I had porcelain veneers put on in July of this year. I am not happy. The canine teeth look crooked and there is a little line above my left front tooth that may be my natural tooth surface showing through. The dentist said that he didn’t want to do anything about that because it was so small and that he could barely see it. I am now so unhappy. I am afraid that I am going to get decay on the top of the front tooth, and I spent so much money. I had old bonding that needed to be replaced so I had to do something to my teeth, but now I am just as unhappy and insecure as with the old bonding on. What should I do? I don’t want to be a difficult patient, is he right about the little bit of tooth surface is it not a big deal? What should I do?
– Elizabeth from New York
I don’t think you’re at a risk for tooth decay in that spot that’s maybe showing your natural tooth. I can’t be sure without seeing it myself, but as long as there isn’t a groove or a ledge that will catch plaque, your tooth isn’t vulnerable there. So your dentist is right on that point.
But it sounds like you aren’t happy with the appearance of your new smile, and I’m disappointed that your dentist didn’t let you know exactly how they were going to look before the porcelain veneers were bonded on. Good cosmetic dentists will always make sure you see exactly how they will look first, often even letting another family member or a friend look at them with you. General dentists tend to give you a mirror while you’re upside-down in the chair and let you see them for a few seconds and then go ahead and bond them on.
If there are things you don’t like about how they look, I would ask your dentist to re-do those things, like the crooked canine teeth. Share my e-mail with him if you want, and tell him I said that you paid for a beautiful smile, and if it doesn’t look beautiful to you, it’s not good enough.
A good cosmetic dentist, for example, wouldn’t say, “That’s so small, I can barely see it, so I’m not going to fix that.” Instead, he or she would say, “That’s so small, I can barely see it. Are you sure you want me to change that?” Because a good cosmetic dentist is first of all a good listener and knows that the patient needs to love the smile.
This is at the heart of a key difference between a good cosmetic dentist and a general dentist who likes to dabble in cosmetic dentistry. The good cosmetic dentist understands that he is treating the self-image of the patient, and that if the patient isn’t happy with how the smile looks, then the treatment is a failure. This is basic. Good cosmetic dentists have many procedures in place to insure that when you go home after the treatment is over, that you love your smile and that you smile with confidence. That is what cosmetic dentistry is all about, and if your dentist doesn’t understand that, then you can help teach it to him by being a “difficult patient.” He will end up being a better cosmetic dentist, thanks to you.
When I was young and only a couple years out of dental school and just learning cosmetic dentistry, I had several cases that when I did them, they looked okay to me, but they weren’t good enough. So later, when I had developed better skills, I completely re-did them at my expense until they were beautiful. This is part of the learning process, and it’s what helps cultivate a great reputation for doing gorgeous work. A great cosmetic dentist is very sensitive about that reputation for beauty and doesn’t want one of his or her patients saying that their work isn’t beautiful. General family dentists don’t care so much about that aspect of their reputations.
– Dr. Hall
Read about smile design.
Read about how some cosmetic dentists use a smile imaging computer to test various smile designs, to help insure that the patient loves the results.
About David A. Hall
Dr. David A. 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 advanced internet marketing for dentists.
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