Anna,

You’re another in a long string of victims of general dentists who don’t know much about cosmetic dentistry but yet try to do smile makeovers.

My first clue was the naive comment by your dentist that, “The people from Lumineers would know exactly what to do.” Two comments about that. First, it is the dentist who is supposed to know what to do and is supposed to tell the laboratory what to do. Second, the Lumineers laboratory is not one of your excellent esthetic dental laboratories. They do NOT know exactly what to do.

But then you have a problem that legally, you don’t have a recourse if the Lumineers are functional. Cosmetic dentistry is not a legally distinct specialty, so it is judged by the standards of general dentistry. The overwhelming majority of dentists are not artistic, so the governing philosophy in the profession is that if the teeth are functional, they are okay. So you’re not going to get support for your complaints.

So, as far as I can tell, what you’re left with is to try to persuade this dentist to refund your money, with sweet talk, flattery, or whatever you can. Unless there is something gross that was done.

Do you have a photograph of your teeth that you can send me? If I can see anything wrong functionally with the teeth, there may be more you can do. Maybe a photograph of just the teeth and a photograph of your face with the teeth showing the mismatch you’re talking about.

Thanks,

Dr. Hall

Links: Lumineers problems.
And we just added a page to mynewsmile where we are soliciting Reviews of Lumineers.

1.How natural veneer can be? I don’t want that veneer looks unnatural, is it possible that veneer have the exact shape like my natural tooth? 2. Color of the veneer can be perfectly like my other teeth? I don’t want and I don’t need any smile makeover I just wanna close that fracture. At the end, do i really need veneer for that small gap? (your opinion) I hope you wiil respond to this mail, Thank you in advance!
- Luka from Croatia

Luka,
A porcelain veneer, if done by an expert cosmetic dentist, looks very natural. But if done by your average family dentist it can look very fake. In your case, where your chip isn’t too noticeable, you could end up looking worse than if you had done nothing.

If you have a small chip in a front tooth, the best way to repair that is with composite bonding. The dentist just roughens the surface near where you tooth chipped, and applies a composite material that is bonded to the tooth. It can last a long time–years. If the repair is small, it doesn’t take a lot of artistic talent to get it to look good. Larger repairs require some artistic ability to get them to blend in with the tooth and look natural.

I hope this is helpful.

Dr. Hall

Sally,
Lumineers is just a particular brand of porcelain veneers, so I will answer your question by talking about porcelain veneers in general.

I am getting the feeling from what you’re telling me that your dentist is uncomfortable with these cosmetic procedures. Porcelain veneers are usually not taught in dental school, and, while they work great for dentists who know how to do them, they can be intimidating for dentists who don’t. I think this is where your dentist is coming from.

One firm rule I always tell people is to not ever push your dentist out of his or her comfort zone. I have received so many e-mails from people who have really gotten burned trying to do this. Dentists are trained not to let you know when they are uncomfortable because it makes patients nervous. You’re lucky that your dentist is giving you these clues. He feels you would be unhappy with the result, and in his hands, you may well be unhappy. But porcelain veneers are a very beautiful restoration when done right.

So my advice is to stay with your regular dentist for your cleanings, checkups, and general dental work, but to find an expert cosmetic dentist to solve this particular problem.

If you otherwise love your smile and the only problem is this one dark tooth, then if it were me doing it, I would just do either direct bonding or one porcelain veneer over this tooth. If there are other things you don’t like about other teeth, then a full set of porcelain veneers may be in order. But find a true dentist/artist for this. Go to our list of recommended Northern California cosmetic dentists. If you’re not convinced you need an expert, please, for your own sake, take the time to read through some of the cosmetic dentistry horror stories that people have told me, and then you’ll be convinced that the average dentist on the corner is no place to go for this appearance-related work.
- Dr. Hall

Marilyn,
That is not true, that a sonic toothbrush will weaken the bond of porcelain veneers or make them loose.

I looked on the Internet to see where you might have found this erroneous information. I found a website of a dentist in Nebraska who is giving that advice about caring for your porcelain veneers – but my guess it that comes from his own reasoning, because the research does not substantiate that.

The University of Missouri at Kansas City did a study that was published in 1998 where they brushed teeth with porcelain veneers on them for two years with a sonic toothbrush and found that there was no loss of bond strength.

The Sonicare toothbrush is an excellent toothbrush, great at removing plaque. Oral B also makes an excellent sonic toothbrush. Either one is fine for use with porcelain veneers.

Dr. Hall

Read more about the post-operative care of porcelain veneers.

Thank you,
Shayna from Georgia

Shayna,
I wouldn’t know for sure what the problem is with your porcelain veneers and your two front teeth without seeing them, but maybe I can be helpful.

Porcelain is very hard and stain resistant. It is actually more stain resistant than enamel, as long as its glaze is intact. But enamel has a certain capacity for self-repair by drawing minerals from your saliva. Porcelain doesn’t do that. This leads me to wonder if the glazed surface of the porcelain has been damaged.

The easiest way to damage them like this is for a dental hygienist to use power polishing equipment on them – that will destroy the glaze in one short appointment. They’ll look bright and clean when you’re through with your appointment, but within a couple of weeks afterward they’ll begin to attract stain and start to become darker.

If they are darkening because the surface has been damaged, it may be possible to restore the beauty of your smile with sophisticated polishing techniques using diamond grit polishers. I would advise contacting one of our Georgia cosmetic dentists and getting an opinion about it. This is beyond the ability of a family dentist.

Dr. Hall

Related links:
Read our page: How long do porcelain veneers last?
Read basic information about post-operative care of porcelain veneers.

My teeth were badly stained by tetracycline. I had tooth bonding done before all the great whitening treatments that are readily available today. I would have preferred that, although my dentist told me that the whitening treatments don’t really work on the type of staining I had.

So … can you let me know what the best route of refurbishing my old veneers would be. THX!
Nancy from New Jersey

Nancy,
Porcelain veneers can be touched up. They can be polished and the margins smoothed off.
But from what you’re telling me, it sounds like you may need a new set.

You say you have a space developing between the top of the veneer and the gumline. In other words, your gums are receding a little and exposing some of the tooth. And if you have tetracycline staining, this may be noticeable, depending on where your lip falls.
Teeth bleaching simply doesn’t work well for tetracycline staining. That stain is very stubborn, and even if you lighten the teeth, they never become sparkling and vital the way you would like.

But you absolutely need one of the best cosmetic dentists for replacing these veneers. I have heard stories like yours and they have the old bonding or old veneers replaced, and they look terrible. We have a number of New Jersey cosmetic dentists we recommend all over the state. I would strongly recommend that you consult with one of them. Only a small percentage of dentists who advertise that they do cosmetic dentistry have the skills necessary to produce a beautiful smile on top of tetracycline stains.

And even though the life expectancy of your porcelain veneers seems to be what your dentist predicted, there is a lot of variability in that life expectancy. From what you’re telling me, the problems you are having are from changes in your teeth, not from a deterioration of the veneers. They might last quite a bit longer if it weren’t for that.

I hope this is helpful.
Dr. Hall

Read more about how long porcelain veneers last.

Adrian,
You’re lucky to have caught this before the porcelain veneers you dislike were bonded onto your teeth.

I doubt that this dentist lied in stating that she was a member of the American Academy of Cosmetic Dentistry. The problem is that any dentist can join this academy, and it is no indication of anyone’s ability. We list a number of cosmetic dentists in your area. All of them are excellent cosmetic dentists. We check their educational credentials and they have to demonstrate their ability with photographs of their work. With my experience, I can tell pretty quickly from their photographs whether or not they know cosmetic dentistry.

With the help of a local cosmetic dentist who actually can see your situation, you may be able to negotiate some kind of refund. You can always have your original look restored. But I wouldn’t give up on your hope of a beautiful smile. In the hands of one of these true artists, they can create real beauty for you. Pay one of them a visit and let them show you what they can do.
Dr. Hall

Other links:
Click here for referral to a cosmetic dentist.

Response:
Oh my gosh Dr. Hall, thank you so much! I am actually seeing Dr. (one of the cosmetic dentists we list in California) today! You’re advice is much appreciated!
- Adrian

Vanessa,
Of the over-the-counter whitening products, Crest Whitestrips and imitation products by some other manufacturers, are the only products I would recommend, and only for limited situations. These strips hold the peroxide in a gel that is attached to the strip. When the strip is affixed to the tooth, it allows this peroxide to penetrate the teeth and whiten them.

Other products with rinses and powerders, or just toothpastes, are on the teeth too briefly to penetrate and do any good. Some of them have acids like citric acid in them that etches the surface of the tooth slightly, and then this etched, roughened surface picks up the white pigment that you follow with. I have tested some of those products, and they do damage the teeth. They make them temporarily whiter, but then within a few days they relapse to being even darker than they were before, because the enamel has been roughened and now picks up more stain.

The WhiteStrips have a disadvantage in your case in that they are designed to cover only the front six teeth. However, you don’t want the very front veneered teeth covered – you want to cover the teeth that are further back. There might be a way you could cut them and get them to apply to the correct teeth, but that’s a lot of monkey business to have to go through. And the whitening with the WhiteStrips goes very slowly, because the peroxide bleach in them has to be fairly weak in order to be sold over the counter. And the Whitestrips kits are expensive, and could end up costing more than if you did this in a dentist’s office.

If it were me, I would go to a dentist and get your teeth bleaching done right. Dentists use a much more powerful version of peroxide and it will cover the right teeth. Some offices even offer free or greatly discounted bleaching to new patients. I don’t advocate shopping for deals for cosmetic dentistry, but basic bleaching is simple enough that it’s hard for a dentist to screw up, so there I might price-shopping. But absolutely don’t price shop for fillings, porcelain veneers, dental implants, or any involved treatments.

I hope this is helpful.

The bleach will not harm the veneers. They won’t change color. There will be a slight lightening of your veneered teeth, but since that will come from behind the tooth, it won’t have a noticeable affect on how they appear from the front.

Dr. Hall

Read more about over-the-counter bleaching products.
Click here for referral to an expert cosmetic dentist.

I’ve been critical on mynewsmile.com and in this blog of Lumineers. They are a brand of ultra-thin porcelain veneers, and I have yet to see a photograph of a Lumineers case that I felt showed beautiful cosmetic dentistry.

But all the photographs of DURAthin veneers that I examined today looked beautiful, and it caused me to wonder about the difference. DURAthin is also an ultra-thin porcelain, and is sometimes used in a no-prep situation.

I think the difference is in the dentists they attract and the way the products are promoted. Lumineers are promoted to general dentists as being very easy to place and very lucrative. Consequently, they attract many dentists who really don’t know what they’re doing when they get into esthetics. Thus, I get many e-mails from their upset clients. DURAthin is taught almost as an elite technique, and the dentists that place them seem to be fairly sophisticated as far as esthetics. For example, Dr. Nils Olson, a mynewsmile.com recommended dentist who has been chosen as the new chairperson of accreditation in the American Academy of Cosmetic Dentistry, and thus could be considered at the pinnacle of excellence (see his Maryland cosmetic dentist website), uses DURAthin in his practice. Dentists like this will use a no-prep technique only when it can produce superior results. Otherwise, they will take advantage of the thinness of DURAthin by doing an ultra-conservative preparation, very possibly in enamel only, which may require no novocain and which could be likened to a mere dusting of the enamel surface.

Anyway, I’m soliciting more DURAthin photographs from our expert cosmetic dentists, and keeping an eye out, and will keep visitors to this blog and website posted.

I just read your “Lumineers cost“article at  and also the “example” question and answer which pertains to this topic and I was so pleased to read it. I write dental websites, and because of my familiarity with the dental world I have long been aware that Lumineers are not the best option available. I prefer not to write about them in favorable terms, but it is sometimes required as part of my job. I was pleased to read this direct and honest representation of Lumineers. In writing for dental websites, I have seen innumerable before and after images of Lumineers and of truly custom porcelain veneers, and the difference is almost always highly noticeable. While I cannot write website articles that warn individuals against Lumineers in a professional sense, I was very pleased to see that someone else has. Your article came up 3rd when I Googled “Lumineers.”

Because of the nature of my work, I prefer not to make my name available and would appreciate your discretion regarding my email address. However, I wanted to thank you for representing Lumineers as an option, but one which may have more negative than positive aspects.

I am amused to read your “hate mail section” - to find that dentists who are not willing to undergo the training which will allow them to do really great dental work are disparaging toward your article and email, and see it only as confirmation of their lack of interest in their patients’ welfare. Sincerely, &tc.

“L”

Dear “L”,
Thanks for your kind comments.