Tag Archives: American Academy of Cosmetic Dentistry

gums inflamed after porcelain veneers

I had porcelain veneers placed on four teeth almost a month and a half ago. Since they’ve been on, my gums have been inflamed. I went in to see the hygienist and she said it is probably that I’m babying the teeth and not brushing well enough. I can assure you that is not the case. Then, at my one-month follow up the dentist removed some excess cement. That helped a little but it has been a week and a half since then and they are still inflamed. My dentist doesn’t seem concerned but I’m worried, not to mention in pain. What do you recommend?

Kay L.

Dear Kay,

Our experience has been patients love their new smiles so much, after getting porcelain veneers, they tend to take better care of them, not worse. Isn’t it a tad annoying when medical professionals blame the patient when they can’t figure out what is wrong?

Cosmetic dentistry is both an art and a science. The health of the gums is one of many things the American Academy of Cosmetic Dentistry looks at in evaluating cases when dentists are working toward accreditation.

The lateral incisors, in this case, received porcelain veneers. Because of the gum inflammation on these teeth, this case would be rejected as unacceptable by AACD accreditation examiners.

In the case above, the gum inflammation on the lateral incisors would be an indication this dentist did something wrong, causing the case to be rejected by accreditation examiners as a means of demonstrating competency.

While there are several reasons your gums could be inflamed, I’m leaning heavily toward your dentist not removing all the excess cement. You said he removed some at your one-month follow-up appointment. When done properly, all the excess cement would have been removed immediately after they were bonded. There shouldn’t have been any to remove at the follow-up appointment.

A couple of other possibilities would be uneven margins or the porcelain veneers going too far under the gumline. To truly know what is going on, though, you’re going to need to see an expert cosmetic dentist.

Getting a 2nd Opinion from an Expert Cosmetic Dentist

The first thing I want you to do is go to the website of the American Academy of Cosmetic Dentistry. (aacd.com). They have a link to find a cosmetic dentist. However, make sure you check the boxes for an accredited dentist. Membership is easy. AACD accreditation requires real skill.

Pick one which is reasonably close to you and schedule an appointment for a second opinion.

Finally, make sure when you go, you get a “blind” second opinion. This means you won’t tell them which dentist did the work or anything they said could be the problem. You want the accredited dentist to give his unbiased opinion without anything to sway him.

Best of luck.

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

can I fix the color of my cerec crowns?

I had a CEREC crown done on one of my canine teeth about three weeks ago. We never really discussed the shade while I was in the office, but as soon as I got home, I realized that it was a bit lighter than the rest of my teeth. Well, once I saw it, I couldn’t un-see it, and now every time I look at myself, all I see is that darn tooth. It looks fake.

I didn’t want to bother my dentist with this at first, so I started playing around with at-home whitening products to try to get the rest of my teeth to match, but I’m just not getting them as bright as that CEREC crown. This probably sounds crazy, but I’m starting to wonder if he can darken it just a bit, so it’s a better match. Is that even possible?

Thanks,

Stan

Dear Stan,

CEREC crown restorations and materials

There are a couple of things about your case that give away that your dentist isn’t really what I would call a cosmetic dentist. Every dentist who is serious about cosmetic dentistry, when they place a crown on a front tooth, will make sure you get a good look at it before it is permanently bonded on. He didn’t do that.

The other problem is that it is a CEREC crown. The CEREC material is a block of material that is a set shade. Unless the dentist is an advanced cosmetic dentist, he won’t know how to use color theory and stains to match a front tooth.

To match a front tooth, a true cosmetic dentist has the ability to customize the shade. Each tooth in your mouth has differences in color from the neck of the tooth to the tip, and it is quite a process to mix different materials to get a crown to match the surrounding teeth.

Tints and Stains Exist

There are tints and stains that can be applied to the CEREC to customize the shade. But on a ceramic, that has to be baked into the crown, so that has to be done before the crown is put in your mouth, obviously.

Sounds Like You Will Have to Have Your CEREC Crown Replaced

You deserve to be happy with your smile and he biffed the color. Hopefully, your dentist will agree to re-doing the crown. However, this time, make sure you get to look at it BEFORE they cement it. Check it out under various lighting conditions—seriously. Look at it in the chair. Get up and go into the bathroom and check it there. Venture to an outside window and view it in natural sunlight. If it isn’t right, don’t let them cement it.

Request a Lab-Made Restoration if All Else Fails

There are crowns that have a core that is made like a CEREC crown and then have porcelain baked over the top. If you want a natural-looking crown on a front tooth, this is the way to go. Although you’ll have to wait two weeks for the lab to make it, the lab technician will be able to tint the crown to match your existing teeth. But the dentist also needs to have a good eye for color and the ability to describe the color variations in your tooth, and your dentist doesn’t sound like he is that much into that. For the best results, you’d really want to switch to someone who specializes in cosmetic dentistry for these sorts of things, but you’ve already started with him, so as long as you’re keen to continue, give him the chance to fix his work too.

If he can’t, look for a dentist who has been accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the country.

This blog is sponsored by Lafayette, LA Dentist Dr. Mike Malone.

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.

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 Dentistry Tourism Disaster

I had porcelain veneers placed on my top teeth and a dental implant and crown on my bottom arch. In the U.S. it would have cost me over $60,0000 but I was able to get it done overseas for around $11,000. At first, I was pleased as punch, but now I’m four months out and the veneers are falling off. I’ve been cutting up the food the way he showed me and not eating with my front teeth at all. In fact, the last one fell off while eating spaghetti. That’s hardly anything to stress about. Three of the veneers have fallen off. They’re all intact. Do I need to have these re-done or can another dentist put them back on?

Catrina

A single porcelain veneer being held up by a dental tool

So, here’s the thing. Those instructions your dentist gave you about eating are a huge red flag to me. There is absolutely no reason why you should have any restrictions at all on what or how you eat. When properly bonded on, porcelain veneers will allow you to eat anything.

This dentist doesn’t know proper bonding technique. That alone, makes me question the skill of the rest of his work. For health and safety reasons, I’d like you to get a second opinion on the dental implant and crown you had done. This is especially important about the implant. If an infection develops it can lead to serious consequences.

Regarding your fallen porcelain veneers. You mentioned they’re still intact. In that case, it is possible an expert cosmetic dentist could clean them up and get them bonded back on properly. However, this is beyond the skill of almost all cosmetic dentists. You will need someone in the top 2%.

Finding an Expert Cosmetic Dentist

Cosmetic dentistry isn’t really taught in dental school so you’ll need to look for someone who invested the time and training into doing it well. In your place, I’d look for a dentist who has reached accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists are in the top 1% of dentists. You can find them listed on aacd.com. Just make sure they’re accredited. They will know the right procedure to help you with your porcelain veneers.

The cost to get them bonded back on properly shouldn’t be too bad, if they can be saved. If they can’t be, these dentists will give you a list of options and let you determine which way you want to go.

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

“Reputable Dentist” Destroyed My Smile

I had an accident which caused me to need a crown on a front tooth. I was nervous about this because it’s my front tooth. Everyone will see it. I looked up many dentists in my community to see who was highly reputable. I found one which everyone seemed to love. The first crown he did wasn’t even close to matching the other front tooth. Even he said he needed to do it again. The second one was closer, but I wasn’t thrilled with it. He was and was going to place it anyway. Fortunately for me it didn’t fit. He went back for a third run and when that one didn’t fit he told me I’d need orthodontics. I gave up at this point even though I have a horrible temporary crown which doesn’t fit right. I need help but I don’t know what to do. Help me please.

Tanya

Dear Tanya,

close up of teeth

These stories make me both sad and frustrated with the dental industry sometimes. First, you should know that a reputable dentist and an excellent cosmetic dentist can be two very different things. There are two different mindsets at play here. In dental school, we’re taught that the dentist knows best. Cosmetic dentists have a different mindset. They feel unless the patient is satisfied (in fact, more than satisfied), they haven’t properly done their job.

Dentists who haven’t done extensive training in cosmetic work see this as pandering to the patient.

All that being said, matching a dental crown to a single front tooth is a very challenging thing even for the best cosmetic dentists. In fact, if your smile is important to you (and it sounds like it is) you will want a dentist with both technical expertise and artistry.

Believe it or not, one of the teeth in the picture above is a dental crown. I bet you can’t tell which one. That’s the type of results a true cosmetic dentist gets.

Finding an Expert Cosmetic Dentist

The easiest way to find a top of the line cosmetic dentist is to go to aacd.com. This is the website for the American Academy of Cosmetic Dentistry. They have a find a dentist link. However, you don’t just want someone who is a member. Any dentist can become a member. You want to find a dentist who is accredited.

In their search options, there is a box to check that you’re looking for an accredited dentist. These dentists have passed stringent oral and written exams as well as demonstrated their artistry in a large number of cases they’ve done.

Anyone of them are more than capable of matching your front tooth with a perfect physical and aesthetic fit.

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

Dentist Said No to CEREC Crowns

My dentist has a CEREC machine. We’ve used it for a crown before, but on a tooth on my bottom arch. Now I need one on my top front tooth and he’s saying “No”. He said they don’t look good on front teeth. I truly liked the convenience. Plus, he wants to crown both front teeth to make them match. Is this legitimate?

Anna

Dear Anna,

Block of porcelain for CEREC crowns

You should be aware that only the top cosmetic dentists in the world can match a single crown to a front tooth. That is even more challenging when it comes to using CEREC. If convenience is what you’re after, go with the two crowns and traditional crowns. I’ll explain why in a moment. If you want gorgeous front teeth with just one crown, you’ll need to find an expert cosmetic dentist.

Matching a Single Crown to a Front Tooth

Your front teeth are right next to each other and much more exposed to the light. Even the slightest deviations will be very noticeable. It will be quite obvious your teeth won’t match.

With even the best dentists, it will take a few try-ins before it matches perfectly. That could go faster with CEREC crowns because it’s milled right there and not sent to a lab. It will still likely take more than one try. This method will take even more skill.

With a CEREC crown, that’s even harder because they are milled from a single block of porcelain. Traditional porcelain crowns use several blocks with variations in opacity. Your dentist would have to be very versed in color theory skills which are not taught in dental school. It’s obvious your dentist doesn’t have that training.

It’s actually showing his integrity that he’s being honest with you. He could have bluffed his way through and given sad looking results.

Finding the Cosmetic Dentist Who Can Do Gorgeous CEREC Crowns

Truthfully, because of the difficulty of this type of case, to get a beautiful, natural looking result which will match your other front tooth, you’ll need to go to a dentist accredited with the American Academy of Cosmetic Dentistry.

AACD accredited dentists have gone through stringent oral and written exams as well as proven their artistry with a large number of cases they’ve done and provided evidence for. All of them have gone through extensive training in advanced cosmetic procedures after graduating dental school.

What it boils down to in this particular case is what’s more important to you— a convenient, fast result, or a natural looking attractive result.

It is definitely your smile and your choice. Don’t feel pressured to go a way you don’t want.

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

Matching a Crown on a Front Tooth

I needed to get a crown on a front tooth. The first one came back way too white. He sent it back and tried again, but the second one he looked at it and said, “That’s better.” then proceeded to bond it one without me seeing it. When I got home, I realized it didn’t match the other tooth. What do I do?

Lacey

Dear Lacey,

A tooth receiving a dental crown
To match a crown to a single front tooth takes an expert cosmetic dentist.

The procedure you need, matching a single crown to your other front tooth, is an extremely advanced procedure. Only the top cosmetic dentists can do it. Even the best will usually charge up to 40% more for a crown on a front tooth. That’s because it regularly takes four or sometimes more try-ins before it is matched completely to the adjacent front tooth.

There are two things your dentist did which make me think he’s not a skilled cosmetic dentist. First, he thought two tries was enough. A truly skilled cosmetic dentist will not be satisfied with anything less than perfection. He would do it over and over again until they matched.

Second, he permanently bonded on your dental crown before letting you get a look at it. He didn’t want to risk you saying it didn’t look right so he tried to take away your ability to say so. You have two choices in getting this fixed.

Finding the Right Cosmetic Dentist to Fix This

You really do need an expert cosmetic dentist if your dentist isn’t willing to put forth the effort for excellence. I’d look at the American Academy for Cosmetic Dentistry’s website (aacd.com). They have a section which allows you to look for a cosmetic dentist.

You need an accredited cosmetic dentist. These are the cream of the crop. Not only are they capable of matching a single crown, but they won’t be satisfied until you are.

If money is a factor, you may want to see if your dentist is willing to get it right at no additional cost. But, if it’s not a huge factor, you’re better served to find a better cosmetic dentist.

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

Should I Have Gone to a Cosmetic Dentist for a Root Canal?

Both my sister and I received root canals within the last year. My dentist put a crown on mine, which meant filing down the tooth to a nub. It’s not that attractive either. It’s toward the back so isn’t completely visible but it still bothers me. My sister sees a cosmetic dentist. When he did her root canal, he put a porcelain veneer on hers. It looks so much nicer than mine and she hardly had any of her tooth structure removed. Did I make a mistake not going to a cosmetic dentist?

Betty

Dear Betty,

Porcelain crown on left and porcelain veneer on right

You should know there isn’t a recognized specialty in cosmetic dentistry, which means every cosmetic dentist is just a general dentist who prefers to also do cosmetic work. However, before we get into choosing a dentist to do cosmetic work, let’s talk about a root canal restoration.

Whether or not you get a dental crown or a porcelain veneer restoration depends on a few things. First, the location. If it’s a back tooth, a crown is more important. After a root canal, a tooth becomes more brittle. The crown will protect it from the biting forces which affect your back teeth.

If it’s on the front teeth, you may have a choice. Most of the time crowns are done because there was so much decay on the tooth there is not enough structure left for anything but a crown. However, if the tooth needed treatment because of trauma and is still fully intact, then you could get a porcelain veneer. This is more effective because of the type of forces your front teeth undergo.

However, you’re talking about getting a porcelain veneer on a single front tooth. This requires a cosmetic dentist with superior aesthetic skills.

When You Need a Skilled Cosmetic Dentist

Most of the skills required to do a beautiful smile makeover are not taught in dental school. The dentist has to invest post-doctoral time in learning the skills required. However, there is an aspect that can’t be taught— an artistic eye.

Like any art form, there are different skill levels. So, how do you find the right dentist? The American Academy of Cosmetic Dentistry realized the quandary patients found themselves in. To remedy that, they began an accreditation program.

To become accredited, dentists have to pass stringent oral and written exams. Additionally, they have to provide evidence of a list of cases they’ve done showing they can give beautiful results. Any AACD accredited dentist can give you a gorgeous smile makeover. They can also match a single porcelain veneer to the rest of your teeth.

If you’re ever in the need or porcelain veneers, make sure you go to aacd.com and find an accredited dentist in your area.

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

What If I Can’t Get Porcelain Veneers?

I’m disappointed with my smile, but my dentist said I can’t get porcelain veneers because I grind my teeth. Is there anything else I can do to improve my smile? I have a gap between my teeth and they are quite discolored.

Mandy

Dear Mandy,

A single porcelain veneer being placed on a tooth

I think your dentist may be a little confused. If the only issue is that you grind your teeth, there is a way for you to get porcelain veneers. It’s possible that he’s not comfortable doing smile makeovers and rather than admit that he’s trying to discourage you from moving forward with that. Don’t pressure him. You will not be happy with the results.

Here’s what I’d recommend. The first thing I want you to do is to get a second opinion. But, make sure you do it with a dentist who’s accredited with the American Academy of Cosmetic Dentistry (AACD). These are the top cosmetic dentists in the country.

In all honesty, in order to get the gorgeous smile you’re hoping for that’s the type of dentist you’d want to do your veneers anyway.

If Porcelain Veneers Aren’t an Option

There are some cases, where other work has to be done before you can get porcelain veneers, such as when you have gum disease. In other cases, they’re good candidates, but this type of makeover is just over their budget. That doesn’t mean you can’t get an upgraded smile. Here are some great, affordable options:

  • Teeth Whitening: This is the most affordable way to brighten your smile dramatically. It will make you look years younger.
  • Invisalign: This is a great option to straighten your teeth without anyone knowing your wearing orthodontics. Plus, it works in half the time of traditional orthodontics.
  • Dental Bonding: This can repair chips and gaps on teeth.

As you can see there are many ways to upgrade a smile. However, no matter what you do, you’ll want to protect your teeth, especially after investing money in improving it. If your dentist hasn’t suggested a night guard to you, knowing that you’re grinding your teeth, then it may be time to get another dentist.

This is a simple orthotic device you’d wear over your teeth and it will take the pressure off of your teeth when you grind them. Without this, your natural teeth will eventually be worn down to nubs, requiring you to get each tooth crowned.

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