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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.

Tetracycline Teeth and No Money

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I have tetracycline stains on my teeth. I had dental bonding placed on my teeth but they are old and chipping. I can’t afford the porcelain veneers my dentist thinks I should get. Is there a whitening option that will work for me? Or if there are ways to get porcelain veneers cheaper than my dentist offers them can you give me that tip? My dentist is one of those top cosmetic dentists so I know he is more expensive than most.

Katya

Dear Katya,

Photo of teeth whitening trays in a blue case.

Teeth whitening trays

I will answer your second question first. If you cannot afford to get porcelain veneers from a skilled porcelain veneers, please don’t go to a cheaper dentist. I can tell you countless horror stories of smile makeover disasters from patients who tried to save money by going to a cheap cosmetic dentist. This is especially true in your case because tetracycline stains are one of the most advanced types of cosmetic cases there are. If you cannot afford to have it done right you have a few options.

If your dentist placed the dental bonding over your dental enamel, you should be able to have your dentist remove the bonding with sandpaper disks. In some states, a dental hygienist can do this for you at a lower fee. Once the dental bonding is off, you can whiten your teeth. If you are persistant enough and stay at it long enough it can make a difference. It will not be a great as porcelain veneers but it will make a difference. Don’t use anything over the counter. They are not strong enough and it will be a profound waste of money. In that same vein, don’t use anything like laser whitening or Zoom whitening. Yes, they are stronger than the take home teeth whitening, but they are more expensive. You are trying to save money and it would take way too many sessions to make a difference.

On the other hand, if your dentist did remove some of the enamel on your teeth, the best you can do at this point is have someone smooth out the dental bonding while you save to get porcelain veneers done by a skilled cosmetic dentist.

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.

Contouring Teeth

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Ever since I had my braces, off the jagged edges of some of my teeth have bothered me. Can this be fixed? If so, would it be done by my regular dentist or is it something the orthodontist would do? I like how straight they are now, but would like smooth edges.

Misty

Dear Misty,

Congratulations on getting your braces off and having lovely straight teeth. The repair for the jagged edges on your teeth is called tooth contouring or cosmetic contouring. You would only want this done minimally on just the enamel of your teeth. Often orthodontists will do this for minor issues at the end of your case. However, if yours didn’t, I wonder if has some complicated issues to it. In that case, I would be very careful who you had do the contouring for you. In choosing a cosmetic dentist to do it, I would likely aim for someone who has real expertise in dental cosmetics. The mynewsmile.com website has a “find a cosmetic dentist” link. They prescreen anyone who wishes to be listed and only the best cosmetic dentists will make the cut. You can’t just purchase your way to a listing.

An Example of Dental Contouring

before and after dental contouring and dental bonding

In the case above, there was some tooth contouring done to smooth out the appearance of the teeth. Then, the dentist added some composite bonding to the sides of the teeth to create a beautiful, aesthetic result. You want to find a dentist who can give you this type of results. Whether or not you are in need of the additional work of dental bonding.

If You Add Bonding

I don’t know your goals for your smile. You may be perfectly content with the contouring work and nothing else. That is fine. If you do decide there are spaces you’d like to close with bonding, it will save you money if you think long-term. When you get bonding done, the color made is permanent. If you will be doing teeth whitening anytime in the next few years, do it before you get the bonding done. This way, you can have the bonding color made with the new brighter, white color.

You don’t have to. If you decide to wait and whiten later, just bear in mind that only natural tooth structure will when. The bonding will stay the same original color. The only way to get them to match at that point is to replace the bonding.

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

My Dental Bonding Looks Awful

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I had some discoloration on my teeth after getting braces. I really regret not getting Invisalign now, but hindsight is 20/20. I had discoloration on several teeth after my procedure was done. I asked her what we could do about it. At first, we tried teeth whitening, but that only made it worse. So, she told me she needed to do some research. She called me back and said the consensus is dental bonding is the right solution. I felt confident going in because this time she researched the solution. Honestly, though, my two front teeth now look like she just glued pieces of chicklet gum to them. They are way too thick and the color looks flat and chalky. I could tell even she wasn’t thrilled with them but she was trying to not make me feel self-conscious about them. Is there anything I can do to fix these at this point or is it too late?

Sheena

Dear Sheena,

before and after dental bonding for broken teeth

It sounds like your dentist cares about her patients but is just in over her head when it comes to the cosmetic end of things. That isn’t terribly surprising. Dentists are in a bit of a pickle when it comes to cosmetic work. It’s not really taught in dental school, nor is it a recognized specialty. If a dentist wants to learn about cosmetic dentistry they have to invest in post-doctoral training to learn more about it. Especially for dentists just starting out, that’s a tough one.

I can tell your dentist had not invested in that training right off that bat with her suggestion about teeth whitening. Two basic tenets about teeth whitening that every dentist should know are:   1. It whitens your teeth evenly.  As a result, when there is discoloration whitening your teeth actually makes that more obvious, not less. 2. It will only whiten natural tooth structure. If someone had discolored dental work bleaching them won’t work.

When that failed, she did what she should have to begin with, and did some research. She was right about the solution. Dental bonding is the correct way to fix this problem. What she didn’t realize is that it is an advanced cosmetic procedure that takes a while to learn, especially because it has to be done freehand.

Another common repair that uses dental bonding is for broken and chipped teeth. if you look at the image above, you can see a repair done by Dr. Delaune. Notice that it blends in seamlessly in both color and texture.  This is what you should expect with a dental bonding case.

Getting Bad Dental Bonding Fixed

The only real fix for this is to have it done over. Based on what you’ve said, I honestly don’t think your dentist has the skills yet to give you a beautiful natural-looking result. Your first step is to get your money back, so you can get this done properly. She likely knows it didn’t turn out beautifully and should be willing to give you a refund.

You’ll want an expert cosmetic dentist to do this repair. It is hard for patients to know who has the training and who doesn’t because there isn’t an “official” specialty. One retired cosmetic dentist realized this and started a website to help patients like you. I would go to the mynewsmile.com website. They screen dentists, who want to be listed, for both their technical knowledge and skill, as well as their artistry. Only the best cosmetic dentists are included. They cannot simply pay to have a listing there. Any one of them can give you the repair you were hoping for to begin with.

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

Damage After Crest Whitestrips

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I had a damaged tooth from years ago that has always been a bit darker than my other teeth. It’s always embarrassed me about my smile. I recently talked to my dentist about it and asked if tooth whitening would be a good idea. He doesn’t offer that service but said that Crest Whitestrips work.  After about a week my teeth became sensitive. I went back and he said he thinks I need a root canal treatment. I don’t know why it would. Do you think I need a second opinion? Also, if Crest Whitestrips won’t work for me should I try another dentist who does do teeth whitening?

Calli

Dear Calli,

 

Photo of teeth whitening trays in a blue case.

Teeth whitening trays

Your dentist showed a fundamental lack of understanding about teeth whitening. I’m glad to hear he doesn’t offer the procedure because he’d do one of the simplest cosmetic procedures ever wrong. No matter what type of teeth whitening you do, it will whiten the teeth evenly. So even if this darker tooth got whiter, so would all the other teeth around it. Therefore, the tooth would still be darker than the rest of them.

In this situation, you would need dental bonding or a porcelain veneer. Either one of these procedures would require an expert cosmetic dentist. Your dentist doesn’t qualify.  Before we go onto finding an expert cosmetic dentist I want to address your immediate issue.

I would get a second opinion before getting a root canal treatment. Crest Whitestrips aren’t very strong. They do whiten, but it would take a significant number of boxes to match what you would get with a dentist. Even then, you would only have your first six teeth get whitened because that is all the strips will reach. I would be surprised if it caused you to need a root canal treatment. That doesn’t mean you didn’t have something else going on.

Bottom line. Get a second opinion. After that is dealt with, if you decide you want to get that tooth fixed cosmetically, I suggest you go to the mynewsmile.com website. They recommend expert cosmetic dentists by zip code. So you should be able to find one in your area.

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

Dealing with Teeth Whitening

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I developed these opaque white spots on my teeth when I was much younger. My dentist insists my teeth are completely healthy. I mentioned to him that the appearance really bothers me, but he is more of the philosophy if it isn’t broke don’t mess with it. When I brought it up a few more times he said if it bothers me that much I could get some whitening strips. I’m looking for something a little faster and professional. There is a dentist in my area who does Zoom Whitening. Is it okay to go to a different dentist just for some cosmetic work or is that considered bad form?

Meagan

Dear Meagan,

A woman getting a porcelain veneer placed on her teeth

So, there are a few different types of dentists. Yours sounds like he holds to the engineering mindset These are dentists who got into the field because they like to fix things. They haven’t invested any time in learning the cosmetic side of their field. This is very obvious from the advice he gave you.

While you are correct that Zoom Whitening is the most effective and quick way to get your teeth whitened, it will not work for your particular issue.

Any type of teeth whitening, professional or not, will whiten your teeth uniformly. This means there will still be color differences in your teeth with white spots.

The Solution to White Spots

Depending on the area affected, you have a couple of choices. If it is a tiny area of white spots, you could have dental bonding done to get your teeth uniform in color.

If it is a large area, you would be better served getting porcelain veneers placed. These will cover the entire tooth and are the top of the line in smile makeover options.

Who Should Do Your Cosmetic Work?

It is fairly common for patients to go to an expert cosmetic dentist and then return to their dentist for the bread and butter type of dental work.

The two particular procedures I mentioned above will require an expert cosmetic dentist. Look at Dr. Delaune’s bio to get an idea of what to look for in the best cosmetic dentists. They will have the skills to give you a stunning smile you will be thrilled to share.

How Can Zoom Whitening Help?

If you would like a whiter smile, you can still use Zoom Whitening to do that and then have the dentist treat the white spots.. It’s important to do any teeth whitening before the other work is done. Both dental bonding and porcelain veneers can be matched to any tooth color. However, once they’re made, their color is permanent. Get your teeth the color you want before having your veneers placed.

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

Pain with teeth whitening

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I had dental bonding done about seven years ago. Since then I’ve been whitening my teeth, the dental bonding isn’t whitening, but that isn’t why I am writing. Recently, I’ve started having pain for about 30 seconds right where the bonding connects to the chipped teeth. Do you think the teeth whitening is damaging the bond?

Fanny

Dear Fanny,

Photo of teeth whitening trays in a blue case.
Teeth whitening trays

You didn’t mention whether or not you are under the supervision of a dentist during your teeth whitening or if you are doing an over-the-counter teeth whitening. There are a couple of ways in which the method you chose won’t matter.

First, neither form of teeth whitening will weaken the bond. Second, neither method will whiten your dental bonding. Even professional teeth whitening will only whiten natural tooth structure. The only way to whiten your dental bonding would be to re-do it.

Here’s where their differences in the methods lie. The strength of over the counter teeth whitening is only a fraction of what you get through a dentist. You have to do countless kits to get the same value in teeth whitening. The second difference is the care you get.

A dentist would be monitoring any complications which would come up during the process, including pain and gum issues.

The pain you are experiencing is likely because of a sensitive spot on that tooth where the bonding agent has worn down. With the age of your bonding, that doesn’t surprise me.

Here’s what I recommend. See your dentist and let him or her know what is going on. There is a way they can cover the sensitive part while your teeth whitening is going on. That should cover the pain.

Then, you can continue the whitening until you get to the level of brightness you want. From there, you can get your dental bonding replaced to match the newer color.

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

fixing this dental bonding

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I had dental bonding done by my dentist in the previous state I lived in. It was getting old and picking up stains so my new dentist tried to spruce it up with teeth whitening. That seemed to just make it darker. Is there some way to whiten this bonding?

Kathy

Dear Kathy,

Photo of teeth whitening trays in a blue case.
Teeth whitening trays

Unfortunately, teeth whitening will not work on your dental bonding. It isn’t just bonding. It won’t work on any dental work. The reason your dental bonding looks darker is the teeth whitening did work on your natural teeth while your bonding stayed the same color.

There is not a way to whiten old bonding. Instead, you’re going to need to have it re-done. I don’t think your current dentist will be the one to do it. He or she didn’t understand how teeth whitening works, which is the bare basics of cosmetic dentistry. Dental bonding takes an expert level of cosmetic skill to get right.

In your place, I’d look for a dentist recommended on the mynewsmile.com website. They pre-screen dentists who wish to be listed for both their technical training and their artistic skill.

One thing you might want to consider is upgrading to porcelain veneers. Your bonding will have to be re-done every few years, When porcelain veneers are well cared for, they can last for two decades. Again, you would need to have this done by a cosmetic dentist.

You can stay with your current dentist for all your general work. However, when you go in for cleanings, make sure they know not to use anything like a prophy jet or acidulated fluoride. Both of those will take the glazing right off your cosmetic work. This will ruin them and cause them to pick up stains.

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

Brown Spots on TEeth

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Most of my teeth are okay, but there are brown spots on my two front teeth which have bothered me since they came in . I was told this was because of a fever I had as a child. My dentist tried all the over the counter whitening products and even professional whitening. She’s thinking about either sending me to another dentist who has a Zoom light or grinding down until the brown spots are gone. Do you think one of these is a better option than another?

Cora

Dear Cora,

I want you to stop letting this dentist work on your front teeth. While it is obvious she is trying to help, she doesn’t have the knowledge for this type of treatment.

Neither at-home whitening or in-office Zoom Whitening will solve your problem. Teeth whitening whitens the teeth evenly. This means your brown spots will just become more obvious.

I certainly don’t think she should experiment by grinding down the brown spots. Does she know how far she’ll have to grind? How will she build the material back up?

Solutions to Brown Spots on Teeth

You have two good solutions to this issue. The first is dental bonding. This uses composite resin which the dentist will hand sculpt onto your teeth to hide the brown spots. This is the least expensive of the two options. However, it doesn’t last as long and will need to be replaced periodically.

Your second option is to have porcelain veneers done. You can do them just on the two front teeth or you can get a complete smile makeover. It’s up to you.

One word of caution. Your current dentist is not qualified to do either of these procedures. I’m going to recommend you pick one of the dentists from your area listed on the mynewsmile.com website. They have the cosmetic training and skill necessary to give you a beautiful result.

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