So there is the link, and if you’d like to help her out, check out the site or tell your friends.

I had a related question. It has been very difficult getting certain information regarding the early AACD accredited dentists and so it makes me feel that there is something to hide. My respect for you is considerable and that’s why I hope you will be forthright with me on this. I wanted to find out if the early doctors were conferred accreditation without much ado. It’s happened before and with other new organizations, such as the fellowship I received, but I think it would be better to be up front about stating that the founders became accredited without examinations and case submission rather than be untruthful.

Kindest Regards,
A cosmetic dentist in Chicago

Dear —
Thank you for your kind words.

I was there in Toronto in 1986 when the AACD first announced the accreditation program. The first dentists accredited didn’t have to pass an exam, because there was no accreditation committee – they had to start somewhere. So there was some agreement that certain of the charter members were skilled enough, and there wasn’t any exam anyway, because there was no one recognized to examine the others. Jack Kammer, the founder, Michael Miller, the first accreditation chair, and others were accredited by being “drafted” so to speak.

For a while after that, to be able to get recognized authorities and lecturers accredited and help establish the credential, there were dentists who were given accreditation “by lecture.” Their lectures were well known and the work they displayed was of recognized quality, so they were granted accreditation without an exam.

I have heard rumors or grumblings, if you will, that some of the very first dentists accredited in this way didn’t have work that was of good enough quality to pass the exam. I have no direct knowledge of any of that. But I do know that once the examination process got established, there were measures taken to tighten up the process and there was much grumbling that the exam was too hard. The failure rate was about 2/3 for a while, and those in charge of accreditation would not budge as far as making it easier. Instead, their answer was to bolster the education and preparation process, and to add mentors to help to bring the dentists up to a certain level of excellence. I know from going through the accreditation process even in the early days (I think I was something around the 47th dentist to become accredited, having started the accreditation process only one year after the path to accreditation was announced) that it was very demanding. I felt as though I had done a masters thesis. It required a great deal of focus, self-criticism, and re-doing of cases before I felt that I had cases that would meet the approval of the committee. And even then I had one case I thought was good enough, but I had used a material that didn’t take a polish well, and I had to resurface it with another material and polish it to a perfect sheen in order to bring it up to their standards. The questioning was tough, and there were dentists who did reasonably nice work who failed.

- Dr. Hall

Links:
Click here to find a cosmetic dentist.

Jason,
Thanks for your kind comments.

When it doesn’t hurt to clench but hurts when you eat, yes, that is almost always this bonding issue. If the dentist uses a self-etching primer, that will practically completely prevent that type of sensitivity. If he doesn’t have a self-etching primer, then he should be careful not to dry the tooth too much after etching. Visible moisture should be removed, but you don’t want the dentin dessicated.

Since the tooth was quite sensitive before it was filled, that kind of weighs on the side that it could be some bacteria in the pulp. Hopefully replacing the filling will do it for you.
- Dr. Hall

Thank you for responding to my true concerns and questions! 

When I reviewed your website material, I was extremely impressed with the way you handled your questions–with pure honesty.  This is why I needed to contact you about how I’ve been feeling since having these crowns in 2004.

Your professional advice has assuaged my unsure decision of having crowns.  And let me tell you, I’ve been unsure since 2004, and I feel better with this decision more than ever.  (I’ve been complaining about this to my supportive husband–the poor guy.)  When my family and I can save more money, I will make sure I seek one of your recommended cosmetic dentists.  I will send you photos once I make the better change.

Please remain active in your specialty and website.  You have been more than helpful. 
THANK YOU THANK YOU.

Sincerely,
Alma

Dear Ogas,
There is something very wrong with your dental work. It my days of practice, I had several occasions to replace dental work done in other countries, and I frequently found poor dentistry with overhangs that would catch food or other basic defects.

The materials your dentist used sound first class. But if there are overhangs on all the crowns, that could produce the putrid smell that you’re experiencing. I can’t tell if that’s the case. There are other possibilities.

If this problem is allowed to remain, it will likely lead to gum disease and early loss of your teeth.

There are excellent dentists throughout the world. But I believe the consensus among the world’s dentists is that there is no place that has as high standards for dental care as the United States. So what I would look for would be a dentist in India with some credentials from an international organization based in the United States. A couple examples of that would be accreditation or some other credential from the American Academy of Cosmetic Dentistry (There are two accredited members of the AACD in Mumbai, India, and several accreditation candidates in the country), or fellowship or diplomate status with the International Congress of Oral Implantologists. There may be other credentials. I would track down a dentist with a credential like that and go there for an opinion on your case. Go to the website of the specific organization and they usually have a search tool for finding a credentialed member.
- Dr. Hall

My name is Ashleigh and I’m currently an undergrad and pre-med/dental student at the University of New Mexico. My mother is a dental hygienist so I’ve grown up around the biz and I’d love to train for cosmetic dentistry. I’m primarily an artist and greatly value aesthetics and form, so I feel this was a wonderful direction in which to switch gears. I’ve got a ways to go before dental school, but I’d like to know exactly what special training (and possibly where to get it) I would need on top of finishing dental school to become a cosmetic dentist? Thank you for your time. All the best, Ashleigh

Ashleigh,
From my experience and from asking other cosmetic dentists this same question, most of us feel it takes about five years after dental school, attending continuing education courses and trying to practice the things you learn, to really feel competent in cosmetic dentistry.

And I believe the best way to learn cosmetic dentistry is to join the American Academy of Cosmetic Dentistry and faithfully go to their annual meetings every year. They have excellent lecturers and hands-on training that are designed for dentists to start learning the basics of cosmetic dentistry and gradually become masters at it. There are other postgraduate programs in cosmetic dentistry, such as at Baylor University in Texas, and other places, too.

And, of course, as I preach throughout this website, a cosmetic dentist needs to be fundamentally artistic, which goes against the grain of the great majority of dentists. So you’ve got a good start in that direction.

Dr. Hall

Click here for referral to a cosmetic dentist.

I would like to hear other patient’s opinions about their experience with him but cannot locate any of this through the internet. Any suggestions? Also do these cosmetic dentists that you recommend typically do other general procedeures like root canal etc.?

Thanks for your help.
Brenda

Brenda,
From your question, I think that maybe you don’t understand what our website is. We recommend COSMETIC dentists. That is very different from recommending dentists. Do you need a dentist for general dentistry, or do you need a smile makeover or other anterior work?

When we recruit dentists for our website, I study their credentials as far as cosmetic dentistry training, and we check photographs of their work. That is what is required in order for me to be able to assure visitors to our website that they will get beautiful work done at the hands of these dentists. While we try to get a sense of the office friendliness and chairside manner, and those do factor into our decisions about who to recommend, those aren’t primary considerations. And no, often dentists who are really passionate about appearance-related dentistry do not do root canal treatments, though sometimes they do.  But they always do basic dentistry, such as cleanings, checkups, and fillings. And while they are always highly skilled, and they are often warm and understanding, they are not chosen on the basis of their warmth.

Some might accuse me of poor salesmanship to say this, but to be absolutely honest with you, I would tell you that if all you want is a general dentist – if you don’t have any appearance concerns – then this isn’t the right website for you.

As far as reviews, they are helpful for some situations but aren’t the answer if you’re looking for excellent cosmetic dentistry, and let me explain two reasons why this is true. First of all, I have dentists that I know very well, and I’ve seen their work, and it is magnificent, but I have seen that they occasionally get bad reviews from people on the Internet. Some patients might think the dentist is too expensive or too high class. And every dentist runs into a wack-o patient or two that they can’t please no matter how hard they try, and so they throw up their hands, ask them to go elsewhere, and end up with a very irate patient. While the vast majority of their patients are very pleased, some aren’t, and they can be the source of bad reviews.

And while patient reviews are helpful, patients rarely have the expertise to compare one dentists aesthetic skills with another. I have seen patients who thought their dentist did okay on their smile makeover, only because they didn’t know how beautiful their smile could have been. So that’s why I think our site is indispensible if you are looking for cosmetic dentistry services and why patient reviews simply aren’t your best source of information. But if you are just looking for a dentist, then you don’t need those credentials, and I would just go to the reviews where you will get a good measure of the dentist’s likability, the friendliness of the office, etc., which are all valid considerations for choosing a general dentist.

America’s Top Dentists is not necessarily that reliable. I don’t know how they pick the dentists they list. I know they don’t conduct examinations of the dentists’ work.

I hope this is helpful.
Dr. Hall

Links you may want to check out:
Read about the difference between an artistic cosmetic dentist and an excellent general dentist.
Click here for referral to a cosmetic dentist, screened for artistic ability and cosmetic dentistry training.

I was wondering how you determine/identify the Doctors listed in your referral page. Do they apply to be listed or do you have prior knowledge of their reputation and skills? I am in need of a dental implant and am exploring services in the Austin TX area. All of my top teeth are crowned (1994) so I also need someone with the skill to restore my smile by matching the new crown to the rest of my teeth.
Thank you,
Ann from Texas

Ann,
The listings we have sometimes come from dentists whose reputation I know through my association with the American Academy of Cosmetic Dentistry or other cosmetic dentists. Sometimes dentists approach me, and most of those requests are turned down. In the case of Austin, where you are, I didn’t know Dr. Sweeney, but found his name on a list of dentists that I have access to – dentists who had passed the written examinations for accreditation with the American Academy of Cosmetic Dentistry. While this speaks of his knowledge, it doesn’t speak of his ability to apply that knowledge. So I checked out close-up photographs of his work to verify his skill, and examined his other credentials. His work was beautiful. I have since met him at a dental meeting.

There are a number of listing services on the Internet that list dentists. However, I have taken the risk of personally recommending any dentist I list, so I check them out to make sure I am comfortable with the dentistry they do. I am not aware of any other website that actually recommends dentists the way I do, and it’s a matter of personal integrity to me that the dentists listed meet high standards. I am confident that Dr. Sweeney, whom I recommend in Austin, has first class artistic ability and does excellent dentistry. So you are in good hands if you go there.

I do publish a disclaimer that is linked from every page in the referral section, to protect me legally. Ultimately, it is the responsibility of the Boards of Dentistry in each of their respective states, to protect the public from incompetent dentistry. I’m not intending to take their place in that role. And the recommendations are my opinion, not my guarantee. I am not in a position to be able to insure that no dentist I list will ever make a mistake. But in my educated and informed professional opinion, the dentists I list are all excellent.

I hope this helps.
- Dr. Hall

Links:
Click here for referral to a top cosmetic dentist.
Click here to visit our Texas cosmetic dentists page.
Read more about smile makeovers.

Gina,
I’m not sure I understand what you’re saying.

Are you saying that you went to a dentist that we recommended on mynewsmile.com, and that this dentist had not heard of bonded, all–porcelain crowns for front teeth?

If so, I’d like to know, and I’d like to know which dentist that was.
And how was it that the lab tech was asked?

l want to try to figure out what happened with your case and then see if I can help you.

Thanks,
Dr. Hall

Dr. Hall
When I mentioned to Dr. N. Summer Lerch of New Haven,CT that I was looking for an accredited cosmetic dentist that would be skilled in bonded all– porcelain crowns for front teeth. Dr. Lerch did not confirm or acknowledge your findings that bonded all-porcelain crowns for front teeth would have the strength that Zirconia would have. Dr. Lerch relied on the lab tech’s recommendations for the crowns. Actually the lab tech refused to make the crowns in stackable porcelain. Unable to find another dentist at that time because I was charged in full for payment of my crowns on the day the lab tech refused to use stackable porcelain on front crowns.
If all this is confusing I will include my home phone if you have questions.
Thanks
Gina

Gina,
Zirconia crowns ARE stronger than bonded all porcelain. They have no metal, and while they are not all-porcelain, I would call them all-ceramic, and their appearance is excellent. They can be made beautifully translucent. A conventional porcelain is usually baked over the zirconia framework, and the end result can be made to look so natural that you could not tell them from natural teeth.

I don’t believe that your dentist was unaware of bonded all-porcelain, but rather than for your situation she felt that zirconia would work better. I’m not in a position to second guess that recommendation, not being able to examine you.

Which particular crowns should be used in a given situation is a matter that depends on a number of factors. I don’t recommend that patients try to push their dentist into using a particular type of crown, because often part of the decision is based on what works well in the hands of a particular dentist, and this will vary from dentist to dentist. Rather, I recommend that each patient find a dentist whom they trust and has the skills necessary to produce a beautiful result, and then give that dentist free rein to choose the material that works best for them in each particular situation.

Dr. Lerch was carefully considered before I recommended her on this website, and I am absolutely confident that she could produce a beautiful result for you. She has been on the accreditation examining board, which means that her esthetic talent and technical ability are highly regarded among her peers.

As far as relying on information from the lab tech, when a dentist has a trusting relationship with a skilled laboratory technician, yes, we often use them as a source of information on new materials. Zirconia is an up-and-coming material that many top cosmetic dentists are turning to, because it is so strong and can be made highly esthetic. And when it comes to the technical information about the strength of the material and its suitability for various situations, then yes, we will turn to the technician. I have criticized on this blog dentists who use the laboratory technician for a shade-matching appointment, because an excellent cosmetic dentist needs to have a great eye for color and an ability to communicate color. But the dentist and the technician are a team and each brings expertise and talent to every project.

I’m skeptical that the laboratory technician made the final decision in your case. If you were giving me trouble over my choice of material, I might use the lab tech’s opinion to help avoid arguing with you. When we as dentists are faced with a difficult patient who wants to push us into a treatment we know will be sub-standard, it’s easy for us to say things that may seem to that patient to be unreasonable. I’m inclined to believe that Dr. Lerch was showing integrity in your case, but I can see how it wouldn’t appear that way to you.
Dr. Hall

Related information:
Read more about porcelain crowns.
Click here to find an expert cosmetic dentist.

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.