finding an expert cosmetic dentist Archives

Help! My Dental Implants are Falling Out.

Posted on May 31, 2021 by writeradmin.

I had a full mouth reconstruction done a year ago and the dental implant crowns have been falling off leaving me with nothing but the screws. Now one of the implants themselves have fallen out. I’ve been trying to reach my dentist for months, but they keep blowing me off. Now I learn he’s actually fled the country. Is there any way I can get some teeth now?

Liz

Dear Liz,

I am sorry for what you are being put through. It seems your dentist was a crook. I think he or she knows they are in trouble as they fled. I wonder how many other victims there are. It will be hard to recoup your money unless he comes back to the country. I can, however, tell you how to get the smile you want.

You made a good choice in getting dental implants. They are the best tooth replacement. I hope you actually needed a full-mouth reconstruction and that wasn’t just another part of his unethical behavior. Either way, you need one now. To be frank, this is one of the most advanced procedures. Unfortunately, this procedure is not taught in dental school. In order for a dentist to get the training to do this properly, it will require a dentist who invested in a significant amount of post-doctoral treatment, specifically in three areas:

Cosmetics – to ensure your smile looks beautiful
Dental Implants – for obvious reasons
TMJ and occlusion – to make certain they know you your teeth should meet with proper occlusion.

I know that is a tall order. Start with the the cosmetic training. I would not look for the cheapest dentist. That usually means they cut corners in order to keep profits up. That is the last thing you need. Look for someone listed on the mynewsmile.com website. Any dentist listed there has had their technical training as well as their artistry evaluated. They cannot just pay to be listed. Next look at their implant training. Dentists with implant training often have TMJ training as well because proper occlusion is necessary for a good outcome with dental implants. For instance, Dr. Delaune did implantology training with the Zimmer Institute, but he also invested in advanced TMJ training with the renowned Dawson Academy.

Please don’t be surprised if they mention you need a bone grafting procedure to get these implants done correctly. Your implants will probably have to be removed, if more of them haven’t failed by then. When that happens, you lose some bone structure. In order for your dental implants to remain secure, you will need that bone support. In fact, it is imperative that bone integrates with the implants for a successful case.

Following these guidelines, you should receive an amazing smile you will be proud to share that will serve you well for many years to come.

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

Matching Dental Work to Really White Teeth

Posted on April 1, 2021 by writeradmin.

I am new to my area due to getting transferred. I’ve always whitened my teeth once every two years and they are very white. With the transfer and the pandemic, I haven’t had time to find a new dentist and recently fell and chipped a tooth. I went to a dentist someone at work recommended. He told me I’d need to get a crown on the tooth to repair it. The problem I am having is getting the crown to match. I’ve asked him to send it back to make it whiter as it is obviously darker than my teeth, but he insists this is the whitest shade and showed me a shade guide to prove it. I’m having a hard time believing that people who whiten their teeth never need dental crowns. Is there no way to make my dental work match my whitened teeth?

Jennifer

Dear Jennifer,

I think what you are up against is your bread and butter family dentist versus a true cosmetic dentist. While there is not a recognized specialty in cosmetic dentistry, there are dentists who have invested a significant amount of more time in cosmetic training than others. Dentists who invest in this training know things your average dentist doesn’t. One of those things is the tools available to match dental work. Your dentist is probably using the old color shade guide (pictured above).

That particular shade guide worked for many years. But, then teeth whitening gained in popularity this shade guide became outdated. Teeth were now whiter than the whitest shade on the guide. To respond to this need, I new shade guide was developed. This one had much whiter shades that dentists can use to match to the needed dental work. This shade guide (pictured directly below) has whiter options.

You did not say where the tooth was, but my guess. is it is a front tooth. This is even more challenging. To be quite frank, I don’t think your dentist is up to the task. The front teeth are the most visible because the light hits them directly, exposing all the variations and subtleties of the teeth. Even expert cosmetic dentists will take one or two try-ins before getting it right. If he does not even have the right shade guide, then he will not be able to match a crown to a front tooth which will need specific additional instructions to the ceramist. In your place, I would look for a dentist recommended on the mynewsmile.com website. These are among the best cosmetic dentists in the country.

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

Click here to learn about our complimentary virtual smile makeover consultation.

Gums Inflamed After Porcelain Veneers

Posted on March 18, 2021 by writeradmin.

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,

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.

What Else is Necessary with Porcelain Veneers?

Posted on January 16, 2021 by writeradmin.

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

Kelly

Dear Kelly,

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

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

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

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

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

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

Retouching up Teeth Whitening

Posted on December 23, 2020 by writeradmin.

I need to get a dental crown on a front tooth. I know the color will be permanent so I want to retouch up my teeth whitening before settling on the color of the crown. Do you have any tips about how to go about this? Specifically, I am looking at how long I should whiten every day and for how many days.

Caroline

Dear Caroline,

Teeth whitening trays

I’m glad you wrote. I am curious though if your dentist was unable to advise you of this. The reason I ask is because placing a dental crown on a front tooth is much trickier than other dental crowns. It takes some expertise in cosmetic dentistry to do a crown properly on a front tooth. If he wasn’t able to answer the questions about teeth whitening, which does not require expertise, I am going to advise you to find a different dentist at least for the crown.

If it turns out that you do need to switch dentists in order to get a beautiful porcelain crown to match your other front teeth, I recommend you see someone who is recommended on the mynewsmile.com website. These dentists have all been prescreened and are among the top cosmetic dentists in the country.

Touching Up Teeth Whitening

In practice, it is up to you how long each day you leave on your teeth whitening trays. The longer you can leave them on each day, the faster they will whiten. But, if your teeth are sensitive and you can only do them a little bit each day, that is okay too. You will just have to do more days. The fastest would be to sleep in the trays if you can.

While there is no cut and dried rule for how many hours per day or days in general to whiten, there is a standard for how long to wait between the time you stop whitening and you go in for your dental crown. I would recommend giving it one week for the color to settle on your teeth before having the dentist create your dental crown.

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

Crooked Porcelain Veneer

Posted on December 16, 2020 by writeradmin.

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,

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

Posted on September 26, 2020 by writeradmin.

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,

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.

Contouring Teeth

Posted on August 26, 2020 by writeradmin.

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

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.

Porcelain Veneers don’t Match

Posted on August 13, 2020 by writeradmin.

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,

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.

My Dental Bonding Looks Awful

Posted on May 9, 2020 by writeradmin.

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,

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.