New Lumineers Over Old

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I wonder if you can tell me what you think of the new Lumineers over old technique. My dentist originally gave me Lumineers that were not nearly as white as I wanted. At the time, the technology did not exist to make them as white as I wanted. I’ve tried whitening them with teeth whitening, but it’s never worked. My dentist did some research and learned the nature of Lumineers means that teeth whitening won’t work on them. Now, the technology has advanced that I can get my Lumineers whiter. I was thinking of having new ones placed on top of my old ones, which my dentist said is possible. I just don’t want to waste money if it is not a good idea, like the whitening we tried.

Callie

Dear Callie,

Lumineers advertisement

I’m going to tell you up front that your dentist is not qualified to redo your smile makeover. You should know that the technology was always available to make your Lumineers white. Your dentist probably just didn’t know how to do it. That doesn’t surprise me because the Lumineers brand is highly marketed to untrained and inexperienced cosmetic dentists. He should also have known that teeth whitening wouldn’t work. In fact, the whitening will only work on natural tooth structure. It is not limited to Lumineers. It will not whiten any type of dental work.

New Lumineers Over Old

While technically you can put new Lumineers over old ones, I don’t recommend it. It is just as much work to place Lumineers on top of one another as it is to completely redo them. However, it is double the risk because now you have two sets of bonding that can fail– the old bonding as well as the new bonding. You are safer just getting them redone completely.

It is perfectly okay to go to one dentist for your general dental work and another for your cosmetic work.  This is because doing smile makeovers is not taught in dental school. Instead, a dentist has to study it post-doctorally. Because there is no recognized specialty in cosmetic dentistry there is no way for patients to know who has invested in this training and who hasn’t.

What I would like you to do is to look at the smile gallery of some cosmetic dentists in your area to see who does beautiful work. Find a dentist whose smile makeovers are stunning. Don’t be surprised if the dentist you pick suggests a different brand of porcelain veneers. Many expert cosmetic dentists prefer a different brand.

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

Don’t Be Fooled By 360-Veneers

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I’m so heartbroken. I went to my dentist to get porcelain veneers to finally get a pretty smile. He told me I would be a better candidate for 360-degree wrap veneers. I asked if that would take off too much structure and his response was “hardly any.” I trusted him and put myself in his hands. I think I made a huge mistake. The temporaries they gave me kept falling off but he told me that was because they don’t use strong cement. Now, I have the permanents and though the look is a little better than my natural smile, it is not the gorgeous smile I was hoping for. The worst part is the permanent ones keep popping off too. Three times now. Plus, my teeth when they come off look like little nubs. That is not the “hardly any” he told me. I’m afraid to go anywhere because they keep falling off. The dentist asked if I’d been following his instructions and I have. I don’t eat anything hard. I cut up my food very tiny. It doesn’t matter, they are still coming off. They’re talking about a new cement, but I’ve lost confidence in them. What do I do?

Carol Anne

Dear Carol Anne,

I am very sorry this happened to you. Being generous, I am going to say your dentist is ethically challenged. You should know there is no such thing as 360 wrap veneers. That is a “synonym” for dental crowns. Below is a picture of porcelain veneer tooth preparation.

toot preparation for a porcelain veneer

Tooth preparation with porcelain veneers

As you can see from the picture above, only a few millimeters of structure is taken off the front of your teeth. This is because veneers do not wrap around. That is what crowns do. You mentioned your teeth look like little nubs. My guess is they look a bit like the picture below.

tooth prep for dental crowns

Tooth preparation for dental crowns

Why Give Me Crowns Instead of Veneers?

One of the first things dentists learn how to do in dental school is a dental crown. So, they graduate knowing how to do that. Though, your dentist seems to struggle with even that basic skill. Porcelain veneers, on the other hand, are a cosmetic proceedure. Cosmetic dentistry is not taught in dental school. Instead, dentists have to voluntarily take post-doctoral classes in the procedures.

Because of that, dentists who do not invest in that training will steer their patients toward dental crowns instead of saying, “I don’t know how to do those.” It’s one thing to steer your client in another direction. It’s totally a different thing to lie to them about what they are getting, which is what happened in your case.

In addition to that, your dentist can’t even make crowns that stay in. He deceived you and the work is not functional. My suggestion is for you to ask for a refund and then find a cosmetic dentist that can actually fix this for you. Unfortunately, you are stuck with crowns now that your teeth are ground down, but that doesn’t mean you can’t have beautiful crowns that give you the smile you wanted AND will stay put. By the way, you should be able to eat whatever you want without them falling out. He’s trying to blame you for his incompetence.

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

Can No-Prep Veneers Work for Anyone?

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I was wondering if no-prep porcelain veneers can work for any patient or if it is best with a certain type of smile, such as someone with thin, tiny teeth? I told my dentist I wanted a smile makeover and he is suggesting the Lumineers brand because they are no-prep. I just want to make sure that my teeth won’t look bulky as a result. I have a big smile.

Candice

Dear Candice,

Lumineers advertisement

I am glad you wrote. While no-prep porcelain veneers can work in some cases, most smiles will need some type of tooth preparation. One of my concerns with your dentist suggesting that brand right away is that Lumineers is a brand that is highly marketed to inexperienced cosmetic dentists as being easy to place. While not prepping teeth does make the placement a bit easier, it has nothing to do with the skill necessary to make them look beautiful.

I would be cautious here. Ask your dentist to show you before and after pictures of Lumineers’ cases he has actually done himself. Many patients have complained they were too bulky and opaque. Some even have gone so far as to compare them to horse teeth.

If it turns out you are a good candidate for no-prep veneers, most skilled cosmetic dentists prefer different brands of porcelain veneers. This is because the Lumineers’ parent company insists dentists use their lab, which is not known for its artistic results. There are many different brands, including no-prep. Each has different qualities, so which brand your dentist picks will depend on the type of smile you want to create.

If you look at your dentist’s smile gallery and are not blown away, do not let him give you your smile makeover. This is a huge investment and you want it done by someone who has the technical training and artistry to give you the stunning smile you’ve been dreaming about.

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

Will Medicaid Cover Porcelain Veneers

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Between my cancer and my bulimia, my teeth have taken a huge hit. I need to do something about them but do not have a lot money. Is there a possibility Medicaid will cover something like porcelain veneers because it is a medical condition?

Stacey

Dear Stacey,

dental crown versus a porcelain veneer

 

Unfortunately, Medicaid, if they cover anything, will only cover the least expensive procedure. So, if they decided they would cover this situation with your teeth (which I honestly doubt) then they would cover you having all your teeth pulled and getting dentures because that would be the least expensive solution. Although, that would be a horrible solution. That is one of the problems with government run healthcare of any kind. It’s sort of a bottom line situation only. They care less about the patient and more about the financial considerations.

When it comes to bulimia, it is the backs of your teeth that take the brunt of the damage from the vomiting. Porcelain veneers only cover the fronts of your teeth. If the damage is to the back, you may need porcelain crowns, which surround the tooth.

However, as I said above, Medicaid will not cover this. It is something you would want to save up for and get done right. I would talk to your dentist about the damage to your teeth and see if he has recommendations to help in the meantime. At the very least, you will want to get some fluoride treatments in order to help fortify your teeth while you are saving up for a solid cosmetic solution.

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

Dentist Said Overbite Means I Can’t Have Porcelain Veneers

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I wanted to get a smile makeover, but my dentist said I cannot have porcelain veneers because my top teeth cover my bottom teeth in what he calls an overbite. Instead, he wants to do six dental crowns. Will that work? Should I get my bottom teeth whitened so they’ll match the crowns on my top teeth?

Farah

Dear Farah,

dental crown versus a porcelain veneer

We see this a lot with family dentists. They don’t have cosmetic dentistry training and do not know how to do porcelain veneers, so they tell their patient that they need porcelain crowns. There are a few things to be aware of with this.

First, smile makeovers are not taught in dental school. Putting one crown on a decayed tooth is a LOT different than doing a smile makeover with crowns. If he can’t make porcelain veneers look beautiful, he can’t make dental crowns look beautiful. You will not want him to do your smile makeover.

Second, as pictured above, dental crowns require your natural teeth to be ground down to numbs. If they are healthy, why would you want to do that? Porcelain veneers on the other hand only require minimal tooth preparation.

Third, if you have an overbite, it makes more sense to get veneers instead of crowns. Porcelain veneers only go on the front of your teeth and hug the sides a bit. Porcelain crowns on the other hand have to go around the entire tooth. They will bump up against your bottom teeth.

My advice, find a dentist who is experienced in placing porcelain veneers to do your smile makeover. Make certain they place your veneers with a temporary try-in paste so you get a look at them before they are permanently bonded on. If you are not thrilled with the results, they should go back to the lab.

As for the teeth whitening, you will want to whiten both the top and bottom arches before having the veneers done. Most smiles are eight to ten teeth wide. If you only get six veneers, you will want the adjacent teeth to match.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.
Click here to learn about our free virtual smile makeover consultation.

Porcelain Veneer Problems

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I went to see my dentist to fix my four front teeth that are misaligned. I had planned on braces, but he told me porcelain veneers could do it faster and I would not have to have any metal in my mouth. That sounded fantastic, so I agreed. In his treatment plan, he told me he would do two porcelain veneers and the shaping of the other two teeth to give me an even smile. He charged me over $8500.00 for the work, which he said included reshaping my other teeth as well. That is something we never discussed so I’m not sure why he did that without asking. The worst part is my teeth are still misaligned. I asked him what else has to be done to make them look straight like I’d originally asked for and now he says I need four root canals and dental crowns on those teeth, which of course he’s charing me for. Out of frustration, I got a second opinion from another dentist across town. He said all I need are four porcelain veneers. He saw no need for any root canals and said that crowns would be an over-treatment. The whole thing will be less than what I originally spent with my regular dentist. What I want to know is if there is any way for me to get my money back from the first dentist?

Kelli

Dear Kelli,

porcelain veneers

 

What a disaster! I am sorry you are having to deal with this. I do believe you will be able to recoup your money but it may take some fortitude on your part. The first thing I would do is make sure this second dentist has the cosmetic chops to do your work well. It is unfortunate, but smile makeovers are not taught in dental school. That means a dentist has to invest in post-doctoral training in order to learn how to do it well. He or she also needs an artistic eye. Look at his smile gallery. Are his porcelain veneer cases stunning? If not, you may end up with a second disaster on your hands. If you do like what you see, ask if they are images of his original work. If they’re not, move on to a different dentist.

If you are confident in this second dentist, I would start by simply asking for a refund. From what you have described of his character thus far, I would not be too shocked if he declined. In that case, you will ask the second opinion dentist to call and let him know that the work really does deserve a refund. If that doesn’t work, your next step is to complain to the dental board. From there, if you’re still having trouble with him, contact an attorney. That should sober him up.

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

Are Veneer Crowns a Thing?

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I am frustrated and worried after getting a full smile makeover of veneer crowns. He did twelve teeth on top and ten on the bottom. The temporary veneer crowns felt okay, but after the permanent ones went on, I started having problems. My dentist looked it over and said that on one of the teeth there’s an abscess and also has the nerves dying. He sent me to an endodontist to have the root canal done and that dentist found four more teeth that failed some kind of test and needed root canals too. My dentist told me there were no risks to this smile makeover so I’m really frustrated and confused. I went back and asked him about it and he said I was just unlucky and he’s never seen this happen. He’s offered to cover half the cost of the root canals, but I’m still out of a LOT of money here and I’m worried the rest of the teeth are going to have the same problem one by one. Have you heard of this happening before?

Elaine

Dear Elaine,

I’m a bit concerned by what I am hearing and I want to start by defining some terms. There are porcelain veneers and there are porcelain crowns, but there is not anything called veneer crowns. So, right off the bat, we need to figure out what you received. Based on the need for root canal treatments, I think you received dental crowns and NOT porcelain veneers. If your dentist told you he was giving you porcelain veneers, but gave you crowns, he could be in a lot of trouble. Here’s how to tell which you have.

Porcelain Veneers Versus Porcelain Crowns

porcelain crown prep

Tooth preparation for dental crowns


With dental crowns, your teeth have to be ground down to nubs in order to fit the crown. You will notice it fits completely over your tooth and you’ll be able to feel them on the back of your teeth as well. This is a much more aggressive treatment and should not be used for a smile makeover unless there were extenuating circumstances that necessitated it. You didn’t mention anything that made me think you needed crowns rather than veneers.

porcelain veneer prep

Tooth preparation for porcelain veneers

With porcelain veneers, you do not need much tooth structure removed at all. Typically, a dentist will remove a few millimeters, about the depth of a fingernail. These cover the front of your teeth and hug the sides a little but will not be on the back of your teeth. It would be extraordinarily unusual for your teeth to need a root canal with a veneer.

I think your dentist gave you crowns. I also think he was too aggressive in the tooth preparation which is why the nerves are dying. My suspicion is he knows that as well because he offered to pay for a portion of the root canal treatments. I would press your dentist into paying for all the root canal treatments. This should not have happened.

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

Staining around Porcelain Veneers

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I had porcelain veneers placed a little over a year ago. I was told these were very stain resistant. What I am finding is that in this short time they are getting stains around them. While I do smoke, I didn’t think this should affect the porcelain veneers. Are they defective?

Stephanie

Dear Stephanie,

porcelain veneers

I wish I had a picture of these. It would help me see exactly what type of staining you are talking about. You were told correctly that porcelain veneers are very stain resistant. In fact, they are more stain resistant than your natural teeth. There are a few possibilities for what is going on here.

Staining on the Surface Area

If the staining is all over the veneers, then it could be that your hygienist accidentally removed the protective glazing by either using a power prophy jet or some acidulated fluoride during your last cleaning and check up. The glaze is what gives porcelain veneers their shine as well as helps protect them from stains. If that glazing is removed, it will not take long for the veneers to begin picking up stains.

A second possibility with these type of stains is that the bonding was not done properly. If there is a gap between the porcelain veneers and the tooth, this will mean that food and other types of bacteria can get trapped between the two. This will make the veneer looked stained. Worse than that, though, is the fact that the tooth will begin to decay.

A third possibility is that you don’t really have porcelain veneers. Some dentists, who are less than ethical, will actually place composite and call it porcelain.

In all three of these scenarios, your dentist would need to replace the porcelain veneers.

Staining on the edges

If the staining is just on the edges of your teeth, than it is more likely that it is the bonding cement that is picking up the stains. When you first had your veneers placed, that bonding cement was polished to a nice shine. A year is enough time for those edges to pick up stains, especially from cigarette smoke. When that happens, it is just a matter of upkeep. Your dentist or hygienist can get in there and use ultra-fine polishing strips to get in there and get them as beautiful and shiny as they were the first day.

I would consider this a part of regular maintenance. It is not hard and does not cost much, but will help make your smile beautiful.

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

Bonding instead of Lumineers?

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I had bonding placed on my teeth about 7 years ago while I was a minor. These are starting to wear down and I was thinking of getting Lumineers to replace them. Then, I started doing some research and learned that most of the really good cosmetic dentists don’t like Lumineers. This scared me off so now I am thinking about just getting bonding done again. I want to make a beautiful smile but am worried people will know they are fake if my smile is too beautiful. What is your experience with these two issues?

Candy

Dear Candy,

blonde woman smiling

These are great questions. You are right that many dentists with true artistry and expertise in cosmetic dentistry do not like Lumineers. This is mostly because their company requires dentists to use their dental lab. This particular lab is not known for its beautiful results. Dentists usually prefer to use their own ceramist whom they trust will produce the results they expect from the instructions they provide.

While your dental bonding can be redone, because these have to be done freehand, doing it well takes a very long time, which drives up the price. Additionally, they will not last as long as you’d like, so I honestly don’t recommend that route. The good news for you, however, is that Lumineers are simply one brand of porcelain veneers.

My suggestion is you find a great cosmetic dentist and let them choose the brand of porcelain veneers that will give you the beautiful result you truly want. Veneers will last many more years.

As to your other question, I would not hold back. While you are intimately acquainted with your smile, others are not. Cosmetic dentists have seen this over and over. A patient gets a stunning smile makeover. When people see them, their comments go something like this…

“Have you lost weight? You look gorgeous. Something is different but I can pin it down. Whatever it is, it’s working.”

My advise? Get your dream smile.

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

Why Do My Porcelain Veneers Look Fake?

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I have a set of porcelain veneers done. I was so excited about finally getting the smile I have always wanted. While they are the right shape and color, something about them looks fake. I’m sending a picture, but I ask that you don’t publish it. My dentist is a friend and I don’t want him to know I wrote another dentist about this.

Name withheld

Dearn Anonymous,

Thank you for sending the photos. I know exactly what went wrong here. I’m going to start by showing you an image of a smile that looks natural. One of the teeth in this image is fake. I suspect you will not be able to tell which one that is.

Beautiful teeth

Notice that on this smile directly above has texture to the teeth. There are smooth grooves. Notice also that the color isn’t the same all the way from the top to the bottom. There are parts that are ore more translucent than others.

When I looked at the photos you sent, the teeth were flat. The color was white. The outlined shape of the tooth looked good, but because your dentist didn’t add any texture, they looked too shiny and fake. It was almost like you had chicklets put on your teeth instead of porcelain veneers.

I know this dentist is a friend, but you will be doing him a favor by letting him know this isn’t the smile you wanted. You can also show him this post, so he’ll understand what went wrong with this smile makeover.

There is no shame in this. Every dentist has to learn and improve. Cosmetic dentistry is an art form and all artists improve over time and learn new techniques.

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