Category Archives: Porcelain Veneers

Invisalign, Porcelain Veneers

Choosing between Invisalign invisible braces or porcelain veneers

I have always wished to have a really beautiful smile, and have finally reached the point where I can afford to do it. I have one tooth that is crooked, but other than that no big problems with my teeth. I want them to be much brighter and whiter, so I’ve been considering getting 10 porcelain veneers on my top teeth. Whenever I look at the pictures on dentist’s websites, I really like the smiles of the patients who got porcelain veneers.

My dentist doesn’t seem all that excited about this, though, which is weird to me because it is a LOT of money I am ready to spend on this. He has suggested that I consider Invisalign invisible braces instead. I can only see one crooked tooth, so that seems like overkill, to get braces for one crooked tooth. He says he will do the veneers, but that I should have the Invisalign treatment first. That will add up to a year to my treatment time, not to mention the extra cost.

Is this usual, to have orthodontic work before getting veneers placed?

Thanks for your input,

Shelly in Grosse Pointe Woods

Dear Shelly,

This is only speculation, but it could be that you have a bite issue or serious crowding issue, and that is prompting you dentist to push for the braces first. If that is the case, he should have told you why he was making that recommendation. It is customary for a dentist to recommend either Invisalign or porcelain veneers, not both. It is also possible that he thinks the use of the Invisalign braces and a professional teeth whitening will yield the results you want without placing porcelain veneers. Again, if this is what he was thinking, he should have communicated it with you.

In this case, I would recommend a second opinion. Don’t tell the dentist what your current dentist said, and see if he recommends a similar course of treatment.

If you do decided to go with porcelain veneers, make very sure your dentist is an expert cosmetic dentist before you have him do the work. Check his work though his website, or ask to see before and after pictures of his porcelain veneer clients.

Porcelain Veneers

Porcelain crowns for a smile makeover?

This may seem like it is coming after the fact, but I am curious about something. I recently had a smile makeover done. I thought I was going to have all porcelain veneers placed, but when I look at the backs of my teeth, it looks like the porcelain goes all the way around. Is it normal to place porcelain crowns instead of porcelain veneers for purely cosmetic reasons? I thought crowns were just for teeth that were damaged. I guess the reason this concerns me is that maybe my teeth were in worse shape than I though, if they needed crowns.

I’ve since seen my general dentist, and she seemed very impressed with the work, so I am not concerned about the quality of the workmanship. Is this standard, to have crowns instead of veneers for a cosmetic smile makeover?

Thanks for your insight,

Ben in Oregon

Dear Ben,

Porcelain crowns and veneers differ only in degree–there really is no specific line of demarcation where a veneer becomes a crown. The fee for a porcelain veneer is usually the same or nearly the same as that for a porcelain crown, because the effort to place each type of restoration is about the same.

It is actually quite common to see porcelain crowns used on the front teeth for cosmetic reasons rather than protective ones. If your teeth were not weakened or damaged, your dentist might have decided to go with crowns to control your bite.

It is surprising that the dentist did not discuss this in detail with you during the course of your treatment. Typically, smile makeovers involve a great deal of give and take between the dentist and the patient, because the dentist will want to make absolutely sure he or she knows exactly what the patient wants.

The simplest solution is simply to ask your cosmetic dentist why he decided to go with porcelain crowns rather than veneers. Crowns are the more aggressive form of treatment, and require more reduction of the natural tooth structure. Veneers require only a little bit of shaving on the front of the tooth. For that reason alone, I would expect your dentist to have a sound reasoning for choosing the crowns. Most dentists will always pursue the least aggressive form of treatment and strive to preserve as much of the natural tooth structure as possible.

Porcelain Veneers

Teeth very sensitive after removal of braces

I had braces for two years, and have just recently had them removed. Ever since they were taken off, I have noticed that my teeth are incredibly sensitive to temperature. If I try to eat or drink anything hot or cold, it is really painful. I can also feel rough patches and dips on the front of my teeth, almost as if the enamel is gone. Could my orthodontist have damaged my teeth when she removed the brackets? I am also noticing that my teeth seem to be getting darker every day. I don’t drink coffee or cola very often, but my teeth seem to soak up every stain like never before.

What should I do? I did not go through two years of ortho to have ugly teeth!

Thanks for your time,

Savannah from Council Bluffs

Dear Savannah,

I don’t think your orthodontist caused this damage, though it is not unheard of that damage can happen during bracket removal. The patches you describe sound like areas of decalcification. These are areas where your teeth have lost some minerals, and those areas are porous, which is causing the staining you are seeing. Those spots may eventually turn brown, and even chip away, leaving pitted holes in your teeth. I am sure this is NOT what you envisioned as you went through orthodontic treatment, and that missing enamel is what is making your teeth so sensitive.

Teenagers are not always as diligent as they should be about brushing their teeth after eating, and when a teen has braces, the problem is magnified. The brackets allow food to sit against your tooth, and underneath the brackets, the acid in your saliva that helps digest food is busy working away at the surface of the tooth. The extent of the problem becomes really evident when the braces come off.

It is important to address the issue before it gets any worse. Bleaching will not help the stains. It will probably make them look worse, so I would not recommend going that route. If the damage is just to a few small spots, a treatment choice might be dental bonding. Freehand dental bonding is one of the most challenging cosmetic dentistry techniques from an artistic standpoint, and if it is not done well, you will not be happy. Make sure you chose a cosmetic dentist who is trained and experienced. Direct dental bonding requires a very high degree of artistry and technical skill that very few dentists possess.

If the damage is extensive and/or severe, you may be looking at porcelain veneers. That is a daunting prospect after two years of orthodontic work, but it is better to be prepared.

If you have friends that still have braces, you can be their cautionary tale. People with braces simply MUST brush after every single time they eat. At the very least, they must rinse thoroughly with water if brushing is impossible. It is very frustrating to go through all those years of ortho work, only to continue struggling with dental issues when you are done.

Porcelain Veneers

How to fix fluorosis stains?

We are having a lot of problems with my 10 year old daughter’s teeth. The permanent teeth that have come in are extremely yellow, and very blotchy. Our dentist says the blotchiness was caused by too much fluoride. I thought fluoride was good for teeth! She has braces right now, so we have a little time to figure out how we should fix the discoloration and blotchiness. We are trying to address these issues now, because she is very self-conscious about her teeth, and we want to start making positive changes before she hits puberty.

Thanks for your help,
Rochelle in Baton Rouge

Dear Rochelle,

The blotchiness is caused by fluorosis, and it is indeed a symptom of too much fluoride while your daughter’s teeth were forming. Most communities have to add fluoride to their water, but some naturally have too much fluoride, and if it is not detected and removed, extended use can cause fluorosis. This can also happens when people drink untreated well water that is naturally high in fluoride. Fluorosis can even be caused by years of swallowing too much fluoridated toothpaste.

Whatever the root cause, if your daughter’s fluorosis stains are severe, you will probably have to treat them with porcelain veneers. In mild cases of fluorosis, the spots can sometimes be treated with bonding to cover only the affected spots. Severe staining will require more extensive coverage, and that indicates that porcelain veneers would be the treatment of choice.

The good news is that there is no minimum age for porcelain veneers, so you could conceivably get something in place when her braces come off. If you do choose to pursue veneers when she is in her early teens, make very sure you choose a highly skilled cosmetic dentist who has experience doing veneers for teenagers.

Invisalign, Porcelain Veneers

What is faster than braces?

I am getting married a year from now, and searching for “The Dress” was an eye-opening experience, and not in a good way. After a while, all I could see in the mirror was my crooked, crowded teeth! I really want to look and feel my best for my wedding day. I had a consultation with an orthodontist, and she told me that straightening my teeth with braces will take at least two years. I don’t have that kind of time! Is there a faster way to have a really beautiful smile for my wedding day?
–Kimberly in Bangor, ME

Dear Kimberly,

If you have crowded, crooked teeth, there are a couple of different ways you CAN have a beautiful smile in just a few months, but only if you consult the right professional. You need to talk to an expert cosmetic dentist, not an orthodontist. An expert cosmetic dentist (especially one accredited by the American Academy of Cosmetic Dentistry) will be able to offer you options that a traditionally trained orthodontist is not qualified to provide.

Invisalign braces can straighten your teeth in six to nine months, depending on the degree of crowding. Extremely crowded teeth might take a little longer, but treatment with Invisalign braces rarely takes more than a year. An added bonus to using Invisalign is that even if your treatment is not completely finished by the day of your wedding, the aligner can simply be removed for the big day and pictures. If your teeth are otherwise intact and attractive, Invisalign might be the way to go.

An even faster option is to go with porcelain veneers, but here especially you must be very careful about choosing the right dentist. Many dentists have the technical skill to place the veneers, but they lack the artistic sense to make your smile truly beautiful and natural. If your teeth are discolored or misshapen, porcelain veneers can give you a really gorgeous wedding day smile quite quickly.

The bottom line is that you really should have the advice of an expert cosmetic dentist that has experience with both treatment types before you make any decisions. Choose your dentist very carefully, and then you know you can count on their advice to be sound.

Good luck, and congratulations on your wedding.

Porcelain Veneers

Dentist wants to replace porcelain veneers with crowns

When my daughter was 8 the dentist I used said she had a calcium deficiency because her front teeth were discolored. He put porcelain veneers on the front ones. She is 11 now and the veneers are discol ored and decaying. We started using another dentist and he said that we needed to put crowns on the front teeth and she also needs braces. I am concerened of how will they put braces on caps and why cant the veneers be replaced?

Thank You,
Suzanne in Alabama

Suzanne,
I’m not sure how many front teeth you’re talking about, and can’t tell whether your daughter needs crowns or not without an examination. But I can give you two possible reasons that the dentist wants to replace the porcelain veneers with crowns.

First would be that the dentist isn’t comfortable doing porcelain veneers. Many dentists aren’t. It isn’t taught in dental school, and many dentists just aren’t very excited about appearance-related dentistry because it is a very different field and they have to be artistic to enjoy that.

Or it could be that there is so much decay that now the teeth need porcelain crowns. Veneers only cover the fronts of the teeth. I would be surprised if your daughter at age 11 has that much tooth decay on these front teeth that she needs crowns, but maybe she does.

We really try to avoid doing porcelain crowns on young patients because when the teeth are young, they have very large pulp chambers, and the chances of irritating or injuring the tooth so that it needs a root canal treatment are large. And anytime we can do less grinding on the teeth to achieve the same result, the better it is.

As far as the braces go, the crowns wouldn’t be a problem. The orthodontist can work around that.

I think it would be prudent to seek a second opinion to see if she really needs crowns. Find a dentist who does a lot of porcelain veneers and see what he or she says.

Porcelain Veneers

I need a small repair to my porcelain veneer

I have porcelain veneers on the front six teeth. A small piece of my front tooth recently cracked and the dentist was able to put some bonding to match. However, after two months, the color is already that dark pasty color and it doesn’t match anymore. Is this normal? I’d rather not replace a whole veneer for a small repair. Should I bond a lighter color so when the color “comes down” a little, it matches the veneer?
– Jim in Michigan

Jim,
There are many different types of composite bonding material for your teeth. Most dentists stock a basic, “all-purpose” composite that really isn’t well suited to doing cosmetic dental bonding on front teeth. While I don’t know for sure without seeing your tooth, it sounds like this is what has happened. These all-purpose materials can tend to stain easily. Other composite bonding materials aren’t very color-stable.

There are bonding materials for your front teeth that take a high polish, are very color-stable, and don’t stain very easily, and that is what you need. I would suggest finding a dentist who is more expert in cosmetic dentistry. A dentist who is accredited by the American Academy of Cosmetic Dentistry should find your porcelain veneer repair to be fairly routine.

These cosmetic dentistry procedures often require more expertise or more specialized materials than most dentists possess. So go to the expert for this, and then go back to your family dentist for your routine maintenance, if you’re pleased with your dentist.

Porcelain Veneers

How to fix my large gap

I have a not-so-small gap between my front teeth. One of my front teeth is also an older crown. I have been told by two dentists that my gap can be corrected without braces. I was also told by a third dentist that without getting braces that I will have gigantic front teeth. I want to ask if veneers or porcelain crowns would be an option. I really want the gap closed. Please give me your advice.
– Suzy from North Carolina

Suzy,
You need to be careful here. Over 90% of dentists become dentists because they like to fix things, and they don’t have strong artistic inclinations. Often, what looks good to them doesn’t look good to your average patient. I once saw a discussion on a dentistry blog where a number of dentists were talking about putting an extra front tooth between a beautiful woman’s two other front teeth in order to fill the gap.

I could tell better if I actually were to examine your teeth, but it sounds like this gap is a little too large to just be fixed simply. So it’s going to be really important that you see a dentist with a strong artistic side. Your best guarantee of finding someone like that is to find someone who is accredited by the American Academy of Cosmetic Dentistry. You’re in North Carolina, and there are several excellent accredited cosmetic dentists there.

For a small gap, when one of your front teeth has a crown, you could get a new all-porcelain crown on that tooth and then a conservative porcelain veneer on the other. If the gap is large, you may need to put porcelain veneers on two more teeth, so that you could make the two lateral incisors a little larger and then make the two central incisors a more normal size and thus close the gap. But you need a true cosmetic dentist with real artistic inclinations to do something like that and have the result look good.

Another option would be to close the gap with Invisalign invisible braces.

Other links:
You may want to visit our Lafayette, Louisiana Dentist website.
How to fix crooked teeth without braces.
Lafayette Louisiana Invisalign

Porcelain Veneers

My porcelain veneers still aren’t right.

I would really appreciate your opinion and advice with regards to the situation I currently find myself in.

I am 23 years old and decided to have porcelain veneers placed last year to improve my smile. My front teeth were aligned well but I wanted to improve the shape and surface, whilst making them whiter.

The veneers were placed and were problematic right away. My bite felt very off and I thought it might settle down in time but it didn’t. The veneers were too large and did not resemble the size of the temporary ones I had worn and approved. I went back to the dentist that placed them and eventually he agreed they were too big for my mouth and to redo them for me without charge.

The veneers have now been redone, the bite is excellent, the size and shape exactly matches the temporories. However I am devastated because these ones are yellow! They are darker than my lower teeth and have a real yellowness to them which I hate. Making the veneers darker was not discussed, I expected them to be quite white like the original set and I was shocked to realise how off the colour is.

I am so worried about this as I now feel very self conscious and I don’t know where I stand with regards to them being corrected, if at all. As my teeth have been done twice already, I am concerned that I need to keep these or risk damaging my teeth even further by attempting to have it corrected.

A different dentist has told me that it would be foolish to consider further treatment, as to treat the teeth for a third time at my age would seriously risk damaging the nerves permanently and I could lose my teeth! Is this likely to be the case?

Just to add that I was told my teeth were prepared conservatively and I did my research beforehand and thought I had chosen a good cosmetic dentist.

I would be very grateful if you could give me any advice on this situation as I am so worried.

Thank you,
Millie in England

Millie,
It’s hard for me to evaluate whether or not your dentist is a good cosmetic dentist, but I will say that it doesn’t sound like it. I could be wrong.

Cosmetic dentistry is a very different field. It requires an artistic sensitivity and ability that the vast majority of dentists don’t have and don’t even appreciate.

If your dentist was willing to re-do the original veneers to meet your satisfaction, that shows honesty and good will. But that doesn’t mean that he’s an artist.

You’re in England. There are some dentists there with credentials from the American Academy of Cosmetic Dentistry. That’s what I’d recommend for you. I believe there is one dentist in England who is accredited with the American Academy of Cosmetic Dentistry. That’s your best bet. Accredited cosmetic dentists have to pass stringent evaluations of their work. Go to www.aacd.com and look for an accredited cosmetic dentist in England. If that’s too far for you to travel, call his office and ask for a recommendation for someone closer to you.

And you don’t have to worry about the teeth being damaged, if the porcelain veneers are done right. A good porcelain veneer preparation is very shallow, and if your teeth were irritated at all by being prepared the first time, they have long since recovered, and they will likely be more resistant to irritation the next time.

Good luck.

this blog sponsored by Louisiana Cosmetic Dentist

Porcelain Veneers

Bonding vs Porcelain Veneers

Hello, I had my 8 front upper teeth fully bonded about 14 years ago to close in gaps between them. I have taken extremely good care of them and they have held up well, although they have stained now from food and drink. I have been told my only option for white teeth is to remove the bonding altogether,then bleach and rebond or go the more expensive route, porcelain veneers. My question for you is this… if the tooth is actually what has become stained and it is showing through the bonding, why wouldn’t bleaching work? If the coffee, tea, etc. got through, wouldn’t they bleach also?? Thank you.
– Patti from Minnesota

Dear Patti,
I think you’re being given good information.

I’m not clear whether you want your teeth generally whiter or you want the stains removed. If you just want the stains removed, the bonding could maybe be re-surfaced. The cosmetic dentist would just remove enough of the surface of the bonding to get rid of the stain, and then bond new material over that. But if you want your teeth whiter than they are, too, then you need to remove the bonding, have the teeth bleached, wait a couple of weeks for the new color to stabilize, and then re-bond.

We do a lot of direct dental bonding, and the bonding material can produce beautiful results. But the bonding resin is a little bit porous, and over the years it will absorb stain. This stain doesn’t respond to any of today’s bleaching techniques, even the state-of-the-art Zoom whitening that we offer.

If you were my patient, I would encourage you to upgrade to the porcelain veneers. Porcelain has the added advantage of being extremely stain resistant year after year. You could have the whitest shade of teeth you want, and as long as you have to have the bonding removed anyway, why not go for the porcelain?

Other links:
Read more about dental bonding.