Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

February 5, 2018

My dentist wants to give me CEREC veneers


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Dr. Hall
I’m about to have CEREC veneers done by a dentist I’ve used very little. He has told me that he does 1.5mm veneers, and that, after research, seems very thick.

I’m not sure of his abilities, and CEREC takes a magician to do correctly and natural.

Should I reconsider?
– Terry from Aurora, Colorado

I wrote back to Terry and asked this:

Terry,
Who’s the dentist? That makes all the difference in the world!
Only about 1-2% of dentists are artistic enough to create a beautiful smile makeover.
So who’s the dentist? That’s the key question – not what material he’s using or how thick.
Dr. Hall

Whereupon he wrote back and gave me his name. Let’s not use the dentist’s real name—let’s call him Dr. Doe. So I responded with this:

Terry,
That’s very helpful.
It’s tough to find out any information about Dr. Doe—no website, no Yelp reviews. His Facebook page tells me nothing useful, no Angie’s List reviews.
I also checked databases that I have of institutions that train dentists in smile makeovers, and cannot find him listed anywhere.
Bottom line—highly risky. Especially given that he wants to make these veneers with a CEREC. There are some dentists who can do that, but this is harder than using a ceramist and requires an exceptional amount of skill. So not finding him among the alumni of these training institutions is troubling. He may be doing that to save money—he doesn’t want to pay a ceramist.

And you have to realize that if you get a smile makeover and end up hating how it looks, you have no legal recourse. As long as the veneers meet the standard of care—they stay on the teeth and function all right—the legal standard of care does not require you to like how they look.

Use one of our recommended cosmetic dentists. We have a couple in the Denver area, and either one could give you a beautiful smile makeover.

I have a bad feeling about Dr. Doe.

– Dr. Hall

And Terry responded:

Dr. Hall, thank you very much for doing the informative research. Even though not much was found, it was enough for me to reconsider my decision, and will give one of your recommended dentists a call, and mention your name.
I appreciate your time, of course your effort, thanks for everything.
– Terry

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.

September 21, 2016

Follow-up on Lyndi’s sinus perforation after extraction


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About three weeks ago I published a post about a patient named Lyndi who had a large sinus perforation after her extractions. She responded telling me about her subsequent experiences, and I gave her some additional advice. Here is a copy of the follow-up correspondence with her.

Hi again Dr. Hall,
I thought I would send an update. I waited the full 2 weeks and saw the oral surgeon for the follow-up this week. In the meantime, I developed yet another bad sinus infection. I had my family doctor call me in antibiotics because I was really scared this infection would spread. I am still having a ton of drainage, but only from the left side, where the perforation occurred. It still pours out my left nostril when I gargle and I have had that same drainage in my denture. The oral surgeon poked around with a q-tip, which was very painful, and said the hole is sealed. He also had me plug my nose and blow (I didn’t blow hardly at all for fear I’d make it worse). I questioned him due to the above symptoms and he basically crossed his arms and said “look I told you the hole is healed and you don’t need surgery. You should be happy.” I explained that news sounds great, but I’m confused and that was the end of my appointment. I’m so lost, still quite sick (4 weeks straight now) and really don’t know where to turn.

I don’t want to make trouble but I am extremely frustrated. I’m out of sick pay, so I’ve lost some pay and also had to work even though I’m sick. I am emotionally and physically exhausted. I still can’t eat well, can’t chew at all for the pain is intense and not worth it. I’ve lost at least 15 lbs and I’m small to begin with. I deal with this horrid smell/taste all day every day and I know it is the infection. I explained all this to the original dentist. Again, any advice would be much appreciated. I am a social worker and advocate for people every day, but for some reason I’m having trouble being heard in this situation.
Lyndi C.

Lyndi,
I’m just going on what you were able to tell me, but the feeling I got from what the oral surgeon told you as opposed to what the ENT doctor told you was that the ENT doctor was the one you should trust. I don’t like it when doctors talk to you the way you are saying this oral surgeon was talking to you. Lecturing you that you should be happy? You’re not happy, and he should care enough to listen to why. There are two ingredients to quality medical and dental care–competence and caring. One without the other isn’t quality care.

Why don’t you just stick with the ENT doctor? It doesn’t sound to me like this oral surgeon cares whether you are sick or not or how much work you are missing. And the oral surgeon could well be buddies with the dentist. He probably gets referrals from her, so part of what is going on may be that the oral surgeon is trying to downplay the seriousness of your complications to protect the dentist.
Dr. Hall

Second follow-up, a couple of weeks later

Dr Hall,
You have been so kind to answer my questions and I appreciate it a great deal. I do still have a small hole that does not want to heal for some reason. I’m under the care of yet another ENT who appears to be taking me seriously. I wanted to update you as I finally received my medical records from the original dentist. My “informed consent” does not have a date, nor my signature. As a matter of fact, on the signature line it states, “reviewed with patient, not signed due to sedation.” Apparently they said they went over this with me the morning of my procedure, while I was under the influence of benzos, as I had been prescribed and told to take both pills 1 hour prior to my appointment. The dentist is refusing to pay my medical bills, saying they forgave my balance with their office in order to free up my money so I could pay the medical bills. I am completely aghast. I have called an attorney but still waiting for a call back. Any comments or advice is appreciated.
Thank you for your time.
Lyndi C.

My response:

Lyndi,
From what you have told me, you have a very valid complaint, and I have some words of advice for you.
First, I would tell the dentist that you are contacting an attorney and let them know that they could make this a lot easier on themselves if they just pay your medical bills, if that’s all you’re asking. When you mention that an attorney is going to get involved, that should trigger a call by your dentist to her malpractice insurance carrier, and they would likely advise her to settle this before it gets out of hand and may reimburse her for any expenses involved in settling it.
You didn’t give them consent, so they are on pretty shaky ground. It seems reasonable to assume that you were too sedated at the time to sign your name, so clearly you were too sedated to give consent. But you have more grounds than just that, as, from what you have told me, they fell short of the standard of care in several important respects.
I may not be getting all this right, but I’ll make a list of what is in my head of their mistakes, as I remember your case and refresh my memory by scanning your emails.

Mistakes made by this dentist:

1. Not getting informed consent from you (consent under sedation isn’t consent).
2. Poor extraction technique resulting in bone fragments being left at the surgical site, a large sinus perforation, and infection (and, I suspect, material being pushed up into the sinus).
3. Not telling you on the spot that there was a sinus perforation.
4. Not beginning treatment of the sinus perforation until the day after.
5. Starting off with the wrong antibiotic.
6. Not changing the antibiotic in a timely manner.

They should compensate you for all the post-operative care expenses you incurred, not to mention the time you missed from work, in my opinion. And, if your case got into court, I think you would be entitled to significant pain and suffering damages and possibly a punitive award.
You also have remedies beyond just going to an attorney, and you might want to let them know you are aware of those. You could complain to the state dental board, and you could complain to the dental insurance company. The dentist would not want either of those to happen.

You could let the attorney know that you have shared details of this with me and that I said I believe you have a strong case. A requirement of any successful malpractice case is the opinion of another professional that the care was substandard. But hopefully the dentist will be reasonable and you won’t need to take that step.

The oral surgeon is very possibly a buddy of the dentist, which could be why you didn’t get very good care there and had to go to the ENT physician.

Dr. Hall

Question and answer go here.

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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 11, 2016

This dentist does a really fast crown preparation


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Hi Dr. Hall,
Should I consider leaving my current dentist? When I first met my dentist, I was amazed a how incredibly fast he could trim down a tooth for a crown. It seemed like less than ten seconds. However it now seems as though he shaved some teeth down too far. Two of his crowns have fallen out twice, and there does not seem to be much tooth left to hold them. Could it be that he was working too fast and took too much off of the existing teeth?
I am not planning on suing but I cannot afford to lose any more teeth to his crown work, and cannot afford implants at the moment. Should I seek out a different dentist? Is there any guarantee with a crown?
– Marcos from New Jersey

Marcos,
While there is not really a guarantee with a crown, there is a concept in dental care called the standard of care–a minimum standard that an average dentist should provide his or her patients. There may be situations where there simply isn’t much tooth left to hold the crown on, so even a dentist who is doing everything right could have problems with an occasional crown staying on. But if there are recurring problems with crowns from a particular dentist with crowns falling off, that could indicate a breach of the standard of care and the dentist could be liable.

I realize that you don’t want to sue, and I’m not suggesting that. But knowing the dentist’s liability can be used to give you a bargaining position to get things fixed correctly without having to pay another dentist to do this over.

You say that two crowns have fallen off twice, and that you could see there wasn’t much tooth left on these teeth. While I don’t know the history of these teeth, that, together with your description of how little time this dentist spent on the crown preparations, suggests to me that the teeth were prepared with too much taper. I refer you to my earlier post on this subject, The Main Reason Your Crown Probably Fell Off, where I explain the role of taper.

In over 20 years of dental practice and placing many hundreds of crowns, I never had a crown that I placed fall off. I say that not to brag but to make the point that if a tooth is properly prepared and a crown properly cemented, it will stay on. Yes, it takes more time and trouble to prepare a tooth precisely so the crown stays on, and it is also more time and trouble to seat and cement a crown with an ideal preparation, which is why most dentists compromise on the ideal preparation a little bit. It sounds like your dentist compromises a lot in the interests of speed.

So to get to the point. Yes, if I were you, I’d find a dentist who does crowns that stay on. And then I would get these two teeth fixed with crowns that stay on. It may be necessary to have new crowns made. Even if a tooth is over-prepared, there are ways to modify the preparation, either with retentive grooves, or with a buildup and possibly the use of pins, so that a crown will stay on better. Or, depending on the material in the crown, it may be possible with bonding technology to get a poorly prepared crown to stay on. I would find a dentist who can take care of this for you, and ask that dentist to help you get some type of refund, even if it’s a partial refund, from your current dentist.

– 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.

June 23, 2016

Follow-up on trouble speaking with new veneers


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This is a follow-up to the previous post, where Susan emailed Dr. Hall telling about problems she was having speaking with her new porcelain veneers.

Susan commented at the bottom of the post:

Thank you for the reply. I think I am going thru a bad nightmare. After complaining about my speech and bite, the dentist took off the front four permanent veneers, to replace them. As he was taking them off he broke #9 [the upper left central incisor] after which I had to have the tooth pulled and an implant put in. I am currently 2 months with the implant temporary. I have to wait three months for it to heal. I asked him to make a matrix of the temporary veneers and the final veneers to see what is wrong. He said all the molars are each side were made too short and the lab made the mistake by using my original bite. Right now I have 9 temporaries in my mouth with the implant. He didn’t replace the 1st molars because he claims they are fine. My temporary veneers were 12.4 length for #9 and #10. Now they 11.8 and hitting my lip. Could it be those back 1st molars being too short? Or should I just run and find a new dentist?

And here is my answer:

Susan,

Again, I do have to qualify what I answer here by saying that not being able to see exactly what is going on, I may be missing something, but I CAN tell that something isn’t right here.

The molars being made too short—that would definitely explain your speech problems. But passing the mistake off onto the lab saying they used the wrong bite? No, that doesn’t work for me. It’s not the lab’s fault. The dentist gives instructions to the lab and the issue isn’t your bite, it’s the vertical dimension. And that has the potential to cause long-term problems. It is called bite collapse. You absolutely need to have your bite opened to its original position. What is starting out as just speech problems can easily progress to TMJ disorder with possible chronic headaches and jaw pain.

Cases like yours where the vertical dimension is altered need to be approached with great care, and a dentist needs more training than what they receive in dental school to pull this off. The dentist will replicate your bite on a machine called an articulator where he or she can carefully study all your bite movements. He or she will establish a vertical dimension by testing it in your mouth with temporary restorations, and then will send your case to the laboratory on the articulator with careful instructions on how to reconstruct your mouth.

And then I’m aghast at what happened to your front tooth. When you take off veneers, the way to do that is to grind them off. You can’t “pop them off” or remove them in any way like that if they’re bonded on properly. They become like a second enamel and the only way is to grind them off, which is a gentle process that is similar to preparing the teeth in the first place. I am again suspecting that he didn’t actually do porcelain veneers but did porcelain crowns and called them veneers. But even then, with front teeth, crowns should also be ground off, and there is no excuse for breaking a tooth.

I would not let this dentist touch your teeth any more—this is getting worse every time he sees you.
Actually, I do know an excellent cosmetic dentist in northern New Jersey. I will send you the name. I know her personally and have absolute confidence in her. She is AACD-accredited, which is no mean achievement, and a Master of the Academy of General Dentistry, and I believe she is one of the best cosmetic dentists in the entire state.

A couple of additional points:
1. You need to get tough with this dentist. As I said, not seeing your case personally I’m at a little bit of a disadvantage, but based on what you are telling me he has violated the standard of care and is very vulnerable legally. He seems to have got in way over his head and has done multiple things wrong. If I were you I would call him and say that you’re going to be nice and not take him to court where you could sue him out the wazoo, but to avoid that he needs to pay for everything that this new dentist needs to do to fix you up. Go to the new dentist first, confirm the details of what has been done wrong, and then confront him.
2. I can’t imagine that your bite and vertical dimension are the only problems with your case. You haven’t said anything about how your teeth look, but it is rare for functional incompetence in dentistry to be blended with artistic excellence. In my mind’s eye right now I can’t imagine that you have a beautiful smile. But based on what you have told me, your case needs to be completely re-done. That is your silver lining. The new dentist, in re-doing this, can give you a beautiful smile.

– 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.

March 5, 2016

Dentistry in Costa Rica

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I’ve written before warning about getting dental work done in Costa Rica. But I just became aware of an incident that truly highlights the risks. Because I am only able to partially confirm this patient’s claims, I am not publishing the name of the dentist, which she had provided, only her story because it illustrates the risks in dental tourism.

dental tourism in Costa Rica

Dr. Hall,
I went to Doctor [name withheld] at [name withheld] Dental Clinic just outside of San Jose Costa Rica for some dental work and to have porcelain veneers placed. The dentist broke one tooth and caused me to need three root canals. He left me with ten open margins, I had crowns pop off, and he screwed up my bite so badly that I now suffer from severe TMJ, constant pain, can’t eat or speak properly etc… I have an estimate of $35,000 to fix my bite (which I don’t have) which doesn’t include the root canals. He refuses to refund the small fortune that I paid him and refuses to pay to have my teeth fixed.

But the story gets worse.

After my follow-up with an American dentist who said that I was the victim of criminal negligence, I hired a Costa Rican attorney. We were able to get three Costa Rican dentists to concur with the American dentist. We met at the Dental Colegio. But all that mattered at the Colegio board meeting was the fact that I complained publicly about Doctor [name withheld]. It was explained to me that it is a felony to speak against the reputation of a Costa Rican citizen unless or until that person has first been found guilty of a crime in a Costa Rican court of law. It did not matter that I filed those complaints online about the dentist from my own home in America. I had to flee Costa Rica immediately to avoid being arrested.

As far as filing criminal charges or a lawsuit, my attorney told me that the dentist would just bribe an official and make the case go away. My only hope was with the Costa Rican dental Colegio and they cared nothing about justice. Their legal system in Costa Rica is very corrupt. There is no justice there for Americans.

I also learned that this dentist didn’t graduate from a dental school in Miami as it claims on his website. He only took a class there.

– Kimberly from Florida

I thought I would just pass on Kimberly’s experience here, as there isn’t much I can do to help other than to help publicize her plight. I did look up the dentist she mentioned, and the website looks very inviting and gives you the feeling that you’re going to get wonderful care. The credentials presented look legitimate. However, as a dentist, I noticed some red flags that I think would escape the normal patient. For example, this dentist claims to have had a minor in implant dentistry from Miami University, as Kimberly mentioned. But there is no such thing as a minor or major or any organized course of study in implant dentistry at any American school—it isn’t a recognized specialty. He also claims to have a minor in Orthodontics and Prosthodontics from the DaVinci Institute. Besides the fact that this makes no sense—there are no “minors” in any dental field in the United States, only majors. And the combination of those two specialty areas in dentistry is made up. If minors did exist, he would have two separate minors—one in Orthodontics and one in Prosthodontics. Besides this, the DaVinci Institute is a think tank in Colorado. It may sound dental because of the famous DaVinci Dental Studio in California (a renowned dental laboratory that makes porcelain veneers), but there is nothing dental about the DaVinci Institute. Then, googling the dentist’s name and the name of his clinic, I discovered that the name of the clinic had been recently changed, a tactic used to escape a bad reputation. Also, there are no Google reviews for this dentist or his clinic, under either of its names, which is very strange. These are all red flags. But they would escape the typical dental patient.

I also found another serious complaint filed against this dentist on the website ripoffreport.com.

Bottom line: Beware! Just don’t do it. Both implant dentistry and beautiful cosmetic dentistry are risky enough in the United States. Don’t compound it by going to a place where you have poor standards of care and absolutely no legal recourse in case something goes wrong.
– 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.

February 11, 2016

She can’t floss after getting porcelain veneers

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Dr. Hall,
I have just had 9 eMax veneers fitted one week ago. I use Oral B Pro Expert toothpaste which dentists in the UK highly recommend for tooth hygiene. Is this toothpaste okay for my veneer care? Also the way my dentist has placed the veneers on I can’t floss in between so I have used Phillips Airfloss to clean gums.
– Michelle from Derby, UK

Michelle,
Before I address the toothpaste, which is a minor matter, the thing you need to be most concerned about is that you can’t floss between your teeth. This is a serious problem. In my opinion this is a serious deviation from the standard of care. At least you are using the Phillips Airfloss to try to clean between the teeth, but this isn’t as good as flossing. You should not only be able to floss between each of your front teeth after getting porcelain veneers, but that floss should glide smoothly along the surface of each tooth, with no snags or rough spots, clear into the sulcus of the tooth.

Without this, your gums will be puffy and not healthy. This is one of the critical things I look for when I examine photographs of the work of cosmetic dentists that I recommend on this website.

Were your veneers made by the laboratory this way? Or did your dentist simply skip the step where the excess cement is cleaned off?

There are situations, such as with advanced gum disease or creating support to hold in a bridge where some front teeth may need to be bonded together in order to strengthen them. But to create that situation for an aesthetic procedure is something I would consider completely inappropriate.

Correct Porcelain Veneer Bonding Technique

Here’s an explanation of a typical method of bonding on porcelain veneers, which I used, and which I believe is pretty much accepted technique among cosmetic dentists, or something very similar to this. After priming the surface of the tooth with the proper etching and bonding agents, I would place the bonding composite in each veneer individually and then press each veneer onto its corresponding tooth, which would cause excess composite to squirt out the sides. I would then remove much of the excess composite with a cotton roll and then begin to cure the bonding composite. This composite is light cured, and dentists use a special high-intensity curing light that emits a particular wavelength chosen so that it activates the hardening agent in the composite. porcelain veneer bonding technique small tip curing lightBut rather than cure the entire tooth, I would use an ultra-small light tip (a 2-mm tip is shown here) so that I would cure only the composite in the center of the tooth. This would tack the veneer in place so that I could floss around it without dislodging the veneer. After thus tacking all the veneers into place, I would carefully floss around the teeth, making sure that all the excess composite was removed and we were left with smooth surfaces between all the teeth.

porcelain veneer curing light large tipOnce that was done, I would go back with a larger curing tip, similar to the 13-mm tip shown here, and cure all of the remaining composite, so that the veneer was solidly attached to the tooth. Then I would finish the case by going between the teeth with fine polishing strips, leaving everything with an ultra-smooth polished finish.

Dentists who don’t do a lot of porcelain veneers may not stock this ultra-small curing tip. Not using a tool like this means a lot of extra work, because cleaning off the excess composite once it is hard is time-consuming and laborious. Of course, if they just skip that step, it’s quick and easy.

The first step I list on my page about how to take care of porcelain veneers after they are placed is “brush and floss faithfully.” If you don’t do that, you risk getting decay around the edges of the porcelain, and you risk losing the teeth to gum disease. Not good.

So I would go back to this dentist, share what I have given you here, and see if he or she can fix this so you can floss. Meanwhile, continue using your Phillips Airfloss–it’s better than nothing. But be sure you don’t put a mouthwash in it that contains alcohol. Alcohol softens the bonding composite around your veneers.

About your toothpaste, I would disagree with your dentists in the UK, that Oral B Pro Expert toothpaste is anything special for general dental hygiene. I don’t believe there is any toothpaste that is anything special for general use. I look at the ingredients in the Oral B toothpastes and I see stannous fluoride, which other toothpastes have. It’s a fluoride compound. I actually think that sodium monofluorophosphate is a better ingredient for delivering fluoride, but stannous fluoride is okay. Some of the Oral B formulas have tartar control agents, which other toothpastes also have. Some formulas have whitening agents, but other toothpastes have those and they don’t really work anyway. Some have antibacterial agents, which, again, are present in other toothpastes. Nothing unique or special here.

There are two toothpastes that are specifically designed for maintaining cosmetic dental work. One is Rembrandt toothpaste, which uses aluminum oxide as an abrasive, which is especially gentle. The other is Supersmile toothpaste, which cleans the teeth with an enzymatic action that actually dissolves the protein pellicle to which the stains attach. Because it is so gentle and thorough, that is my recommendation for maintaining cosmetic dental work, and when I placed a set of porcelain veneers, I started each patient off with a complimentary tube of Supersmile.

If you learn anything more about why your dentist made it so you can’t floss between your teeth, I’d love to hear from you.
Thanks,
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.

November 4, 2015

My dentist said my new veneers may come off every couple of months

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Dear Dr. Hall,

I just got 8 top veneers placed on. As I was leaving the office, I was told they may come off every couple of months. I know I can’t eat apples or crunchy things with them but are they going to fall off that often??
Thank you for any info you can give me.
– Dorothy from Maine

Dorothy,
Really! They told you your new porcelain veneers may come off every couple of months? That’s a new one!

If they do come off, I will tell you what to do. Go back to their office and demand a refund or you will call a lawyer, because if they do, they weren’t done right. Take a copy of this email with you and show them – I’ll stand behind that statement 100%.

There is a principle in the dental profession called “the standard of care.” Now, unfortunately, since cosmetic dentistry isn’t a recognized specialty, the standard of care for cosmetic dentistry is pretty low. Your new veneers don’t have to be beautiful. They may even look dingy and still meet the standard of care. But they do have to stay on. That much is pretty basic. So if your veneers begin falling off within the first couple of years, that is a breach of the standard of care, and the dentist is legally liable for that. It’s hard to put a number on it, because they should never just fall off. But if I had to use a number, I would say they should last ten years, at least.

And about your dietary restrictions. I placed many veneers over a period of maybe 15 years, and I never told my patients not to eat apples or crunchy foods. I told them to eat whatever they wanted, except for pins and bottle caps and stuff like that.

In fact, I will go this far. I would encourage you to test the veneers by eating some apples. If these veneers aren’t going to stay on, it is better if you find out now rather than later. Put them through a stress test and see if they’re bonded properly. A properly bonded porcelain veneer will not come off. I had a couple of cases where I had to re-do some porcelain veneers, and you have to grind them off, just as if they were part of the enamel, they are bonded so tightly.

There are only a couple of legitimate restrictions to your activities after you have a set of porcelain veneers, and I list those on this website on a page dedicated to the postoperative care of porcelain veneers. That is to avoid biting metal objects, and to wear a mouth protector when playing contact sports. But even those activities would potentially cause the veneers to chip or crack, not to come off.

If someone tends to grind their teeth at night, I also would wear a nightguard over the teeth to protect the veneers from chipping or breaking.

But apples and crunchy foods? You should be fine with those. Go enjoy yourself, that’s what I would say.
– 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.

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