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Invisalign

porcelain veneers & invisalign?

I’m hoping you can help me make a decision. I want to whiten my teeth and I have two crooked front teeth. I was thinking I could fix both getting porcelain veneers. I spoke to my dentist about it and he said that would be fine, but he’d like me to straighten the front teeth first. I was hoping not to have to do orthodontics because they’re so unattractive and take forever. Is it really necessary?

Kathryn

Dear Kathryn,

Invisalign aligner
You can now straighten your teeth invisibly

First, please understand that I haven’t seen your teeth and can only go by your description. Unless there is something your dentist hasn’t explained to you, I’m puzzled why you would need both as well.

Generally, a patient will either do porcelain veneers or orthodontics, not both. There could be an exception if you have either a serious bite problem or overly crowded teeth. In those unusual cases, it would be helpful to have orthodontics first. Other than that, you can just have porcelain veneers placed and it will make your front teeth appear to be straight.

If you are in that position, then I have some helpful news for you. You can completely straighten your teeth without anyone knowing. Invisalign uses clear aligners. You can see an image of one of the aligners above. When you are wearing them, they are completely invisible, even at a conversational distance.

The best part is they have the benefit of being able to whiten your teeth simultaneously. The aligners used to straighten your teeth can also double as teeth whitening trays.

Invisalign or Porcelain Veneers

If you have the choice and all you want to do is whiten and straighten your teeth, you would save a lot of money using Invisalign. However, if there are other things about your smile you want to change, such as the shape or length, then porcelain veneers are the way to go.

These are the go-to for a complete smile makeover. One word of caution. They require technical expertise as well as an artistic eye. Not every dentist can do a smile makeover with porcelain veneers. There are countless cosmetic dentistry horror stories to back this up.

If you decide to go that route, you will want a dentist who has been accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the country.

If you go the Invisalign/teeth whitening route, just about any family dentist can do it.

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

Porcelain Veneers

problems with my porcelain veneers

I need some advice about my porcelain veneers. Things haven’t gone well for me with this. My dentist did ceramic veneers. The first time they came in they were way too white for the adjacent visible teeth (and even for my personal taste). II told him I wanted them to match the other teeth (which we determined was an A2) asked him to redo them and he did. When they came back the second time he bonded them on without me getting to look at them. When I did see them, they were again too white. I’m assuming I’m stuck with that color now and am hoping to get the teeth next to them to match so I don’t feel foolish. My other problem is one of them broke in half horizontally. My dentist is replacing it and said he would do so for 3 years. Should I be worried they won’t last longer than that? I did pay a pretty penny. Would I have been better off getting porcelain veneers? Are they stronger?

Mandy

Dear Mandy,

A single porcelain veneer being placed on a tooth

Let’s start with the longevity and breaking of your porcelain veneers. These are tiny wafers, whether made of porcelain or ceramic. You could easily crush them in your fingers. Their strength comes from the bonding procedure, which your dentist obviously hasn’t mastered.

If you’d approved of the porcelain veneers before he bonded them, then yes, you’d be stuck with that color. The easiest solution to get the adjacent teeth to match is teeth whitening. Fortunately, only your natural tooth structure will whiten. It will have no real effect on your porcelain veneers.

That being said, I don’t think you have to accept the color you’ve been given. He bonded them on without your permission. Informed consent is the cornerstone of any practice–medical or dental. Without that, he committed malpractice. You have the right to a refund.

Getting Your Porcelain Veneers Done Right

When you have this case redone, I want you to have an expert cosmetic dentist do it. This way you will get a smile you’re not just satisfied with but proud of.

A true cosmetic dentist would never place a smile unless you are thrilled with it. Most of them have a beautiful smile guarantee.

Look on the website of the American Academy of Cosmetic Dentistry (aacd.com). They have a link to find a cosmetic dentist. When you do the search, make sure you place a check mark on accredited. You want an accredited cosmetic dentist. These are the ones who can give you the right smile.

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

Cosmetic Dentist

dentist ruined this man’s bite

I’m worried I made a horrible mistake having a gap closed. I had a large gap between my two front teeth. To fix it, my dentist did six dental crowns. Ever since then, I’ve been in a lot of pain, I can’t speak properly, and my mouth is dry all the time. Can I put the gap back? Would that fix this?

Peter

Dear Peter,

CEREC Crown being placed on a tooth
Sometimes a dentist gets in over their head

Your problem isn’t because the gap was closed. These large gaps can be fixed without any negative repercussions. Instead, I think your porcelain crowns were not done properly. This case was probably too challenging for your dentist. As a result, he has inadvertently damaged your bite.

This is rather serious and needs to be addressed right away. My suspicion is your dentist made your dental crowns too thick, which opened your bite too much. This led to the pain you are experiencing as well as lip incompetence.

When your crowns are too thick, it leads to your mouth staying agape. That will cause the dry mouth you are struggling with. It is absolutely imperative your mouth closes naturally. Without that, you won’t have enough saliva in your mouth. Saliva is a key component in fighting decay because of its bacteria fighting minerals.

Pain is also a result of a bite being opened too far. This can lead to problems with TMJ Disorder. Though, pain is enough of a reason to have this fixed.

Your dentist appears to have been in over his head fixing this gap. I want you to see an AACD accredited cosmetic dentist. They’ll have the expertise you need to fix this. They can also help you secure a refund from your dentist.

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

Porcelain Veneers

Porcelain veneers with an overbite

I want to get a smile makeover. I asked my dentist about porcelain veneers and he said because my top teeth cover my bottom teeth I’m not a good candidate. Instead, he suggested I have crowns placed on my six front teeth. My teeth have some dark stains because of tetracycline too. Does this mean after the crowns are done, I’d whiten the bottom teeth to match?

Lisa

Dear Lisa,

A single porcelain veneer being placed on a tooth

I want to caution you not to do dental crowns for your smile makeover. I think I know what is going on here. It sounds like your dentist isn’t as comfortable with designing and placing porcelain veneers than he is with dental crowns.

He doesn’t want to tell you this and cause you to think less of him as a practitioner, so instead he suggests the procedure he feels he does better.

Blaming your bite is creative but not valid. Even thinking about it logically, porcelain veneers would be a better fit for your bite. Porcelain crowns surround your entire tooth, but porcelain veneers only are bonded to the front. They would actually be less intrusive.

On top of all of that, with dental crowns, your teeth have to be ground down to nubs. Because of that, you can never have anything but crowns on those teeth for the remainder of your life.

There is another hint to me that your dentist isn’t an advanced cosmetic dentist. He’s suggesting six teeth be treated. Unless you have a narrow smile, that won’t be enough. Most people show between eight to twelve teeth when they smile.

Finding an Advanced Cosmetic Dentist

Your particular case is particularly challenging and requires a top-notch cosmetic dentist. Tetracycline stains are quite tricky to get right. You need the teeth to have the look of natural translucency, but at the same time still be opaque enough to cover the deep stains.

Only the top 2% of dentists can do this well. In your place, I’d look for a dentist who has been accredited by the American Academy of Cosmetic Dentistry. They have both the technical skill and artistry to give you a stunning smile, even with tetracycline stains.

Regarding the teeth whitening you mentioned. Yes, you would whiten the remaining teeth which don’t get veneered. However, you want to do the teeth whitening first. When you get them to the level of whitening you want, it will be time to get your porcelain veneers. The KöR  Teeth Whitening System has been the most effective in whitening tetracycline stains.

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

CEREC

CEREC or Regular Veneers

I told my dentist I wanted to get a smile makeover. He’s suggesting we do CEREC veneers. Are those as good as the porcelain veneers? I want to make sure I get the right material. Which would you recommend?

Olivia

Dear Olivia,

Block of porcelain for CEREC crowns

It is great that you’re trying to do research ahead of time. I wish more patients did that. I’m going to shift what you are researching though. The materials used do not matter nearly as much as the dentist who is working with the materials. Think of it this way. If two artists were given a block of the same type of marble and told to make a statue of the same person, would the statues turn out exactly the same? Of course not! One artist will definitely be superior to the other. Whether your dentist is creating CEREC veneers or traditional porcelain veneers, what matters most is his skill.

What I’d like you to look at is whether or not your dentist has the technical skill and artistry to pull this off. Doing a smile makeover using the CEREC veneers can be done, but only by top of the line cosmetic dentists. The reason for this is a CEREC machine mills your veneers or porcelain crowns out of a single block of porcelain. However, our teeth don’t have uniform levels of translucency.

In order for a cosmetic dentist to get these to look both beautiful and natural, he or she will need to know a lot of color theory and understand how the different stains available can manipulate the level of translucency and opaqueness in a tooth. Without that, you could end up with teeth that look fake and flat.

Is Your Dentist Good Enough to Do CEREC Veneers?

Before moving forward, I want you to ask your dentist for two things:

1. Ask him to see before and after pictures of recent CEREC veneers cases he’s personally done. If he doesn’t have any, find another dentist. If he does have some and you love the results, you will likely be okay to go ahead as long as he agrees to the second point. If you don’t love the results, find another dentist.

2. Make sure he’s willing to stand behind his work with a form of a beautiful smile guarantee. This should mean that he’ll put the veneers on with a try-in paste when he’s done and let you look at them in several different lightings. If you are not over the moon thrilled with them, he’ll re-do them. No veneers should be permanently bonded until you are ecstatic.

If these two things can’t be met. You need to find a better cosmetic dentist.

Finding an Expert Cosmetic Dentist

If I were getting a smile makeover, I”d want one of the best of the best cosmetic dentists. The easiest way to find those is to go to aacd.com. They have a “Find a dentist” link. You want to look for a cosmetic dentist in your area who has reached accreditation. They have a box you can check for accredited.

AACD accredited dentists have passed stringent oral and written exams as well as demonstrated their artistry on a large number of cases. Any one of them can give you a stunning smile.

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

Invisalign

pain with Invisalign

I know that braces cause pain because all my friends complained about it when I was growing up. I’m old enough to know I don’t want a mouth full of metal while I straighten my teeth. It would just seem unprofessional. However, I want to know what I’m signing up for. Does Invisalign have pain the way traditional braces do?

Laurie

Dear Laurie,

Invisalign aligner

It’s always wise to go into any treatment with a good idea of the pros and cons. The pros of Invisalign are obvious.

  • They work in half the time as traditional braces
  • You can eat and drink whatever you want
  • You can brush and floss much more easily
  • You can straighten your teeth without anyone knowing
  • You don’t have to worry about cuts and abrasions from metal wires and brackets.

There is one point in which Invisalign aligners can ache a bit. You switch aligners every two weeks. For the day or two when you first put in your new set of aligners, they will feel snug and ache a bit.

This is because the aligners are sculpted to the next alignment your teeth should be in by the time the two-week time period is up. After those first few days, your teeth will be in that new position and the aligners will feel loose.

Usually, just some over-the-counter pain reliever is enough to keep the pain at bay.

An Unexpected Benefit with Invisalign

One extra treat you can get out of Invisalign is inexpensive teeth whitening. The aligners can double as teeth whitening trays. So, all you will need to purchase from your dentist is the whitening gel that you can place in your aligners for a period of time each day.

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

Lafayette LA Dentist

Pimple turning tooth gray

I think I need help fast, but I don’t have a dentist. I have a pimple on my gums which is causing serious pain. I think it’s poisoning a tooth tooth because one of my teeth has turned gray. What do I do if I don’t have a dentist?

Brooke

Dear Brooke,

Woman grabbing her jaw in pain needing an emergency dentist
Tooth pain is a dental emergency

I’m very sorry you are in so much pain. You’ve got two things going on here. One of which is considered a dental emergency.

Pimple on the Gums

Let’s start with the pimple on your gums. This is a sign you have an infected tooth. The pimple is known as an abscess. This happens because the infection is severe. Infected teeth are considered dental emergencies.

These infections will continue to spread. In some cases, they become life threatening quickly. This is a result of where they spread and how long they’re left untreated. Your jaw is very close to your brain and heart. If the infection reaches there, sometimes it is too late to do anything. There were too many people who died from tooth infections last year, given how preventable it is.

I do realize you don’t have a dentist. Because this needs to be seen to right away, I’m going to suggest you do an internet search for an emergency dentist. These are general dentists who are willing to see non-established patients quickly in cases of emergencies such as yours.

Often, they’ll do what they can to get you out of pain, prescribe an antibiotic for hold off the infection and schedule a follow-up appointment to give the tooth the entire treatment it needs.

A Gray Tooth

When a tooth has turned gray, that is a sign it is either dead of dying. This tooth was also infected, which is a definite indicator the infection is spreading.

The dead tooth won’t have any pain, but the infection is still there and will need to be removed by the dentist. Unlike medical infections, you can’t just take an antibiotic and be done. Antibiotics will only keep a dental infection at bay, it won’t rid your body of it.

With dental infections, the dentist has to get in there and physically remove the infection with a procedure called a root canal treatment. This often requires the tooth to be crowned as well.

Don’t put off getting this seen.

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

Porcelain Veneers

tri-colored porcelain veneers

I’ve got a smile makeover disaster. I have three different colored teeth right now. First, my ugly natural yellow teeth, then I had four porcelain veneers placed. Three of them look okay, but one of them is an uneven gray color. I paid a lot of money hoping to get a beautiful smile, but now I feel ridiculous with three different colors of teeth. I don’t even smile. My dentist said she’d make the gray one thicker to even out the colors, but I’m not sure how that will look and I’m losing confidence in her. What do you recommend?

Laurie

Dear Laurie,

A single porcelain veneer being placed on a tooth

Yikes! I can understand why you are unhappy. It sounds like you went to your family dentist who was in over her head. First, don’t let her make the graying veneer thicker. In fact, I think you need to ask for a refund and start over.

If I’m right about the graying veneer you have a good case for one. Because it is a splotchy gray, I think there isn’t a good bond between the porcelain veneer and the tooth. This is bad for your teeth. It allows things to get between the two, leaving you vulnerable for decay.

When you have this re-done, the first thing the dentist will have you do is whiten your teeth. This will keep your adjacent teeth from being an obviously different color. This is why your natural teeth look so obviously different from your four porcelain veneers.

Finding the Right Cosmetic Dentist to do Your Porcelain Veneers

It is imperative you have an excellent cosmetic dentist to re-do your porcelain veneers. Unfortunately, doing beautiful smile makeovers aren’t taught in dental school. Dentists have to invest time in getting the training they need.

Even with training, as with every art, some dentists have a more artistic eye than others. If you want the best cosmetic dentist, I’d go to aacd.com and look up an accredited cosmetic dentist in your area.

AACD accredited cosmetic dentists are the top cosmetic dentists in the country. They’ve passed stringent oral and written exams. Additionally, they have to provide visual evidence of a large number of cases they’ve done in order to show they are both technically skilled and artistic.

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

Cosmetic Dentist

3 traits of a great cosmetic dentist

I plan on getting a smile makeover. I keep hearing the dentist is the key, but how in the world do you know if you’ve got the right key?

Amanda

Dear Amanda,

Brunette woman with beautiful smile
Beautiful smiles require great dentists !

You’ve asked a great question and doing so will save you a great deal of agony. There have been countless cosmetic dentistry horror stories of patients from another practice who came to us in tears needing their “smile makeover” fixed.

The problem most patients run up against is there is not a recognized specialty in cosmetic dentistry. That means any general dentist can call themselves a cosmetic dentist if they dabble in one or two cosmetic procedures.

Unfortunately, to get great results in cosmetic dentistry, it takes a lot more than dabbling. Here are three important things to look for in a cosmetic dentist.

Trait One: Empathy

This one is hard to quantify, but you can quickly tell if a dentist has it or doesn’t. Dr. Hall calls this trait, “The root of a good cosmetic dentist.” They know you want a beautiful smile and they will make sure you get one you can be proud to share.

In general dental school, dentists are taught they know better than the patient. Cosmetic dentistry is different. It’s the way the patient sees their smile that matters. They’d never let a patient leave unhappy and will make any changes necessary to make sure it is the smile of your dreams.

Trait Two: Training

How to do stunning smile makeovers isn’t taught in dental school. It requires a dentist’s willingness to invest in extensive post-doctoral training. They’d invest time and money in continuing education at reputable institutions.

Trait Three: Artistry

Smile makeovers are a type of art form. As with any art, some artists are better than others. The evidence isn’t necessarily in the art school they went to but the results of their work. Never hesitate to look at a cosmetic dentists smile gallery to see what type of results they get.

Especially look for specific examples of the procedure you’re getting. if you want porcelain veneers, ask to see those pictures. If you have tetracycline stains, see what type of success they’ve had covering those.

Where to Locate Dentists with these Traits

The American Academy of Cosmetic Dentistry realized the predicament patients were in locating a great cosmetic dentist. Because of that, they began an accreditation program so dentists with the right skills could have a way of letting patients know.

They have to pass stringent oral and written exams as well as provide visual evidence and a large and varied number of cases demonstrating their artistry.

If you’re really looking for the best, go to aacd.com and do a search for an accredited cosmetic dentist.

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

CEREC

Dental crown looks fake

I’ve had dental crowns before but they’ve always been on back teeth. This is my first one on a front tooth. My dentist did a CEREC crown which was very convenient. I liked that, but for some reason it looks really fake compared to the tooth next to it. It almsot has a painted, dull appearance. Is this typical of crowns? Is there a way to get them to look natural?

Dana

Dear Dana,

CEREC Crown being placed on a tooth
Whether or Not a Crown Looks Natural Depends on Two Things

A crown on a front tooth can look natural and blend in naturally. Whether or not that happens depends on two things:

  • The cosmetic skill of the dentist
  • The materials used

Getting a Beautiful Dental CEREC Crown

CEREC crowns are made of all-porcelain, which is great. Porcelain mimics the appearance of natural teeth by reflecting light. When you get traditional porcelain veneers, they are milled from several different blocks of porcelain.

Our natural teeth aren’t the same all the way down. If you look closely at your front teeth the bottom parts of your upper front teeth are more translucent than the middle parts of your teeth.

Even though it still requires an expert cosmetic dentist to place a dental crown on your front teeth, traditional all porcelain crowns are a little easier simply because they’re milled from several block of porcelain making it easier to get the different levels of opacity versus translucency.

With CEREC crowns, this is more challenging. They are milled from a single block of porcelain. That makes it harder to show the subtle differences in color. Dentists have to be very familiar with color theory and stains to get a front CEREC crown to look natural.

Without that, you end up with a flat looking front tooth as you’re experiencing.

Which Dentists Can Place a Crown on a Front Tooth?

Front teeth are more exposed, making it imperative the dentist has the right skills to match and blend the crown with the adjacent teeth exactly. In your place, I’d only use an AACD accredited cosmetic dentist. Dentists who’ve reached accreditation are the top cosmetic dentists in the world. You can go to aacd.com to find one in a reasonable distance to you.

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