Dear Doctor Hall
I am so grateful I found your web site. I recently had 8 porcelain veneers placed. My right tooth seems to be slightly slanted. They seem thick but I am not sure how to determine that. I have small gaps on each side of the front two teeth. I also have a slight roughness at the back of my newly veneered teeth. Most disappointing is the drab color. I feel the color is very displeasing. I am distressed about the color of the veneers. I have looked at them in my hand mirror a hundred times a day in all different lights and they are not the same color as my teeth. When I visited with the color specialist he asked me if I bleached my teeth. I told him no and he showed me a color chart from the non bleached palette. I chose the whitest color from this palette. I wish he had given me the option of choosing from the bleached palette. I think I would have found a more pleasing color. I have researched so many web sites to see if there was a possibility of whitening the veneers but of course the web sites claim there isn’t any other recourse but to remove them and start over. Is this true? You can imagine my disappointment after paying so much money and to not be 100% delighted. I have tried to be happy with the color and have asked close friends and family and they all have agreed that the veneers are not as white as my teeth were. I have tried to make myself like the color and for this whole month have debated every day with myself if I can live with it.

I hope Dr Hall you can give me your honest opinion. I would like to send a picture, too.
– Melissa from Texas

Teresa,
Your basic problem is that you got your porcelain veneers from a dentist who isn’t really that big into appearance-related dentistry and is of the mindset that these porcelain veneers are “good enough.”

I’m going to take the occasion of your question to go into some detail about this process and then post my answer to try to be helpful to others. So here are some differences between your experience and what a truly committed cosmetic dentist would have done:

1. Every excellent cosmetic dentist has some mechanism for figuring out what you are looking for in your new smile before they actually have the porcelain veneers made, so that you are not just satisfied with your new smile, but excited about it. To the excellent cosmetic dentist, satisfied isn’t good enough. There must be genuine enthusiasm that you show.

2. One of the critical issues that is discussed with every smile makeover patient is how white they want their veneers. You made some reference to seeing a “color specialist.” I don’t even know what that means. I have never heard of such a thing among excellent cosmetic dentists. It sounds like there is some other person in this dentist’s office, or maybe connected with the lab, to whom the dentist has delegated the task of figuring out what color the veneers should be. What you told me sounds like a very casual conversation – the “color specialist” asked if you had bleached your teeth and since you hadn’t, they picked a shade from the “natural” color shade guide. Here’s how I dealt with the color question with every smile makeover, and every excellent cosmetic dentist has a way to address this that is just as intense. I asked each patient to tell me, on a scale of 1 to 10, how white they wanted their teeth. 1 was natural, and 10 was bright white. So the very darkest we would ever give a patient was the lightest shade or two from the natural shade guide that was shown to you as the only option. The other end of the spectrum was a dramatic white, what I would teasingly call “ballistic white.” Almost everyone wanted a shade that was at least lighter than the natural shade guide, and there were a few people who wanted the “ballistic white.” A serious cosmetic dentist has to know how to figure out where you are on that spectrum, but this dentist didn’t take that very seriously and even delegated it to another person.

3. An excellent cosmetic dentist would be in touch with the desires of his or her patients, and would have thoroughly explored the possibility of bleaching your teeth before doing the veneers. Goodness – when we even did a single crown on a front tooth, we would always tell the patient that if they ever thought they might like their teeth bleached, do it before we put the porcelain crown on. When we were doing an entire smile makeover, we’d often have a treatment plan of bleaching the lower teeth and veneering the uppers because almost all the patients wanted teeth that were pretty white. When you’re getting a new smile, you want it WHITE. That’s cosmetic dentistry 101.

4. Finally, an excellent cosmetic dentist would have been SURE that you were excited about your new smile before bonding on the porcelain veneers. When I am checking out a dentist by phone call, let me tell you the questions I ask them to tell how committed they are to beautiful cosmetic dentistry. I first ask what system they have in place for making sure the patient is going to be happy with the new smile they’re going to give them. They will usually tell me that after a discussion with the patient about what they are expecting, they will create the new smile in acrylic first and have the patient wear it as a temporary smile makeover. This gives them an opportunity to play with the shade, shape, or whatever until the patient is happy. Only then is the order sent to the laboratory with instructions for the ceramist as to how to make the veneers.

After discussing that question, I follow up with this hypothetical: “Say you’ve gone through all of this and the veneers are back from the lab. I assume you try them on with some type of try-in paste, and then you ask the patient how they like them. Let’s say the patient responds, ‘Oh, I guess they’re okay.’ What’s your next step?” Every excellent cosmetic dentist will pick up on the lack of enthusiasm in the patient’s response. They expect a much more enthusiastic response, and, before they bond on the new smile, they will want the patient to not just be passively satisfied but actively excited about the new smile – they can’t wait to get it put on permanently. If there is an unenthusiastic response, the dentist will send it back to the laboratory if necessary to get it made to the patient’s expectations.

Did I get this right? It sounds like none of this happened in your case. Is that true? And as a result you ended up with porcelain veneers that feel too thick, there are gaps between them, and the color is drab. Yes, you can send me a photograph. Try to make it as close-up but yet as clearly focused as possible – when I get fuzzy photos from patients it is hard for me to be helpful. Clearly focused is more important than close-up.

And what to do now? You are right that the only cure for poor porcelain veneers is new ones. They don’t bleach. Closing the gaps could be possible, but impractical. And making them less thick would be a major project that would probably make the color and texture worse. And PLEASE don’t try to re-make your current dentist into an artist. You would have to infuse him or her with new DNA. It doesn’t work. His or her total mindset about cosmetic dentistry is way off the mark. You need a real cosmetic dentist.

There is a possibility of getting some money back, if you’re assertive but pleasant about it. I would start by going to a true cosmetic dentist. Get a plan for how to fix your smile so you’re truly happy with it, and then go back to the original dentist and see if you can get some recourse, with the assistance of the new cosmetic dentist. Dentists like to maintain a good reputation, and if he or she feels they could avert a negative Google review or a complaint to the dental board or a colleague or patient who thinks poorly about them, and you are nice about things, they may be willing to refund some or all of the fee.

Let me know how this works out. And when you get back to me, tell me more about who this “color specialist” was, if you could.

– Dr. Hall