mynewsmile.com Archives - Dr. Duane Delaune's Blog

My Daughter’s Dental Crowns are Ugly

Posted on July 10, 2021 by writeradmin.

Years ago, when my college-aged daughter, was a middle-schooler she had a fall that caused some tooth trauma. Two teeth were crowned and one of them even needed a root canal treatment. One of the crowns has turned gray over the years, so we were looking for a solution. We went to this dentist who provided two porcelain veneers for us. Whle they are more attractive than what she had, we’re still not too thrilled. The biggest thing is that one tooth is still darker than the other. The second is that one of the teeth are thicker, which he said was due to the fact that he was trying to cut down on some of the grayness of that tooth. He also said that we have unrealistic expectations. Do we? I feel like after $5,000 she should feel confident about her smile. Am I being overly critical?

Morgan

Dear Morgan,

I will say up front you are not being overly critical to want two front teeth to match in color and size, especially when you are paying a cosmetic dentist to do it. That being said, I want to clear one thing up before we get into the solution to this. You said he was giving you porcelain veneers, but that previously she had crowns. Once you have crowns, they can only be replaced with other crowns. Unless of course, your dentist was planning on placing porcelain veneers on top of her dental crowns. However, that would be a dumb thing to do because they are less secure and an equal amount of work for the dentist. My suspicion is that he gave her porcelain crowns and called them porcelain veneers. Crowns go all the way around her teeth, which means the tooth structure is ground down quite a bit.

For now, I’m going to go on the assumption she actually has crowns, but the principles I’m about to share are the same either way. While getting a single porcelain crown to match a front tooth is extraordinarily hard and takes the top 1% of cosmetic dentists, getting two crowns to match should not be that hard. This dentist is not the best dentist for you. I believe your dentist is in over his head. While I can tell you the procedure to help, your best bet would be to find a dentist who does not need to be taught.

The first thing I want you to do is ask for a full refund from this dentist. Then, look on the mynewsmile.com website. They have a find a cosmetic dentist link. You input your zipcode along with the distance you are willing to travel and they will bring up a list of skilled cosmetic dentists in that area. Everyone they will recommend has been prescreened for both their technical training and skill as well as their artistry. They’ll be able to give your daughter a smile she will be proud to share.

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

Dental Bonding Doesn’t Match and Falls Off

Posted on June 1, 2021 by writeradmin.

I have tetracycline stains and my dentist said dental bonding would take care of it. It has not worked out at all like I wanted. First, the color doesn’t match and it is pretty obvious. Plus, you can still see some of the tetracycline stains through it. As if that weren’t bad enough, the bonding fell off after just three days. I went back for him to repair it. At the time, I told him about the color problem so he made them thicker, which looks weird in its own way. Now they have fallen off again just a few days later. I called him back and he said they’re not meant to be permanent so I should not have high expectations. However, I was told they’d last up to five years, this is like just a few days. What should I do?

Calorie

Dear Calorie,

As you can see from the image above dental bonding can blend in quite naturally with your teeth. I think the biggest problem you are facing is the skill and technical knowledge of your dentist. Both dental bonding and tetracycline stains are some of the most advanced procedures in cosmetic dentistry. You should be aware that cosmetic dentistry is not a recognized specialty. Any general dentist can call themselves a cosmetic dentist regardless of the amount of training they have invested (or not invested) in.

I think your dentist is in way over his head. Dental bonding should not fall off, especially after just a few days. As for the color, if he is an inexperienced cosmetic dentist, he probably doesn’t even have the colors and other materials necessary to make things blend well. An additional problem in dealing with tetracycline stains is making the teeth opaque enough to cover the stains, while translucent enough to look natural. That is not an easy accomplishment, even for a skilled cosmetic dentist.

Honestly, the better treatment for you would be porcelain veneers and not bonding. It is more permanent, decades rather than years. Plus, it is more stain-resistant. I don’t think your dentist is the one to do it. Here is my advice. Do not let him “fix” this. instead, ask for a refund. Then, we’re going to get you to a highly skilled cosmetic dentist.

Finding an Expert Cosmetic Dentist

Because there is not a recognized specialty in cosmetic dentistry it is hard for patients to know who has the skills and who doesn’t. There is a website that strives to help patients in your position. A retired cosmetic dentist runs the mynewsmile.com website. He prescreens all dentists that want to be listed on his site. They cannot purchase their way on. Instead, they have to show their training credentials, in addition to proving their artistry and skill on cases they’ve completed. Any dentist he lists can provide you with a stunning smile.

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

Smile Makeover Disaster

Posted on May 15, 2021 by writeradmin.

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,

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.

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.

The Secret to Very White Teeth

Posted on March 31, 2021 by writeradmin.

I have been using whitening toothpastes for years and never seem to get very white teeth. I’ve about given up and am now looking at getting Lumineers at the suggestion of my dentist. It looks like it can give me very white teeth, but I wanted to make sure I am on the right track with this before investing that much money. Any advice?

Melissa

Dear Melissa,

You have a few good options. Before we get into that, I’d like to discuss why your whitening toothpaste hasn’t worked. These don’t actually whiten our teeth as much as scraping them clean. Whitening toothpaste uses an abrasive on your teeth, which removes the stains. However, it also will scratch the surface of your teeth. This has the unfortunate effect of damaging the surface of your teeth, in turn making them pick up stains more.

I’m a bit concerned that your dentist jumped from whitening toothpaste straight to Lumineers. It is massively more expensive than some of your other options. Lumineers are one brand of porcelain veneers. It’s a highly marketed brand. Unfortunately, it is mostly marketed to inexperienced cosmetic dentists. This rarely goes well for the patient. Plus, porcelain veneers are not intended for simply whitening your teeth. Instead, they are for total smile makeovers. If that is what you want, then great. Get porcelain veneers. They can be made as white as you’d like. They can also change the shape and size of your teeth. It’s important you choose an excellent cosmetic dentist to do that procedure. If you decide to go that route, I suggest you look for a dentist that is listed on the mynewsmile.com website. These dentists are pre-screened for their training, technical knowledge, and artistry. They cannot just pay to get listed.

If you are not looking for anything quite that expensive, then you can get your teeth very white by doing professional teeth whitening. Doing bleaching trays can get them very white and you can do it at your convenience. If you want them white super fast, then you can go with Zoom Whitneining which will whiten your teeth in just one appointment. Unlike with porcelain veneers, you won’t need an exceptional cosmetic dentist for either teeth whitening procedure. Pretty much any dentist who offers the services can do them without any problem.

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

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.

Lumineers over Crowns

Posted on March 5, 2021 by writeradmin.

I have old dental crowns that look horrible. I’d like to get veneers and am told that the Lumineers brand can go over dental crowns. Would I be a candidate for this? How do I go about finding a dentist to do it?

Everett

Dear Everett,

Above you will see an advertisement Lumineers placed years ago marketing this very concept. While I am certain you will be able to find a dentist to do this for you, what I’d like you to do is go over the information I’m about to provide and ask yourself if that’s what you want. First, let’s talk a little bit about Lumineers. They are simply one brand of porcelain veneers. This particular brand happens to be highly marketed to inexperienced cosmetic dentists. As a result, those are usually the type of dentists you will find that place them.

Dentists with expertise in cosmetic dentistry almost always prefer other brands. This has more to do with the fact that the company that owns Lumineers, DenMat, requires dentists to use their lab, which is not known for its artistic results. When it comes to getting a beautiful smile, you are better served by finding an expert cosmetic dentist and letting them choose the best brand to give you the results you want.

Should You Put Veneers Over Crowns?

Problem One:

Placing veneers over crowns is going to be bulky looking. If you consider that many patients find Lumineers themselves too bulky, you may find yourself feeling like you have horse teeth.

Problem Two:

There will be bonding issues. It is much more secure when you bond porcelain to natural tooth structure than it is when you bond porcelain to porcelain. This means you are at a greater risk of bonding failure. Additionally, your crowns are getting old. What if the bonding for those fails? Now you have double the risk of bonding failure– One from your old crowns and another from the porcelain veneers being bonded onto the crowns.

The Solution to Old Ugly Dental Crowns

The best thing for you to do is simply replace the crowns you have. An artistic cosmetic dentist can give you a gorgeous smile with dental crowns just as easily as with porcelain veneers. I would look on the mynewsmile.com website and get one of their recommended cosmetic dentists to do this procedure for you. Most of them even have a beautiful smile guarantee.

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.

My Lumineers Do Not Look Right

Posted on January 4, 2021 by writeradmin.

I had porcelain veneers done almost 20 years ago. I loved them but it was time to get them replaced as they had started to show their age. My old dentist had retired and I used his replacement. I wish I had not now. It has been a completely different experience. First, even though I told him I wanted them to match my last porcelain veneers exactly, he made some changes. He used a different brand of porcelain veneers he called Lumineers because he said they were thinner and he was placing these over my old veneers. That sounded okay to me. But, then he also put a strain on the Lumineers, which he did not mention ahead of time. When they came in I told him I wanted whiter and he said to give it a couple of days and see what I think then. He felt they looked more “natural” this way. I did and still didn’t like them. He told me to come in and he would “fix” it, if that is what you would call it. His fix was to sand off the front which had the staining. Now I am left with this dull underneath. What do I do?

Lorainne

Dear Lorainne,

There are a couple of problems going on here. First, the fact that he put Lumineers over old porcelain veneers is a problem. Porcelain sticks much better to natural tooth structure than to other porcelain. Now not only will you have to worry about the bonding of your new veneers failing, but your old veneers are eventually going to wear down as well and he attached the new ones to them. It is just as much work to place new over old as it is to just do them over. It doesn’t make sense that he did it the other way.

I’m not surprised he placed a stain on them to “make them look natural,” nor that he told you to give it a few days and you would get used to it. What he really meant by that is he didn’t want to do this over and he was counting on you to give up. Most patients don’t have your courage to stand up for themselves. A true cosmetic dentist would not bond on your porcelain veneers until trying them on with a temporary try-in paste and then letting you see and approve them. If you weren’t happy with the color he would never ask you to give it some time, but rather would send them straight back to the lab to be re-done.

He never did this. He may not even have the experience to know about a temporary try-in paste. When he suggested Lumineers, I knew you probably were not getting a highly skilled cosmetic dentist. Cosmetic dentistry isn’t a recognized specialty. Any dentist can try the procedures regardless of their skill level. This particular brand of porcelain veneers is marketed to inexperienced cosmetic dentists as being easy to place.

Under normal circumstances, you would have no recourse. The standard of care in dentistry is functional. They don’t have to be beautiful, even for cosmetic work. However, once he ground down your Lumineers, they were no longer functional. He removed the glazing on them which is what protects them. Because of that, you have the right to ask for a refund.

Once that is secured, you can use that money and go to a true cosmetic dentist to have these re-done. Look for a dentist listed on the mynewsmile.com website. Each of those dentists are pre-screened for both their technical knowledge and artistry. They can not pay to be listed. Instead, they have to be skilled cosmetic dentists.

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

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.