Dear Dr. Hall,
I’ve been going to the same dentist for three years. I started on the path of veneers in November 2019 and I’ve been miserable since then. My teeth weren’t that bad, one shorter than the other in front, chipped here and there, and not a pretty white anymore. My dentist ground my eight front top teeth down to little dark yellow nubs. I wore temps for two weeks then got my permanent veneers done.
Every week since then I’ve had one or more teeth pop off. I call and they get me right in and glue my tooth/teeth back on. She knows I grind and I’ve been wearing a nightguard since I’ve had my veneers. She said she doesn’t know why they keep coming off and keeps blaming me for grinding. She also told me I needed the veneers because all my teeth were getting cracks from the grinding and I needed to protect them by wearing veneers. Some of the veneers have like a ledge on the backside and those are often the ones that pop off.
I’m beginning to know when one is getting ready to come off because my breath starts to smell horribly and when the veneer pops off, omgosh it stinks! On Christmas with all my family here I had three teeth missing in the front. I was so embarrassed. In March I went to DC with my 10-year-old’s class and had to carry super glue around because one tooth kept popping out.
Last week she told me to come in and she wants to try something different. I’m beginning to think I’m being her guinea pig and in my humiliation and expense. I cry every day when I look at myself and don’t want to go out for fear a tooth is going to pop out. Are dark yellow little nubs normal? Is it normal to grind them down so little? She told me they’d last 20 years. Are they going to keep falling out for 20 more years?
Yesterday two veneers fell off just while eating a banana! I cried off and on all day! We spent so much money already and I don’t know what my options are. Can my teeth be fixed? Can I still wear veneers or am I going to have to get all my teeth removed and get dentures? We’re a military family and moving out of Texas in one month. I’m scared I’ll be moving toothless and another dentist won’t even touch me and my gosh I can’t imagine how much more fixing my teeth is going to cost. We can’t afford this. I don’t know what to do, is there anything I can do?
Another question. She has me take an Ativan pill the night before my appointment, then one right before I go in. I have to bring in the other two pills that came with the prescription and she gives me them while I’m being worked on as well as having nitrous. I don’t remember anything while I’m there and don’t even remember leaving her office. My husband tells me I’m out of it for the rest of that day and the next day as well. Is this normal?
– Dorianne from Texas
(See Dr. Hall’s answer below.)
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Dorianne,
My, what a real cosmetic dentist horror story!
The short answer for you is that no, the things you are experiencing are not normal. You have had an awful time with what should have been a wonderful experience. I’m so sorry about what was done to you, and I do believe it crosses the line into malpractice. There are several things that were done wrong to you—let me take them one by one.
First, your dentist did not do veneers—she did crowns.
A typical porcelain veneer preparation
For porcelain veneers, about half a millimeter is usually reduced from the front of the tooth only. For a crown on a front tooth, the preparation is rather aggressive, and the tooth can be ground down to a nub, as you have put it. This is major overkill. Your experience with these crowns not staying on suggests to me that your dentist didn’t know how to do porcelain veneers, because she does not appear to be familiar with bonding technology.
A typical porcelain crown preparation
So now you are stuck with teeth that have been ground down to nubs, and your options for fixing this are fairly limited.
Second, even doing the crowns, there was lacking what we call proper retention form. A crown can be kept on with conventional dental cement, if the tooth is prepared correctly. It doesn’t need bonding technology. But she hasn’t even been able to do that. My guess is that your teeth have been left even shorter and stubbier than the photograph I’m showing. And this is the major legal problem that she has. While many dentists do not know how to properly do porcelain veneers, every dentist is taught in school how to properly do a crown preparation and get a crown to stay on. So in this she has grossly violated the standard of care and is legally liable. What is happening to you is that the crowns are getting loose in function, and that looseness allows saliva and bacteria to get in under the crown, which is where the awful smell and taste are coming from.
Third, the sedation. I’m not even sure why you need sedation. You haven’t said anything about any problems with dental anxiety. Why can’t you just have novocain? Or maybe just nitrous oxide plus novocain if you are anxious? And so much sedation that you don’t even remember going home. But maybe you didn’t tell me that part and you need some type of sedation. So let’s say that you need sedation. Why Ativan? Ativan has a serum half-life of about 24 hours, which means that after 24 hours, half of the dose is still in your bloodstream. It can take a couple of days for it to be eliminated. For oral conscious sedation, most dentists use Halcion (triazolam), which has a serum half-life of about three hours, which is plenty for a dental appointment.
So what to do now? As I said, your dentist, in my opinion, is legally liable for the damage done to you. Your teeth have been ground down to nubs when that didn’t need to be done. You grind your teeth, which puts extra stress on your teeth, and with them ground down so severely, they are at serious risk of breaking off at some point later in life. In a just world, I believe this dentist should first pay to have your teeth done right by someone who knows what they are doing, but then should go beyond that to compensate you for what else could go wrong with these teeth over your lifetime because of this aggressive over-treatment. You sound like a sweet person who wouldn’t want to cause any trouble with anyone, and you maybe need someone to go to bat for you.
I would start by finding a competent dentist who could fix what has been done. I would do that in your new location. You can let me know where you are going and I would be happy to help you find a dentist to help you. Then, that dentist can help you confront the dentist who did this. Hopefully she will take care of you without your having to go to court. Her malpractice insurance should cover whatever you need to have done. If you do end up going to court, my prediction would be that you would get a substantial award.
– Dr. David Hall
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About David A. Hall
Dr. David A. 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 advanced internet marketing for dentists.
Dr.Hall, thank you so much for getting back with me! We did move last June and it’s been kinda crazy since then. Of course all the COVID-19 distancing and closing down of businesses hasn’t made seeing any kind of medical easy. The only thing positive (other than not catching or spreading the disease) is that since we have to wear masks I don’t have to be seen in public with these ugly teeth.
As you knew I would, I’m still having problems with these teeth popping off. I use gorilla glue to re-glue them back on which last a few days. They mostly pop off when I’m eating and I’m thankful I haven’t swallowed any of them. Also that way I have it so I can glue it back on. They’ve also been starting to hurt more than just occasionally and Tylenol doesn’t always work.
You mentioned being able to help me find a dentist that could hopefully help with my situation. I guess I’ve been holding off getting them fixed, if it can be done, because I’m afraid they’d have to grind these off more and I just don’t know what I’d be left with. Just going through the whole process from the dentist that did this grinding to my teeth has me scared. The fear of the unknown.
We moved to Lexington North Carolina, which is a little more than an hour north of Charlotte. It’s a very small town, not much around here. I’m not sure if you know anyone in this area, but I sure hope so. I really don’t know who or where to turn to at this point.
Im sure your a busy man, I hope to hear from you at your earliest convenience, and thank you again for responding to me before.
Dorianne Block
https://barringtondentist.com/porcelain-veneers-coming-off/
Interesting this same story and response appears on another site. Hmm.
Response by Dr. Hall:
I am aware that other bloggers use material from my blog, and I have no problem with that. This post was published a year ago May, in response to an email from a woman whose actual name is Dorianne and she’s from Texas, and the advice is all mine. The other post you reference was published 7 months later and I agree that, while the story and the answer are re-phrased and the name is changed, it is close enough that it is most likely the same story being re-told by a writer who read this post. As long as they don’t copy the post word-for-word, thus damaging the SEO value of my original post, I am perfectly fine with that. It spreads the things I am trying to teach to reach more people.