Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

December 12, 2016

How do I get a digital smile makeover?

Filed under: Smile design — Tags: , , — mesasmiles @ 7:26 am

We thank our advertisers who help fund this site.

Dr. Hall,
I saw on TV that I can upload a picture of myself and see what I’ll look like with better teeth. How can I do that?
I am seriously interested in doing something to fix my smile because I hate it.
– Amy from Kentucky

Amy,
Yes, for many years there has been software available to give you what is called a digital smile makeover–to take a photograph of you and have it altered so it shows you with a new smile. I got one of the early systems back in the late 1980s – it’s much simpler now to do these digital smile makeovers.
I don’t believe any of the companies that do this offer it directly to the patient. You need to visit a dentist who offers this service, and they will use it to show you what can be done with your smile. Without a dentist who has the capability of translating the image into reality, the digital smile makeover isn’t much more than a game. But if a dentist has this software and has the capability of creating a beautiful smile, often they will offer to provide this service for free.
We used to do that in my office for free, and most of the people who got the digital smile makeover went ahead and did the actual procedure. If you do this, realize that you will probably end up wanting the work done–it’s a pretty powerful way of convincing you to get it done.
Some cosmetic dentists who don’t offer digital smile makeovers will do what is called a provisional smile makeover, which is one step better than altering a photograph but it’s more work and may not be offered for free. They will create a new smile in plastic that you can actually snap over your teeth and try out the new smile to see if you like it.
Just remember not to expect your family dentist to be able to actually create the smile makeover. My estimate is that maybe 2% of dentists care enough about appearance-related dentistry to pursue the education they need to be able to create beautiful smiles.
I see that you’re in northern Kentucky, and the closest major city is Cincinnati. One of our mynewsmile.com recommended dentists is Dr. Tara Hardin in Cincinnati, and she offers this digital smile makeover service. I would check with her as she may well offer this for free.
– Dr. Hall

Question and answer go here.

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.

March 28, 2016

How Donald Trump got his smile makeover

We thank our advertisers who help fund this site.
.
Does Donald Trump have porcelain veneers? Yes, he does, and here’s the interesting story behind his getting them.

It was back a little more than 15 years ago that I heard this story from Dr. Larry Rosenthal, a prominent cosmetic dentist with offices just off Madison Avenue on Manhattan’s upper east side. I had gotten to know Larry when we worked together on the first Public Relations Committee of the AACD in 1994-95.

In one of his lectures that I attended, Larry told about Donald Trump coming to him for a smile makeover. Larry was famous as a “dentist to the stars,” doing many new smiles for famous models, actors, and actresses.

Dr. Rosenthal looked at Donald Trump’s teeth and then told him he needed a certain number of porcelain veneers for his smile makeover. I don’t remember the exact number. Let’s say it was ten. Trump said he didn’t want to do that many. Maybe he only wanted six. Again, I don’t remember the exact numbers here, only that he said he wanted to be significantly more conservative. Dr. Rosenthal was adamant that he didn’t want to do the case unless he could do it the way he wanted and insisted that he needed to do ten teeth or he didn’t want to take the case. So Trump walked out.

Donald called back later that day and scheduled an appointmentDonald Trump has porcelain veneers to get the work done.

When Dr. Rosenthal told this story, it gave me the impression that Donald Trump had actually thought over what Dr. Rosenthal had said and changed his mind about going forward. But knowing now what I know about The Donald, I am convinced that this was only a tactic that Trump had used to determine that Dr. Rosenthal was being straight with him. I’m confident, for example, that if Dr. Rosenthal had waffled and as Trump was getting ready to leave said, “You know, if you insist, we can do just the six teeth,” that Trump would not have gone forward. It was a negotiating strategy, walking out, to see exactly how strongly Dr. Rosenthal felt about it and if he was willing to lose him as a patient over it. Once he knew that, he trusted him.

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.

Donald Trump's smile makeover

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 29, 2013

You can get too analytical about a smile makeover and miss the beauty.

Hi Dr. Hall,
Love your site. I am planning to have 6 front upper teeth redone by a dentist you recommend on your site. Four crowns and two veneers. The dentist and I discussed the shape of teeth I wanted, looked at photos. I mentioned several times that I wanted more prominent eye teeth. He said I would be able to see this if we made a model. I paid $365 to have a model done but the model looks kind of like what I have now. He said not to worry that he would make the adjustments when he does the teeth. Is that possible? Does this mean he is creating the shape when he makes the temporaries. He’s not been really clear about this. It is expensive so I’m concerned. Please advise as my appt. is in a few weeks.

Thank you
– Eileen from Michigan.

Eileen,
What your dentist is doing sounds reasonable. However, I’m worried that there may be a communication breakdown in the making here, so I will give you some advice on what to do.

The model you had made would be called a diagnostic model. When the porcelain veneers and crowns are made, the model will be used as a pattern only. The ceramist will have the model sitting on the bench in front of him or her and will visually use it as a guide. And the change you are asking for, having more prominent canine or eye teeth, is not too complicated. The dentist may make the change on the model before it is sent to the ceramist, or he will simply tell the ceramist the change.

But since there could be differences of opinion in what constitutes more prominent canine teeth or just how prominent you want them, it would be reasonable, in my opinion, for you to ask to see the model done the way you want it before your appointment, which I’m guessing is the tooth preparation appointment. Especially since you have paid for this diagnostic model. That will assure you that you are both on the same page. Be bold in your request. I’m confident the dentist will not be offended, and making sure you are happy with the design at this stage could save him time and money down the road.

Your basic guarantee that you will have the smile you want, that you will love, will come when the dentist does the try-in. Every excellent cosmetic dentist will want to be sure, before any new smile is permanently bonded, that the patient loves the smile and will be proud to show it off. The veneers and crowns will be tried in with some type of try-in paste, and you will be given a good look at the final result. If you are hesitant at all, make sure that the dentist understands your concerns and makes the requested changes before the case is bonded on.

This is a key difference between the 98% of dentists who may be good dentists but are not esthetically sensitive, and the remaining 2% who are excellent cosmetic dentists – they are passionate about making their work beautiful, and they understand that the beauty of the smile is in the eyes of the patient who owns it. I have talked with many of these excellent cosmetic dentists, and they all have that commitment to a successful try-in on a happy patient before a smile makeover would be bonded onto the teeth. If at the try-in, you are not happy with how it looks, every excellent cosmetic dentist I have asked has said that he or she would, without hesitation, send the case back to the ceramist to be fixed or remade. So speak up now, and it will save your dentist that risk.

If you have any difficult with this, please let me know. I would be more than happy to intervene on your behalf. It’s important to my reputation, also, that the dentists I recommend do beautiful cosmetic dentistry that pleases their patients.
– Dr. Hall

Eileen took my advice, had the teeth prepared, and then e-mailed me again two months later:

Dr. Hall,
You answered one of my concerns but now I have a much larger one. I went ahead and agreed to have my 6 teeth done with one of the people on your list. I think he is an excellent dentist but I am concerned about the place I find myself now. I did ask for a wider smile and it appeared that it was in looking at the model. What I didn’t realize is that in order to create that wider smile, the new teeth would overhang my bottom teeth creating a kind of overbite. It looks okay when I’m smiling and when my mouth is closed, but when I”m talking or my mouth is open, the bottom teeth look pushed back compared to the new teeth. I couldn’t tell this was happening in the model but mentioned it immediately after the temporaries went in. Everyone in the office said they really didn’t notice it.

I wrote the dentist a detailed email. He said I shouldn’t focus on the bottom teeth so much and that it looked fine and I should tell the lab about my concerns. Which I did when I went to see the teeth and the lab guy said he thought they looked fine too and wasn’t noticing the overbite. Then we got off on other subjects around the teeth. I called the next morning to say I felt we hadn’t really resolved the overbite issue and the lab guy said there wasn’t much he could do and had already finished the teeth for my approval.

The lab guy said he made the teeth less straight and a little more curved than the temporaries but that he really couldn’t do much about the overbite. I do feel that the “overbite” concern” really wasn’t ever addressed and I guess I’m wondering too if I’m just focusing on it too much. I’ve included some photos. Could you look at these and tell me whether you think this is within the acceptable range. I know the new teeth are slightly more curved at the bottom so that should help a little but I’m still concerned it looks a little weird. I’m attaching a couple of photos. These are the temporaries and my original smile.I’ve included two where you can see the overbite I’m concerned about. I do understand that compromise is always a part of something like this I just wonder if this was the right one…. Thanks so much for your help. Hope to hear your thoughts soon…..Eileen

Have liked you on Facebook. Great resource for all of this. The only one I trust online….

Here is my “before” smile:

eileen-original smile

And here are a couple of after photos, from the front and from the side:

eileen-full-face-after

eileen-profile

Thank you,
– Eileen from Michigan

Eileen,
I looked at all the photographs, and your smile looks quite attractive. I don’t see any problem with the work.

I would see this with some of my patients – they would try to analyze their teeth with their “left brain,” and that doesn’t work too well and doesn’t produce a beautiful result. To really appreciate the attractiveness of a smile, you need to “disconnect” your left brain and look at it with your right brain – to perceive the feeling that the smile gives you. If you look at it for too long or try to get analytical about it, you reduce the smile to logic and formulas and miss the beauty. And the smile you are showing me is quite attractive – it has a lovely, warm feeling to it. I think your dentist was correct to focus on getting the upper teeth looking attractive and not letting that be compromised by the lower teeth.

This is also a problem that so many dentists have when they try to do cosmetic dentistry. They are drawn to dentistry because they like to fix things and they are left-brained, analytical people, so they can’t produce a beautiful smile. They simply have no artistic flair. And they get that way by focusing on technical details without ever stepping back and taking an assessment of the “feeling” a smile conveys.

My opinion.

Thanks for sharing this with me.
– 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.

February 17, 2011

Sometimes it may not be wise to try to improve your smile.

Filed under: Smile design — mesasmiles @ 9:18 am

This is a question I discovered on Yahoo! Answers, and answered it, and my answer was voted by the readers the best answer to this girl’s question. I share this case with you for the benefit of our visitors.

Is there any way i can make this small gap here go away at home? The small triangular part? Is there any type of file i could use?

incisal-embrasure-sm

Answer:

I didn’t make it a practice to argue with my patients when they came with esthetic concerns, but some situations warrant an exception and this is one of those situations.

I would strongly recommend not doing anything to your front teeth. What you have circled is a very normal incisal embrasure, and if you were to try to square off your front teeth, they would look weird. The opposite side of these front teeth, the sides next to your lateral incisors, are very rounded, so having this embrasure be squared off would look strange.

There are many different natural smile designs. You didnt’ say how old you are, but in looking at the shape and wear patterns on your teeth, and the gums, it looks like you are at the oldest in your early twenties. Your central incisors are a couple of millimeters longer than your other front teeth. This is a smile style that we call the sexy smile. It conveys an impression of youth, sexiness, and boldness. As you get older, the teeth tend to wear down to be more square and more even in length. When that happens, we call that the sophisticated smile. It conveys an impression of sophistication, maturity, and wisdom.

You have a nice-looking smile. I would smile proudly.

Dr. Hall

Links: See our smile design page.
Learn how to find a qualified 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.

May 10, 2010

A seriously botched $25,000 smile makeover

Filed under: Crowns for front teeth,Smile design,Uncategorized — mesasmiles @ 10:06 am

Dr. Hall,
Recently I had $25,000 worth of porcelain crowns on both my top and bottom teeth-paid up front. I went for my consultation, picked my smile style, and told the consultant that I wanted a white bright smile that looked natural. I was given something to lighten my bottom teeth. I also had a metal bridge replaced so that it would match my upper teeth. All top teeth were crowned. After extensive xrays and mouth impressions, I was fitted with a temporary set of teeth. I was told that by wearing the temps, I would be able to see how my teeth would look, the shape and size, and color, in case I wanted to make any changes in my porcelain crowns. I was also told that I was the one who had to be happy. Two weeks later, when my crowns came in, the first thing I noticed as they were on the table was that they looked dark. I commented on this, but the girl who was to put them on said that they would look different in my mouth. When she put them in (not cemented) she told me to be careful when I sat up to look in the mirror because they were not in yet. From the moment I looked at them, I said “They are too dull!” I continued to say this, even as they were falling out and I! could see I had no teeth left on top. By the way, I went in because my front teeth had been bonded years ago and had been chipped away by my bottom teeth. Other than that, I had strong, white teeth. As I continued to say I did not like them, she said suggested we go outside in the natural light with a mirrow. Even on the outside, I kept saying I did not like them and that they looked dull. She told me that my eyes were playing tricks on me because I was used to the white temporaries and that once on, I would see a difference. We went back in and I looked in the big mirror above the sink in her lab. One of my front teeth feel on the floor and she picked it up and watched it off…. I was about to cry. Then the girl who cleans the teeth stepped in and said how I would love them once they were in and polished up. Never once did the doctor I paid the money to come in to see what was going on…Never once was I offered an option like, “Do you want them whiter?”

I was so frustrated and upset. I felt pushed against the wall about the matter, having no teeth in my mouth and being convinced that I was seeing things. Needlesstosay, she cemented them in. After they were in, the doctor came in and started trying to level my top and bottom teeth. Once he found out I was unhappy, I had to tell him, he told me to wear them a week and come back and he would finish … He said we want you to be happy.

After a week, I went back. In the light I had also discovered that the bridge I had replaced did not even match the other teeth. The girl said, You have a metal bridge (4 teeth @ $1700) so it’s going to be different. I explained to the doctor that I had tried to tell the girl befo! re she put them in I was unhappy with the color… He said ” Well we have to be fair to everyone, the lab, the workers ,,, no way can we redo what we have done.” He then said maybe he could remove the stain on my porcelain crowns to match the white bridge. I am suppose to go back in a week. He said if the lab used a certain stain, this might be possible. I am so upset. I trusted these people. I don’t know what to do. My husband is going to go with me this next visit. I have to go back. I can’t eat with the crowns because they have not been level and are very painful. Any suggestions? Thanks for any help!
– Sandi from Texas

Sandi,
If I am sizing up correctly what was done to you, based on the story you have told, you are the victim of seriously unethical cosmetic dentistry. You were told that they would be sure you were happy with your smile makeover, but it sounds like they had no intention of actually honoring that promise.

Again, if I am sizing up this situation correctly, and if it happened the way you told me, you are dealing with very pushy people, and you are going to have to take a different tack if you are going to get anywhere. You have to be willing to get a lot more serious with your complaints and maybe get some legal help. Are you up to standing up for your own rights?

If these teeth were put in over your objections, then this is classic malpractice. A fundamental principle of health care is that all treatment is rendered with informed consent. When you didn’t consent to the treatment, and they put in the teeth anyway, legally, that amounts to assault. But if you are going to get anywhere, you have to have some steel in your spine and be willing to stand up to these people. And just having your husband go in with you to the appointment isn’t good enough.

My judgment would be that you will need to help this dentist see that he is legally on thin ice in order to get him to fix this. I would suggest getting a lawyer to write a letter that promises that you will sue them unless they totally redo this for you and honor the promise they originally made that you had to be happy with how they look before they would put them in. Or, if you don’t want to do that, you could take this e-mail and that might help open their eyes. Then, if they don’t agree, you could go to a lawyer.

For additional help, there is a great cosmetic dentist in nearby Tyler, Texas that could give an opinion on this work. He is Dr. Robert Burnett. And besides being a great dentist he is a great guy. If it were me, I wouldn’t settle for this dentist re-doing the work. I wouldn’t ever let him touch my teeth again. Instead, I would demand that he pay me to have the work re-done by someone more compassionate and skillful. At this point, do you trust him? I wouldn’t.

Good luck,
Dr. Hall

Other links:
Click here to find an expert cosmetic dentist
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.

March 26, 2008

Can my teeth be longer with Lumineers?

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

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

Dear Donna,

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

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

Furthermore, the dentist is suggesting the Lumineers brand of porcelain veneers, which has a poor reputation among expert cosmetic dentists for esthetics. Check out my Lumineers page for more information on that.

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

Good luck.

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

– Dr. Hall

Click here for referral to an expert cosmetic dentist.
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.

November 23, 2007

Unhappy with new porcelain veneers

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

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

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

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

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

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

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

When I was young and only a couple years out of dental school and just learning cosmetic dentistry, I had several cases that when I did them, they looked okay to me, but they weren’t good enough. So later, when I had developed better skills, I completely re-did them at my expense until they were beautiful. This is part of the learning process, and it’s what helps cultivate a great reputation for doing gorgeous work. A great cosmetic dentist is very sensitive about that reputation for beauty and doesn’t want one of his or her patients saying that their work isn’t beautiful. General family dentists don’t care so much about that aspect of their reputations.
– Dr. Hall

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

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 2, 2007

Pointed cuspids

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

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

Thanks
– Sam in Virginia

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

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

Dr. Hall

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.


Categories