I have an appointment scheduled at the University of Iowa dental school at the end of November. I am seriously considering having veneers done through their dental school. A friend of mine is in their last year of school there, and is learning to do veneers through the supervision of a faculty member. I would like some recommendations as to whether this is a good decision, and how I can get the best possible results if I pursue this option.
– Teresa (Her e-mail is edited to remove the names of the dentists she shared with me).
I really don’t know what to say to answer this question. You’re already moving in this direction of having a student do your porcelain veneers, and if you think that this could possibly work out, I think we’re operating in two different worlds and nothing I could say would sway you.
Here’s how I would put it. Why would you want to go through all that trouble and getting something permanently bonded onto your teeth for the result of a mediocre smile? Why not just leave your teeth the way they are and not do anything? Do you really think that in dental school is where you find beautiful cosmetic dentistry? Do you really think that you could find any Hollywood star or New York model who had his or her smile done at a DENTAL SCHOOL? Dental schools are bastions of professional political correctness where they are uncomfortable with the art of designing smiles.
To see an illustration of the type of thinking that reigns in dental schools, read my recent post from earlier this month, answering a sweet patient from the San Diego area who had a horrible experience with her “cosmetic” dentist. And Iowa in particular is a stronghold of this type of thinking. The dental profession there is very conservative, and it has been hard for me to find good cosmetic dentists in the state to recommend. When I lived there, I drove clear to Chicago to have my own dental work done.
I’ll tell you a story about the University of Iowa that may help. This was back in the 90s, when white composite fillings for back teeth were just becoming very popular. The technical issues of their wear resistance and toughness had been resolved, and my patients had reached a point where that was all they wanted – to a person they were willing to pay the extra above and beyond what dental insurance plans would pay to have the composite fillings and I was only doing two or three amalgams a year. At the time I had a lovely girl come work for me as a dental assistant. She was studying to become a dental hygienist. She asked me to replace all her amalgams with composite, which I gladly did for her. Well, she was involved in a traffic accident and fractured her jaw, and went to the University of Iowa to have that repaired. While she was under the anesthetic, without her knowledge, the dentists at the dental school decided that this was so terrible that she had these white composite fillings on her back teeth that they broke the first rule of dental malpractice and removed them all, putting amalgam fillings back in her teeth. When she discovered this, she called me, crying, wondering what she could do. She could have sued them and won, but that wasn’t her nature. But this is the strength of the dental school culture – they know what is best, and they will decide what your teeth will look like. Now since then, composite fillings on back teeth are enjoying more professional acceptance, but the culture of dental schools has not changed.
I am somewhat familiar with the name of your dentist. He is highly respected. And so is the dental school professor you mentioned. But they are both highly trained engineers of dentistry and they are not artists. The type of dentists who become cosmetic dentists are those highly skilled practitioners who found dental school stifling and who, once they get out, want to break free and explore the art of dentistry. Back in dental school, paying too much attention to what the patient wanted was considered pandering to the patient and unprofessional. But as these budding cosmetic dentists interact with patients, they decide that is exactly what they want to do. It is a transformation process that takes several years to complete, because of the shift in attitudes and the extra training and experience required to blend beautiful art with highly developed technical skills.
I’m not sure if this will have any impact on you at all. You’re likely to go ahead and have your friend do this under the supervision of the dentist you named. I imagine you will get a smile that will be okay, with mediocre-looking teeth, and porcelain veneers that are bonded very well, that are very smooth and very technically correct and that sadly will last for years and years. Too many years. Then when you’re ready to replace them, come to me and I will help direct you to where you can get a truly gorgeous smile.
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