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Why Did I Need Root Canal Treatments After Porcelain Veneers

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I had ten veneers placed on my upper teeth and the same number placed on my bottom. During the diagnostic stage, I was told everything was fine and there were no real risks involved. Since the procedure, I’ve had a lot of pain. My dentist made a few height adjustments, but that did not seem to help. Then, two of the teeth developed an abscess and, when he did the x-rays, it showed my nerves have died, even though they were fine before. Now I have had to have root canal treatments. I’m still in pain and worried more of my nerves will die. My dentist said he’s never had this happen with veneer crowns. What is going on?

Jayla

Dear Jayla,

The first thing I am wondering about is whether you actually received dental crowns instead of porcelain veneers. There are a couple of things that make me things this. First, you called them veneer crowns. That is not a thing. Either you have porcelain veneers or you have dental crowns. There is not a combination. A second inconsistency here is the height adjustments that were made. That is something done with dental crowns. Finally, it is the damage to the nerves.

The Difference in Preparation between Crowns and Veneers

tooth preparation for porcelain veneers.

Tooth preparation for porcelain veneers

When a tooth is prepared for porcelain veneers, there is hardly any of the tooth structure removed. Here is an example in the image above. Notice only the surface is affected. Now contrast this with the image below.

Preparation for a dental crown

Preparation for a Dental Crown

Notice with this tooth, much of the tooth structure had to be removed. It is a much more aggressive preparation and your nerves are at a greater risk as a result. I think this is the treatment you received.

One way to tell is by how far around the tooth your restoration is. With porcelain veneers, it just covers the very front of your teeth and will hug the sides slightly. But, with porcelain crowns, the restoration goes around your entire tooth, including the back.

If your dentist told you that you were getting porcelain veneers, but then gave you porcelain crowns, that is unethical. Plus, if the only reason for the restorations was a smile makeover, porcelain veneers are what you would do— not dental crowns. To be honest, I would tell your dentist he needs to cover the cost of the root canal treatments. I’m sorry this happened to you.

This blog is brought to you by New Orleans Cosmetic Dentist Dr. Duane Delaune.
Click here to learn about our free virtual smile makeover consult.

Smile Makeover Disaster

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I need some serious advice. I went to my dentist with the intent of having my cleaning done and then getting a recommendation for an orthodontist. My four upper front teeth are crooked. He said he could make them straight with cosmetic dentistry and I would not have to worry about the inconvenience of braces. That sounded great to me so I agreed. He told me that two porcelain veneers and dental bonding would make my smile look completely straight. I was excited about the possibility of having a beautiful smile. When the makeover was “completed”, it wasn’t anything like he promised. The teeth are still uneven, the porcelain veneer is too small and you can see a gap between the veneer and my gums. He also charged me for reshaping my lower teeth which was never even discussed. I was quite upset and told him this wasn’t the outcome I expected. Then, he proceeded to tell me the only way to get the outcome I want is with four dental crowns. Of course, that will be an additional fee. Is this allowed? Can he get away with it?

Fanny

Dear Fanny,

porcelain veneer being placed on a tooth

No. Your dentist cannot get away with this. I would go back to him and ask for a refund. If he says no, remind him that he was the one who told you what this outcome would be and he didn’t deliver on his promise. On top of that, the porcelain veneer he provided for you has an open margin (what dentists call that gap you described). Open margins put your teeth at risk because it allows food and other bacteria to get caught between your teeth and the veneers, leading to decay. A second issue that can get him in big trouble is reshaping your bottom teeth without your permission. It sounds like this dentist was using you for practice. Let him know you will be taking this issue to the dental board and I think he will provide your refund.

Once you have secured your refund, you will want to get the smile makeover you wanted. Believe it or not, it is probably still possible to do with porcelain veneers. You just need a skilled cosmetic dentist to do the work. I would look for a dentist who is recommended on the mynewsmile.com website. Dentists cannot pay to be listed on this site. Instead, they are screened for both their technical skill as well as their artistry. Any dentist recommended on there will give you a stunning smile.

I will say, if you are planning on just getting four porcelain veneers (and it is okay if you are) then I suggest you have teeth whitening done first. Most patients smiles are six to ten teeth wide. Getting your teeth whitened allows you to have your non-veneered teeth blend in better than if you left them their current tone.

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

Gums Inflamed After Porcelain Veneers

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I had two porcelain veneers placed on my front teeth. Since they were placed my gums have been painful and inflamed. The hygienist said she’d never seen that happen and wondered if I was brushing correctly. I’ve been brushing my teeth for several decades now, so…yeah, I’m pretty sure I’m brushing correctly. Actually, her response sort of ticked me off. Then, a month later I went in for a follow-up visit with the dentist and he removed some cement from the back of my teeth and smoothed down some rough edges. While that did help some, I am still in pain. They don’t seem to care, so I’m wondering what my next steps are.

Madeline

Dear Madeline,

porcelain veneer being placed on a tooth

I am sorry that this happened to you. It is infuriating when professionals blame others simply because they don’t understand their field well enough. My experience has shown that when people get a smile makeover, they usually care for their teeth even better than before, so no, I don’t think the problem is the way you were brushing.

This is especially true because of what you described in your follow-up visit. Not cleaning up all the excess cement is an issue we often see with dentists who do not place porcelain veneers very often. Those that do regular, advanced cosmetic work have a routine down to ensure this does not happen.

  • First, they will tack the veneer on the tooth by curing the cement in the center only.
  • Then, while the remainder of the cement is still soft, they will be certain to remove all the excess, knowing it is much easier to do while soft.

This did not happen in your case. While your dentist did remove some at your follow-up visit, it would not surprise me in the least if there were still excess cement lodged somewhere.

There is also a second possibility for what could be causing your inflammation and pain. If there is some unevenness where the porcelain veneer meets with your tooth (what dentists call the margins) this could lead to problems. Or your dentist could have placed the veneer too far under the gumline. If he did that and encroached on the gingival attachment, that would also cause the problems you mentioned.

Obviously, your current dentist is either disinterested or does not have the skill to recognize what he did wrong. You next steps, in either case, would be to see an expert cosmetic dentist and have them examine your porcelain veneers in order to let you know what went wrong, then you can formulate a plan based on the diagnosis.

I would use one of the cosmetic dentists listed on the mynewsmile.com website. They are pre-screened for their technical knowledge and skill, as well as their artistry. They will have the knowledge to let you know what went wrong.

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

Too Much Shine on My Porcelain Veneers

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I had a smile makeover done. I know the porcelain veneers should have some shine. However, these have so much shine on them that it is obvious they are fake. It’s almost like a shiny white piece of gum. Is there a way to take off some of the shine so they can look more natural? I paid a small fortune for these and I’d like to have something I can feel good about.

Laney

Dear Laney,

Beautifully textrued teeth

 

You’ve brought up an interesting point about cosmetic dentistry. I wish I had an image of your smile makeover results to give me a better idea of what you’re dealing with. Based on what you described, it sounds like your glazing was done in a flat, uniform type of design. If you look at the teeth in this photograph with work done by Dr. Delaune, you can see that teeth aren’t flat. They are textured. Also, the color is not uniform. Instead, they have varying degrees of opacity throughout the tooth.  By the way, only one of the teeth above is “fake”.

The glazing on the tooth is what is responsible for the shine you are experiencing, especially if your dentist did not texture it. However, I am not sure you will want to remove that glazing. It is also what protects your porcelain veneers and makes them stain-resistant. Occasionally, we run into a new patient who had their cosmetic work done at another office. Because that particular office didn’t properly go over cleaning procedures for cosmetic work with their hygienist, she used a power prophy jet during cleaning, which takes the glaze completely off. Within a few days, that patient’s veneers began to pick up stains.

Hopefully, you have a dentist who cares about the patient’s satisfaction with their work. A true cosmetic dentist would never bond your veneers on until you had a chance to look at them with a temporary try-in paste and give your approval. If you weren’t thrilled with the results, they would go back to the lab. It doesn’t sound like you were given that option. That is likely the result of your dentist not having much experience with this yet and therefore doesn’t carry (or may not even know about) these try-in pastes. This is just one of the problems with cosmetic dentistry not being a recognized specialty.

My suggestion is you simply go back to your dentist and explain how you feel about your veneers. You paid for a beautiful smile and should get one. Some cosmetic dentists even have a beautiful smile guarantee. If he or she is not sure how to do it any differently, you can let them see this post.

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

Cracked Porcelain Veneers

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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,

a porcelain veneer being placed on a tooth

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.

Crooked Porcelain Veneer

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I had a chipped tooth that had dental bonding done. It was getting old and ended up breaking. I wanted to just replace it but because the chip is 1/5 of my tooth they said it was not possible to replace the bonding. My dentist wanted to repair it using a dental crown but I didn’t want to lose any more tooth structure, so I suggested a porcelain veneer, which doesn’t take away as much. When the veneer came in, the size and shape looked fine. The color was whiter than my other teeth, but I anticipated that because we knew I would be whitening my teeth later. I saw it before they bonded it on and everything seemed great. After they bonded it they told me it was gorgeous and sent me on my way. It wasn’t until I got home that I realized it was a tad crooked and the bottom was too long compared to the other tooth. Plus it sticks out a bit almost like they put on too much glue, which also puts a small gap behind the bottom of the tooth. I called them about it when I got home. They said there isn’t anything that can be done about the length but they can fill in the gap. To me that doesn’t sound like it will make the tooth stick out any less. Is there anything I can do about this?

Morgan

Dear Morgan,

a porcelain veneer being placed on a tooth

These type of stories are so frustrating to hear. This is one of the big problems with cosmetic dentistry not being a recognized specialty. Any general dentist can do it regardless of the amount of training or skill they have. There are quite a few things wrong with your case. First, the dental bonding. That could have been replaced. My guess is she doesn’t know how to do dental bonding so she steered you toward a procedure she is familiar with, dental crowns.

You were wise not to get that. Not only would it have severely ground down your healthy tooth structure, but it is rather tricky to match a dental crown to a front tooth. With your dentist’s cosmetic skills I don’t think it would have looked very natural. A porcelain veneer should have been fine.

As for it being whiter in anticipation of whitening your teeth, your dentist should have had you do the teeth whitening beforehand, when it would make more sense. You can exactly match a porcelain veneer to the tooth color, but it is almost impossible to exactly match teeth whitening to a porcelain veneer. Plus, whitening the underlying tooth structure is always helpful.

Now to your current problem. I find it curious they let you look at it before but not after they bonded it on. My suspicion is they knew something was off. Even when you get your hair cut they have you look at the result before you get up. It’s interesting to me that they told you nothing could be done about the length. This is just more evidence to me that she doesn’t know what she’s doing with cosmetic work. The length on the porcelain veneers can be trimmed.

However, your situation is more complicated and more serious. If it is crooked, not only will it look weird but there are going to be areas where there will be gaps that can harbor bacteria. This leads to decay under your veneers. The only way to solve your case is to get a refund from this dentist and have the case re-done by a cosmetic dentist with more expertise. My suggestion is you use one of the dentists listed on the mynewsmile.com website. Each of them are prescreened for their technical expertise as well as their artistry.

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

Porcelain Veneer Fell Off Twice

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I had six porcelain veneers placed by Dr. [name redacted]. After four days, the left incisor fell off. I was only eating bread. The tooth was super sensitive from the moment the veneer fell off so I got an appointment at his office as soon as possible. He said it fell off because my bite was off so he shortened the veneer and the tooth beneath it. Less than a week later it fell off again, this time when I ate a banana. I was none too pleased, and again he said the bite was off so he wants to do a porcelain crown instead. I’m having serious doubts about this. Do you have an alternate recommendation?

Patrice

Dear Patrice,

a porcelain veneer being placed on a tooth

My first suggestion is not to allow this dentist anywhere near your teeth. He is in over his head and doesn’t have the integrity to admit it. First, he says your porcelain veneer fell off because your bite was off. As the dentist, it was his responsibility to notice things like that before he bonds them on and make sure the veneers are crafted in a way the helps that.

However, I don’t buy that excuse. When a porcelain veneer is properly bonded on, the result will be a chipped porcelain veneer if there is a problem with the bite. It wouldn’t just fall off.

Doing smile makeovers isn’t taught in dental school. Compound that problem with cosmetic dentistry not being a recognized specialty and it puts patients in a real quandary. Any dentist can call themselves a cosmetic dentist regardless of the training they received. To do it well requires significant post-doctoral training. I don’t think your dentist has that training.

Now the second bonding falling off he’s also blaming on your bite being off. But, didn’t he already adjust that? Now he wants to destroy healthy tooth structure to place a dental crown? I don’t think so. That is a massive overtreatment.

I’m going to recommend you look on the mynewsmile.com website. The dentists listed there are prescreened for their technical training, skill, as well as the artistry of their work. Any one of them can properly bond on the veneer that keeps falling off.

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

Porcelain Veneers don’t Match

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I had several porcelain veneers and one dental crown placed. When the temporary ones were done, they looked too long.  Because of that, I asked they be made a little shorter. The did that, but they don’t seem to match. My two front teeth are slightly different sizes. I didn’t really get to see them the second time around, they just cemented them on. I’m hoping they can be made to match. Is that possible after they’ve been bonded on?

Maralynn

Dear Maralynn,

a porcelain veneer being placed on a tooth

You paid your dentist to give you a beautiful smile and you should get one. Though, I can tell right away your dentist isn’t a true cosmetic dentist. The reason I can say that so confidently, is he never tried them on with a temporary try-in paste first. A true cosmetic dentist wants to be certain their patients absolutely love their smile. Anything less than that is unacceptable and would be re-done until the patient is happy. Additionally, front teeth are extremely important to your smile. It is fairly standard that they would have to be the same size.

Yes, it is possible to fix this issue, but it will mean re-doing the porcelain veneers. I would talk to your dentist about this. When he does re-do them, tell him you’d like to see them with a temporary try-in paste first to make sure it was what you had in mind. When you ask him to re-do it, be nice about it. Not that I think you won’t. Hopefully, he will care enough about the quality of his work and patient satisfaction to do something about this issue.

One problem you may face is it is what is considered the standard of care in dentistry. If they are functional and look decent, it won’t matter if you don’t like them. That is the only standard of care.

This is one of the negative “side-effects” of cosmetic dentistry not being a recognized specialty. It is up to the dentist how much time and training they invest in creating beautiful smiles, which leaves the patient at a distinct disadvantage in knowing who does beautiful cosmetic work and who doesn’t.  If you ever decide to get more cosmetic dental work done, my suggestion is to look for your dentist on the mynewsmile.com website. They pre-screen cosmetic dentists for their technical training and artistry. They cannot simply purchase their way onto the list.

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

 

 

Porcelain Veneers Beginning to Pick up Stains

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I have porcelain veneers that are only about 14 months old. They’re beginning to pick up stains in between the teeth.  While I do smoke, I was told these were very stain resistant. Are mine defective?

Kelly

Dear Kelly,

A woman getting a porcelain veneer placed on her teeth

It is true that porcelain veneers are very stain resistant. In fact, they are more stain-resistant than your natural teeth. Without an image of the type of staining you are experiencing, I can’t give you any definitive cause. However, I can go over some basic types of staining that can happen with porcelain veneers and what the solution is.

Staining over the Entire Surface

First, if you are experiencing staining over the entire surface of the veneer, then it is likely your glazing has somehow been removed. This can happen when your hygienist uses something like a prophy jet or acidulated fluoride with your cleaning and checkup. Experienced cosmetic dental offices rarely have this occur. However, often people have their cosmetic dentistry done in one place and their general dental work in another. The general dentist’s office may not realize what can damage their veneers.

A second option with staining over the whole surface is when there is a gap between the veneer and the tooth. In this case, food and other bacteria carrying items can get between the two. Not only does that make it look like the porcelain veneers are stained, but it can do severe damage to the teeth bringing on extensive decay.

In either of these cases, the veneers will need to be repaired or replaced at the dentist’s expense.

Staining on the Edges

If there is a gap between the margins of the veneers and the tooth, that is a tricky fix, but it would need to be done because decay will again be an issue. However, much of the time, it is just an area of composite bonding there. When your dentist placed your veneers, he polished that up well. Over time, they will pick up some stains that can be easily polished out again. This should be considered regular maintenance for your new smile. As a smoker, yours will be more obvious than others so you’ll want to keep up with that maintenance.

When you go back in to have them polished, go to the dentist who originally did your porcelain veneers. Your family dentist may not know the method or even have the necessary tools to do the procedure.

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

Overbite and porcelain veneers

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I have pretty bad tetracycline stains and wanted to get porcelain veneers to help cover them. My dentist said I am not a candidate for porcelain veneers because of my overbite. Instead, he wants to do dental crowns on my top six teeth. Is this a good alternate solution? Do I just bleach the bottom teeth?

Kaitlyn

Dear Katilyn,

A tetracycline case done by Dr. Delaune.

Please don’t let your dentist do dental crowns. This will require him to grind your healthy teeth down to nubs. He is likely saying that because he doesn’t know how to do porcelain veneers. I’ll give him credit for having a creative excuse. I’ve never heard a dentist use an overbite as an excuse. In reality, an overbite is easier with porcelain veneers.

You can see from the image above that a tetracycline case can be made to look stunning. There is a big “HOWEVER” when you’re considering this though. Smile makeovers aren’t taught in dental school. Instead, a dentist has to invest in post-doctoral training in order to truly know how to create a beautiful smile. Now, factor in tetracycline stains. These are among the most difficult type of cosmetic cases to do.

What you need is an expert cosmetic dentist. The images above show a tetracycline case done by Dr. Delaune. You want to find a dentist with his training and skills in artistry.

Finding that Expert Cosmetic Dentist

One thing I will suggest is you look on the mynewsmile.com website. This site is run by a retired dentist who is accredited in cosmetic dentistry. He screens each dentist who wants to be listed for both their technical training as well as looking to see what type of beauty they create in the cases they do.

One thing to be aware of, I”m pretty sure whichever cosmetic dentist you end up with will suggest more than six porcelain veneers. Most of our smiles are at least eight teeth wide.

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