Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

August 17, 2016

Why you shouldn’t ask your family dentist to do porcelain veneers

We thank our advertisers who help fund this site.

Dr. Hall,
2 days ago, I had a porcelain veneer placed on one of my upper 2 front teeth because it was chipped. I had bonding on this tooth before, but that fell off. This new dentist said bonding was out of the question because 1/5 of the tooth was chipped, and she recommended a crown. But I told her that I would like to do a veneer as it is less invasive than a crown.

Just before the veneer was placed, I had a chance to look at it on my tooth. It looked nice. It was lighter than my other tooth–I picked a few shades whiter anticipating bleaching my teeth afterwards. The shape looked perfect, so I signed the consent.

Once it was glued on, I had no chance to view it. The dentist and the assistant told me it looked great.

Once in the car, I looked in the mirror, and was in shock. The length of the tooth is a millimeter over to the next tooth and it looks like it is now placed a little forward. It looks like she put too much glue and that overall, the tooth looks protruded. On the back side of the tooth (closer to the tip of the tooth), I can feel a gap between the placed veneer and the back of my original tooth. When I bit in my sandwich I can feel the length difference of my teeth.

I called the dentist today and explained the issues. The assistant said the gap in the back of the tooth may be fixed but nothing could be done regarding the length. She even said it’s probably because the tooth moved. I told her I noticed right after the procedure when I got back to my car.

I have the feeling that I may need a second opinion. I made an appointment with the dentist, but I’m afraid to go.
I don’t know what to do, where to start. Any advice would be much appreciated.
Thank you so much in advance.
– Jennifer from Virginia


Unfortunately, I hear about this type of situation a lot.

Most dentists have an engineering mindset, and their appreciation of esthetics in a smile is very rudimentary. This is why they don’t take the time and trouble to learn proper techniques for doing esthetic procedures.

Let me tell you how I’m reading this situation. Admittedly, I’m making some assumptions, and I could be way off base as far as this individual dentist is concerned. But this will help you understand how many dentists think and also understand better how to get this done right.

First, the dentist says that bonding is out of the question. Why? And why so dogmatic about it? There’s no discussion of the pros and cons, just “out of the question.” It worked before, so it’s clearly not “out of the question.” With 1/5 of the tooth chipped, bonding would have been my first choice for repairing the tooth, and it would be the first choice of many cosmetic dentists. My guess is that she’s not that good at bonding. This is what dentists will do to deflect requests for procedures they don’t feel comfortable with.

So she recommends a crown. You perceived this as overkill (I would agree with you), so you asked her to do a porcelain veneer. Based on what happened to you as this procedure was completed, it seems to me that this dentist has limited or no experience with porcelain veneers. But your dentist, thinking that the artistic part is going to be done by the dental lab and not wanting to push you too hard, agrees to do the porcelain veneer, even though she doesn’t feel completely comfortable with that procedure either.

So the veneer is done and tried on. You said the shape, length, and thickness were fine when the veneer was tried on. You got a good look at it, which is appropriate. So far, so good. But then when the veneer was bonded on, this is where it gets odd. The instinct of the dentist would be to show you the final product. They had a mirror that they used before, why none now? That was always the last thing we did in my office whenever we did work on the front teeth–hand them a mirror so they can see the final product. Goodness, even my barber does that. But why didn’t your dentist? Because she’s embarrassed at how it turned out. They just told you it looked great. Ooooh, that part really annoys me, that they would try to tell you that.

This sounds like a case of getting the veneer positioned wrong when the bonding material was applied, and then when they got done curing it they saw that. This positioning of the restoration is something that is very different between veneers and crowns. It is very easy to seat a crown on a tooth–you just slip it on and it’s very easy to tell when it is fully seated and on correctly. With a veneer, the dentist doesn’t get that same feel for it being seated correctly and it is very easy to get the veneer seated in the wrong position.

It also bothers me that when you called with this rather serious issue (your smile has to look at least a little funny with one front tooth longer than the other) that they had the dental assistant answer your questions. And the dental assistant is not right. Of course something can be done if the veneer is too long. If it were otherwise okay, it could be trimmed. In your situation that wouldn’t be good enough–the veneer needs to be re-done. But trimming it would certainly help. And it’s ridiculous to attribute the problem to your tooth moving. Your tooth isn’t going to move like that regardless of how much time had elapsed since the veneer was bonded.

As I said, they probably just got the veneer seated wrong. That’s not a fatal mistake. That actually happened a once to me. The bigger problem to me is their reaction to it. They should have said something to you immediately. The correction, after the veneer is bonded, has to be to completely re-do the veneer. So if this had happened in my office, I would have trimmed and polished the veneer so it looked like the adjacent tooth, I would have told you what happened after showing you the result, and then made an appointment to re-do it.

Oh, and another point. If you’re going to bleach, the dentist should have bleached your teeth FIRST, then waited a couple of weeks for the bleached color to stabilize, then done the veneer. Your front teeth need to match exactly, and you can’t bleach teeth to match a certain color. The only way to get the teeth to match is to do the bleaching first. An expert cosmetic dentist would have told you that.

So, what to do from here?

First you need to get with a genuine cosmetic dentist. Go to our website, put in your city, and see what your options are. We have several near you in northern Virginia.

And of course your dentist should refund your money. It seems to me that she is embarrassed about this, and I believe she won’t put up much resistance to your request for a refund. If she does give you any trouble over that, you could file an ethical complaint with the dental society or the dental board. But my guess is that she will want to make this right for you. Be sure you get good documentation about how this looks–have the expert cosmetic dentist take photographs of the front and back of the tooth, because it should be fairly easy to show that the veneer isn’t seated fully. This is a clear error that any dentist should recognize.

Dr. Hall

Do you have a comment or a question or anything else to add? We’d love to hear from you. Enter your comment below.

Click here to ask Dr. Hall a question of your own.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

August 11, 2016

This dentist does a really fast crown preparation

We thank our advertisers who help fund this site.

Hi Dr. Hall,
Should I consider leaving my current dentist? When I first met my dentist, I was amazed a how incredibly fast he could trim down a tooth for a crown. It seemed like less than ten seconds. However it now seems as though he shaved some teeth down too far. Two of his crowns have fallen out twice, and there does not seem to be much tooth left to hold them. Could it be that he was working too fast and took too much off of the existing teeth?
I am not planning on suing but I cannot afford to lose any more teeth to his crown work, and cannot afford implants at the moment. Should I seek out a different dentist? Is there any guarantee with a crown?
– Marcos from New Jersey

While there is not really a guarantee with a crown, there is a concept in dental care called the standard of care–a minimum standard that an average dentist should provide his or her patients. There may be situations where there simply isn’t much tooth left to hold the crown on, so even a dentist who is doing everything right could have problems with an occasional crown staying on. But if there are recurring problems with crowns from a particular dentist with crowns falling off, that could indicate a breach of the standard of care and the dentist could be liable.

I realize that you don’t want to sue, and I’m not suggesting that. But knowing the dentist’s liability can be used to give you a bargaining position to get things fixed correctly without having to pay another dentist to do this over.

You say that two crowns have fallen off twice, and that you could see there wasn’t much tooth left on these teeth. While I don’t know the history of these teeth, that, together with your description of how little time this dentist spent on the crown preparations, suggests to me that the teeth were prepared with too much taper. I refer you to my earlier post on this subject, The Main Reason Your Crown Probably Fell Off, where I explain the role of taper.

In over 20 years of dental practice and placing many hundreds of crowns, I never had a crown that I placed fall off. I say that not to brag but to make the point that if a tooth is properly prepared and a crown properly cemented, it will stay on. Yes, it takes more time and trouble to prepare a tooth precisely so the crown stays on, and it is also more time and trouble to seat and cement a crown with an ideal preparation, which is why most dentists compromise on the ideal preparation a little bit. It sounds like your dentist compromises a lot in the interests of speed.

So to get to the point. Yes, if I were you, I’d find a dentist who does crowns that stay on. And then I would get these two teeth fixed with crowns that stay on. It may be necessary to have new crowns made. Even if a tooth is over-prepared, there are ways to modify the preparation, either with retentive grooves, or with a buildup and possibly the use of pins, so that a crown will stay on better. Or, depending on the material in the crown, it may be possible with bonding technology to get a poorly prepared crown to stay on. I would find a dentist who can take care of this for you, and ask that dentist to help you get some type of refund, even if it’s a partial refund, from your current dentist.

– Dr. Hall

Do you have a comment or a question or anything else to add? We’d love to hear from you. Enter your comment below.

Click here to ask Dr. Hall a question of your own.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

November 4, 2015

My dentist said my new veneers may come off every couple of months

We thank our advertisers who help fund this site.

Dear Dr. Hall,

I just got 8 top veneers placed on. As I was leaving the office, I was told they may come off every couple of months. I know I can’t eat apples or crunchy things with them but are they going to fall off that often??
Thank you for any info you can give me.
– Dorothy from Maine

Really! They told you your new porcelain veneers may come off every couple of months? That’s a new one!

If they do come off, I will tell you what to do. Go back to their office and demand a refund or you will call a lawyer, because if they do, they weren’t done right. Take a copy of this email with you and show them – I’ll stand behind that statement 100%.

There is a principle in the dental profession called “the standard of care.” Now, unfortunately, since cosmetic dentistry isn’t a recognized specialty, the standard of care for cosmetic dentistry is pretty low. Your new veneers don’t have to be beautiful. They may even look dingy and still meet the standard of care. But they do have to stay on. That much is pretty basic. So if your veneers begin falling off within the first couple of years, that is a breach of the standard of care, and the dentist is legally liable for that. It’s hard to put a number on it, because they should never just fall off. But if I had to use a number, I would say they should last ten years, at least.

And about your dietary restrictions. I placed many veneers over a period of maybe 15 years, and I never told my patients not to eat apples or crunchy foods. I told them to eat whatever they wanted, except for pins and bottle caps and stuff like that.

In fact, I will go this far. I would encourage you to test the veneers by eating some apples. If these veneers aren’t going to stay on, it is better if you find out now rather than later. Put them through a stress test and see if they’re bonded properly. A properly bonded porcelain veneer will not come off. I had a couple of cases where I had to re-do some porcelain veneers, and you have to grind them off, just as if they were part of the enamel, they are bonded so tightly.

There are only a couple of legitimate restrictions to your activities after you have a set of porcelain veneers, and I list those on this website on a page dedicated to the postoperative care of porcelain veneers. That is to avoid biting metal objects, and to wear a mouth protector when playing contact sports. But even those activities would potentially cause the veneers to chip or crack, not to come off.

If someone tends to grind their teeth at night, I also would wear a nightguard over the teeth to protect the veneers from chipping or breaking.

But apples and crunchy foods? You should be fine with those. Go enjoy yourself, that’s what I would say.
– Dr. Hall

Do you have a comment? We’d love to hear from you. Enter your comment below.

Click here to ask Dr. Hall a question of your own.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

July 28, 2011

How to get a refund from the dentist who screwed up.

Dr. Hall,
In November 2009 I had a crown put on my number 8 front tooth. My tooth was slanted from sucking my thumb when I was little, and this was to fix that.

About 3 weeks after my crown was put on my tooth was really sensitive to hot and cold. I was told that was normal for the first few weeks. About 4 months later my tooth was hurting so bad that I had to go to the ER! The next day my face swelled up and I was out of work for 5 days. When I went to another dentist, they told me that my tooth was infected and that I would need a root canal and a new crown. I was like WHAT??? how could this happen? She told me that I had an open margin and it was from the crown not being placed properly.

I called the first dentist, who did the crown, and I told the secretary the situation. I told her that i deserved my money back because for his mistake i have to pay for another crown and a root canal!! she said that once the crown was in my mouth it was my responsibility!! I said even if it was a failed job???

Is he liable for this? Shouldnt he pay?? I have seen the xray and the open margin is huge! ! If he we re to have taken xrays at the end of the job he would have seen the open margin and knew it had to be redone.

At the time I was making payments on the crown and paid a little more than half. After I found out about his mistake i told the office i was not paying the balance . About three months later I got a notice saying he was suing me for the balance! I couldnt believe it ! I of course filled a countersuit and when I went to the small claims court his lawyer told me if i drop the counter claim then the dentist would “forgive my debit”. I said NO I want the money that I paid him and his lawyer said “Well he is not willing to do that.” The case now has to be handled by the superior court because civil court can’t deal with things like this.

My question is should this guy have fixed his mistake? Because of him I was in the most extreme pain I was ever in, I had to miss days of work, I had almost a dozen appointments ( emergency room, doctors and dentist visits), my face swelled up so bad that I could barely see and I had to get a new crown and a root canal . Please let me know what you think!

– Sarah from Massachusetts

You have quite the story!

I have to qualify this because I can’t judge this without seeing. But just going from what you’re telling me, yes, your former dentist is liable for violating the standard of care. The most important thing to check when a new crown is being seated on a tooth is to run the explorer around the margins and make sure there is a good fit to the crown. Usually a dentist won’t take an x-ray before seating a crown, but they always need to run that explorer completely around the margins of the crown and check for any open margins. But having the x-ray you have is good documentation showing his negligence.

The problem, though, in many cases like this is that the dollar amounts involved make it impractical to involve lawyers and to go to trial. But here are a couple of things you can do to increase the pressure on this dentist to refund your money:

1. Threaten to complain to the dental board. Not as serious as a malpractice suit, this is still something that the dentist is strongly motivated to avoid.
2. Have the new dentist help you. A call from one dentist to another, verifying that there was indeed a problem with the work, can be very persuasive. In a trial, you HAVE to have an expert opinion of a dentist to back up any claim of negligence. Your word isn’t good enough.
3. Have a lawyer write a threatening letter. Rather than pay for an entire malpractice case, just having a letter from an attorney can get the dentist to take your complaint more seriously.

Dr. Hall

Click here to read more about porcelain crowns on front teeth.
Click here to ask the dentist a question.


We thank our advertisers who help fund this site.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

April 23, 2011

Unhappy with Lumineers

Just two days ago I took my daughter in to have some Lumineers put on, first four teeth on the top. Prior to this she had braces to fix her teeth, and close in as many spaces as they could. We were told that the Lumineers were the least invasive and would close the gaps and be better than using bonding to fill them in. When talking with the dentist earlier, we saw a picture of before and after from the Lumineer book and said that we wanted them to be more tapered and not square, similar to the picture. They said they would take care of it and let us know when they came in.

When I asked if we could see them first before going on they said yes, but the way they did this was not the way they said they would. She had them in her mouth with some kind of temp material and her mouth was pulled back with a rubber device that really was hard to tell what was going on, and I couldn’t get a good view of them. Earlier they said she could get up and walk around with them in different lights, but this never happened. He assured us that it would look better when they are put on permanently.

I realized right away how big they appeared compared to her other teeth and how bulky they looked. I asked if there was something they could do to taper them, but he said to live with it for a week and see how we feel. I approached this again, and said how big they looked in the front, but they kept telling us how perfect they were. I felt like we were in shock and didn’t know what to say.

So, at home we really could see that these did not fit her face or her other teeth. They were large, straight across and she seemed to be having trouble talking and closing her mouth. Bottom line is that we are very unhappy.

The next day she went to school and the poor girl got teased, horribly. The kids comments were, horse teeth, they look fake, and the nice kids would say, they are nice but too perfect and big.

I see now, after the fact, that you really do need a cosmetic dentist. He claims to do cosmetic work, but when I checked out further, he is a general dentist. I called today and they are going to tapper them more, and they should look a lot better. But now I’m afraid of what the integrity will be. We could try this, but I think we just want them off and be refunded, so we can see a cosmetic dentist. What do you think is our best approach so we can do this without legal matters? We paid by credit card and we are not going through the insurance.

Cindy – Not happy in Oregon

I think there is a decent chance you could get money back to get this fixed right, if you go about this the right way.

I don’t know this dentist you’re talking about, so I’m judging this by what you are telling me. But it certainly sounds like you are right, and you have a dentist there who simply lacks the passion for appearance-related dentistry that you need for a case like this. An excellent cosmetic dentist would have been able to predict that these teeth would end up looking bulky. That is what Lumineers do. Also, an excellent cosmetic dentist would never have rushed through the try-in process, and would not have pooh-poohed your concerns when you first expressed them. He would not have said they will look better when they are put on permanently, and would not have asked you to live with them for a week and then see how you feel. All of these are attempts to brush aside your dissatisfaction.

One of the fundamental differences between dentists who are “fixers” and not artists is that the artists are very sensitive to your opinion of the appearance of their work, and they will deal with even the slightest hint of dissatisfaction.

A problem in dealing with a patient’s dissatisfaction with the appearance of dental work is that the standard of care for dental work involves primarily the function of the work, so it is difficult to get restitution simply because you are unhappy with the appearance. But your complaint is more than just that you don’t like how it looks – you were deceived about how the process would work, and the biggest thing is that you must have told them you didn’t want them to be put on – because you told me that they tried to assuage your concerns by telling you they would look better once they were on permanently – which isn’t true. Plus the embarrassment suffered by your daughter is very real and very documentable.

You say you want to get this resolved without involving lawyers. To do this, however, you will be most effective if you tell them that is your intention, while letting them know that you understand the strength of your position if you actually were to go that route. Here’s how I would proceed.

First, I wouldn’t have them do any more work on this. Wherever you are in the process, stop right now. Not only will this help your case, but it is more fair to them. The less chair time they waste on this, the lower their costs are. Plus that way you are making the strongest statement about your dissatisfaction.

Second, I would be very clear about your dissatisfaction, that you were led on and that you were told things that weren’t true. I would also be clear about the embarrassment being suffered by your daughter. These are your bargaining chips.

Third, you need to enlist the help of another dentist who will be sympathetic and who will go to bat for you, and be the person who will get you the deal from this dentist. Dentists are very conscious of their reputations with other professionals, so the other dentist will be in a little better position than you are to get this done.

I would suggest going to a dentist from out of town, because they would be more likely to take your side on this issue. Find an excellent cosmetic dentist on our list, and go see them for an opinion, and ask what they would be willing to do to help you get a refund of this procedure,

Also, if you haven’t yet paid the credit card charge for this procedure, I would tell the dentist that you intend to lodge a complaint with the credit card company and refuse to pay that bill unless you get a refund. This gives you one more avenue of protection, because the credit card company may be persuaded to take your side in a dispute over the charge.

I wish you well. I feel for your daughter. School mates can be cruel.

Dr. Hall


We thank our advertisers who help fund this site.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

Powered by WordPress


Follow this blog

Get every new post delivered right to your inbox.

Email address