized specialty goes. But, there are some things to look for when choosing a dentist to treat your TMJ.

You’ll want a dentist who has invested in post-doctoral training in the diagnosis and treatment of TMJ Disorder. Some of the more reputable institutions are:

  • The Dawson Academy
  • The Seattle Institute
  • The Kois Center
  • Pankey Center
  • Las Vegas Institute (LVI)

Dentists who’ve studied with one of these institutions will be a practitioner who can help find the root cause or causes of your particular TMJ problems.

A couple of Causes of TMJ

One leading cause of TMJ problems is teeth grinding or clenching. Over time, this not only does damage to the hinge joint, but it is also devastating to your teeth. It can cause them to crack or break, requiring dental crowns. It can even cause them to come loose.

The grinding motion wears them down to nubs and could end up costing tens of thousands of dollars for a full-mouth reconstruction. To make matters worse, if you don’t regularly see a dentist you may never know you’re even doing it until it is too late. That’s because most people do it in their sleep.

Fortunately, for most patients, when caught early, there’s a simple fix. A night guard can protect your teeth. It fits like a custom made comfortable mouth guard and places a barrier between your teeth.

Another cause is malalignment of the teeth. If your bite is off, it can throw off your jaw joint leading to serious TMJ problems, including lockjaw. Sometimes, it is just a matter of simple orthodontics, other times it’s more serious.

A good dentist will always start with the least invasive treatment before moving onto other more drastic measures.

Best of luck to you.
This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.