The Cosmetic Dentistry Blog

March 26, 2008

Can my teeth be longer with Lumineers?

Filed under: Lumineers, Smile design — iowasmiles @ 10:08 am

Dr. Hall,
My teeth are straight with absolutely no gaps. They are a little discolored because of age. I wanted bigger and whiter teeth so my dentist recommended Lumineers. I have already had impressions and it was sent to the lab. They came back with that they could whiten the teeth but not really make them much longer or bigger. The dentist called the company again and they said they could make them no bigger. What is up? I am sitting here looking at their brochure right now and they say they can make your teeth bigger. The before and after pictures show that they can. The dentist has now suggested bonding the 6 upper teeth that she was going to use Lumineers on. I have already had 2 appointment and spent over $400. What do you think is going on??? What should I do?
- Donna in Kentucky

Dear Donna,

Big red flags here. You asked me what I think is going on. I am pretty confident that what is happening is that your dentist doesn’t know what he is doing.

What is this where the laboratory is telling the dentist that the teeth can’t be made any bigger? The dentist is supposed to be a doctor. The laboratory technician is just a technician. It’s the dentist that is supposed to give instructions to the laboratory, not the other way around. Unless, of course, the dentist doesn’t know anything. You mean to tell me that your teeth can’t be made any longer or bigger but this dentist didn’t know that when you first consulted with him?

Go get a second opinion from one of our Kentucky cosmetic dentists. I don’t know why the lab is saying what it is saying, and I couldn’t tell you from this distance about what can and can’t be done with your smile. If you check our smile design page, you’ll see that with porcelain veneers, such as Lumineers, there are a lot of options as far as how to shape the teeth. Maybe you have some special circumstance–an expert cosmetic dentist like the ones we recommend on our web site could tell you more.

Good luck.

Fortunately, it sounds like not too much damage has been done in your mouth so far. I’d let him keep your $400 and count yourself lucky that’s all you’ve lost.

- Dr. Hall

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Click here to ask Dr. Hall a question.

November 23, 2007

Unhappy with new porcelain veneers

Filed under: Porcelain veneers, Smile design — iowasmiles @ 11:16 am

Dr. Hall,
I had porcelain veneers put on in July of this year. I am not happy. The canine teeth look crooked and there is a little line above my left front tooth that may be my natural tooth surface showing through. The dentist said that he didn’t want to do anything about that because it was so small and that he could barely see it. I am now so unhappy. I am afraid that I am going to get decay on the top of the front tooth, and I spent so much money. I had old bonding that needed to be replaced so I had to do something to my teeth, but now I am just as unhappy and insecure as with the old bonding on. What should I do? I don’t want to be a difficult patient, is he right about the little bit of tooth surface is it not a big deal? What should I do?
- Elizabeth from New York

Elizabeth,
I don’t think you’re at a risk for tooth decay in that spot that’s maybe showing your natural tooth. I can’t be sure without seeing it myself, but as long as there isn’t a groove or a ledge that will catch plaque, your tooth isn’t vulnerable there. So your dentist is right on that point.

But it sounds like you aren’t happy with the appearance of your new smile, and I’m disappointed that your dentist didn’t let you know exactly how they were going to look before the porcelain veneers were bonded on. Good cosmetic dentists will always make sure you see exactly how they will look first, often even letting another family member or a friend look at them with you. General dentists tend to give you a mirror while you’re upside-down in the chair and let you see them for a few seconds and then go ahead and bond them on.

If there are things you don’t like about how they look, I would ask your dentist to re-do those things, like the crooked canine teeth. Share my e-mail with him if you want, and tell him I said that you paid for a beautiful smile, and if it doesn’t look beautiful to you, it’s not good enough.

A good cosmetic dentist, for example, wouldn’t say, “That’s so small, I can barely see it, so I’m not going to fix that.” Instead, he or she would say, “That’s so small, I can barely see it. Are you sure you want me to change that?” Because a good cosmetic dentist is first of all a good listener and knows that the patient needs to love the smile.

This is at the heart of a key difference between a good cosmetic dentist and a general dentist who likes to dabble in cosmetic dentistry. The good cosmetic dentist understands that he is treating the self-image of the patient, and that if the patient isn’t happy with how the smile looks, then the treatment is a failure. This is basic. Good cosmetic dentists have many procedures in place to insure that when you go home after the treatment is over, that you love your smile and that you smile with confidence. That is what cosmetic dentistry is all about, and if your dentist doesn’t understand that, then you can help teach it to him by being a “difficult patient.” He will end up being a better cosmetic dentist, thanks to you.

When I was young and only a couple years out of dental school and just learning cosmetic dentistry, I had several cases that when I did them, they looked okay to me, but they weren’t good enough. So I completely re-did them at my expense until they were beautiful. This is part of the learning process, and it’s what helps cultivate a great reputation for doing gorgeous work.
- Dr. Hall

Related information:
Read about smile design.
Read about how some cosmetic dentists use a smile imaging computer to test various smile designs, to help insure that the patient loves the results.

October 2, 2007

Pointed cuspids

Filed under: Smile design — iowasmiles @ 2:33 pm

Dr. Hall,
I read the page on vampire teeth. I understand that cosmetic dentists may only want to do this as a temporary procedure. But isn’t there a permanent proceedure where one can have cupsids (not large) but normal size but made to look pointier? I don’t want anything unnaturally large, just more pointy.

Thanks
- Sam in Virginia

Sam,
Yes, more pointy cuspids lend a more aggressive look to the smile, and that would seem to me to be a reasonable request, and it could be done with porcelain veneers and made to be permanent. While there are more people who want the cuspids made less pointy for a softer look, there are some people who want pointed cuspids for that bold, aggressive look.

But you would need a true cosmetic dentist who has an understanding of the different images associated with various smile designs.

Dr. Hall

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