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Invisalign

Invisalign or porcelain veneers

I wanted to get Lumineers. I have a tooth which is a little crooked. Not enough for full orthodontic treatment. That’s why I was hoping to do Lumineers because I was told they could just go on top of my teeth. My dentist said I could do them, but would need Invisalign first for the crooked tooth. Are both really necessary? That’s more money than I was planning.

Katie

Dear Katie,

Invisalign aligner

Please bear in mind that I haven’t seen your case, but in general you would either do Invisalign or Lumineers, not both. There would be some exceptions in severe orthodontic cases. Based on what you’d mentioned, I don’t think that is your situation.

Let’s go over what you can do with each treatment and you will have an idea of which will most help you meet your smile goals.

Invisalign

These use clear aligners to straighten your teeth. No one will know you are wearing them, even at a conversational distance. That is why some people call them invisible braces.

They are more comfortable than traditional metal wire and bracket braces and usually work in half the time.

The aligners have the additional benefit of being able to double as teeth whitening trays. This allows you to straighten and whiten your teeth simultaneously.

If all you feel your teeth need are a straighter look and whiter color, this method will save you thousands of dollars.

Lumineers

The first thing you should know is that Lumineers are simply one brand of porcelain veneers. Most expert cosmetic dentists prefer other brands. This is mostly because this brand is owned by the DenMat company, which requires dentists to use their labs. This lab is not known for skilled results.

Porcelain veneers, when done by a skilled cosmetic dentist can completely remake your smile. They can change the shape of your teeth, the size of your teeth, and the color of your teeth all at the same time. It is the go-to for celebrities trying to get that perfect Hollywood smile.

While it won’t straighten your teeth, it can make your teeth look straight.

Even without the need to make your crooked tooth look straight, doing a smile makeover is an advanced procedure. Your particular case requires a little more expertise.

If you want to go that route. I’d go to aacd.com and search for an accredited cosmetic dentist in your area. Dentists who’ve reached accreditation are the top cosmetic dentists in the country.

This blog is brought to you by Lafayette Cosmetic Dentist Dr. Mike Malone.

Porcelain Veneers

covering tetracycline stains

I have pretty bad tetracycline stains, as did my sister. She had porcelain veneers put on them a number of years ago. While they look better than my teeth, they do not look natural. They told her they had to use an opaquer in order to get them to cover the stains. I was hoping in the last few years or so they’ve made some advancements so that if I had porcelain veneers done, they would look more natural. What are my chances?

Avery

Dear Avery,

A single porcelain veneer being placed on a tooth

When it comes to making natural-looking porcelain veneers, the need isn’t for better advancements; rather, it’s for better cosmetic dentists.

The technology has been around for years, but very few cosmetic dentists have the training and skill required to pull it off. To be fair, tetracycline stains are among the most challenging a dentist can face.

The porcelain veneers have to be opaque enough to cover the stains, yet translucent enough to reflect light and look normal. I would say only the top 1% of dentists in the country are capable of pulling this off.

Finding an Expert Cosmetic Dentist

If you want the best cosmetic dentist, and you will need that for tetracycline stains, you will want an AACD accredited dentist.

The American Academy of Cosmetic Dentistry realized, because cosmetic dentistry isn’t a recognized specialty, patients would have a hard time distinguishing who was actually skilled and who just dabbled.

To reach accreditation, dentist have to pass stringent oral and written exams as well as provide a large number of cases which demonstrate they have artistry in their work as well.

Those who reach this level are in the top 1-2% of dentists in the country. You can locate them at aacd.com. Just make sure you check you want an accredited dentist.

This blog is brought to you by Lafayette, LA Cosmetic Dentist Dr. Mike Malone.

Cosmetic Dentist

family dentist versus cosmetic dentist

I had composite bonding done on a chipped tooth. The dentist who did them retired. My new dentist said they couldn’t replace the bonding and suggested a dental crown. He said because it was a front tooth the only way to get it to match was to do two crowns. I trusted. him. Now I have two crowns on healthy teeth and, while the match each other, they’re grayer than the rest of my teeth and look fake. What do I do?

Cameron

Dear Cameron,

a before and after picture of dental bonding for a chipped tooth.

The biggest problem you have here is you’ve got a family dentist who doesn’t understand cosmetic dentistry. You needed composite bonding repaired. He didn’t know how to do that. Instead of telling you that, he says it can’t be done and you need crowns. Why crowns? Because those are what he’s familiar with.

A second issue is the fact that he said you needed two crowns in order to get them to match. A skilled cosmetic dentist can match a single crown to a front tooth.

In your place, I’d suggest you do one of two things. First, tell your dentist you need these crowns re-done. But, only allow him to do it on some conditions.

  • He’ll need to use a temporary try in paste so you can see the crowns in your mouth to make sure they’ll match and you are pleased with them.
  • If you’re not thrilled with them, he needs to be willing to re-do them until you are happy with them.

If he doesn’t agree to that, then my second suggestion is you ask for a refund. He told you the teeth would match and they don’t. He also lied to you about the possibility of just getting the dental bonding repaired. You have the right to a refund.

Once you secure that, it is time to find a good cosmetic dentist to do this properly.

Finding an Expert Cosmetic Dentist

I’m going to suggest you look for an AACD accredited dentist. You can look them up for your area at aacd.com. These are in the top 1% of cosmetic dentists in the country. There aren’t many of them, so it may be hard to find one depending on where you live.

If that’s the case, there is a second resource. Look on mynewsmile.com . They screen cosmetic dentists for both their technical knowledge and training, as well as their artistic ability. Any of their recommended dentists can provide you with two gorgeous crowns

You may want to consider whitening your teeth if you are going to get the crowns replaced, this will essentially give you a bit of a smile makeover.

This blog is brought to you by Lafayette Cosmetic Dentist Dr. Mike Malone.

CEREC

dentist pushing cerec crowns

I need a dental crown on a tooth in the front of my mouth. My dentist is really pushing for me to get a CEREC crown. I know he’s invested a lot in the machine and probably needs to recoup his money, but I want to make sure these crowns are just as good as the regular ones before getting it. It’s more of a big deal because I’m talking about a front tooth and don’t want to look stupid.

Kevin

Dear Kevin,

Block of porcelain for CEREC crowns
Cerec restorations are made of all-porcelain.

Trying something new can be exciting, but when it comes to your smile, you want to be certain the results will be something you won’t want to hide.

Advantage of CEREC Crowns

With traditional porcelain crowns, your dentist designs it and then send it off to a lab to be completed. This process takes about two weeks. In the meantime, you will be provided with a temporary crown. This is designed to protect the tooth.

They are designed to come off easily so some patients find it more challenging to eat with them on. They’re also a little less attractive than the final result will be because of their temporary nature.

With CEREC Crowns, you walk out of your appointment with your permanent crown in place. This is because it is milled right in the office.

That convenience is its biggest advantage. You don’t have to come back for a second appointment, which means there is no need to get additional time off work or find a babysitter for a second appointment.

Because they’re made of all porcelain, they are just as attractive as traditional crowns. There isn’t much of a cost difference either.

CEREC Crowns on Front Teeth

This issue of a front tooth is more an issue of the dentist than the type of crown. Matching a crown to a front tooth takes an expert cosmetic dentist, especially on a single front tooth.

In that case, I’d ask your dentist to show you images of results of crowns he’s done on front teeth. Ask specifically for an example of CEREC crowns as well. Because they’re milled out of a single block of porcelain, your dentist will really have to know his color theory.

If he doesn’t get beautiful results, you may be happier switching to a different dentist for this one procedure with a different dentist. You can still get a CEREC crown, but you’ll get it by a dentist with expertise in cosmetics. Ideally, you’d see a dentist who is accredited with the American Academy of Cosmetic Dentistry.

This blog is brought to you by Lafayette Dentist Dr. Mike Malone.

Lafayette LA Dentist

porcelain crowns turning yellow

I had some porcelain crowns done about six months ago. When I first received them, they were beautiful. I loved how they looked. Unfortunately, they are already turning yellow. I don’t think it is anything I’m doing. I do drink one cup of tea in the mornings, but water the remainder of the day and I brush regularly. Do you know what’s going on? I thought they were supposed to be stain resistant.

Elaine

Dear Elaine,

woman smiling with a dentist

Yes, porcelain is very stain resistant. That means, if you truly have porcelain crowns, something went wrong. I haven’t seen your crowns so it is hard for me to tell you exactly what happened. However, I can give you some possibilities.

If you see a general dentist who doesn’t do much cosmetic work, then it is possible the hygienist or the dentist did something to damage the glaze on your porcelain crowns. It’s been six months since the crowns were placed and that is about the time you would have gone in for a checkup and cleaning.

Some things which damage the porcelain include:

  • The hygienist using a power prophy jet during the cleaning process. This would feel fine at the end of your appointment, as well as look normal, but the glaze would be gone and you’d quickly begin to pick up stains regardless of how good your oral hygiene was.
  • Acidulated fluoride. Some dentists use this, but it will chemically eat away at your glaze.
  • If your dentist made any adjustments to the crown, he could have ground away some of the surfaces.

Get a Second Opinion from a Qualified Dentist

As I mentioned earlier, not all dentists are familiar with cosmetic work. Because of that, they may not even recognize what went wrong with your crowns.

I’m going to suggest you see an expert cosmetic dentist in order to get a knowledgeable second opinion. To find that level of expertise, I’d like you to go to the mynewsmile.com website. Any dentist they recommend, will have the knowledge you need to get to the bottom of what is going on with your crowns.

It’s important you follow some basic guidelines when getting a second opinion to make sure the dentist isn’t influenced in his or her decision. Dr. Hall has a post on porcelain crowns. In the last paragraph, he gives some tips on getting an unbiased second opinion.

This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone.

Invisalign

Fixing long teeth

My two front teeth are insanely long. They also stick out a bit from the rest of my teeth. I feel like a beaver and hate all of my pictures. I’m trying to find a cosmetic solution but can’t find one. Do you think the only solution is for me to have my front teeth removed and have dental implants placed? I’m desperate.

Lucy

Dear Lucy,

Invisalign aligner
Invisalign can straighten teeth without anyone knowing.

Please don’t remove your front teeth!! There are always solutions. I am going to make a suggestion, but want to preface it with the precaution that I haven’t examined you. This is a solution based on my understanding of your description.

Your front teeth can be trimmed by an expert cosmetic dentist using diamond burrs and diamond strips. They can be filed down on the sides to narrow them and on the biting surfaces to make them smaller.

Once they’re a size you’re pleased with, Invisalign can be used to align them properly. An added benefit of Invisalign is the aligners can double as teeth whitening trays. This lets you get a mini smile makeover.

Depending on how much structure has to be removed, you may need porcelain veneers to cover any exposed dentin.

You Need an Expert Cosmetic Dentist

None of my suggestions matter, though. You need to see an expert cosmetic dentist and let them tell you what is the best solution. They’ll give you a smile you’ll be proud to share.

The best cosmetic dentists in the country are accredited by the American Academy of Cosmetic Dentistry. These are the top cosmetic dentists in the country.

This blog is brought to you Lafayette, LA Cosmetic Dentist Dr. Mike Malone.

Lafayette LA Dentist

dental filling disaster

I had never had a cavity until I switched dentists. My insurance changed so we needed to go to a different practice. On my very first appointment, he said I had a cavity, which surprised me. I went ahead and had it filled. The filling caused continual pain even after he adjusted it. It got to the point where he said I’d adjust to it. I waited out the full year with my insurance than switched to one that allowed me to go back to my old dentist.

When I did, he said I likely didn’t even need the filling at all. He said there’d been a spot on my x-ray for years that hadn’t changed. He said he’d replace the filling to make it better. The pain was instantly better, but the filling was uneven I guess and food would get trapped in it.

He decided to adjust that because he said it would become an issue. Since he’s adjusted it I’ve had problems with a serious sensitivity to hot and cold. Now my dentist is talking about extracting the tooth. I don’t want that so I’m afraid to go back. Is there anything I can do?

Betty

Dear Betty,

A blonde woman hodling her left cheek and jaw in pain

It’s unusual for a dentist to fake diagnose a single filling. It’s not a financial gain for him or her. In all honesty, it is more of a hassle. So, I don’t think you were taken for a ride by the new dentist. I’m actually more concerned that your original dentist saw a spot on your x-ray for years and never even mentioned it.

The trouble I’m seeing here is you have two incompetent dentists working on your teeth. The dentist who did your filling couldn’t do it correctly and rather than repair it he said, “You’ll adjust”. That’s dental speak for, “I don’t know what to do.”

When a dental filling is done right, you don’t even notice it.

Then, when you went back to your original dentist, he couldn’t get the filling right either. Now he’s talking about extracting the tooth?! I don’t think so.

My guess is your insurance has a preferred provider list. They do that to keep the fees cheap. But, the better dentists won’t sign on to plans like that. So often (not always) preferred provider means less than adequate dentist.

I’m going to suggest you go to an out of network dentist who has good reviews. You need this fixed. Don’t let your dentist extract your tooth.

The last thing you need after all of this is another expensive procedure and, believe me, tooth replacements cost a pretty penny.

This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone

Porcelain Veneers

porcelain veneers during pregnancy

I’ve been saving up for a smile makeover. I just reached the amount I needed and I found out I was pregnant. Am I able to move forward wtih the porcelain veneers or do I need to wait until after the baby is born?

Melinda

Dear Melinda,

A single porcelain veneer being placed on a tooth

Congratulations on your new little one! While there are so many things you’ll have to protect your new child from, porcelain veneers won’t be one of them.

There are some cosmetic procedures which are not recommended during pregnancy, such as teeth whitening. This is because, especially during the first trimester, when the baby is most vulnerable you don’t want them ingesting any unsafe chemicals.

Fortunately, porcelain veneers do not have anything which could endanger your baby. The only chemical used would be lidocaine which has already been proven safe in pregnancy.

It is up to you at this point. Some women struggle with intense nausea during their first trimester. That may make having your mouth messed with a challenge. Because of that, you may want to wait and see how your body reacts to this new baby first. If you seem to be fine, you can move forward. If not, there is no harm in waiting.

Who Should Do Your Porcelain Veneers?

You don’t want just anyone doing your smile makeover, though. This is a once in a lifetime procedure and you’ll want it done right. Because there isn’t a recognized specialty in cosmetic dentistry, there is no real way to know if the dentist doing your procedure has had enough additional training to do the job well.

In your place, I’d look for a dentist who has attained accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the country.

They’ve passed stringent oral and written exams to prove their technical knowledge. Additionally, they had to provide visual evidence on a large number of cases they’ve done to show they are also artistic.

Any one of them can give you a stunning smile.

This blog is brought to you by Lafayette, LA Cosmetic Dentist Dr. Mike Malone.

Cosmetic Dentist

lumineers trouble

I had Lumineers placed on both my top and bottom teeth. The top ones did absolutely fine. It’s the bottom ones I am having trouble with. They’re in massive pain and I’ve already lost one tooth when a root canal didn’t help. My dentist is going to put on a bridge free of charge. He doesn’t know why there is so much pain. He’s trying to help but I’m living on pain killers right now. I don’t want this to be the rest of my life, especially knowing how addictive they are. Can you help? Have you heard of this happening before?

Margie

Dear Margie,

There are a couple of things going on here. First, Lumineers are often advertised to inexperienced cosmetic dentists as being easy to place. That gets many well-intentioned dentists in over their heads.

A lot of this is because the Lumineers’ company promotes them as being no prep. Sometimes that can work out well on top teeth, though not always. Many patients complain about them being bulky. The bottom teeth, however, are a completely different story.

Second, when you’re talking about a no-prep technique, the teeth are about two millimeters longer as well as sticking out a tad. On bottom teeth, this can throw your teeth out of their proper occlusion and cause lots of pain for you.

That is likely what is going on in your case.

Cosmetic Work on Bottom Teeth

When it comes to smile makeovers, unless there is something which needs to change structurally with your bottom teeth, we’ll put porcelain veneers on the top teeth, but only whiten the bottom arch. Though, there are times veneers make sense. In those cases, however, tooth prep is necessary.

It does sound like your dentist is trying to take responsibility and make things right for you. That’s a sign you have an ethical dentist who just happened to do a procedure he wasn’t ready for. Don’t be too hard on him. We all start somewhere with procedures that are new to us. It’s a good sign that he’s stretching himself and adding to his field of knowledge.

Make sure you are out of pain before the bridge is placed. If he’s having trouble with that, you can suggest he talks to an expert cosmetic dentist, who’s studied occlusion as well. I’d look for an AACD accredited dentist in that case. Feel free to show him this post.

This blog is brought to you by Lafayette, LA Cosmetic Dentist Dr. Mike Malone.

CEREC

dentist pushing a cerec crown

I need to a get a dental crown. I’ve always gotten the regular kind so I was expecting that again. Instead, my dentist wants me to get a CEREC crown by a machine. Before I commit, I want to make sure they’re okay. I’d rather have it made by a human, but if they’re okay I guess I’ll go ahead.

Paul

Dear Paul,

Block of porcelain for CEREC crowns

You are fine getting a CEREC crown, with one possible exception which we’ll talk about in a moment. Using the CEREC machine to mill the crown, you will get a great fit. It uses sophisticated software to make sure your crown is precisely cut.

Because they are all-porcelain, they will have the same translucency as your natural teeth. They will look beautiful if your dentist knows how to use the machine well.

Their biggest benefit, though, is you can get your dental crown in just one visit.

The one exception to this would be for front teeth. These are trickier. When your teeth are milled by a CEREC machine it uses a single block of porcelain.

Our natural teeth are not the same level of depth all the way down. Some parts are more opaque than others. Because of this you need a dentist with expertise in color theory and staining in order to mimic the different levels of color needed for front teeth.

Finding a Dentist to Do CEREC Crowns on Front Teeth

Only about 1-2% of dentists will know how to do this correctly. If your crown is needed on another tooth, you should be fine, but with a front tooth, I’d look for an AACD accredited dentist.

Dentists who’ve been accredited with the American Academy of Cosmetic Dentistry have done extensive training. In order to reach accreditation they have to pass oral and written exams as well as demonstrate their artistry .

Any dentist who has reached accreditation can give you a gorgeous crown, even on a front tooth.

This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone.