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Trying to Figure Out This Smile Makeover

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Can you help me figure out what is necessary for my smile makeover? I want to get porcelain veneers. My dentist said that I’ll need to get my teeth whitened first, which seems odd to me because the veneers should change the color, right? The other question I have is he wants me to get Invisalign first as well because I have one front tooth that is a bit crooked. I really just wanted the porcelain veneers. Is that possible?

Cadance

Hi Cadance,

porcelain veneer being held up near a tooth

I am glad you wrote. Your dentist’s advice here is about 50/50. His recommendation for teeth whitening before getting your porcelain veneers done is solid. It is actually to save you money. Most people cannot afford to get a porcelain veneer placed on each and every tooth. What you don’t want is part of your smile to look beautiful and white from the porcelain veneers and the others to look dingy and stained. That ends up making your veneers look fake.

So, unless you are planning on getting a porcelain veneer on every tooth, getting teeth whitening done helps the natural teeth to blend in with the veneered teeth, giving you a smooth, natural looking smile makeover.

The Invisalign is completely unnecessary in your case. A skilled cosmetic dentist can make a slightly crooked looking tooth appear straight when he plans your smile makeover. This begs the question “Is your dentist a skilled cosmetic dentist?” If he doesn’t know how to make that took look straight, then I would say he is not.

You will be better served getting your smile makeover done elsewhere by someone who does have the technical skills and artistry to give you a smile you will be proud of. I highly recommend looking at a dentist’s smile gallery to see if they can deliver the type of results you are looking for. If they do not have a smile gallery that is a red flag. Move on.

The other thing to look for is some type of beautiful smile guarantee. This means that your veneers are tried on with a temporary paste and you get to see them up close and in various lightings before approving them. If there’s something you want changed, the dentist should be willing to change that before any permanent bonding is done.

I hope this helps.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Concerned About My Porcelain Veneer Repair

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A couple of weeks ago I had some porcelain veneers placed. While I was there everything looked fine. However, when I got home I noticed a small horizontal scratch across one of them. I could even feel it with my tongue. I went directly back in and showed them. They got the dentist who said he could fix it right then. He sat me in a chair and smoothed it out, which was his description of the repair. I looked and couldn’t see the scratch and everything felt normal with my tongue so went home satisfied. Now I am noticing that the area he repaired seems duller than the rest of the tooth and I’m wondering if the fix could have changed the color at all. Should I be worried about this? I paid a lot of money for this smile makeover.

Beatrice

Dear Beatrice,

porcelain veneer being held up near a tooth

It sounds like when your dentist buffed out the scratch, he did it by removing the glaze on the veneer. This needs to be repaired as quickly as possible. It is the protective glaze that protects your porcelain veneers from picking up stains. Left the way it is, that area of your tooth will soon be a completely different color than the remainder of your smile.

Because he caused the damage, he needs to make this right. Generally, when this happens, the repair is simple, but it does require some technical knowledge and equipment that includes using a diamond polishing paste. Because he didn’t use this in the original repair, I suspect he does not do a lot of cosmetic dentistry and will not know how to do the repair this way.

In that case, you are better off asking him to simply replace the porcelain veneer. That should be easy to do because he already has the instructions ready from when he did it last time. Don’t put off calling him about this. The longer it stays this way the more stains the veneer will pick up and he may even try to blame you for it. Calling him now connects it with his repair.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Cavity on Tooth with a Porcelain Veneer

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I have several porcelain veneers. One of the teeth with a porcelain veneer has a cavity. The dentist wants to remove the veneer and place a crown on that tooth. I really think that is overkill. He insists it is the standard procedure. Is that right?

Laurie

Dear Laurie,

A porcelain veneer being placed on a tooth.

I am not flat out saying that your dentist is incorrect here, but I would recommend a second opinion before going through with this. First, a crown would only be necessary for quite a large cavity. I would say at least 20% of your tooth should have decay. If the decay isn’t that significant I question why the dentist is wanting to do a crown instead of a veneer. Some dentists do not have the skill to do porcelain veneers so they steer their patients toward crowns. Here’s the problem with that. If he can’t do porcelain veneers, what are the chances that he can match a single crown to the remainder of your front teeth? Very few dentists can do that well.

I would go see an excellent cosmetic dentist and ask them if the tooth actually needs a crown. If not, don’t get rid of all that healthy tooth structure. When you have porcelain veneers, the most vulnerable place for decay is right at the margin where the porcelain meets your tooth. However, it is not too difficult to prevent that decay. There are two keys. One is the frequency of eating. Your saliva will do a lot of the work if you just don’t snack too much, giving it time to do its job. The second thing is flossing. Making sure to floss every day will get in the margins.

I’m not confident this dentist can give you an attractive result no matter which restoration you end up with. Instead, I would start looking for dentists who do beautiful cosmetic work. One of the things to look at is their smile gallery. If they do not have a smile gallery, they do not do enough cosmetic work. In their smile gallery, specifically look for before and after images of both porcelain veneers and porcelain crowns. If you love the results you see on there, make certain you take one additional precaution and call the office to ask if the gallery is populated with images of the dentist’s own work or stock images. You want it to be work the dentist has done.

This blog is brought to you by Duluth, GA Dentist Dr. David P. Marion.

360 Veneers Disaster

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I went to my dentist asking for e-max veneers. He said he thought I would be a better candidate for 360 veneers. I specifically asked how much tooth structure had to be removed for the 360 veneers. They assured me not much at all would need to be removed. I agreed to their suggestion. When I first got the temporary veneers, a few of them kept falling off. I noticed then that my teeth were down to small nubs, which was much more removal of tooth structure than they implied I would need. I expressed my concern about them falling out all the time. They assured me that when the permanent ones were bonded on that would not be an issue. Yet, like the promise about the tooth structure, this has not proven to be the case. So far two have fallen off. They tried a different cement, but yet some structures are still falling off. Now they’re talking about ordering a special stronger cement. I’ve just lost confidence in them. While I am relieved that I haven’t swallowed any of them while I have slept, I am living in complete fear of them falling off in public. Do you have any advice for me?

Emily

Dear Emily,

I am going to be blunt in telling you that you were taken advantage of and misled by your dentist. My first clue was when he told you 360 veneers. There is no such thing. Porcelain veneers only go on the front and hug the sides a little. If the restoration for your smile makeover went 360 degrees around your tooth, then it was porcelain crowns.

tooth prep for porcelain veneers A second hint of their unethical behavior was the nubs the created of your teeth. When your teeth are prepared for porcelain veneers, only a small amount of tooth structure is removed, as pictured to the left.

You described a small nub, which is what is used to prepare teeth for porcelain crowns. That is two times they have lied to you.

Often, when dentists steer patients toward porcelain crowns instead of porcelain veneers it is because they are not comfortable with the advanced cosmetic procedures. They tend to want to convince you of the procedure they are comfortable with instead of admitting the skills they lack. In this case, your dentist can’t even do the basic crown procedures. This is distressing because it is one of the first things dentists have to learn to do. You shouldn’t even be able to graduate dental school without having the ability to successfully place dental crowns. Most dentists go their whole careers without having a crown fall out. That has not been the case for your dentist.

So, what is my recommendation? You need to find another dentist. One with post-doctoral training in cosmetic dentistry as well as artistic skill. Look at the bio on their website. Then look at their smile gallery to see what type of results they create. They may even be able to help you get a refund on your badly done work. After all, a basic expectation is that the work will actually stay in!

This blog is brought to you by Dr. David Marion, who was honored by the International College of Dentists as being one of the top dentists in the world.

Porcelain Veneers While Pregnant

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I just found out I am pregnant. Before I knew that, I had complete porcelain veneers placed on my teeth. My aunt told me that you can’t have dental work while you are pregnant. Did I do something that will harm the baby?

Lydia

Dear Lydia,

porcelain veneers placement

First, congratulations on becoming a mother! What wonderful news. Now, I want you to take a deep breath. Your aunt is a tad confused. In dental school, we are taught to do our best to schedule dental work for pregnant women in the second trimester. That is because in the first trimester, things are a bit riskier and in the third trimester, women are usually too large to sit comfortably in the dental chair.

That being said, getting porcelain veneers will not have caused your baby any harm. The only medication used during this procedure is Lidocaine. This particular medication has been deemed safe for use on pregnant women. It is often even used during the delivery itself. Your baby will have no ill effects from you getting your smile makeover.

Best to you and the little one.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.