Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

March 5, 2013

Did you really need that full mouth reconstruction? I’m suspicious.

Dr Hall,
I have been going to a local female dentist here for the last 10 years and over the last few years she has put new crowns in the top front (6 or 8) teeth with the metal backed crowns and they leave a black stain across my gums (and chipping, breaking) all the time and she charges to repair these…. so she doesn’t back up her work.

I found a cosmetic dentist in nearby (town’s name withheld), Dr. (doctor’s name withheld) and he inspected my mouth and told me that not only did those horrible teeth need to come out but that my bite wasn’t right and the top teeth were wearing down the bottom to the point of my bite collapsing. Well yesterday Dr. (name withheld) gave me 28 new temporary crowns – will get my permanent ones next week. They will be porcelain and the temps look great it’s just that I find it difficult to eat and maybe it will take some time. I guess I need to get used to it and learn to deal with it.

One more thing is when I order my new permanent crowns I want to make a couple of changes, such as slightly lengthening my eye teeth or maybe offset them slightly to give me a less perfect smile or should I say maybe they won’t look like false teeth. Do you have any input on this situation? It will be about a week or more before I have this done but I want to come out with the best “natural” looking and less fake smile. Is there any other tips! or tricks that I could do as well?

Thanks,
– David from Mississippi

 

David,
I’m glad you e-mailed me. You could be in for a lot of trouble, and you should take your next steps very carefully. I would not let this dentist put your permanent crowns on until you get two big issues solved. I am highly suspicious of this whole situation. I’m going to give you my phone number, and I want you to call me about this. But let me explain your situation first.

1. The number one issue is that you need to be sure that your bite is comfortable with the temporary crowns before proceeding with the permanent crowns. If I were you, I would call the dental office and ask that the laboratory order be put on hold until you have temporary crowns that are comfortable to your bite. Your dentist is opening your bite with a full mouth reconstruction. This is a risky procedure, and could leave you with serious TMJ disorder if it’s not done right. Clue number one for your impending trouble is that you find it difficult to eat. Clue number two is Dr. (name withheld)’s website, where, when I read his bio, I don’t see any clue that he has the advanced training that would be necessary to do work of this complexity. Ordinary dental school education isn’t enough – there are institutes such as the Pankey Institute in Florida or the Las Vegas Institute for Advanced Dental Education that train dentists to do this. And when dentists go through the trouble to obtain this advanced education, it is highly unusual that they would have a website that wouldn’t mention it.

2. You have some matters you want addressed in the appearance of the teeth. Those need to be settled BEFORE the dental laboratory starts making them.

Here is what you need to do, and I am emphatic about this. DO NOT let Dr. (name withheld) or anyone on his staff talk you out of this.
1. Get the laboratory work put on hold until you get the two issues above solved, and until you can get a second opinion about this work.
2. Go get a second opinion. You are spending well up into five figures on this, plus you are putting the rest of your life on the line. If this work isn’t done right and you end up with TMJ disorder, that can make you miserable for the rest of your life until you would get the work re-done. Don’t take this lightly.

I’m going to recommend you go see an excellent dentist in Lafayette, Louisiana, for an opinion on this. I have looked for excellent cosmetic dentists in your part of Mississippi, and haven’t been able to find any, so I think it would be worth it to you to make the trip to Lafayette. I looked up directions on Google Maps, and I see this is a drive of several hours for you. But that’s a small thing when you’re talking about something so major. It is Dr. Mike Malone. He is highly expert in both cosmetic dentistry and reconstructive dentistry. He’s a past president of the American Academy of Cosmetic Dentistry and has been trained in advanced reconstructive dentistry at the Pankey Institute. But more than that, I have known him personally for many years, and he is a decent, honest dentist who will tell you what you need to do. Additionally, if you get out of the Jackson area, you avoid complications that can occur when the dentist giving the second opinion knows the first dentist. They might be buddies, which isn’t good, or they might be fierce competitors, which could be worse. And be sure you see Dr. Malone personally. He has two associates who do the general dentistry, and he does the advanced restorative. When you call, tell him that I referred you. His website is www.mikemalonedds.com, and the contact information can be found there.

I can’t make any declarations for sure without seeing you myself, but as I said in the beginning, I am highly suspicious. There are dentists who recommend full-mouth reconstructions purely for the profit involved. I certainly hope this isn’t the case with you, but you need to find out before this work proceeds any further. If the dental laboratory doesn’t make the crowns, that makes this whole thing a lot easier financially. You could transfer to another dentist, for example, for no additional expense. On the other hand, if the crowns are installed, then fixing you would involve starting all over from the beginning, preparing the teeth, and making new crowns from scratch.

Please call me on my cell phone, and you can talk to me about this.
– Dr. Hall

Link: Click here for information on getting a referral to an excellent cosmetic dentist.

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.

March 4, 2011

I don’t really think I had five cavities.

Dr. Hall,
I recently went to a new dentist to get my teeth cleaned. I floss every day and I brush my teeth in the morning and most nights also, I dont drink alot of sodas either. I take really good care of my teeth. My old dentist told me I had great teeth. I found it weird that the dentist I went to the other day told me i have 5 cavities. All of them were in my back teeth. I went and had them filled, which he filled them with the white ones.

Since then I’ve had alot of problems with pain. I’ve had him adjust my bite but it still hurts. I really dont think I had cavities at all though. Should I get an xray from before and bring it to another dentist to see if I even needed the fillings? I looked at the xray after he took it, I didn’t see anything, but of course I’m not a dentist either. I just never had pain before and now I do, plus with the care I take with my teeth I dont see how I could have had 5 after just going to the dentist last year and had none. Just wanting another opinion.
– Alicia in Tennessee

Alicia,
It is possible that you had cavities that the first dentist missed. I had an experience after I got out of dental school where I had a large cavity in my own mouth that had been there for quite some time and the x-rays taken at dental school missed it because they were taken at the wrong angles. But I think you’re reasonable to be suspicious. Yes, if you have reason, like you do, to be suspicious, I would ask for a copy of the x-rays and get a second opinion. But tell the second opinion dentist as little as possible, and don’t let the second dentist know the name of the first. I would just present the x-rays and show up and say, “I’d like a second opinion on this dental work” without planting any ideas like that you thought the work was unnecessary. A dentist who is hungry for patients will sometimes try to agree with a patient in order to convince a patient to quit the other dentist and become a patient. And a dentist who is personally acquainted with another dentist will sometimes hold back and feel a strong obligation not to criticize. To get the very best second opinion, you could visit a dentist in a distant city while you’re on vacation or something.

The post-operative pain you’re feeling also makes me suspicious. It sounds like the white fillings may not have been done correctly – not bonded correctly. Do you have pain when you clench your teeth together? Or is it just pain when you’re actually chewing something? If it doesn’t hurt to clench, but it hurts to chew, that’s an indication that something went wrong in the bonding process. If that pain persists, it may be necessary to replace the fillings to alleviate it. If it hurts to clench, then it’s probably that the bite just needs to be adjusted.

– Dr. Hall

Links: read more about pain after new fillings.
Click here to find a cosmetic dentist.

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.

October 20, 2010

Can I Switch Dentists in the Middle of Treatment?

Dr. Hall,
I am in a situation that I do not know what to do. I am in treatment for full crowns except for the six lower front teeth. My terms were all porcelain, they use empress, and flush emergence from the gums. The Dr. assured me he could do that, he is a prosthodontist with an in-office dental lab. First fitting (the upper 6 teeth only so far), the teeth were rounded at the gums and I could feel the line between the crown and the natural tooth. They did not look like normal teeth. I had him do them over and then the crowns were pushed up against my gums which made my gums lose the pinkish color. They looked like a set of dentures. He said I didn’t have any gums. I wore them out with temp glue and returned with my before pics and made sure he could see my gums. They made new ones and they are in now with temp glue. Some have flush emergence from the gum, but in the back, the crowns do not cover the sensitive area of my underneath teeth. I cannot stand to put anything hot or cold near the roof of my mouth. I am so distraught. I STILL have temporaries on all my other teeth. I am so concerned about the pressure on my real teeth and gums right now.

I want to get a 2nd opinion but I don’t know if anyone will even take my case at this point. Will they? I have paid this Dr. $29,000. Can I get a refund and go somewhere else at this point? I have taken pics of the last permanents that I had him do over and I can take pics of these. I cannot go to Dr. D (a dentist that we recommend) at this point because he was my next choice from this Dr. and Dr. D knows that. I can go to someone in (City A) or (City B). I am terrified because this is my whole mouth!! Please advise me. Thank you.
– Deborah

Deborah,
Prosthodontists tend to be the ultimate in the engineering mentality that think that your concern over how the teeth look is not worth their time to address. So you have a basic conflict with the dentist. You want a beautiful smile. While he may be polite, he thinks that he would be pandering and unprofessional if he is that concerned with a trivial thing like the appearance. In his mind, he knows best, the teeth he has made look good enough, and you are a troublemaker. You are really in the wrong office, and the faster you get out, the easier – unless you just want to turn the dentist loose and have him do it the way he wants. But you’ll be crying every day you look in the mirror if you do that.

I’m not sure I understand why you can’t go to Dr. D. Are you saying that he was your second choice and he knows that? Why should that matter? You made a very understandable mistake – you thought that a prosthodontist was the ultimate expert in crowns, and you didn’t realize that prosthodontists are engineers usually and not artists. That’s a very reasonable assumption, and I can’t see how that would be a problem to admit that to Dr. D. He would be flattered that you chose him in the end.

Anyway, you need to go to an artistic cosmetic dentist. Pick one. If you want to be sure you don’t make a mistake this time, go to one of the cosmetic dentists we recommend. I take this responsibility of recommending cosmetic dentists very seriously, and everyone on our list is carefully screened for artistic ability and cosmetic dentistry training. And then ask this cosmetic dentist how he or she can help you from this point. I can’t tell you anything more specific than that without a personal examination of your case.

Dentists are obligated by a code of ethics to do everything they can to make it so you can switch dentists, even in the middle of treatment. The two dentists would need to talk and figure out between them how to proceed, and you would have to work out what payments would have to be made to whom. It can be done, and it’s not hard. Take that first step and go in for a second opinion, and everything after that will be relatively easy.

Good luck,
Dr. Hall

Links: You may be interested to read my post, What is the difference between a prosthodontist and a cosmetic dentist?

Click here to find a cosmetic dentist near me. Every dentist listed is personally screened by Dr. Hall for artistic ability and cosmetic dentistry training.

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 14, 2010

Same one-size-fits-all treatment plan from Clear Choice Virginia

Filed under: Clear Choice Dental Implants Centers,Second Opinions — mesasmiles @ 6:54 pm

Hello Dr. Hall,

I called and made an appointment at Clear Choice in Vienna, Virginia, in September of last year after viewing a TV commercial about the concept of  “having teeth in a day”. Upon my arrival, they provided a group of us with a very impressive presentation. After hearing their speech, I was a tad bit hesitant in what they were offering versus the dental work I felt that I needed. I have an upper partial and 2 dental bridge and I was looking forward to replacing with implants. Also, my four front teeth were in perfect heath and only needed either veneering or bonding. The sales person tried to talk me into pulling all of my teeth, and then he tried to convince me of investing into other expensive options – all of which was not the right option for me. In the end, he gave me the plan that I initially requested and then asked for a $1K down payment. The total cost came to $17K. I provided the down payment but I didn’t want to get the dental work done until 2010. Here it is, April of 2010 and I’m hesitant to go back. I don’t feel comfortable, in fact, I feel as if I made the wrong decision about going to Clear Choice and now I’m in search of a second opinion.

Thanks so much for creating this website. I only wish that I had found it much sooner!!

– Mona in Virginia

Dear Mona,
Thanks for your comments.
Yes, be very suspicious of Clear Choice. Everyone I have ever heard from has received the exact same treatment plan – extract all the remaining teeth and do All-On-Four dental implants. Sounds like they tried the same with you. Good for you to stick to your guns and insist on saving teeth you knew were fine. Most patients aren’t that strong-minded.
Even though they gave in to your request, I personally would not trust their treatment plan. So get a second opinion.

– 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.

March 20, 2010

A case of serious overtreatment?

Filed under: Crowns for front teeth,Second Opinions,Tooth bonding — mesasmiles @ 6:30 pm

Dr. Hall,
I had bonding placed on my 6 front top teeth for whitening purposes. Since then it has chipped off. I relocated to South Carolina and went to a dentist here. He told me that my teeth are stained inside and that I either needed internal bleaching or porcelain crowns. What options do I have?
– Deanna from South Carolina

Deanna,
I get so aggravated hearing of situations like yours. This sounds to me like a dentist who doesn’t know what he or she is talking about, and I strongly suggest getting a second opinion from an expert cosmetic dentist. I’m on a plane answering this question, so I don’t have access to any maps, but hopefully Summerville is near one of the cosmetic dentists we recommend in South Carolina. Even if it isn’t, it would be worth several hours’ drive to get this done right.

Maybe I don’t fully understand your situation. Do you have root canal treatments on your front teeth? From what you’re telling me, the only problem is the color. If that is true, crowns are overkill, and internal bleaching isn’t possible. I don’t understand where this dentist gets this idea. For crowns, your front teeth have to be ground down to stubs. And if this dentist knows as little about cosmetic dentistry as your e-mail makes it sound, I have grave concerns about how these crowns would look when he or she is done with you. Don’t let him or her grind your teeth down.

And six teeth aren’t a smile. Don’t be surprised if a real cosmetic dentist suggests doing eight or ten teeth. When the teeth are dark and the front six teeth are made considerably lighter, the result looks really weird.

Depending on what your teeth look like, the amount of discoloration, and their general health, you either need simple teeth bleaching or conservative porcelain veneers bonded onto the fronts of your front eight or ten teeth. Anything more is overtreatment.

Good luck.

Dr. Hall

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.

March 12, 2010

A question from an oral surgeon

Filed under: Clear Choice Dental Implants Centers,Second Opinions — mesasmiles @ 12:16 pm

While I applaud your effort to educate the public about Clear Choice, I am slightly curious why you would recommend implant candidates seeking opinions FIRST from a general dentist, prosthodontist, etc? You state that a surgeon should not be the first point of contact. I don’t, for one second, claim that a surgeon and only a surgeon should place implants. As an oral surgeon, I constantly mentor local general dentists with implant advice and I’m happy to do it when it’s in the patient’s best interest. After all, that should rule the way we practice. However, to suggest NOT seeking an opinion of a surgeon seems off base. I would surmise that even the worst surgeon has more implant experience that most general dentists. If you understood the requirements of a surgical residency, this point would be evident and obvious. In our community, far too many general dentists escape to Vegas for a weekend course, return to their struggling practices, and preach “expertise” about implant surgery. How do I know? I have the opportunity to see the disasters; implants in the sinus, drill prep into the IA canal, implants placed so close that bone will surely necrose, and on and on it goes. So while I applaud your effort to inform the public about Clear Choice and the flaws that surround it, please don’t misguide the public in thinking that a specialist should not or does not fit into the equation when it comes to learning about implant surgery. Thank you.
– an oral surgeon in Utah

Dear oral surgeon,
I agree with you that generally oral surgeons and periodontists are the most qualified professionals to be actually doing the implant surgery. The reason I recommend the CONSULTATION with the restorative dentist first is that I believe that when the surgeon places the implants, he or she should do so according to a restorative treatment plan. I have had reports of oral surgeons who have placed dental implants without a restorative treatment plan, and the outcome has been less than optimum.

I hope that helps. Maybe I should explain that more carefully. In no way to I intend to de-emphasize the importance of adequate surgical skills in the actual implant surgery.
Thanks,
Dave Hall

Dear Dave,
Thanks for your reply. I appreciate your clarification and totally agree with your point. To not include the restorative dentist is suicide.

I really appreciate your efforts to inform the public regarding Clear Choice. Recently, they set up camp in Salt Lake. I think they have only found modest success and a not so warm reception. Interestingly, I have seen six or so patients seeking a second opinion. In a sense, they have done some marketing for all of us. The consistent complaints of cost continues to turn people away.

Thanks again for your reply and taking the time.

Warm regards,
Utah oral surgeon

Other links:
Read about the cost of Clear Choice Dental Implants

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.

February 1, 2010

My dentist recommended

Filed under: Crowns for front teeth,Second Opinions — mesasmiles @ 3:05 pm

Hi Dr. Hall,
My dentist had recommended porcelain fused to metal crowns for my front top anterior teeth to fix wear and a gap. After reading all the different kinds of crowns available I asked if he could do an all ceramic set maybe Zirconia. His reply and his partner’s reply is that they will only do porcelain fused to metal crowns. Their credentials (at least the partner who overlooked my case) are quite impressive as are their prices, and they say that since I tend to grind my teeth and I do not want to wear a night guard that if I get Zirconia they feel that they won’t hold up. Is it true that occasional grinding without a night guard eliminates Zirconia or an all ceramic crown. I have been waiting for years to have this fixed and they are ready to start the process. They also charge more for anterior crowns vs posterior, not sure if that is the norm. I need to get my smile back. Thank you for any response you could provide!
– Bob in Los Angeles

Dear Bob,
I recommend a second opinion. Yes, Zirconia crowns are very strong and will work on the front, even under great stress. And something great about them is that they can be made thinner than porcelain fused to metal, meaning that less of the tooth is ground away, which will leave your front teeth stronger. I used all-ceramic crowns on front teeth with people with severe grinding problems, and they didn’t break. And zirconia is much stronger than the materials I used then.

Not knowing your mouth, I can’t prescribe with certainty, and the issue may be more that they feel they need metal as an opposing chewing surface for your lower teeth, which doesn’t wear down the lower natural teeth as much. Although there are soft porcelains that can be used on the surface of zirconia, too.

I suspect that, in spite of your dentist’s credentials, he may not have that passion for appearance-related dentistry. His passion may be for things that work well – it’s kind of an engineering approach. Many dentists that have a great deal of education are very academic types and consider it beneath them to worry too much about appearance issues.

And don’t ever try to push a dentist outside his or her comfort zone. For others that may read this post, if your dentist recommends porcelain fused to metal crowns for front teeth, don’t try to get them to do all porcelain. If they really care about the artistic quality of their work, they will have a strong aversion toward placing porcelain fused to metal single crowns on front teeth. If you don’t like the preferences of your dentist, then find a dentist who is more in harmony with those preferences rather than push your dentist outside their comfort zone and risk disaster. You’re fortunate that your dentist had the integrity to resist your request. Some will say, “fine, we can do that,” and they really aren’t good at the technique that you want, at all.

But I would strongly encourage you to give in on the night guard issue. There is a risk beyond just wearing your teeth down. As you get older, you can break off your teeth at the gumline from the grinding. That can happen whether you have crowns or not, and may even happen more readily if you have crowns.

Yes, some dentists charge more for anterior crowns.

You’re in the Los Angeles area. We recommend a number of excellent Los Angeles cosmetic dentists there. Go to one of them for a second opinion. See what an expert cosmetic dentist says before you go ahead with this.
– Dr. Hall

Click here to read more about porcelain crowns on front teeth.

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 29, 2009

My cosmetic dentist wants to restore all my teeth

Filed under: Choosing a cosmetic dentist,Second Opinions — mesasmiles @ 7:26 pm

I have seen a “cosmetic dentist” who is not on your list, and he is suggesting replacing all of my teeth—even the ones that have nothing wrong with them, with all porcelain crowns to correct bite, beautify look of smile. I am concerned about grinding down perfectly good teeth for this. I chose the dentist in question because he has a good reputation in the community, puts a three-year guarantee on his work in writing, does sedation dentistry (I am VERY nervous patient) — and he has spent a good amount of time answering my questions, doing wax-ups that I am supposed to view on Wednesday. However, I am really feeling quite concerned now…and even more anxious.

After reading your website, I am even more ambivalent than I was, and feel that I should RUN to the dentist recommended for the St. Petersburg/Tampa area.

What do you think? Thank you in advance for your reply.
– Pat from Florida

Dear Pat,
Your instincts are good. While I can’t evaluate your case without seeing it and it’s possible that you do need the aggressive treatment being proposed, the way you’re explaining it to me makes me distrustful of this dentist.

Ethical cosmetic dentists will be very careful to avoid unnecessary dentistry. I heard it continually repeated in various cosmetic dentistry lectures, that if the patient is happy with his or her smile, there is no treatment indicated. The majority of excellent cosmetic dentists believe in that ethical standard and would not try to push cosmetic dentistry onto a reluctant patient. For me, personally, I would not trust a dentist who came up with an aggressive treatment plan like you’re explaining without my requesting it.

My general advice is to stay away from dentists who appear to be dental salespeople, and stick with professional dentists who tend to be conservative in their treatment recommendations. There are occasions when the treatment proposed for you would be indicated. You are talking about a full mouth reconstruction. But that should only be required if you have serious bite problems that are causing pain, or if you have a collapsed face, or a large number of broken-down teeth.

You’d be smart to go to one of the dentists on our list for a second opinion.
– Dr. Hall

Related links:
Read more about cosmetic dentistry costs.
Click here for referral to an expert cosmetic dentist.

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.

January 18, 2008

Crowns won’t stay on.

Filed under: Dental crowns,Second Opinions — mesasmiles @ 10:20 am

My husband’s dental crowns keep coming off usually within a week or two of getting them recemented. His dentist is saying there is nothing more they can do. We are thinking about implants but it doesn’t look like they stick up much…will he have the same problem with the implant crown coming off? Are there different types of glues for crowns that could be causing this problem?
– Pat in Arizona

Dear Pat,
It isn’t that hard to get crowns to stay on. I’d get a second opinion. In twenty-some years of practice, I never had a crown that I put on come uncemented and have to be recemented, once I permanently cemented them. If they are done right, they stay on.

How well crowns stay on depends on the shape of the tooth preparation. When the preparation is too tapered, it’s hard to keep the crown on. So that’s probably the problem. You may need new crowns, or a knowledgeable cosmetic dentist may be able to bond these crowns on. There are bonding agents now that bond metal, porcelain, teeth, and everything imaginable. Expert cosmetic dentists are trained in all these high-tech bonding techniques. I can’t tell you without seeing them, but this is ridiculous to put up with crowns that won’t stay on.
– Dr. Hall

Click here for referral to an expert cosmetic dentist.
Click here for information about temporary crowns, all-porcelain crowns, or Cerec crowns.
Click here to ask Dr. Hall a question.

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.

December 22, 2007

Dentist says she needs crowns now, not porcelain veneers

Filed under: Choosing a cosmetic dentist,Porcelain veneers,Second Opinions — mesasmiles @ 3:29 pm

Dr. Hall,
I needed to have 4 crowns on my top teeth replaced because of staining. My dentist recommended replacing them with porcelain crowns and also strongly suggested that I also get 6 veneers, 3 on either side of the 4 crowns to broaden my narrow smile. I was hesitant but he talked to me for a long time and told me how great the new veneers would look and completely change my smile. I agreed to go forward. Well, I had all the work done on Tuesday and started having pain on Thursday. I was going back for a follow-up visit on Friday so I didn’t think much of it. After about an hour of working on my mouth, the dentist told me that the reason for my pain was because a veneer came loose because of my grinding. He made me a bite plate to wear but then he broke the bad news to me. He said that because of my bite, I will probably have to remove the veneers and have all six of those teeth crowned!! I am in shock. I don’t know what to do. Tonight while eating a pizza, one of the veneers fell off. What is happening? Do you think I should see another dentist for a second opinion?
– Geri in Florida

Dear Geri,
It may be good to get a second opinion before you go any further. It’s possible that your dentist is right, but there are so many dentists out there who think they understand cosmetic dentistry and porcelain veneers, and they don’t. And if you are having a porcelain veneer fall off, then I am suspicious that this dentist really isn’t an expert cosmetic dentist. And if he now spots a problem in your bite, but he didn’t see that before he started, then that also makes me suspicious that he is in over his head. Like I said, maybe he’s right. But I’d recommend getting another opinion from someone you know is an expert cosmetic dentist.

My guess is that only 2% of the dentists who claim to be cosmetic dentists are really what I would call expert cosmetic dentists. This is really a very specialized field that requires a lot of post-graduate education, and so many dentists try to get into this because it is a profitable area and kind of fun to do, but they don’t know what they’re doing.

Generally, you can still wear porcelain veneers even if you grind your teeth–but not always. But you would chip and crack the veneers. When one just falls off, that seems to indicate a failure of the bonding technique. I doubt that is from your grinding your teeth.

You have several excellent Florida cosmetic dentists near where you live, that we list on our web site, and they all I’m sure would be able to help you see if you are being taken care of properly.
– Dr. Hall

Related information:
Smile design
Wear a nightguard if you have porcelain veneers and tend to grind your teeth
More information about teeth grinding and other TMJ problems

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.

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