Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

February 27, 2018

Another porcelain veneer horror story


We thank our advertisers who help fund this site.

Hello Dr. Hall,
I have had 6 veneers done on my top teeth. They are too bulky and not natural looking.

When I first started the process I was very clear with the lab and the dentist what I wanted. He sent back the first set because they were too bulky yet continued to use the same lab. At this point most of this was paid for so it wasn’t like I could have just gone somewhere else. It was all very rushed. There was no style guide whatsoever provided either. I really tried to be patient and put my trust in this dentist professionally. He was nice and everything but that is totally irrelevant.

The day of the cementing I was totally stressed with this whole process and when they held up the veneers for me to see they kept falling out making it impossible to make a proper judgment call. I was unsure about it but they kept telling me that they could make adjustments after. Which was untrue. They were not able to, hence me reaching out to you.

I have tried for the last month or so to get a hold of the dentist, asking for a refund and I’m being avoided it seems. Any advice would be so appreciated, how do I get my refund? I’ve cried so much over this, literally. It’s my teeth not a haircut—teeth don’t grow back after all.
– Leanne from Toronto, Ontario

Leanne,
Your basic problem is that the vast majority of dentists, while they may know in theory how to place porcelain veneers, don’t have the artistic inclinations to do a smile makeover. At the same time, most dental laboratories, while they know the mechanics of making the porcelain veneers, don’t know enough about the artistic aspects of the work to do a smile makeover.

So you go in to this dentist and you say you want porcelain veneers, and he thinks he can do this and thinks his regular dental lab that he uses for crowns can do this. When the first set came back completely inadequate, he’s not going to sour this long-standing relationship with the lab by demanding a refund and switching labs.

Every excellent cosmetic dentist has had a first smile makeover. I had mine, and I will tell you honestly that I wasn’t proud of how it turned out. But I have learned over the years in talking with hundreds of cosmetic dentists that the excellent cosmetic dentists have a fundamental difference in attitude in that they will not be satisfied unless the patient is excited with the result, and they will go through whatever expense or work they have to until the result is beautiful and makes the patient happy. You will never have what happened to you, where they pressure you to accept the result. In my case, my first smile makeover patient was borderline satisfied with the result and didn’t object to my bonding the veneers. But the teeth didn’t have any sparkle, and when she came back for a checkup I told her that her results weren’t good enough, that I didn’t want a mediocre smile out there attributed to me, and I re-did them with a different lab completely at my expense. I have learned since that this is what all of the really good cosmetic dentists will do.

So your dentist, because he lacked this commitment to your satisfaction, either didn’t bother to learn about try-in pastes or decided to skip that step so that you weren’t able to see for yourself how this would turn out before they were bonded. And now, rather than wanting to fix it, he doesn’t want to be bothered.

To get satisfaction and to hopefully get a refund, you’re going to need to get an excellent cosmetic dentist on your side. We’re a little thin on recommended cosmetic dentists in the Toronto area, but we do have Dr. Goodlin there. I would go to him for an opinion, and see if he will work with you to try to get a refund from your dentist. A call from one dentist to another can be very persuasive. Your legal leverage in this case, unfortunately, isn’t that great if the veneers have stayed on and are functionally okay. Your dentist has probably met those two standards, which is how the profession at large will judge your case. Your best point to make, legally, is that you were pressured to have the veneers bonded on against your will with false promises. If you have to go to a lawyer to get enough pressure on this dentist to refund your money, that is the point your would want to make.

I wish you well and hope you end up getting the beautiful smile you thought you paid for. And a tip for others in your situation—even though you have paid for the work, you can switch to another dentist at any point. A dentist is ethically obligated to help facilitate that change, for whatever reason you feel you need to switch.
– 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.

October 12, 2015

Should porcelain veneers have a hump at the gumline?

We thank our advertisers who help fund this site.
.

Dr. Hall,
I am in the process of having two front teeth veneers replaced. I started out with these teeth having bonding. Then I had that replaced with veneers, but they felt bulky. They looked fine but it was hard to close my mouth. So then my new dentist did bonding, but the job came out horrible. So my dentist told me she could help me have a more comfortable smile and still look good by doing a new set of porcelain veneers, so she has prepped my teeth for new veneers.

My question is, is it necessary that the front teeth hump out for veneers or is it possible to have a smoother surface at the top? Most of the veneers I have seen seem to be humpy but I did see a nice transition on the durathins. Right now I am in temporaries and they look ok but have that hump at the top I am referring to. Please, I would be happy to hear any of your thoughts.
– Yolanda from Virginia

 
Yolanda,
You don’t sound to me like you have a lot of confidence in your dentist, and, from what you say, I’m not having a lot of confidence in her either. If you have to tell her not to make a “hump” up near the gumline, you’re in trouble. The first step in getting beautiful cosmetic dentistry is having an artist for a dentist, and I’m not getting the feeling from you that you have that. Maybe you do. Hopefully you do. But if she’s the one who did the horrible bonding, that doesn’t bode well for your veneers.

To answer your question, no, there absolutely should not be a “hump” near the gumline. Not only can that look bad, but it creates an area that tends to attract plaque and will cause gum inflammation. But your dentist should know that.

And the question is not whether or not you should have bonding, or conventional porcelain veneers, or DURAthins. All of those will produce a beautiful result for you in the hands of the right dentist.

But with you already in the hands of this dentist, what do you do now? I would make sure you get a try-in so you get a good look at these porcelain veneers before they are bonded on. Don’t let her pressure you into bonding them on unless you can see clearly how they look IN YOUR MOUTH and you like them. If you don’t like them and your dentist says, “Oh, they’ll look better once they’re bonded on,” don’t let her do it. Every excellent cosmetic dentist will insist that you love the result before bonding on veneers permanently because everything about them can be fixed before they’re bonded, but once they’re bonded, you’re stuck.

And if she ends up not ever getting it right, you can switch and have a more artistic cosmetic dentist take over. But I’d give her the chance to get it right first.

I hope it goes well.
– Dr Hall

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.

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 19, 2015

I have a bad feeling about how these Lumineers are going to turn out

 

We thank our advertisers who help fund this site.




 
.

Dr. Hall,
My husband and I went to a local dentist who advertised cosmetic dentistry. We wanted Lumineers. Our teeth were prepped and impressions were taken. She told us the veneers would arrive in 2 weeks. Exactly 2 weeks later the dentist called and told us that the lab had called, there was a problem with the impressions, and that we needed to return to have the impressions redone. My question: is this common? We paid upfront so they have our money. Your thoughts will be so helpful as we are a bit anxious. Thank you so much.
—Didi from California

Didi,
I’m a little concerned over your situation.

That is not a big deal, to have the first impression not work out and to have to take another impression when you’re having laboratory work done. That happens in the best dental offices from time to time. And I’m confident you’ll get your Lumineers.

What concerns me about your case is what I’m reading between the lines. Admittedly, I’m doing a little guesswork, but this is informed guesswork. And I have some advice for you on how to handle this. It appears that you are dealing with a dentist who may not know what she is doing. I’m drawing this conclusion from the time delay in discovering that the first impressions were inadequate and that this information had to come from the lab.

Knowing what goes on behind the scenes with these things, here’s what appears to have happened. The dentist sent the case to the dental laboratory. The laboratory began working with them and realized that there was a fatal flaw in both impressions. They then called your dentist and told him that. Your dentist would likely resist, because this is embarrassing to have to tell a patient that they need to come back for new impressions, so the flaw must be serious enough to make the case unworkable. The problem is that the dentist didn’t recognize the problem herself, but had to be told. And it wasn’t just one of the cases, but both of them. Added to that is the fact that these are Lumineers, not another brand of porcelain veneers, and Lumineers tend to attract novice cosmetic dentists.

Here’s what I recommend that you do to protect yourselves. Insist that before the Lumineers are bonded to your teeth that they be placed with try-in paste. Insist on this. If your dentist doesn’t have any try-in paste, tell her to get some, because you need to have a good look at these on your teeth and be sure that you are happy with them. If you have any hesitation at all, backing out before they are bonded onto your teeth is comparatively simple. They can always be sent back to the lab to be re-worked or even re-made. And if your dentist can’t put them in with try-in paste, or if she can and you’re not happy with how they look, you can easily switch dentists if it’s before they’re bonded. By the dental code of ethics, enforced by the dental board, your dentist has to cooperate fully if you want to switch dentists, even if it is in the middle of a procedure like this. She would have to forward the models and Lumineers to another dentist. And if it comes to that, let me help you find an expert cosmetic dentist who will be sure that your case turns out looking good.

And don’t accept any excuses here. I have all kinds of stories in my files of patients who had try-ins like this and they didn’t like how they looked, and the dentist pressured them to having them bonded saying that once they got bonded permanently they would look better. Or they would look better in a couple of weeks. Or the patient would get used to them and learn to love them. Don’t buy any of these lines.

Try-in pastes for Lumineers or other brands of porcelain veneers are water-soluble gels that will hold the Lumineers on the teeth very loosely–not firmly enough so that you could wear them out of the office, but enough so that you could stand upright and look at yourself in a mirror. As I said, you and your husband need a good look at these before they’re bonded on, and if your dentist can’t do this for you, then you can find a dentist who can.

Now there are other possibilities for what has happened here. It’s possible that the impressions were damaged or lost after being sent to the lab. Or it could be something else. But I would still insist on the try-in based on this suspicion that we’re dealing with a novice. Excellent cosmetic dentists will all do this and if you have any hesitation about how the smile makeover looks, they will insist on fixing it before they are bonded on. Do a search on “beautiful smile guarantee,” and you’ll find the websites of a number of dentists we have advised about this and will learn how each of them has a variation of this same practice. They will try on the veneers before they’re bonded, and if you don’t love them, they will adjust them or even re-make them until you do and then bond them on. And maybe this is what your dentist was planning on doing all along. But if not, you still have a right to insist on this.

I hope this is helpful.
Dr. Hall

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 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.

Powered by WordPress

Follow this blog

Get every new post delivered right to your inbox.


Categories