Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

September 4, 2017

Wanting a cheap way to fix tetracycline stains


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I have terrible Tetracycline stains and thinking about Veneers, I am curious if the they cover just the front of the tooth?
Also, I am 60 years old and really want a nice smile before I pass on, not wealthy at all. Are there any dental schools that do work with interns?
Thanks
Tony from Louisiana

Tony,
Porcelain veneers cover the fronts of the teeth, but in the case of tetracycline-stained teeth, they need to wrap around the teeth somewhat in order to completely cover the very dark stain of tetracycline.

As far as the cost, you are in for potentially serious trouble if you are looking for cut-rate porcelain veneers. Covering tetracycline stains is a very demanding cosmetic dentistry procedure and I wouldn’t consider going to any dentist who would charge less than about $1000-1200 per tooth for this. I would absolutely not go to a dental school for this. Dental schools exist to teach the fundamental techniques of dentistry, not the artistry, and they are so ingrained with an engineering mentality that most dental school professors actually look down their noses at cosmetic dentists and procedures that patients want just to enhance their appearance. Also, not only would your “intern” be doing his or her first tetracycline case, but likely the instructor would also.

If you want to save money, the best way to do that is to do nothing. Otherwise, I would simply save up and have this done right. Make a selection from among the best cosmetic dentists in your area. Check out my recommendations in Lousiana–I list several excellent cosmetic dentists there. You want a dentist who has done several tetracycline cases and can show you beautiful before-and-after photographs of his or her results. Otherwise, your first attempt at having this done would probably end up being throwaway money, and then you would have to swallow hard and pay the full price to have your teeth re-done right. I have a huge stack of emails from patients who have made the mistake you’re contemplating making.

Another option for saving money without risking the need for expensive corrective work would be Kör whitening. I believe that Kör is the strongest whitening system available, and while it doesn’t whiten as much as some dentists claim, it could lighten your stains considerably for a fraction of the cost of porcelain veneers and without the risk of needing later expensive corrective work.

– 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.

August 14, 2015

My front teeth are darkening under my veneers

My Lumineers are 7-8 years old. Originally I had them on 16 teeth. At the time I had the money….there is no way I could afford this now. Soon after I had them put on by a dentist in Kona, Hawaii, I moved to Austin, Texas and they began to fall off. Two fell off and I paid to have them reinstalled. I told the dentist in Hawaii, and he ended up (after many letters and threats of legal action) sending me a very small refund so I could pay the dentist in Austin. The veneers had also begun to darken/no fit well at the gum line, making me self conscious more and more as time goes on. Since then no further veneers have fallen off, but over the past year I have noticed my front teeth darkening UNDER the veneers, one more than the other. I am afraid that I will need to have them removed and replaced and I definitely don’t have the money to do that. Interestingly, when I first chose the color of my new teeth I nearly chose a darker color to look more natural…as they seemed nearly too WHITE. But now they seem far darker…..I’m not flashing as white as my friends with natural teeth. Anyway….scared and disappointed I guess. Need advice on how to deal with the darkening teeth.
– Debbie from Texas

Debbie,
You’re right that the veneers will now need to be replaced. They are leaking, and the problem isn’t just the color, but when dental work leaks, the next step is that it begins to decay. When stain can leak in, bacteria also leak in.

It doesn’t sound to me like either dentist, the one in Hawaii or the one in Austin, knew enough to do this right. They weren’t bonded right in the first place, as you now understand. But very few dentists know how to re-bond porcelain veneers. The old bonding material would first need to be completely cleaned off, with some type of sand-blasting equipment which few dentists have. Then the inside surface of the porcelain should have been etched with hydrofluoric acid, again something that few dentists would stock. The veneer could then be primed and bonded onto your tooth, where it should remain without leaking for many years.

If your veneers could be just popped off, they could probably be cleaned up and re-bonded properly, and you should be fine. But I’m guessing that the Austin dentist probably bonded them on pretty well, just not well enough to hold up over these years. So they would most likely break in trying to take them off.

Another issue will be getting the new veneers to match your old ones. Make sure you go to an expert cosmetic dentist for this. Don’t look for cheap here–you’ll end up paying more in the long run.

I hope this is helpful.

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.

June 1, 2012

A cosmetic dentistry horror story – but there is a silver lining

Hi Dr. Hall.
I got 8 porcelain veneers and 2 crowns 2 weeks ago. I am 48 and have tetracycline stained teeth. I am very disappointed in a few ways and don’t know what to do. First thing is that they are too white. I look silly. I am Italian with dark skin and I look like I have Chiclets in my mouth. My dentist gave me an option on the color so I realize I am stuck with that problem. I will probably not smile very often now.

But the worst things are that I feel like they are loose and may come off at any time. I can’t bite down hard as it hurts in my molars. And also I can’t relax my teeth as it feels like the upper teeth are too long and my entire face aches like I am clenching and grinding my teeth. Help me with some advice please. I have had 5 kids with dental issues I always took care of. They are grown and gone and I finally was able to do my own smile. I am so sad about it.

Thank you.
Jamie from Virginia

Jamie,
This is the sort of story have heard so much over the years, and is the reason I operate this website. 98 to 99% of dentists simply don’t know how to do beautiful cosmetic dentistry. They chose the field because they like to fix things, and they think like engineers, not like artists.

You’re kind to take the responsibility for the color of your porcelain veneers. But there are about three things a dentist who is truly passionate about doing beautiful cosmetic dentistry would have done differently in your case.

First of all, he or she would have been knowledgeable enough about the results you would get to predict how you would look when your case was done, and would have coached you to a more beautiful result. You’ve never had a smile makeover before – how are you supposed to know how a particular color will look once it is in your mouth? A truly artistic cosmetic dentist would be focused on creating a beautiful smile, and would steer you in that direction.

Second, every excellent cosmetic dentist I have ever asked, and I have interviewed a number of them on this subject, has some method for making sure that you will love your new smile before it is ever bonded permanently. They will often make a set of what they call provisional veneers in acrylic that will be temporarily cemented onto your teeth so you can “test drive” the final result, to make sure that you will be happy. In addition to this, they have a try-in with the actual veneers – they will use a try-in paste to insert the porcelain veneers to let you see exactly how they will look. You will get as much time to look at this as you want – will get to see it under different lights, have a friend or family member come in to give you feedback on how it looks – whatever it takes to make sure that this will make you proud to smile before these are bonded on permanently. Most recently, I interviewed a cosmetic dentist in the Boston area that we recommend on this site. In 30 years, he has never had a patient who has not been happy with their new smile. If he ever did, he would re-do the case.

And that brings me to the third thing an excellent cosmetic dentist would do. These dentists, as I said, are passionate about creating beautiful dental work. Most of them, if they heard you say what you just wrote to me – that you won’t be smiling much any more – would be so embarrassed that they would re-do the case for free. I had this happen to me. I was a young dentist and it was the first time I had done porcelain veneers on someone with tetracycline stains. When dentists are inexperienced with tetracycline stains, they will make one of two mistakes. These tetracycline-stained teeth are so dark on the inside that the color shows through most dental materials, and the dentist will have them made too translucent so that the gray-brown shows through. This is what I did. Or, they will make the teeth too opaque and white so that they look pasty and fake. This appears to be what your dentist did. Well, with the case that I did, after I gained more training and experience and knew better how to make this type of case look beautiful, I offered to the patient to re-do them for free, because I didn’t want work that I was responsible for not looking beautiful. The patient never complained, but I could tell she wasn’t excited about how they looked, and I wanted her to be excited. I’m not unique – that’s typical of artistic dentists who love to create beautiful smiles.

So what do you do at this point? There really isn’t much remedy other than doing the porcelain veneers over. And this time you need to be very careful about the dentist you pick to do them. Pick one from our list – that’s why I have this website. I personally check every dentist I list to make sure they can do beautiful smile makeovers.

But I need to say a word about how your mouth feels now. The porcelain veneers cannot be loose – if they were loose they would immediately fall off. But what I am worried about is that your teeth are getting loose. You say that your entire face aches, like you are clenching and grinding now. And you think that the upper teeth are too long. I can’t tell this from a distance, but it certainly sounds like your bite has been thrown off. This could potentially be very serious and could lead to serious TMJ disorder or breaking of the dental work, or premature wearing down of your teeth, or periodontitis leading to early tooth loss, or even breaking of your teeth. This could actually be the silver lining of your cloud, because this could give you grounds for asking this dentist to compensate you so you can have this re-done correctly. Here’s what I would suggest. Go to a dentist on our list of recommended dentists. See what he or she thinks of what has been done – if the work has indeed thrown your bite off to where it is causing serious problems. And then see if he or she will help you get some satisfaction from this other dentist. You need someone more than just a skilled cosmetic dentist – you need someone who will be understanding and willing to stick their neck out a little to help you get what you deserve.

Good luck,
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.

June 21, 2011

A cosmetic dentistry horror story – so many things turned out so wrong

Dear Dr. Hall,
Last year, I had gotten six veneers on top and two on bottom. After the dentist cemented them I realized that some of them had brush marks left from the lab. I told the dentist that I was unhappy. He tried shaving and polishing the veneers over several visits, and that only made them worse, as it destroyed the shine, made them fuzzy and irritated my mouth. After much arguing, he agreed to redo the four veneers that he had tried to polish, initially asking for a full price, but later agreeing to do it free of charge because I argued that it was his fault from initially not inspecting the veneers and later making the situation worse by trying to shave and polish them.

Second time around, when the veneers came back from the lab, some did not fit, all were a wrong shade and did not match the rest of my veneers. They had to be redone twice, to finally look decent. On the third attempt, the veneers fit, but were still a little off in color. The dentist told me “so what, the color is not that different.” There were also a small gap between two veneers, he also told me “so what, real teeth have gaps too.” Fed up with the unprofessionalism, I got the veneers cemented, since he told me that it was the best he could do. Two weeks later, the veneer that initially had a gap fell out. He put it back in. The next morning the veneer fell again. He just cemented it back on, telling me that this time around he etched the veneer better and it will not fall again. The gap got even bigger and I was very unhappy. I kept on insisting to get the veneer redone, he told me to “get out of his office” and that he is releasing me of his care.

One week after he cemented the veneer back on for the second time, the veneer fell again for the third time. I have visited several dentist and they all told me that in general my dentist has done a bad job and that all my veneers need to be redone. Out of the top six veneers, two old ones have huge spaces between the veneer and my gum and the yellow cement is showing. The four that he had redone also have visible spaces between the veneer and the gum, the veneers are discolored, one keeps on falling and one is crooked. Two of my teeth on top have become extremely sensitive, not only to cold and hot water, but even to air. One dentist told me it could be due to bad bonding. The cement on two bottom veneers has turned brown, one veneer is placed higher than the other.

I have seen three different densitst and they are all telling me to get the veneers redone, but I am concerned about redoing the veneers for the third time since I am only 28 years old. What are the risks of redoing the veneers three time in two years? What is the best solution in my case?

I have also sent a letter to my previous dentist, expressing my dissatisfaction and asked for a refund, but he has not responded. Should I pursue a civil action against him or file a complaint with the dental board? I would at least like to get a refund and be able to redo the veneers. I want to also make sure that this dentist does not do this to anyone else. He is extremely unprofessional and rude. I also feel that he should not represent himself as a cosmetic dentist, since he obviously scewed up my veneers. What is the best course of action? Thank you in advance for your time.

All the best,
Liana from California

Liana,

It sounds like you’ve been around and around with this dentist. I’d like to try to help you, but I need something more from you first.

Anyway, in general I think your frustration comes from working with the wrong dentist. You need to understand that a dental degree and a dental license don’t make a dentist an artist. Cosmetic dentistry is art, and they don’t teach it in dental school in the regular curriculum. Dental schools are designed to teach dentists how to fix teeth that are broken, not how to create beautiful smiles. And because the profession will not declare cosmetic dentistry a specialty, any dentist, without any extra training, can claim to be a cosmetic dentist, and it’s all legal.

The bonding technique is only a small part of what you need to have this done right. Remember that when they were done the first time, they were apparently bonded correctly, because they stayed on your teeth, but they were ugly and then he made them fuzzy and you asked to have them removed. If you hadn’t done that, they would still be on your teeth today, it seems to me. Is that right? So now you want to go to a different dentist who will bond them correctly. But how will they look, and, if they stay on, what will you do when you don’t like how they look?

You’re asking about the risks of doing porcelain veneers a third time and you are only 23. There isn’t a single answer to that question. If you are just going to a “dentist” to get this done, then the risks are high. It all depends on how you are picking the professional who is going to do this for you. In the hands of the wrong dentist, this is very risky. In the hands of the right dentist, there is practically no risk.

If you’d like me to help you with this, why don’t you write back and tell me the name of the dentist you plan to go to to have this fixed, and I’ll try to tell you something of the risks I think you’ll encounter. I have resources where I can look up a dentist’s training and get other information about them that helps me evaluate these things.

Once you find the right dentist to re-do this for you, I can help you work with the previous dentist. But your problem here is that cosmetic dentistry is not a legally distinct specialty, so to pursue any action against this dentist you need more of a case than that you just don’t like how they look. That is why it is so important to pick the right dentist in the first place, because when it comes to cosmetic dentistry, often you have no recourse. Yes, he was promoting himself as a cosmetic dentist, but MOST of the dentists who promote themselves as cosmetic dentists aren’t very good at it. I would think you could get a refund, though, but it will depend on how you go about it, and you need another dentist to back you up, first. So let me know and I’ll see what I can do to help.

Dr. Hall

Links: read more cosmetic dentistry horror stories.
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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.

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