Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

April 3, 2019

No, these weren’t really da Vinci crowns


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My dentist sold me da Vinci crowns for my front teeth. He said they had to be made by da Vinci in California because they had found they did the best work. I waited a long time and they finally said they had come in the mail, so I went in that day to get them placed. Anyway, they weren’t happy with them and said they were going to have to get them worked on a little. To my surprise a “man from the lab” showed up in the door to take the teeth and work on them. I saw him. Now I am in Tennessee and the lab is in California. I don’t think he flew in that fast to work on my teeth. Why would the sell me da Vinci teeth made only in a lab in California then have the work done in this area? This area has never made any teeth that suited me. I told them that. Damn. I think I have a problem no matter what you tell me!

– Charlene from Tennessee

Charlene,
It does sound like there is some funny business going on here. While it is possible that your dentist had the laboratory work done at da Vinci and then had a local technician do modifications, that doesn’t seem likely to me, since the local technician would charge extra where da Vinci would make adjustments for free.

But your question gives me an opportunity to say something about dental laboratories in general and da Vinci Dental Studios in particular. When I was practicing in Iowa and was getting into top level aesthetic work, I tried to find a dental laboratory in Iowa that would help me create beautiful smile makeovers. I couldn’t find one, so I ended up sending my smile makeover work to da Vinci. I did that for several years, but at one point it seemed to me that da Vinci was going through some upheavals, so I switched. Uri Yarovesky was one of the partners at da Vinci, and he split off to form his own laboratory, Opus One. I began sending my work to him, and was extremely pleased with the work he and his associates did for me.

In my opinion, the vast majority of dental laboratories don’t have ceramists with the artistic talent required to create a beautiful smile makeover. But I wouldn’t say that da Vinci is the best in that department. Yes, they are very good. And they have a name that lends itself to their branding as a dental laboratory that produces beautiful work. But they are a large laboratory, and not every ceramist there is what I would call a master ceramist. During the years I used them, while most of their work was truly beautiful, I got some cases from them that I wasn’t happy with and had to send back. And the very best cosmetic dentists usually have a very close relationship with a master ceramist working out of a small dental laboratory. And I will add that those master ceramists often have fees considerably higher than da Vinci.

Back to your situation. There are some very mediocre cosmetic dentists who advertise that they place da Vinci crowns and veneers. As I said, da Vinci is a fairly large dental laboratory and, unlike some master ceramists, will accept work from just about any dentist. Don’t be fooled thinking this is going to give you a beautiful smile. It’s not that easy. A great dental laboratory cannot make up for the deficiencies of a mediocre dentist, which is why many master ceramists are picky about the dentists they will work with. Larger labs like da Vinci are also picky in that their top ceramists will work with the big name cosmetic dentists, and they will refer the “lesser” dentists to their other ceramists.

Bottom line for all our readers—if a dentist advertises that he or she places da Vinci crowns or veneers, take that claim with a grain of salt. Not only is da Vinci no guarantee that you’ll end up with a beautiful smile, it sounds like you don’t even have a guarantee that the dentist will actually send the work to da Vinci.


– Dr. Hall

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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 3, 2018

Botched case by a very reputable dentist


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Dear Dr. Hall
This started about five years ago when I wanted to get a single crown for my front tooth (#8). The crown ended up being bulky and the color was off. After that, I was referred to a very reputable dentist. The first crown he did was too gray. The second crown he did was closer, but didn’t fit into my mouth because of a protruding lower front tooth. At that point the dentist told me to get orthodontic work. When I did that, I ended up with a gap.

I’m now shopping around for a dentist I feel comfortable with, and I feel very uncertain about this. I am not 100% sure these dentists are going to follow through with getting it right. My last dentist has a really great reputation. He charged me enormous fees, paired me with a reputable ceramist, and it still didn’t work. Strangely, as I interview other dentists, when they hear his name, I am forced to defend myself. If they see the work, they back off, but everyone assumes the patient is at fault. As if I somehow caused the poor looking crown. Or am just being too picky?
– Melissa from Southern California

Melissa

Melissa,
Yes, I’m very familiar with stories like yours. But it’s interesting—you say the dentist and ceramist had “great reputations.” Oh, there is such a difference between a dentist with a great “reputation” and a great cosmetic dentist, and likewise for ceramists.

If you do a lot of reading on my blog, you’ll learn that institutional dentistry—most dental schools, the American Dental Association, and the “reputable” dentists look down their noses at cosmetic dentists. They mock them, calling them “cosmetologists” and unprofessional. I was taught in dental school that, on issues of how the dental work should look, we should not listen to the patient but should use our professional judgment. To these academics and dental leaders, true cosmetic dentists are pandering to the patient and unworthy. Read the Wikipedia article about cosmetic dentistry, written by someone with this academic mindset, and you’ll get a flavor of this condescending attitude.

This goes to the heart of why I founded this referral service and this blog—to be the politically incorrect advocate for beautiful dentistry.
Here, read two of my blog posts that deal with this issue. In the first one, the patient didn’t like the result because the teeth looked too white and phony, but the dentist insisted that they were fine, basically telling the patient that her professional opinion should out-weigh the patient’s opinion.

In the second post, I answer a patient named Glen from Massachusetts who kept having reservations as his smile makeover proceeded. As he voiced those reservations, his dentist kept telling him, “trust me.” After the work was completed and Glen was still unhappy with it to the point where he was embarrassed to smile, the dentist sent him a certified letter where he relates his professional opinion combined with that of several colleagues that the work looks great. This contrasts with the attitude of great cosmetic dentists that they are treating the self-perception of the patient and if the patient has reservations about the appearance of the final result, the case is a failure.

This is what I see over and over again when someone gets a recommendation from a dentist in this institutional mindset for appearance-related dentistry. They get a great mechanical dentist who has a “great reputation” among his or her peers but is really psychologically unfit for appearance-related dentistry. True cosmetic dentists are outliers in the dental community.

If you can come to fully understand that and realize that you were victimized by this institutional mentality and referred to a dentist who had a great reputation with the wrong crowd, and now you are moving into a different world that plays by a different set of rules where everything depends on whether or not the patient likes the final result, you may find it in yourself to trust again.

Dr. Hall

Do you have a comment 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.

September 3, 2015

Which costs less, DURAthin veneers or Lumineers?

Dr. Hall,

Dr. Hall, what is the price of Durathin verses Lumineers? I would like to know which one is less expensive. I like the picture of the Durathin much better.
– Sharon from Virginia

Dear Sharon,

I need to change how you think about porcelain veneers. They are not a commodity like a necklace that you would just go to a store and buy and it doesn’t matter what store you get it from. The actual cost of the porcelain I would guess is in the neighborhood of 1% of the cost that you pay as a patient. And I’m just guessing at that because even as a dentist ordering veneers from a lab, I never even thought of that. What you are paying for is the labor and the skill in taking that material and making it into a beautiful smile. Let’s take my guess of $10 as the value of the porcelain in a veneer. The laboratory technician (ceramist) will mark that up to maybe $100 to $300, depending on his level of skill, and that is what the dentist will pay. Then the dentist will mark that up again to $1000 to $2500 which will be the cost a patient will pay for a single veneer.
And how it looks depends much more on the skills of these people than on the material itself. The reason Lumineers don’t look very good is that, because of trademark restrictions, they have to be made in the Lumineers lab, and they’re not a good lab in my opinion. DURAthin and other brands can be made by a ceramist of the dentist’s own choice. With a highly artistic dentist and ceramist, you get a much more beautiful result.
Some dentists will charge very little for Lumineers–maybe around $500 to $700 apiece. I wouldn’t let any of those dentists anywhere near my front teeth. Some dentists will charge that same amount for other brands of porcelain veneers. Same story–stay away.
I would say that in Virginia, you should be able to get a quality smile makeover from one of our recommended cosmetic dentists for somewhere around $1000 to $1200 per tooth. And that would be with DURAthin veneers or some other brand of ultra-thin veneers, which seems to be what you want. Be very selective in who you go to. Remember than only 1-2% of dentists have the artistic skills and training necessary to create a beautiful smile makeover.

Dr. Hall

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

We thank our advertisers who help fund this site.
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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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