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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.

Did I Make a Mistake Getting Porcelain Veneers?

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I’m wondering if I made a mistake getting porcelain veneers. My teeth have been getting shorter and shorter recently and it was really beginning to bug me. My dentist suggested I get porcelain veneers. They were expensive but my dentist said they could make my teeth longer. I was excited about that. I went forward. I wasn’t crazy about how they turned out. While they are longer, they look a bit boxy. Plus, two of them have popped off. My dentist always puts them back on for free, but it does take time off work. I’m wondering if this was a mistake. I kept thinking for that much money they’d be beautiful, not just longer. Did I have unrealistic expectations?

Melanie

Dear Melanie,
A single porcelain veneer being placed

Porcelain veneers are a great way to remake your smile. I think the mistake is simply allowing your family dentist to do it instead of an expert cosmetic dentist. I have another concern aside from your dentist’s cosmetic skill. You mentioned your teeth have been getting shorter. That combined with your veneers popping off, makes me think you’ve been grinding your teeth at night. Your dentist should have recognized these signs.

It’s important this is dealt with or your teeth will continue to grind down until they’re nubs. Then, you’ll be forced to get a mouth full of porcelain crowns in order to chew. I’d be lying if I didn’t say I was concerned about your dentist not bringing this up.

There is a simple solution. You just need to wear a night guard and then it will protect your teeth and your porcelain veneers from being damaged any further.

Getting Gorgeous Porcelain Veneers

Getting a smile makeover is a bit like commissioning an artist to do your portrait. You want to research the artist carefully. They need to have post-graduate training. But, like any art, there also has to be some natural skill there. Your dentist needs an artistic eye. So, how is a patient to research all of that? Well, you could check their credentials, research their smile gallery, check their reviews, etc.

Fortunately, the mynewsmile.com website does all of that for you. If you go to their site and click on “Find a cosmetic dentist”, you simply input your zip code along with how far you’re willing to travel to get a beautiful smile and they’ll list all the expert cosmetic dentists within that range.

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

Is It Possible to Replace My Metal Crowns with Porcelain Veneers?

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I see these gorgeous pictures of porcelain veneers, then look in the mirror at my horrible ugly crowns and get discouraged. Is there a way I could replace my crowns with veneers? They’re cloudy looking to me. Now they’ve developed some kind of weird line at the gumline. I don’t want to be ashamed every time I smile.

Sandy M. – Little Rock, AR

Sandy,

I have bad news and good news. I always start with the bad news so we end on a hopeful note. It is impossible to replace crowns with porcelain veneers. When you had your crowns placed, your dentist had to grind down a good deal of your tooth structure to make room for the crowns. Porcelain veneers need to be bonded to intact teeth. With that tooth structure gone, there’s nothing for the veneers to bond to.

However, that doesn’t mean you are stuck with an unattractive smile. A good cosmetic dentist can give you a stunning smile using all-porcelain crowns. Based on what you described, you have metal-based crowns. They’re the ones that develop a gray line at the gumline. It also explains the cloudy look you mentioned. The crown is made more opaque to cover the metal.

All-porcelain crowns solve all of those problems. They can be as translucent as natural teeth. Combine that with the artistry of a great cosmetic dentist and you have a recipe for a smile you’ll be proud to show.

This blog is brought to you by Dr. Duane Delaune.

Tired of Re-doing my Composite Bonding

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I’ve had composite bonding for about six years and I’ve already had to re-do it twice. I do need to do something. I have a tooth gap and three different front teeth are chipped. I’m just tired of replacing them. What are my other options? My dentist suggested crowns, but my teeth are healthy so I’m not too keen on that idea. Are those the only two options?

Helen C. – North Dakota

Helen,

Yes, there is a much better option than either dental bonding or dental crowns. But, it’s generally used for total smile makeovers. Porcelain veneers can change anything you want to about your smile. It can change their shape, size, and color of your teeth. While bonding only lasts a few years, veneers last for many. With proper care, well over a decade. It’s the same procedure that celebrities use to remake their smiles.

I wouldn’t pressure your dentist to do the procedure though. If he didn’t mention it, it’s likely because he isn’t comfortable doing it. If you press him, he may do it to please you and it wouldn’t turn out nearly as well as you’d hope.

That doesn’t mean you’ll have to switch dentists to get this repaired the way you want. I’d just recommend going to an experienced cosmetic dentist for your porcelain veneers and your family dentist for everything else. Just make sure when your dentist does your check up, the hygienist doesn’t use anything like a prophy jet or other ultra-sonic cleaner on the veneers. That will take off the glazing.

This blog is brought to you by Dr. Duane Delaune.

I’m afraid my hygienist will ruin my porcelain veneers!

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I’ve got eight veneers on my front teeth. I have a regular cleaning coming up and I am worried about the tools the hygienist uses. Could my veneers become loose or even break during the cleaning? — Sara

Sara,
Porcelain veneers are very strong, so a hygienist won’t pull them off or break them; however, with that said, she could chip them or dull the surface if she’s not careful. If your hygienist doesn’t know how clean veneers safely, you may want to go to a cosmetic dentist. If that’s simply not an option, you’ll need to be very specific with your hygienist about what she can and can’t do. Here’s some quick tips:

  1. Don’t let them use Dentsply’s Prophy Jet or some other brands of power polishers. The mixture of sodium bicarbonate and water on your teeth will get them super clean very quickly. While your porcelain veneers will look amazing when she’s done, this process completely removes the glaze and your veneers will be susceptible to staining almost immediately. This is the worst thing a hygienist can do to your porcelain veneers.
  2. An ultrasonic scaler can also damage veneers on the margins, causing little chips on the edges that will attract stain and plaque. Heavy duty manual scalers will do the same thing, so if your hygienist needs to use one, be sure she doesn’t scrape hard right on the margins.
  3. Ask your hygienist to only use fine or ultra-fine polishing pastes, preferably with an aluminum oxide grit–no pumice.
  4. If you hygienist suggests a fluoride treatment, make sure she uses a neutral fluoride gel, rather than an acidulated fluoride that will etch the surface and remove the glaze.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.