Am I Too Young for Porcelain Veneers

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I am twenty-two years old and have had my braces off for several years. Despite that, there is still a slight gap between my front teeth. I would like to get some porcelain veneers because I also have some chips and have always thought my teeth were too short. My dentist hinted I may be too young for porcelain veneers and to wait until I was 25. If I am too young, should I try to get Invisalign to close the little gaps? Or maybe dental crowns because my dentist said that could make the teeth longer?

Melanie

Dear Melanie,

A porcelain veneer held up against a tooth

I fear that your dentist is steering your toward dental crowns because he knows how to do those. Doing dental crowns is taught to every dentist. However, advanced cosmetic work, such as porcelain veneers, has to be learned after dental school in post-doctoral training. If the teeth are healthy, grinding them down for dental crowns makes no sense.

There is a second factor here. Just because he can do dental crowns, doesn’t mean they will look beautiful or natural. Most dentists will just use a standard shade guide. With back teeth, that is fine. But, with front teeth, there is a lot more that goes into making it look natural and matching the other teeth perfectly.

Invisalign, while a great option for straightening teeth, is not great a closing those tiny spaces left after braces. That is because those tend to open back up fairly quickly after you stop orthodontics. You could have some direct dental bonding placed there to close the gap, but they tend to pick up stains quickly and will have to be replaced more than you’d like.

Your best option to deal with all the issues you described including the lengthening of your teeth is to get porcelain veneers. Plus, they are even more stain resistant than your natural teeth and should last for many years.

So, what about the age issue? The fact is, that once your teeth are fully erupted, which generally happens around the age of 18, you are old enough for porcelain veneers. The caveat will be to find a dentist who can provide you with a beautiful result. You do not want to end up as one of those cosmetic dentistry horror stories.

Look at their smile gallery, which contains before and after pictures of cosmetic work they’ve done. Look specifically at their porcelain veneers cases. If they’re not stunning, find someone else to do them. If a dentist does not have a smile gallery on their website, then they don’t do enough cosmetic work to be good at it.

I hope this helps.
This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Options for Fixing My Nephew’s Smile

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For my Nephew’s graduation, I gave him a gift of fixing his teeth. His mother never had enough money for braces and I didn’t want him spending his entire adult life feeling uncomfortable about his appearance. I was thinking orthodontics, but his dentist told him that he could get his smile fixed much faster with Lumineers without having a mouth full of metal, but he’s asking close to $25,000! Is there some other option for him that is faster than braces, but not as expensive as Lumineers?

Selena

Dear Selena,

A comparison of braces versus Invisalign

I’m glad you wrote. If the only thing wrong with your nephew’s smile was that fact that his teeth were misaligned then what his dentist is recommending would be a massive overtreatment. Lumineers are a brand of porcelain veneers. When someone is looking for that Hollywood smile, that is when they get porcelain veneers. They can change the shape, size, and color of your teeth at the same time. If you’re just looking to straighten your teeth, or even straighten and whiten your teeth, then there is a much better option.

Invisalign uses clear aligners to straighten a patient’s teeth. Even at a conversational distance, no one would be able to tell that your nephew is wearing orthodontics. They also work in half the time of traditional braces. If he does need teeth whitening, you can save money here because the aligner can double as teeth whitening trays. His dentist can simply provide him with the gel, which he can wear in the aligners at a point in the day or night that is most convenient for him.

What If He Wants a Total Smile Makeover?

A porcelain veneer being held up to a tooth

Let’s say there is more wrong with his teeth and he does need a total smile makeover, and it is something you are wiling to pay for, I would not go to a dentist who is recommending Lumineers to have this procedure done. This particular brand of porcelain veneers are highly marketed to inexperienced cosmetic dentists as being easy to place. Unfortunately, this does not mean that it is easy to create beautiful smiles. In fact, smile makeovers are not adequately taught in dental school. In order for a dentist to do it well means that they need to invest in post-doctoral training.

A second problem with Lumineers is the fact that their parent company requires dentists to use their lab, which is not known for creating good results. What you would want instead, is to find an expert cosmetic dentist and let them choose the brand as well as the lab.

This blog is brought to you by Marietta Cosmetic Dentist Dr. Cristi Cheek.

Did the UltraSonic Scaler Damage My Porcelain Veneers

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I had four porcelain veneers placed on my front teeth. I just had a cleaning where a magnetostrictive ultrasonic cleaner. Within two days, a couple of them were fractured. Was that the cause of the fractures or is something else going on? Is this a common problem? How do I get my veneers back to the way they were?

Ellen

Dear Ellen,

porcelain veneer being placed on a tooth

There are two types of ultrasonic scalers.

  • piezoelectric
  • magnetostrictive

While the magnetorestrictive scaler is more gentle than the piezoelectric, there is a greater chance of damaging the tooth if it is not done with the proper technique. In the hands of a skilled dental hygienist this will cause no damage. However if it is done incorrectly, then, yes, there will be damage to your porcelain veneers.

In order to get a crack or fracture on your veneers, the dentists would have had to hold the tip of the scaler on the surface of your veneer. This is a huge NO. I’m not sure why your hygienist would have done that.

They should bear the responsibility of replacing the veneers that they damaged. Then, in your position, I would not stay in a dental office that does not know how to care for your cosmetic dental work. I’m also a bit concerned that they only did four porcelain veneers.

Most smiles are eight to ten teeth wide. This would mean that you have natural tooth structure that is visible next to your porcelain veneers when you smile. My hope is they at least used teeth whitening on them before placing your veneers. If not, your smile will look weird. It’s not too late to get this done if it wasn’t.

If you are not confident that they can properly replace the damaged veneers, then you can get a refund and go to a more experienced cosmetic dentist of your choice to get it done.

This blog is brought to you by Marietta Cosmetic Dentist Dr. Cristi Cheek.

Looking for a Cheap Smile Makeover

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I want to get my top teeth improved. They’re all discolored. My dentist is suggesting composite bonding for them at a price of just $3000 total. I would jump on that but have one reservation. I chipped a tooth a couple of years ago that knocked a good portion of my tooth off. My dentist fixed it with dental bonding. While my dentist did make the tooth whole again, the bonding part is very obvious and has been from the beginning. Now it is much more stained. I’m not sure I want my front eight teeth looking like that. He said the next option was porcelain veneers but they are really expensive. I have found there are some online veneers that are much less expensive. They pop over the front teeth. Is this a viable option for me or is there something I should be aware of?

Loren

Dear Loren,

porcelain veneer being placed on a tooth

I am going to start with your dentist’s first suggestion of dental bonding. I’m going to strongly suggest you do not use this for your smile makeover. First, he obviously does not have the cosmetic skills required to do a beautiful job with advanced cosmetic procedures, such as the dental bonding. Though, I suspect you have already figured that out.

When you are getting a complete smile makeover, porcelain veneers are the go-to procedure. When done in the hands of a skilled cosmetic dentist, it can give you a beautiful, natural looking smile that will last for years.

The snap on type of veneers you are considering are not at all like the porcelain veneers provided for you by a dentist. The ones online that snap onto your teeth are made of acrylic. They will not look as natural. From close up it will be obvious they are fake. Plus, because they snap over your teeth, they tend to look a bit bulky.

If you truly want a smile makeover, I suggest that you wait and save up for the porcelain veneers. Though, you may want to find a more experienced cosmetic dentist to do the work.

Before you do that, I did have a question. The only thing that you mentioned fixing about your smile was the discoloration. A complete smile makeover would typically be for fixing more than just the color, but also the shape and the size. If that is what you had in mind, then by all means save up for the porcelain veneers. However, if all you needed was to adjust the color, teeth whitening would be the right solution. It will also cost you thousands of dollars less.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Choosing a Cosmetic Dentist on Yelp?

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I am getting a smile makeover. I’ve narrowed the cosmetic dentist I’m going to use down to three of them, but have some questions before I settle on which one. All three are highly rated on Yelp. It sounds like dental bonding is less expensive than porcelain veneers but may not last as long. Do you have a recommendation on which to use? As I am in my 60s, would it look silly if I went with really white teeth?

Joyce

Dear Joyce,

porcelain veneer being placed on a tooth

Congratulations on getting a smile makeover. They can be life changing. I’m going to start with the bonding versus porcelain veneers question.

Dental bonding is typically for small repairs, such as a chipped tooth or a gap between two teeth. It will last a few years, but not much longer. While it is inexpensive with the small repairs, if you wanted to use it for a full smile makeover, you will find it will end up more expensive. It is done by hand and over such a large surface would be quite time consuming. You will definitely want porcelain veneers.

I don’t recommend that you choose your cosmetic dentists simply based on their Yelp rating. While I do use Yelp for certain recommendations, such as a plumber or electrician, it is not a great way to pick a dentist to do your cosmetic work. This is because they don’t distinguish the reason for the ratings. A dentist can have over one hundred 5-star ratings, but most of them could be just about how friendly he or she is and not their cosmetic skill.

As an example, I just did a search on Yelp for “Best Cosmetic Dentist” in a mid-sized city. Just looking at the top three dentists, only one of them even does cosmetic dentistry. On the one who did, when I looked on her website, there wasn’t even a smile gallery. That is a sure sign that they don’t do enough cosmetic dentistry to be serious about it.

A smile makoever is an advanced procedure. It takes more than technical knowledge. It also needs some artistry. I would look at whether or not they have any post-doctoral training in cosmetic work as well as the type of results they get with the cases they’ve done. This is where the smile gallery comes in handy because you get to see the before and after pictures.

As for the color, this is very subjective. If you want a white smile, you should get one. If you speak with the cosmetic dentist about the type of smile you hope to create, he or she will be able to advise you on the color.

This blog is brought to you by East Cobb Cosmetic Dentist Dr. Cristi Cheek.

Solution for a HUGE Tooth Gap

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I have a large tooth gap. I think my dentist said it was about 8-10 millimeters between my front two teeth. I didn’t want braces, so he suggested snap-on smile. I paid for the x-rays and the dentist sent everything in to the company. I received a call this week telling me I’m not really a good candidate for that procedure. He said we could look into Lumineers. These cost a whole lot more than the snap-on smile. If it is my only option, I will bite the bullet. Before I did, though, I wanted to get another opinion on how to handle this.

Mike

Dear Mike,

Image of Invisalign Aligners

I am glad you wrote. Please, please don’t move forward with the Lumineers plan. First, the gap between your two front teeth is substantial. This is large enough to fit another tooth in. It would take one of the top cosmetic dentists in the country to do this correctly. Your dentist said he would “look into” Lumineers. This tells me that he is not trained in cosmetic dentistry. Lumineers is just one brand of porcelain veneers. While the Lumineers brand is highly marketed to inexperienced cosmetic dentists as being easy to place, most expert cosmetic dentists find the Lumineers brand inferior. Plus, being easy to put on the teeth has nothing to do with the skill required to make them beautiful and natural looking.

You don’t have to have braces to get the gap closed. I would look into getting Invisalign. These use clear aligners to straighten your teeth instead of the metal wires and brackets that are used with traditional braces. Even at a conversational distance, noone would know that you are straightening your teeth.

Invisalign has another hidden benefit. The aligners can double as teeth whitening trays. Your dentist can provide you with whitening gel that you can wear in the aligners at a time that is convenient to you. This allows you to straighten and whiten your teeth simultaneously.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Buying Dental Veneers Online

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I have a couple of defects with my smile. I went to my dentist in order to get it repaired and he recommended I get porcelain veneers. The cost he quoted me seemed astronomical so I did some calling around and that is about the average. Wow! So, I looked online and it looks like you can get some do it yourself veneers that just snap onto your teeth. I can get a complete set for around $700 dollars. Some were more, but that was about the most common price. Is this a decent way for me to go?

Duke

Dear Duke,

A porcelain veneer being held up to a tooth

Getting snap-on veneers works for some people as long as they keep their expectations pretty low. It is not going to give you the gorgeous smile that you could get with porcelain veneers. Porcelain veneers are custom designed to give you a smile makeover that can change the shape, size, and color of your teeth. Because they are made of tiny wafers of porcelain they look just like natural teeth. They’re also permanently bonded to your teeth allowing you to just go about living your life.

Snap on veneers are going to be made of acrylic. They will not look as natural, especially up close. As they snap over the teeth, they can look bulky depending on the shape of your smile. The one benefit is that if you don’t like them, you’re not stuck with them. You can simply unsnap them from your teeth. Be aware that they will only last a few years and then you’ll have to replace them.

If you do decide to go this route, the best brand is Snap-on Smile. However, I would still do it through a dentist and not online. The companies who sell these directly to patients have no way of fitting them to your bite properly. If you want them to be comfortable, some adjustments have to be made to them.

This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.

A Cavity with Porcelain Veneers

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

Catina

Dear Catina,

Porcelain Veneer being placed on a front tooth

I am glad you wrote. My suggestion is that you get a second opinion before going through with what your dentist is suggesting. In practical terms, only about 2% of dentists are able to match a dental crown to a porcelain veneer. In addition to that, the decay would have to be quite significant for your tooth to need a dental crown. I would say at least 20% of your tooth would need to be decayed to necesitate a crown.

When you have a porcelain veneer, the most susceptible part of the tooth to decay is the edge of the porcelain veneer. Your dentist may either not have the comfort level or skills to do a porcelain veneer or he doesn’t have the tools to do a composite filling on the edge where you likely have the decay. This may be why he is suggesting a crown which is a less specialized treatment. But, this would require grinding down a significant amount of your tooth strucutre. You do not want to do that unless it is absolutely necessary.

Get a second opinion by a skilled cosmetic dentist. When you do, make sure it is a blind opinion. By that I mean do not tell them who your dentist is and what they suggested. Just tell them you want a second opinion on the tooth. If they ask for the dentist or the diagnosis, explain that you want a blind, unbiased opinion. They should understand that. The reason for this is because the dental community is small and they probably know each other. You don’t want him feeling pressured not to say anything negative about a friend’s diagnosis.

This blog is brought to you by East Cobb Dentist Dr. Susan Dennis.

Why Are My Porcelain Veneers Sensitive?

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I just had six new porcelain veneers placed on my upper teeth, from eye tooth to eye tooth. Love love love my new smile! There’s only one drawback: they are so sensitive. Just about anything sets them off, but especially cold things. I know it’s only been five days since I had them placed, but it seems like the sensitivity should have gone away by now. Why are they so sore, and is there anything I can do about it?

Thanks,
Kennedy

Hey Kennedy, great question. First of all, congrats on your new smile! It’s an exciting time, to be sure. Let’s see if we can get to the bottom of this.

Why are new porcelain veneers sometimes sensitive?

The Preparation

There are a number of possible causes that your porcelain veneers can be sensitive, beginning with the initial appointment. When your teeth were prepared, a very small amount of your natural tooth structure was removed, about a half millimeter. The idea is to remove enough enamel to accommodate the veneer, but not so much as to compromise the integrity of the tooth. Occasionally, this removal thins the enamel enough that some sensitivity occurs. This is more common with patients who already had sensitive teeth.

The Bonding Process

When it comes time to place your new veneers permanently, your dentist will bond them directly to your tooth. This involves first acid-etching the enamel, which opens the tiny dentinal tubules and prepares the surface for the bonding agent. This can sometimes cause you some temporary sensitivity. The bonding agents may also occasionally cause some people temporary sensitivity as well.

Normal Recovery

Whenever a tooth is treated, especially if any type of preparation is involved such as removing decay, reduction of tooth structure for a crown or veneer, or bonding/cementing certain materials, sensitivity following the appointment can result. This is temporary and the tooth will calm down over time.

After any new crowns, bridges, or veneers are permanently placed, there is always an adjustment period. At this appointment, your bite will be adjusted and the fit fine-tuned and customized for you. There may be a “high spot”, or a small area where the teeth are out of alignment and the occlusion needs to be adjusted. Even if it’s a very small amount, it can cause pronounced discomfort. It’s a simple matter to fix by adjustment, and the tooth will calm down over the following few days. This is a bit different from the sensitivity you are describing, but it is worth mentioning to your dentist if this doesn’t resolve soon.

The Margins

Typically, porcelain veneers should fit directly against your teeth and snug up to the tooth’s natural gum line. There should be no gaps between the veneer and your gums, or the veneer and the back of your tooth. These areas should feel smooth and should fit with integrity. If any areas persist that are not protected by the veneer or by enamel, sensitivity will result. This can also result in bacteria and other foods getting trapped, so it will be important the dentist resolve this in order to protect you from decay.

How Long Should I Wait?

Typically, we assure patients that their teeth should calm down within a week or so, give or take. You are not quite a week out from your appointment; these teeth may just need a bit more time to adjust. If it does not subside, or if it worsens, call for an appointment right away. In the meantime, using a toothpaste designed for sensitive teeth and a mouthwash with fluoride (alcohol-free) should help alleviate symptoms.

This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.

Porcelain Crowns Versus Porcelain Veneers

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I am concerned about a procedure that I have coming up and need to make a decision. I had a porcelain veneer on one front tooth and a porcelain crown on another. They never quite matched each other in color. Now my porcelain veneer has broken and my dentist said the lab is pressing him to do two dental crowns in order to get them to match perfectly. I’m not crazy about this idea because I don’t want to grind down a healthy tooth for another dental crown. Is that the only way to get them to match?

Sylvia

Dear Sylvia,

Porcelain Veneer being placed on a front tooth

 

I am not too confident in the dentist you have doing this for a few reasons. First is the initial color mismatch. While dental crowns and porcelain veneers have to use different types of color maps in order to get the same results, it is possible. He should never have bonded them on if he didn’t have the match right to begin with. This leads me to my second concern.

Porcelain veneers by themselves are very fragile and can be easily crushed or broken. It is the bond that makes them strong. If your dentist had properly bonded them, it would be highly unlikely the veneer would have broken to begin with.

A third issue I see is his excuse. He said the lab is pressuring him. It is the dentist who tells the lab what to do, not the other way around. So, either he is not being honest with you and is lying to make an excuse or he’s letting a subpar lab boss him around. Neither of those is a great option.

My advice is to get a different dentist to do this procedure. It may take several try-ins even with an excellent cosmetic dentist so be patient while he or she gets it right, but they will be able to get it right. They will need to use a temporary try-in paste for the porcelain veneer that is being replaced. You should get to look at it in a variety of different types of lighting. If they do not match, your dentist should send it back to the lab with new instructions in order to make the changes you need before it is permanently bonded on.

This blog is brought to you by East Cobb Cosmetic Dentist Dr. Cristi Cheek.