Help! Know this is short notice, as having work started on Wednesday, December 4, 2019. And thank you for the great website, that just discovered today.
Am approaching 70, medium fair skin tone, but not pale, blue gray eyes, medium neutral blonde hair. Have decided on bonding for economical reasons. Am a big time grinder, so will need a new nightguard when finished with dental work.
Have downloaded some color charts. Realize very white teeth would look un-natural with my age and coloring. Want bright, happy smile. Any suggestions on bonding color? Will have six teeth total, 2 central, 2 lateral, and 2 canines. There is bridge work on first premolars both sides; probably BL2 or BL3 color. Perhaps all six BL2, as bonding will darken a little with time? Tea drinker with half/half, white wine only, never red, and dental cleanings 4x a year (2 with Periodontist)
Thinking of having my dentist start with the canines. On yelp, he is ranked within top three dentists for smile makeovers in Pittsburgh. Thank you so much Dr. Hall. Appreciate your help.
– Mary from Pittsburgh
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I’m going to break down your questions into three parts.
Let me start by taking the easiest one to address. You’re not going to find the best smile makeover dentist by looking at the Yelp rankings. I love Yelp and am a Yelper myself, but sometimes the dentists they list as the best cosmetic dentists aren’t very good. They rank this with an algorithm, based in large part on their reviews, but it doesn’t appear to me that they make any distinction as far as what is in the reviews.
Let me show you that by the Yelp results in another market that I am very familiar with. This is in a suburb of a major United States city with a population of about 150,000 where I know a number of the dentists. Searching in Yelp for the best cosmetic dentist in this suburb gives as the #1 ranking a dentist with 33 reviews with an average rating of 4.5. However, none of the reviews say anything about smile makeovers. Only one mentioned anything with any appearance component, and that was just a single tooth where the dentist got the color right. The website of this dentist shows no significant cosmetic dentistry credentials and there is no smile gallery. The dentist I would rate as the best cosmetic dentist in this suburb ranked #13.
Getting more specific with your search term, I thought I’d try to search for “best smile makeover dentist” in this suburb. The #1 result was a group practice with six dentists, none of which had any credentials at all in cosmetic dentistry. The website has a smile gallery, but it displays stock photos they got from their dental website company, presumably because they don’t have any of their own to display. The #2 result is a dentist who has no website at all. None of the reviewers mentioned having a smile makeover. They mentioned things like doing a great job on a root canal, being gentle, reasonable fees, cleaning was great, the office was clean, etc. The #3 result was an oral surgeon who extracts teeth but doesn’t do any restoration.
This ties in with the reason I set up this referral service, because there aren’t really good ways for the public to tell who are the great cosmetic dentists. Lacking any other guidance, my advice would be to check the smile gallery yourself, make sure it tells you clearly that it is showing the dentist’s own work, and go from that. There are some technical issues you’re not going to be able to evaluate, so this method is imperfect, but it’s better than asking Yelp.
On Your Color Questions
All these questions you asked about the color—I really don’t know how to help you with that. There isn’t a formula for choosing the right color. The basic issue is how white you want to go. When you get into the darker natural shades of teeth there are yellow-whites, tan-whites, gray-whites, and brown-whites, but when you’re into bleached teeth colors, we don’t make those distinctions. If you’re going to do only six teeth, you’re going to be limited in that you have to match the color of the premolars. The color is best chosen in consultation with the dentist doing the case.
On Bonding vs Porcelain Veneers
And you didn’t ask this question but I’m going to address it. You’re looking for a budget smile makeover so you think you’re going to save money by doing it with composite bonding rather than porcelain veneers. I will tell you that it’s going to be really tough to get a beautiful smile makeover that way. There are great cosmetic dentists who won’t do a full smile makeover with composite bonding, and the reason is that it is so time-consuming to do that well, they would have to charge MORE for the composite than the porcelain. In all my years of practice, I only did two full smile makeovers with composite. One was on a young girl who had badly splotched teeth after she was done with her braces, and that was because she needed to be a little older before getting the porcelain. The other was on a patient I talked into letting me do that for a reduced fee so she could be one of my accreditation exam patients. I made her a deal to do that first and then the next year I did porcelain veneers over the bonding.
Another problem with composite bonding is that it stains or dulls so easily that often it only looks good for two or three years when it is done over that large an area. And then, since you grind your teeth, composite chips much more easily than porcelain. That would be another obstacle—protecting this bonding from breaking. I’m reading between the lines here that you have worn your teeth down and will need them made longer. If you came to me, I would decline to do your case in composite because I would feel it would be taking your money but doing you a disservice—it just wouldn’t hold up. Your risk is that you’ll get a dentist with poor ethics who will agree to do this for you. I think you’d be best getting porcelain and then protecting that with a nightguard.
So there’s my opinion for what it’s worth. I wish you the best. I’ll email you privately with my recommendation for a cosmetic dentist for you. I like to do that privately so I don’t offend the dentists I don’t recommend.
– Dr. Hall
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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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