Category Archives: Porcelain Veneers

Dealing with Enamel Hypoplasia

I am have enamel hypoplasia on my teeth and it is very embarrassing. I try my best not to smile, but sometimes you just have to. I want to have a smile that I am not ashamed of. Do you know what are the best ways to treat this? I suspect with today’s cosmetic dentistry, there are solutions.

Pamela


Dear Pamela,

You are correct that there are some good solutions for this situation. An image with two examples of enamel hypoplasia

If you are reading this and wondering what in the world enamel hypoplasia is, it is when the enamel on teeth does not fully develop. This can happen because of a genetic defect, or because of an illness contracted during the formation of the the adult teeth. This is generally before age twelve.

Mild Enamel Hypoplasia

before and after dental bonding

Some cases of hypoplasia is mild, such as on the case on the left image, which gives a mottled appearance to the teeth. If this is your situation, dental bonding would be a good solution. This is done using a composite that is bonded directly to the tooth. It is often used to repair tooth gaps or chips in teeth, such as in the example above.

Severe Enamel Hypoplasia

porcelain veneer being placed

Some cases of hypoplasia are much more severe, such as with the image on the right. As you can see, the teeth are pitted and there is significant discoloration. Dental bonding will not work in this situation. Instead, I would look into having porcelain veneers done.

Both of these procedures are quite advanced and will require you go to an experienced and artistic cosmetic dentist. You may even want to look for an office that has an AACD accredited dentist. They are the top cosmetic dentists in the country.

Once you have this work done, you will no longer be ashamed to smile. In fact, a beautifully done smile makeover can completely change your life because of the confidence that comes with it.

I hope this helps. Enjoy your new smile!

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Covering Tetracycline Stains

I am looking for a solution for my tetracycline stains. My sister and I both had them. She had hers fixed five years ago, but her dentist had to make them very opaque in order to cover the tetracycline stains. I was wondering if there have been some new developments that can make them more natural looking? Would I be better off with teeth whitening?

Laurie

Dear Laurie,

before and after tetracycline stains are treated.

Porcelain Veneers for Tetracycline Stains

I’m glad you wrote. You may or may not want to tell your sister this but it was possible to get translucent, natural looking porcelain veneers even back when she had them done. How that could have been accomplished would be by using an expert, artistic cosmetic dentist. Doing porcelain veneers is hard on its own. When you add tetracycline stains, it becomes even more complicated. In fact, it is one of the most advanced cases using veneers. In this case, I would only use one of the top of the line dentists. My suggestion would be an AACD accredited dentist.

Teeth Whitening for Tetracycline Stains

While teeth whitening is a possible treatment, you would have to be very persistent and patient. It would take a long time. If you pursue this avenue here are some tips:

  • Only use at-home professional teeth whitening trays. While Zoom Whitening is very effective, the number of sessions you would need to cover these stains would be cost-prohibitive. Using the trays allows you to do it long-term without breaking your budget.
  • Wear the trays for as long as you can each day. Ideally, you would wear them overnight.
  • The best time of at home whitening for this time of situation would be the KöR teeth whitening system.

Best of luck with whichever procedure you end up with!
This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Cavity On A Porcelain Veneer Tooth

I have porcelain veneers on four teeth. One of them now has a cavity and my dentist wants to remove the porcelain veneer and replace it with a dental crown. Is that absolutely necessary?

Dana

Dear Dana,

Porcelain veneer being placed on a tooth

I am going to recommend you get a second opinion on this for a few reasons. First, in order for a tooth to need a dental crown for decay, the amount of decay would have to be pretty substantial. I would say over 20% of the tooth would have to be decayed to justify needing a dental crown. If that is not the case, then why would he recommend one?

The most likely reason is that he is not comfortable treating a cavity with porcelain veneers. The margin is where a tooth with porcelain veneers is most susceptible to decay. If that is where your cavity is he may not have the tools or skills to bond the composite to a porcelain veneer.

That leads me to the second reason you need another opinion. If he’s recommending a crown unnecessarily, then his cosmetic skills are limited. This does not bode well for the crown either.

I would say only about 2% of dentists can match a dental crown on a front tooth to a porcelain veneer. In fact, You would need one of the best cosmetic dentists around, like an AACD accredited dentist. If he is pushing you toward a crown, he is not the dentist to do the work.

Getting a Second Opinion

I’d like you to see an expert cosmetic dentist and have them look at the tooth with the cavity. It is important you make this a blind second opinion. By that, I mean do not tell him who your dentist is or what the diagnosis and recommendation were. If he or she asks, tell them you are keeping that to yourself in order to get an unbiased opinion.

This blog is brought to you by Lafayette, LA Dentists Drs. Thimmesch and Foreman.

My New Teeth Keep Popping Off

For our anniversary, my husband told me I could get a smile makeover. I’ve dreamt of one for several years. My teeth are chipped here and there, stained, and I have a few that are shorter than the others because of teeth grinding.

My dentist ground my natural teeth down to tiny yellow nubs and gave me temporary veneers. Then, my permanent ones came in. All totaled I have eight veneers. They look okay. Certainly at least whiter than my old teeth. The big problem I am facing is they keep popping off.

While she always puts them back on for me, I am living in constant fear of being humiliated in public. This week, two fell off while I was eating bread at a restaurant with a friend. I spent the entire rest of the day crying from the shame. It is always the veneers that have a slant on the back that seem to come off.

My dentist is blaming it on my teeth grinding, but I wear a nightguard for that, which I was told would protect both my natural teeth and my veneers. What do I do now? We’re a military family and about to get transferred to another base in the states. I’m afraid no dentist will want to deal with my freakish nub mouth. What do I do? I thought this would be a wonderful experience and it has turned out to be a nightmare.

Angie

Dear Angie,

This is a cosmetic denistry horror story for the books. I am so sorry that this was your experience. I believe this dentist has committed malpractice. First, I’ll tell you why and then we’ll go over what you can do about it.

The first thing you should know is that she did not give you porcelain veneers. What she provided was dental crowns and called them porcelain veneers. This is unethical. Here is how I know this.

Image of teeth prepared for porcelain veneers
Tooth preparation for porcelain veneers

When your teeth are prepared for porcelain veneers only a small layer on the front of the teeth is removed. Directly above I posted an image showing what this type of tooth preparation looks like. This is not what you described.

Image of tooth preparation for dental crowns
Tooth preparation for dental crowns.

Instead, I think your teeth look more like what you see in this picture– little nubs. This means she gave you porcelain crowns. Unfortunately, once that tooth structure is gone, there is no way to get it back. This weakens your teeth and makes them more susceptible to breaking later down the road.

Second, she hasn’t been able to bond your dental crowns on properly. While there are a number of dentists who would not know how to properly bond porcelain veneers, every dentist has been taught how to place and bond a dental crown. The fact that she can’t keep yours in shows a serious lack of basic skills. It also violates the basic standard of care.

Your dentist is legally liable for the damage done to your teeth. I don’t want you to just ask for a refund. Instead, I believe she needs to pay to have this repaired properly. I want you to find an expert cosmetic dentist in your new area and have them repair your smile makeover. When y ou get to your new base. Look up on mynewsmile.com to see which cosmetic dentists they recommend in your area.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Getting Dental Veneers Online

I have some spots on my teeth and want to get a nicer smile. While I understand that porcelain veneers with my dentist would be better, they are pretty pricey. I’m wondering if it would be a good idea to get those online dental veneers?

Alex

Dear Alex,

It would help if I knew what type of spots you were talking about. If they are recent white spots that have turned up, they are likely decalcification spots, which are precursors to tooth decay. You want to make sure you are getting adequate care for your teeth in addition to improving their appearance.

The only kind of dental veneers you can get online are removable. The best brand of removable, dental veneers is snap-on smile. However, they do have to be done under the supervision of a dentist. They do get some complaints from patients who are disappointed with the results. I have found, however, that as long as a dentist lowers the patient’s expectations they end up satisfied. They will have an okay smile, not a stunning one. These are made from acrylic, not porcelain so the results will not be comparable.

Getting Veneers Online

The biggest problem with trying to do something like this online is the complications you run into without the help of a dentist. Not only will you have a lower quality result, but you might end up in pain.

These appliances don’t come in as a perfect fit. Your dentist has to make adjustments to the device when it arrives to ensure it fits both securely and comfortably.

If you want to get removable veneers, I recommend going with Snap-on Smile through your dentist. In the meantime, start saving up for something that can provide you with a stunning smile such as porcelain veneers.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimessch.

Porcelain Veneers Staining Around Edges

I had porcelain veneers done about one year ago. I’m almost 3/4 of the way through paying these off and they have started picking up stains around the edges. While I am a smoker, I was told these would be very stain resistant. Is something defective in them? Should I schedule an appointment with the dentist?

Laurie

Dear Laurie,

If the staining is just at the edges, then it is likely an issue at the margins. There are a couple of things which could be causing this. First, it could be there is a gap between the porcelain veneers and the teeth. This can be a problem to fix and a rather difficult one.

However, it will be urgent to fix it because, in this case, the staining means there is debris and bacteria being caught between your teeth and the porcelain veneers. This will lead to decay. A gap in the margins is an error on the part of the dentist and as such he or she should take responsibility for fixing this.

A second possibility is it is the composite bonding that is picking up stains. This is normal and easy to fix. Your dentist polished these up when you first got your veneers and I would consider it a normal part of their maintenance. In this case, you should expect to pay it but it will not be very much at all.

It does require special strips to do so. Don’t go to your family dentist, but rather the dentist who did your smile makeover to begin with. They will have the means and knowledge to polish these up.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Porcelain Veneers During Pregnancy

I have an appointment to get porcelain veneers next week and just found out I’m pregnant. Do I have to cancel the appointment or can I go forward with it?

Lisa

Dear Lisa,

First, let me congratulate you! Becoming a mother is a wonderful thing.

In dental school, we are taught to schedule routine dental care during the second trimester of a pregnancy. This is for a couple of reasons. During the third trimester, it is hard for the mother to sit comfortably for any significant amount of time. You’ll want to have any work done before this period of time.

On the other end of the spectrum are the precautions recommended during the first trimester. We are trying not to introduce any chemicals into the body that are a risk to the baby. These first few months are the most sensitive.

The only chemical introduced during the porcelain veneer procedure is a local anesthetic, usually Lidocaine. This is considered safe during pregnancy. From that aspect, you are likely safe to go forward.

That being said, you may want to postpone to the second trimester out of an abundance of caution, to ensure you are past what is considered the danger period.

There isn’t really a right or wrong answer for this. There is nothing being introduced that is a problem from a medical standpoint, but pregnancies are unpredictable as is the human body, so there are not definitives.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Root Canal with a Porcelain Veneer

I have eight porcelain veneers that I love. I recently found out that one of the teeth needs a root canal treatment. I am a bit worried the procedure will damage my porcelain veneer. Is this safe or will I need to replace the veneer?

Maggie

Dear Maggie,

A single porcelain veneer being placed on a tooth

If your tooth needs a root canal treatment, you don’t want to leave the infection untreated. That would be quite dangerous. Dental emergencies have a way of turning into life-threatening medical emergencies when you don’t get timely care.

To put your mind at ease about your porcelain veneer, though, it shouldn’t have any impact on the porcelain veneer itself. One thing that does become an issue is the underlying tooth turning dark, which in turn will cause your porcelain veneer to turn dark. There is a way to forestall this, however.

Have your dentist carefully follow these instructions if they don’t already know this procedure.

The most important step is to make sure they get all the underlying material out of the canals from the root tip all the way to the crown of the tooth.

Once that is done, your dentist will want to put in a white fiberglass post. From there, he or she will fill the remainder of space with white composite material.

Doing this will keep the tooth white much longer than would otherwise be possible. It works even better when the tooth has a porcelain veneer, as yours does.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Smile Makeover Disaster

I need some advise. I had porcelain veneers done. The first time they came back they were way too thick. Even my dentist knew that by looking. I asked him to send them back, which he did. When they came back again, they didn’t really let me see them. They did tell me they could make any adjustments necessary after they were bonded on. That turned out not to be true. They ended up very bulky looking and, though I did ask for a white smile, they ended up chalky and fake looking . I absolutely hate them, but my dentist isn’t returning my calls. Do you have a recomendation of how I can get this fixed?

Carla

Dear Carla,

A single porcelain veneer being placed on a tooth

I think you’re suffering from having a decent family who is trying to do cosmetic dentistry he’s not qualified to do. Believe it or not, smile makeovers aren’t taught in dental school. A dentist has to invest in a significant amount of post-doctoral training in order to develop the skills necessary to create beautiful smile makeovers. My guess is your dentist didn’t invest in that.

True cosmetic dentists also know that it is the patient’s perception of their smile that matters most. Because of that, they will use a temporary try-in paste so you can get a good look at your porcelain veneers in a variety of lightings before they are bonded on. You have a legal advantage. He misled you regarding the ability to make changes to your porcelain veneers after they were placed, bonding them on without your official permission.

Getting Your Porcelain Veneers Done Right!

Normally, I would say insist on a refund, however, you mentioned he’s not returning your calls. That may be because he is avoiding you or, if we want to be generous, maybe he’s not checking messages as much if his office is closed during the COVID-19 quarantine. Though, they should be open for emergency procedures.

Leave him another message letting him know if you don’t hear back from him this time, you’ll be contacting a lawyer. That will kick him into gear. If you do end up having to get a lawyer involved, you have a pretty solid case. I’m sure his insurance holders will advice him to settle quickly.

When you go to have these re-done, I want you to be certain you use a dentist with both training and artistry.. Ideally, you’d see an AACD accredited dentist (which is different from just being a member). Accredited dentists are in the top 1% of dentists in the country. If you can’t find one of them within a reasonable distance to you, contact me again and we’ll help you find someone.

This blog is brought to you by Lafayette, LA Cosmetic Dentist Dr. Mike Malone.

Caring for My Porcelain Veneers

I recently had porcelain veneers placed, before all this quarantine craziness. I do love the veneers but want to make sure I take good care of them. Is there a particular toothpaste or mouthwash I should be using. Normally, I make my own mouthwash, but don’t want to use it if the ingredients are bad for my veneers. Our governor closed all dental offices so I don’t think I can even reach my dentist.

Here’s my recipe:

  • 8 oz. of filtered water
  • 8 oz. of 3% hydrogen peroxide
  • 2 T. of sea salt

Karli

Dear Karli,

A single porcelain veneer being placed on a tooth

I’m glad to hear you love your porcelain veneers. Too many patients end up with a disappointing smile because they don’t go to a skilled and experienced cosmetic dentist.

Caring For Your Porcelain Veneers

Let’s start with the toothpaste. Generally, for any type of cosmetic dental work, I recommend Supersmile toothpaste. It was specifically designed to work with all types of porcelain as well as normal tooth structure. Unique in its ability to keep your teeth stain-free without damaging the glaze on your porcelain veneers or the enamel on your teeth.

Other whitening brands of toothpaste contain abrasives. While they can make your teeth look whiter and cleaner for a while, they are also putting micro etches into the tooth, which will cause it to pick up stains more quickly.

As for mouthwash, when you brush and floss regularly, you really would only need mouthwash occasionally, if at all. If you do want to use a mouthwash, the one thing you want to avoid is any mouthwash which contains alcohol. The alcohol will eat away at the bonding that keeps your veneers attached to your teeth.

The recipe you listed, while safe for your porcelain veneers, has one ingredient which requires caution. Hydrogen peroxide is great at killing bacteria. Unfortunately, it will also kill the helpful microbes allowing candida yeast to thrive.

If you use this recipe sparingly, like once a week, you should be fine. Much more than that and you’ll end up with thrush, which is an oral yeast infection.

I hope this was helpful. Enjoy the extra time with your family during this COVID-19 quarantine.

This blog is brought to you by Lafayette, LA Dentist, Dr. Mike Malone.