Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

February 13, 2018

The hundred thousand dollar smile makeover


We thank our advertisers who help fund this site.

Dear Dr. Hall,
I have had a terrible experience with my “smile-makeover.” It turned out horrible, so the dentist just refunded my money, and I am looking for a new dentist. I found your website while I was still his patient and was able to figure out that he had little to no knowledge of what you describe as a true cosmetic dentist.

So I made appointments with the first 3 cosmetic dentists on your list. I must say I was so disappointed with the 1st. While he rightly said my bite was off, I was there for a 2nd opinion of the 6 upper anterior crowns I had. He said I would first need to spend $300-400 with his hygienist, and then, to deal with my bite issues and everything the cost would range between $50,000 and $100,000. “About the price of a new car,” he said. I only wish I could replace my 6-yr-old car bought used, for 1/3 his idea of a new car. He never got to what type of smile I would end up with, as his idea was to build up my back teeth and have “an appliance” covering several teeth and add porcelain “where needed.”

My teeth and gums are pristine according to a general dentist I went to for opinion and a periodontist I also went to for opinion earlier. I don’t understand why I need all of this, and I can’t begin to afford this and want your opinion.
Thanks,
– Sally from Texas

Sally,
There’s a great variation in what some expert cosmetic dentists charge, and the fees you’ve been quoted are definitely on the high side, even if you actually need all the work that has been quoted. I would keep going down the list and get another opinion. Meanwhile, let me give you a little insight into what I think is going on in your case.

You said that you know your bite is off, and it appears that you’re being quoted a fee for a full-mouth reconstruction to rebuild your bite. Do you actually need that? I don’t know that, but I can tell you that some dentists are very fussy perfectionists and they insist that every patient accept what they call “ideal treatment.” Other dentists are more pragmatic and will consider other options for patients who can’t afford the ideal. Fortunately, you’re in the Dallas-Fort Worth area where we have several recommended cosmetic dentists. Go ahead and shop around for second opinions.

I want to tell you a story about this cost issue and dentists’ fee levels. There is a city where we have two recommended cosmetic dentists—let’s call them Dr. Smith and Dr. Jones. Dr. Smith is famous and has patients flying in from far and wide to see him. He does absolutely exquisite work. Dr. Jones also does very beautiful work and has won awards for the beauty of his work. Dr. Smith’s fees are about triple of what Dr. Jones charges. Is Dr. Jones an inferior dentist? I don’t think so because, guess what, Dr. Smith goes to Dr. Jones for his dental work.

So get another opinion or two.

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.

December 27, 2017

A case of collapsed bite


We thank our advertisers who help fund this site.

Hi Dr. Hall,
I really hope you can help me.

I am not sure if my issue is related to my lips, teeth, or jaw, but I absolutely can’t stand my smile. It feels very forced to be able to show my upper teeth. When my mouth is in repose it is just empty space and you cannot see my teeth (especially my upper) and it makes me extremely self-conscious.

I also have jaw pain and wear a night guard and when I wear it my mouth feels more comfortable and I feel like it supports my lips better. It also gives an impression of upper tooth show that I would very much like. I also find I have difficulty pronouncing certain words especially when it’s cold, almost as if my jaw tightens and I can’t open it properly to speak. P and T words are especially uncomfortable.

Are my only options veneers? Do I even have any options?

It’s very frustrating for me. I can attach pictures as well if need be.
– Laura from Ontario

Laura,
I’m glad you’re emailing me now, before going to a dentist to have this fixed. It’s painful to have to write back to people after a problem like yours and the dentist messed up their mouth.

This is a very difficult problem and you need to be very careful in picking a dentist to treat this for you. While I can’t tell for sure just with your description, it sounds like you may have a collapsed bite plus some other complicating TMJ issues (TMJ disorder). Veneers wouldn’t be the answer, at least not as a sole treatment. Opening your bite with crowns could solve your problem, but it would need to be done methodically by a dentist with experience in full-mouth reconstruction.

The proper way to open a bite is to do it reversibly first, with some type of provisional restoration. When that provisional is successful, then permanent restorations should be made that duplicate what was done provisionally. By successful I mean that you are out of pain, are happy with your appearance, show your upper teeth normally, and have no speech difficulties. That’s a tall order, but a dentist with adequate training should be able to do this.

It’s a small minority of dentists who have the training needed to address this type of situation. There are several training institutes in the United States that train dentists in this level of complex restorative dentistry. Those would be the L.D. Pankey Institute and the Dawson Academy in Florida, and the Las Vegas Institute for Advanced Dental Studies in Nevada. There are others, but these are the best known. I don’t believe there are any such institutes in Canada.

To help cement this idea of being careful in picking a dentist to do this, you may want to visit other blog posts I wrote for patients where the dentist opened their bite and caused more problems than they started with.

I will email you privately with a dentist recommendation for you. It will involve some travel, but you need to get this done right.

– 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.

Powered by WordPress

Follow this blog

Get every new post delivered right to your inbox.


Categories