Tag Archives: finding an expert cosmetic dentist

Are CEREC Veneers Risky?

I plan on getting CEREC veneers, but I have not exactly used this dentist before. He told me that he generally makes porcelain veneers 1.55 mm. I have done some research and that seems a little thick to me. Should I reconsider? I understand that the dentist who does the veneers could affect the outcome so I’ll tell you ahead of time, his name is [ name withheld ].

Patricia,

Dear Patricia,

porcelain veneer being placed on a tooth

I am very glad you wrote. Instead of saying “the dentist could affect the outcome”, I would say the dentist determines the outcome. He or she would be the key to the outcome of your smile makeover.

Doing CEREC veneers is much harder than doing traditional porcelain veneers using a master ceramist. In that case, the skill and training of the dentist becomes even more important. I looked up the dentist you mentioned to me. I started by looking at his website and I saw nothing that indicated any cosmetic training. That was a red flag. But, I went ahead and did some extra work and looked up the institutions that do the type of training he would need. He is listed on none of their alumni lists. Because of that, I am going to recommend you go a different direction.

If you are set on CEREC veneers then I suggest you go to a practice that has an AACD accredited dentist on their staff. Nothing less than that would give you the outcome that I believe you want.

Let’s say you go to a dentist to get a smile makeover and he or she does a terrible job. You will have no recourse. The standard of care is that it the results of the procedure are functional, not attractive. This is not what you are going for when you want a smile makeover. Therefore, you as a patient, as to be proactive and find the dentist who will not only care that you have a beautiful smile, but has the training and skills to provide them for you.

This blog is brought to you by Lafayette, LA Dentists Drs. Forman and Thimmesch.

Cavity On A Porcelain Veneer Tooth

I have porcelain veneers on four teeth. One of them now has a cavity and my dentist wants to remove the porcelain veneer and replace it with a dental crown. Is that absolutely necessary?

Dana

Dear Dana,

Porcelain veneer being placed on a tooth

I am going to recommend you get a second opinion on this for a few reasons. First, in order for a tooth to need a dental crown for decay, the amount of decay would have to be pretty substantial. I would say over 20% of the tooth would have to be decayed to justify needing a dental crown. If that is not the case, then why would he recommend one?

The most likely reason is that he is not comfortable treating a cavity with porcelain veneers. The margin is where a tooth with porcelain veneers is most susceptible to decay. If that is where your cavity is he may not have the tools or skills to bond the composite to a porcelain veneer.

That leads me to the second reason you need another opinion. If he’s recommending a crown unnecessarily, then his cosmetic skills are limited. This does not bode well for the crown either.

I would say only about 2% of dentists can match a dental crown on a front tooth to a porcelain veneer. In fact, You would need one of the best cosmetic dentists around, like an AACD accredited dentist. If he is pushing you toward a crown, he is not the dentist to do the work.

Getting a Second Opinion

I’d like you to see an expert cosmetic dentist and have them look at the tooth with the cavity. It is important you make this a blind second opinion. By that, I mean do not tell him who your dentist is or what the diagnosis and recommendation were. If he or she asks, tell them you are keeping that to yourself in order to get an unbiased opinion.

This blog is brought to you by Lafayette, LA Dentists Drs. Thimmesch and Foreman.

Advice on Fixing One Crooked Tooth

I have one crooked tooth in the front that is well behind the other front tooth. So far behind you can barely see it. Dentists keep suggesting different things and I don’t know who to trust. One dentist said to get braces. Another suggested I just pull that tooth. Then there are all the pieces of advice in between. Would Invisalign even be a possibility for me?

Marie

Dear Marie,

Invisalign aligners
Invisalign Aligner

It used to be that Invisalign would only work on the more ideal cases. These days are different. Invisalign can work on all but the most complicated cases. Because of that, there is a great possibility that Invisalign will be a good solution for you.

They also have the added benefit of the aligners being able to double as teeth whitening trays, which means you can straighten and whiten your teeth at the same time, if that is something you are interested in.

Don’t let the dentist pull your tooth. First, if you left it as is, you would never look normal with a smile that is asymmetrical. If you wanted to replace the tooth with something like a dental implant, you would still need to open up the space with some type of orthodontics. In that case, why not keep your natural tooth structure?

If you decide not to go with Invisalign, another possibility is to use porcelain veneers. These will not actually straighten your teeth, but it will make them look straight,

Veneers are typically used by someone who wants a full smile makeover. That is because they can change the shape, size, and color of your teeth. If you decide to go that way, you will need an expert cosmetic dentist, like an AACD accredited dentist because your case is more complicated.

My suggestion, if the only thing that bothers you about your smile is that one crooked tooth, is to see a dentist who offers Invisalign. Let them examine you and they’ll be honest about whether or not you are a good candidate.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

My New Teeth Keep Popping Off

For our anniversary, my husband told me I could get a smile makeover. I’ve dreamt of one for several years. My teeth are chipped here and there, stained, and I have a few that are shorter than the others because of teeth grinding.

My dentist ground my natural teeth down to tiny yellow nubs and gave me temporary veneers. Then, my permanent ones came in. All totaled I have eight veneers. They look okay. Certainly at least whiter than my old teeth. The big problem I am facing is they keep popping off.

While she always puts them back on for me, I am living in constant fear of being humiliated in public. This week, two fell off while I was eating bread at a restaurant with a friend. I spent the entire rest of the day crying from the shame. It is always the veneers that have a slant on the back that seem to come off.

My dentist is blaming it on my teeth grinding, but I wear a nightguard for that, which I was told would protect both my natural teeth and my veneers. What do I do now? We’re a military family and about to get transferred to another base in the states. I’m afraid no dentist will want to deal with my freakish nub mouth. What do I do? I thought this would be a wonderful experience and it has turned out to be a nightmare.

Angie

Dear Angie,

This is a cosmetic denistry horror story for the books. I am so sorry that this was your experience. I believe this dentist has committed malpractice. First, I’ll tell you why and then we’ll go over what you can do about it.

The first thing you should know is that she did not give you porcelain veneers. What she provided was dental crowns and called them porcelain veneers. This is unethical. Here is how I know this.

Image of teeth prepared for porcelain veneers
Tooth preparation for porcelain veneers

When your teeth are prepared for porcelain veneers only a small layer on the front of the teeth is removed. Directly above I posted an image showing what this type of tooth preparation looks like. This is not what you described.

Image of tooth preparation for dental crowns
Tooth preparation for dental crowns.

Instead, I think your teeth look more like what you see in this picture– little nubs. This means she gave you porcelain crowns. Unfortunately, once that tooth structure is gone, there is no way to get it back. This weakens your teeth and makes them more susceptible to breaking later down the road.

Second, she hasn’t been able to bond your dental crowns on properly. While there are a number of dentists who would not know how to properly bond porcelain veneers, every dentist has been taught how to place and bond a dental crown. The fact that she can’t keep yours in shows a serious lack of basic skills. It also violates the basic standard of care.

Your dentist is legally liable for the damage done to your teeth. I don’t want you to just ask for a refund. Instead, I believe she needs to pay to have this repaired properly. I want you to find an expert cosmetic dentist in your new area and have them repair your smile makeover. When y ou get to your new base. Look up on mynewsmile.com to see which cosmetic dentists they recommend in your area.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Invisalign or Porcelain Veneers

I had been saving up to give myself a smile makeover. I’d planned on porcelain veneers. There is not anything major wrong with my smile, but I heard porcelain veneers were the procedure to do for a smile makeover. When I met with my dentist he suggested I do Invisalign first and then get the porcelain veneers. I was under the impression you do one or the other. I don’t have a major orthodontic case, just one crooked tooth. My dentist suggested Lumineers, which I was fine with, but that confused me more because their advertisement said they can make crooked teeth look straight. What am I not understanding?

Olivia

Dear Olivia,

Invisalign aligners
Invisalign Aligners

I can understand your confusion. In general, unless as you said there is a major orthodontic case, the porcelain veneers can make your teeth look straight if the dentist is skilled enough to do it right. I am concerned that your dentist is not and that is why he is suggesting Invisalign first. The fact that he wants to place Lumineers reinforces my fears. That particular brand of porcelain veneers is highly marketed to inexperienced cosmetic dentists.

If you decide to go with porcelain veneers, you need to find a different dentist to do it. I would look for a practice that has an AACD Accredited Dentist on staff. That being said, I don’t think you actually need porcelain veneers.

Based on your description, it sounds like you are just wanting to whiten and brighten your teeth and change the appearance of that one crooked tooth. You could do that at a fraction of the cost of any brand of porcelain veneers using Invisalign.

Plus, the aligners can double as teeth whitening trays. This allows you to straighten and whiten your teeth at the same time. Now, if there are other things about your smile you want to change, such as their shape or chips, then, yes, spend the extra money on porcelain veneers (though I do not recommend the Lumineers brand). Just make sure you get them done right with an expert cosmetic dentist.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

What to do About a Huge Tooth GAp

I have a gap in my two front teeth. It is substantially large enough for another tooth to fit there. Would getting Lumineers help? They could make each of the teeth a little wider. One dentist recommended that. Another recommended orthodontics. I really don’t want braces though.

Angie

Dear Angie,

Invisalign Dental Aligner

I am trying to imagine that dentist thinking that extending your teeth out that far will look in any way normal if that gap is as large as I’m picturing. I wish I had a picture.

I will say that dentists who suggest Lumineers are not usually in the top tier of cosmetic dentists. That particular brand of porcelain veneers is often marketed to inexperienced cosmetic dentists as being easy to place. The type of cosmetic case you are describing is very advanced and would take the best of the best in cosmetic dentists. I wouldn’t let anyone except an AACD accredited dentist touch that.

However, that doesn’t mean you’ll have to have traditional metal and wire brackets. Orthodontics have come a LONG way. These days, you can get Invisalign. Instead of wires and brackets, they use clear aligners. These are invisible even at a conversational distance.

This will allow you to straighten your teeth without anyone noticing. If you want, the aligners can even double as teeth whitening trays which allows you to straighten and whiten your teeth at the same time.

It looks to me like you need to seek out a third dentist if the one who suggested orthodontics didn’t offer Invisalign, unless there is something else about your bite that wasn’t mentioned. If it is a simple matter of a gap then it is the perfect solution.

This blog is brought to you by Lafayette, LA Dentists Drs. Thimmesch and Foreman.

cerec crowns on front teeth

I was in a car accident and damaged both my front teeth. I need to get crowns on them. I am trying to decide between regular crowns and CEREC crowns. Is one better than the other?

Benjamin

Dear Benjamin,

porcelain block for CEREC crown

CEREC crowns are made out of single block of porcelain. This will give it a very uniform look. This works fine on most teeth. However, our front teeth are much more visible and exposed to light.

Natural teeth aren’t uniform. Look at this image of a tooth directly below. There are varying levels of translucency and opaqueness depending on where you are on the tooth.

image of a tooth

When a dentist does a traditional crown, it is built in layers with varying shades of porcelain. This can make a crown look more natural. However, even then, you’d need an expert cosmetic dentist because this takes a high level of skill.

If you really want a CEREC crown, then having an expert cosmetic dentist is even more important. They need to have a high level of skill in color theory so they can use various stains to give it that variated look while keeping that natural translucency.

Cosmetic Considerations with Dental Crowns

The dental crown can be made to match your teeth exactly. However, the color is permanent. If you are happy with the color of your teeth, then you do not need to take any further steps. However, if you want your teeth any whiter, the time to take care of that is before having the crowns designed.

In that case, your first step is to have your teeth whitened. You can do that in one appointment if you see a dentist who does Zoom Whitening.

Then, give it a couple of weeks for the color to calm down. That’s when your dentist can match the permanent color for you.

When you’re talking about front teeth, whether you get a traditional or CEREC crown, you will need a dentist capable of the skills required. I suggest you see an AACD accredited dentist.

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

Solution for huge tooth gap

I have a large tooth gap. It was last measured at 9mm. I thought about doing Snap-on Smile, but after all the tests and things, it turned out I wasn’t a candidate for that procedure. I’m too old for braces, so I’m thinking about Lumineers. I have scheduled an appointment with a Lumineers certified dentist in a couple of weeks but thought I’d check and see if you thought that was a waste of my time and money.

Kevin

Dear Kevin,

I am very glad you wrote before going through with this plan of Lumineers. While I am sure you could find a dentist willing to do it for you, it would end up a disaster!

The size of your gap is enough to fit another tooth. Unless the dentist is a top of the line, expert cosmetic dentist you are going to end up with something that looks ridiculous. And I will tell you right off the bat, dentists who advertise as placing Lumineers tend to be at the bottom of the barrel of cosmetic dentists.

The Lumineers company markets themselves to inexperienced cosmetic dentists as being easy to place because they don’t require any tooth preparation, the way other brands of porcelain veneers do. There are two problems with that.

One, that rarely turns out looking anything but bulky. Some people have described it as horse teeth. And, two, there is a whole lot more to creating a beautiful smile than just the tooth preparation.

An Invisible Alternative to Braces

side by side compairison of braces
Braces versus Invisalign

You mentioned you were too old for braces. Has your dentist discussed Invisalign with you yet? These are sometimes called invisible braces.

Both people in the image above are wearing orthodontics. The one on the left is wearing traditional braces. The one on the right is wearing Invisalign. No one will be able to tell you are wearing them even at a conversational distance.

With the size of the gap you are talking about Invisalign would be my number one recommendation for repair. It has an added benefit as well. Invisalign uses clear plastic aligners to straighten your teeth. Those aligners can double as teeth whitening trays. This will allow you to straighten and whiten your teeth all at once.

If you don’t like the idea of any orthodontics, then you will need to go with porcelain veneers. However, as I mentioned above, you will need an expert cosmetic dentist in your case. I would only see an AACD accredited dentist to do your porcelain veneers case, if that is what you decide on.

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

Three Different Color Teeth with Porcelain veneers

I had four porcelain veneers placed on my front teeth. Unfortunately, the two in the very front are turning gray. This has left me with three different colored teeth. First, there are my natural yellow teeth, which still show on either side of my porcelain veneers. Then, there are the white veneers next to them, and the two front teeth which have turned gray. I feel this whole endeavor has been a disaster. What can be going on and what can fix it?

Marla

Dear Marla,

A single porcelain veneer being placed on a tooth

The main problem you are facing with your smile makeover is the inexperience of your dentist. First, the porcelain veneers on your front teeth are defective. This can happen to a new cosmetic dentist. However, an even more basic error was made.

If you are only getting four porcelain veneers and your teeth are yellow, your teeth need to be whitened before your veneers are placed. Your dentist didn’t even know enough to do that.

As for the grey veneers, there are two possibilities I can think of immediately. I couldn’t tell you which without a photo, but I can describe it to give you an idea of what to look for.

If they are uniformly grey, then it’s likely the glaze has been removed somehow. This destroys your porcelain veneers because the glaze is what protects them from picking up stains.

If the gray is uneven, you may have what is known as microleakage. This means the bonding isn’t done correctly and you’ve got things getting between the porcelain veneers and your teeth. This will not only give them a splotchy look, but it will lead to decay.

Fixing a Porcelain Veneer Disaster

Because your family dentist is in over their head, I don’t think they’re going to be able to fix this. You need to ask for a refund and have this case redone by an expert cosmetic dentist. They’ll likely first suggest you whiten your teeth. Then they’ll do the case from scratch.

My suggestion is look to see if there is a dentist who is accredited by the American Academy of Cosmetic Dentistry in a reasonable distance from you. AACD accredited dentists are the top cosmetic dentists in the country. They will provide you with a stunning smile you will be proud of.

This blog is brought to you by Lafayette, LA 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.