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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.

Porcelain veneers or crowns for tetracycline stains?

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I’ve seen two different cosmetic dentists about dealing with my tetracycline stains. They’ve recommended two very different solutions. The first dentist, who is well within my budget, wants to do porcelain crowns on the visible teeth. The other one, who goes several thousand dollars over my intended budget, wants to do porcelain veneers. Is there anything wrong with doing the crowns?

Cassie

Dear Cassie,

porcelain veneer being held up by dental tool

Before we get into the cost difference, I’d like to talk about the different procedures. With dental crowns, you have to have a great deal of tooth structure removed. If those teeth don’t need that structure removed, you are weakening them unnecessarily.

Ask yourself why a dentist would choose to use a procedure which is unnecessarily aggressive. My guess is, it is the only procedure he’s comfortable with. Every dentist places dental crowns. That doesn’t mean they are skilled in cosmetic work.

With porcelain veneers, you only have to remove a minimum amount of tooth structure, about the thickness of a fingernail. You can always switch from veneers to crowns. But, once you have dental crowns, you will always have to have dental crowns.

Choose the Dentist Carefully

Tetracycline stains are among the most challenging cosmetic cases there are. Whatever is used needs to be opaque enough to cover the stains completely, but still be translucent enough to reflect light and look natural.

I would say only the top 1% of dentists in the country could do it beautifully. You need one of those dentists. I would recommend you look on the mynewsmile.com website. They screen every dentist who wants to be listed on their website.

No one can pay to be listed. They have to provide background on their cosmetic training as well as visual proof of their artistry.

One last thing, price doesn’t always give a good picture of the skill of the dentist. Some really bad dentists have high prices. Some really great dentists have average prices.

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

teeth darkening under porcelain veneers

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I’m really worried something is seriously wrong with my teeth. I had porcelain veneers placed about six years ago. I moved shortly after that. Two of the veneers fell off. A dentist placed them back for a small fee, that after a receiving a letter on an attorney’s letterhead my original dentist finally reimbursed me for. Now it looks like the teeth under the veneers are darker. So much so that the porcelain veneers are no longer white. Even my friends with natural teeth have a whiter color now. What do I do?

Mark

Dear Mark,

A woman getting a porcelain veneer placed on her teeth

I’m afraid neither of your dentists have done you a great service. I’m sure it is obvious to you the first dentist wasn’t a skilled cosmetic dentist by the fact they would just fall off.

The problem you are facing is they weren’t bonded on correctly to begin with and things are getting underneath them, including bacteria. This can lead to serous decay.

It sounds like the second dentist didn’t have enough expertise to recognize the problem or to rebond them on. Truthfully, very few dentists know how to properly re-bond.

Re-Bonding Porcelain Veneers

One of the problems you will run into is very few dentists have the skill and equipment to do this properly. Using sand-blasting equipment, the old bonding material would first need to be completely cleaned off. After that, they’d have to etch the inside surface of the porcelain with hydrofluoric acid. The final step is to prime the porcelain veneer. Only then could it be bonded on again.

Now, if your porcelain veneers can be removed without them breaking, you can likely find an expert cosmetic dentist to do this properly.

Unfortunately, I’m worried the second dentist bonded them on strongly, without fixing the problem. This may mean they’ll break when the dentist tries to get them off.

If that happens, you will have to have them completely re-done. You may be able to get a refund as your porcelain veneers weren’t placed on properly and have put your teeth in danger.

Finding an Expert Cosmetic Dentist

To find a cosmetic dentist skilled enough to do either of these correctly, I recommend you go to the mynewsmile.com website. They have a link to help readers find a cosmetic dentist.

The biggest benefit to this website’s list is they prescreen every cosmetic dentist who wishes to be listed. They have to prove both their technical knowledge as well as their artistry to ensure that anyone they recommend has the expertise and artistic eye to give patients a stunning smile.

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

Deciding between traditional & ultra-thin Veneers

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I’m very excited about getting a smile makeover. I don’t want to go into this blind. At the moment, I’m trying to decide between traditional veneers and ultra-thin veneers. The only thing is, i keep reading that some people who get the ultra-thin veneers end up with a bulky smile, while others a beautiful one. I can’t figure out how ultra-thin veneers can create a bulky smile. How do I know which one to choose?

Katherine

Dear Katherine,

porcelain veneer being held up by dental tool

It’s great that you are doing research. I’m a big believer in increasing our knowledge of everything we can. The only thing is you are researching the wrong thing.

The reason some cases of ultra thin veneers look wonderful and others don’t is the various skills of cosmetic dentists. An expert cosmetic dentist can make a beautiful smile out of both traditional and ultra-thin porcelain veneers. However, a so-so cosmetic dentist will make a lot of artistic errors.

You asked how ultra-thin veneers can look bulky. I can answer that. There is a particular brand of ultra-thin veneers which is highly marketed to inexperienced cosmetic dentists as being easy to place because no tooth prep is required. While it may not be required, it is sometimes necessary. Not every smile does well without any tooth preparation and ends up with that bulky look you read about.

Finding an Expert Cosmetic Dentist

If the key to a gorgeous smile makeover is the artistic and technical quality of the dentist, how does a patient go about finding the right one?

I’m sure you’ve seen the commercials that Staples did with an “easy button”. Here’s the easy button to finding a quality cosmetic dentist. Go to mynewsmile.com. They have a link for finding a dentist. You input your zip code and how far you’re willing to travel. They provide a list of dentists for you.

Every dentist on their list has been pre-screened for both their technical knowledge as well as their artistic ability. They cannot just pay to get on the list. Anyone listed can give you beautiful results.

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

Worried Dentist Ruined My Porcelain Veneer

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I just had a set of porcelain veneers placed. I did like them but noticed one of them had a scratch on it. I mentioned it to him and he said it’s no problem he could even fix it before I left. I was thrilled and he bonded them on. Then he did some something he called “buffing out the scratch”. It looked fine and I left happy. It’s been a couple of days and now that tooth he buffed looks different from the rest of them. It looks duller. I’m worried something is wrong with it. Am I overreacting?

Alora

Dear Alora,

A single porcelain veneer being placed

No, you’re not overreacting. Your worry is quite founded in reality as well. It sounds like your dentist removed the scratch by removing the glazing. Not only is the glazing what gives your porcelain veneers their shine, but it’s also what protects them. Your veneers will quickly begin to pick up stains.

You need to have him replace this porcelain veneer. It’s best you call him right away. If you wait, he could try to say you did something to it. This way, if you call right away, he’ll have to admit it’s something he did.

Make Sure Your Dental Office Knows How to Care for Porcelain Veneers

Though as a patient this shouldn’t be your responsibility, it sounds like your dentist isn’t a true cosmetic dentist and doesn’t quite understand how he’s supposed to care for or repair porcelain veneers.

The key for you, in keeping them healthy, will be making sure your hygienist doesn’t use anything like a power prophy jet during your cleaning. It will take the entire glazing off your teeth.

When You Need an Expert Cosmetic Dentist

There isn’t a recognized specialty in cosmetic dentistry. A cosmetic dentist is actually just a general dentist who does cosmetic procedures. However, it isn’t something really taught in dental school. For a dentist to become skilled in it they have to invest in post-doctoral training.

However, it’s hard for patients to know who is trained and artistic. One way I’d recommend patients get an edge is by going to the mynewsmile.com website. They have a link to help patients find excellent cosmetic dentists in their area. All of them are pre-screened. Dentists can’t just pay to get listed, they have to show their technical knowledge, skill, and artistry.

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

Bleeding Gums with Porcelain Veneers

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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.