Archives for January 2021

Cracked Porcelain Veneers

Posted on January 31, 2021 by writeradmin.

I received an inheritance that I used to get a smile makeover about a month ago. I always had short teeth and they looked a little crooked. Now they’re longer and look bright and straight. I truly love them. However, I went to the best cosmetic dentist I could find for the procedure. The only problem I have is there is a horizontal crack that I can feel about a 1/5 of the way up. Do you think they’ll repair this or blame me for it? I can promise I have taken very good care of them. I don’t really have much money under normal circumstances. That inheritance was a one-off. This isn’t the kind of dentist I can normally afford.

Cara

Dear Cara,

I’m glad you love your porcelain veneers and that you knew enough to go to an expert cosmetic dentist. Too many people just go to the family dentist on the corner and end up with disastrous results.

Under most circumstances, even a cracked porcelain veneer will stay secure when it is properly bonded on. The thing that worries me about yours is it sounds like it is near the incisal edge of your tooth. There may not be much of anything keeping it on. I would simply call the dentist who did your smile makeover and have them look at it. It sounds like they will need to replace that one porcelain veneer. I don’t think they will blame you. It sounds more like there was a manufacturer’s defect.

I do not think you will need to worry about them blaming you. Most great cosmetic dentists know that patients take great care of their smile makeovers when they are thrilled with the results. They are also used to patients coming to them for smile makeovers but not being able to stay with them as patients for general dental care.

Some cosmetic dentists have patients who travel from other countries to do their smile makeovers. They certainly don’t expect them to keep coming back. I would simply explain to them your financial circumstances and that you love the cosmetic work they did for you but cannot afford their fees on a regular basis. They will understand.

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

Should She Finish This Full-Mouth Reconstruction?

Posted on January 27, 2021 by writeradmin.

I went for years grinding my teeth without any intervention or knowledge that it was happening. I moved to a new city, which meant a new dentist. He was the one who told me about the grinding. I would explain why my jaw always hurt. I am wearing a night guard now, but he also suggested a full-mouth reconstruction. I was a bit nervous about that because I have a very sensitive mouth. I once had Zoom Whitening done and it was absolute agony. I did (and do) trust this dentist so I went ahead with the reconstruction. He’s finished the first half, which is the bottom arch. While it does make that part of my smile look much better, it almost looks too perfect. I liked the quirky look of my old smile. Plus, like the Zoom, the procedure was agony for me. I’m no longer hurting, since he did the first half and I’m wondering now if it is necessary to finish. There is a color difference wtih my bottom teeth being whiter. If Zoom weren’t such a painful experience for me I’d just do that. Do you have an opinion?

Katherine

Dear Katherine,

You’ll need to bear in mind that I haven’t examined you, nor have I seen any x-rays. I can give you some generalities. I am not usually one to recommend half of a full-mouth reconstruction. In general, restorative material is harder on your teeth than natural tooth structure. That could cause a problem with your upper teeth, including increased sensitivity–something you definitely don’t need.

If not having the quirkiness bothers you, there is an easy solution for that. Most cosmetic patients want the perfect smile look. My feeling is your dentist and his ceramist would LOVE the opportunity to be more creative and add some quirkiness. You mentioned having some pain with the reconstruction. If the numbing medication isn’t working it is likely because with your sensitive teeth you have had enough bad experiences to give you dental anxiety. There is something about how the anxeity affects your body chemistry that causes it to interfere with the effectiveness of your medication. Oten, doing something as simple as using nitrous oxide before the procedure starts will relax you enough to enable the numbing medication to do its job.

All of that being said, if you feel the first half of your reconstruction has served the purpose you needed and all you truly want at this point is the whitening, you don’t have to use Zoom Whitening, which can be a tad strong for people with sensitive teeth. Instead, you can do home whitening trays. You will wear the gel at your convenience for as long as you can comfortably tolerate. You may find that a better solution for you. There are a variety of teeth whitening options.

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

What Else is Necessary with Porcelain Veneers?

Posted on January 16, 2021 by writeradmin.

I want to get porcelain veneers. My dentist is fine with that but said he wants me to get my teeth whitened first and my crooked front tooth straightened with Invisalign. I thought that porcelain veneers made your teeth whiter and could make a crooked tooth look straight. What else is really necessary with porcelain veneers?

Kelly

Dear Kelly,

I can give you some guidelines here, but bear in mind that I have not examined you so it would be irresponsible to give specifics. In principle, you are right, porcelain veneers can change the shape, size, and color of your teeth. If that is the case, why would you need anything else?

Let’s start with the teeth whitening. Most dentists will suggest you whiten at least your bottom arch of teeth. Patients generally only get veneers on their upper teeth, so if you want your two arches to blend, whitening the bottom teeth is an inexpensive way to do that. You would only need to whiten the upper arch of your teeth if you were not getting enough porcelain veneers to cover the teeth that are exposed when you smile. Most people have a smile that is 8-10 teeth wide. Let’s say you were getting just six porcelain veneers. Then, the adjacent teeth would not match when you smiled. Whitening them will help them to blend.

The Invisalign is a whole different story. It is rare for a patient to need orthodontics and porcelain veneers. You mentioned you had a crooked front tooth. An experienced cosmetic dentist can make crooked teeth look straight with porcelain veneers. The exception to that would be if you had a pretty complicated orthodontic case. That doesn’t sound like you at all.

This gives me a clue to your dentist. It is quite possible your dentist is using Invisalign like a crutch. He doesn’t feel comfortable shaping crooked teeth with porcelain veneers so he only wants to work with the ideal cases. If it isn’t ideal he suggests other procedures until it is. This is a waste of your money and time.

I suggest you get the teeth whitening with him. It is inexpensive and useful. Then, get the porcelain veneers with an expert cosmetic dentist. I recommend looking on the mynewsmile.com website. The man who runs this site is a retired cosmetic dentist. He prescreens every dentist who wants to be listed there for their training, technical knowledge, and artistry. Any one of them can give you a stunning smile makeover, without having to do unnecessary procedures to get there.

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

My Lumineers Do Not Look Right

Posted on January 4, 2021 by writeradmin.

I had porcelain veneers done almost 20 years ago. I loved them but it was time to get them replaced as they had started to show their age. My old dentist had retired and I used his replacement. I wish I had not now. It has been a completely different experience. First, even though I told him I wanted them to match my last porcelain veneers exactly, he made some changes. He used a different brand of porcelain veneers he called Lumineers because he said they were thinner and he was placing these over my old veneers. That sounded okay to me. But, then he also put a strain on the Lumineers, which he did not mention ahead of time. When they came in I told him I wanted whiter and he said to give it a couple of days and see what I think then. He felt they looked more “natural” this way. I did and still didn’t like them. He told me to come in and he would “fix” it, if that is what you would call it. His fix was to sand off the front which had the staining. Now I am left with this dull underneath. What do I do?

Lorainne

Dear Lorainne,

There are a couple of problems going on here. First, the fact that he put Lumineers over old porcelain veneers is a problem. Porcelain sticks much better to natural tooth structure than to other porcelain. Now not only will you have to worry about the bonding of your new veneers failing, but your old veneers are eventually going to wear down as well and he attached the new ones to them. It is just as much work to place new over old as it is to just do them over. It doesn’t make sense that he did it the other way.

I’m not surprised he placed a stain on them to “make them look natural,” nor that he told you to give it a few days and you would get used to it. What he really meant by that is he didn’t want to do this over and he was counting on you to give up. Most patients don’t have your courage to stand up for themselves. A true cosmetic dentist would not bond on your porcelain veneers until trying them on with a temporary try-in paste and then letting you see and approve them. If you weren’t happy with the color he would never ask you to give it some time, but rather would send them straight back to the lab to be re-done.

He never did this. He may not even have the experience to know about a temporary try-in paste. When he suggested Lumineers, I knew you probably were not getting a highly skilled cosmetic dentist. Cosmetic dentistry isn’t a recognized specialty. Any dentist can try the procedures regardless of their skill level. This particular brand of porcelain veneers is marketed to inexperienced cosmetic dentists as being easy to place.

Under normal circumstances, you would have no recourse. The standard of care in dentistry is functional. They don’t have to be beautiful, even for cosmetic work. However, once he ground down your Lumineers, they were no longer functional. He removed the glazing on them which is what protects them. Because of that, you have the right to ask for a refund.

Once that is secured, you can use that money and go to a true cosmetic dentist to have these re-done. Look for a dentist listed on the mynewsmile.com website. Each of those dentists are pre-screened for both their technical knowledge and artistry. They can not pay to be listed. Instead, they have to be skilled cosmetic dentists.

This blog is brought to you by New Orleans Cosmetic Dentist Dr. Duane Delaune. Click here to learn more about our cosmetic consultations.