Can Lumineers Fix My Lumineers?

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I got Lumineers a few years ago. They were never the color I wanted, but looked a tad stained to me. My dentist said they didn’t make them as white as I wanted. Now I’m seeing people who’ve had smile makeovers with much whiter teeth so I”m thinking the technology has changed. Can I get Lumineers placed over old ones to make them whiter? My dentist said teeth whitening won’t work.

Andrea

Dear Andrea,

single porcelain veneer being held up by a dental tool

Your dentist was mistaken about the first set of Lumineers. Any porcelain veneers (and Lumineers are just one brand of porcelain veneers) can be made as white as you want and that has been true since their inception. This tells me your dentist is an inexperienced cosmetic dentist who was trying to make sure your smile looked “natural”. It doesn’t surprise me he recommended Lumineers. They’re highly marketed to beginner cosmetic dentists as being easy to place.

Years ago, the Lumineers brand tried marketing itself as a way to “fix” old, ugly looking crowns. The reviews were horrible by those who had it done, which may be why they no longer market for that.

It is just as much work and safer for you to just have your porcelain veneers re-done than it is to place new veneers on top of old. Otherwise, you have two bonding procedures. If one fails, they both fail. It’s more secure to bond porcelain to natural tooth structure than it is to bond porcelain to porcelain.

Getting Your Porcelain Veneers

I don’t think you should go to the same dentist to have your porcelain veneers re-done. He doesn’t seem to understand how smile makeovers work. It’s not actually taught in dental school so dentists have to invest time and money for additional training to develop their skills.

I would look up some dentists who advertise as cosmetic dentists in your area. Before doing anything, check out the smile gallery on their website. If they don’t have one, they don’t take cosmetic dentistry very seriously. If you love the results they create, the next step would be to check their reviews.

This helps you know what other patients have felt about his or her practice. Once you are satisfied with both of those things, make sure they have some form of a beautiful smile guarantee. This way you can be certain you’ll get the smile you really want.

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

Unexpected Benefits of Same Day Crowns

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My dentist has switched to only doing same day crowns. I’m a little concerned with getting it in the same appointment it will end up being rushed and not fit or look right. Am I being silly or should I find a dentist who does traditional crowns?

Carrie

Dear Carrie,

porcelain block for CEREC crwons

Most people know the obvious benefit is not having to have two appointments and getting your crown the same day. However, there are some unexpected benefits as well which should allay some of your concerns.

No Gooey Impressions

With CEREC same-day crowns, you don’t have to worry about gooey, messy impressions. Instead, digital 3-D scans will be made of your tooth.

A Perfect Fit

Using CAD-CAM Technology, a sophisticated software program designs and then mills your crown right there in the office. With the accuracy of computers, your crown will have a great fit. It’s not rushed because computers can do computations and milling much more efficiently than humans.

A Natural Looking Tooth

Because these crowns are milled out of blocks of porcelain and do not have a metal base as some traditional crowns do, they will have the natural translucency the teeth next to it have. This allows the crowns to blend very well with the adjacent teeth.

A Cosmetic Consideration with Same Day Crowns

CEREC crowns can be matched to any tooth color. The one consideration is to know the color will be permanent and cannot be changed once it is made. If you are happy with the color of your teeth then you are good to go. However, if you’ve ever wondered about whitening your teeth the time to do it is before you have your crown made.

Doing the teeth whitening first will save you money. If you wait until later, your teeth will whiten, but the crown will not. Then, after the whitening is completed, you’ll have to have a new crown made to match the more youthful color of your teeth. You don’t have to endure weeks of teeth whitening. Instead, you can get your teeth whitened in just one appointment with a dentist who offers Zoom Whitening.

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

Treatment for TMJ Disorder

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My doctor has been unable to find a cause for my headaches. They are debilitating, especially in the morning. It’s kept me from being the mom I want to be. At my last visit, my doc suggested I see a dentist and ask about TMJ Disorder. He called it a “Hail Mary”, because he doesn’t know what else to do for me. I did see my dentist and mentioned what my doc said. He told me if I have headaches in the morning it is because of TMJ and I’ll need to have a full-mouth reconstruction. He had the business office write me up an estimate. It will cost me a fortune. Before I invest in this, I just want to make sure this is the correct course of action. Should I move forward or get a second opinion first?

Ellen

Dear Ellen,

An illustration with a close up of a TMJ Joint

There are many causes and solutions to TMJ Disorder

While a full-mouth reconstruction is a legitimate treatment for certain cases of TMJ Disorder, there are other treatments. Treatments which are much less invasive. Which treatment is used, depends on what the underlying cause is. You need the right treatment for the right cause. If that is the right treatment, it requires a dentist with exceptional training in both restorative and neuromuscular dentistry that is not gained in dental school. Because of that, I am going to suggest you get a second opinion by someone with the right training.

Sometimes, those headaches in the morning are caused by your clenching or grinding your teeth. Many patients don’t even realize they are doing it because they only do it at night. It is hard to know what you are doing in your sleep. A full-mouth reconstruction wouldn’t even help that issue. Instead, all you would need for this is to wear a night guard while you slept. It’s a simple and comfortable mouthpiece that is worn over your teeth.

Finding a Qualified Dentist to Evaluate Your TMJ

What you want is a dentist who invested time in post-graduate training. There are several schools which have great TMJ training. Here are a few of the best:

  • The Dawson Academy for Advanced Dental Study
  • The Las Vegas Center for Advanced Dental Studies
  • The Pankey Institute
  • The Kois Center

A dentist who has studied at one of these institutes will be qualified to both diagnose and treat you. It may be something simple, such as I mentioned earlier. If it turns out that you do need a full-mouth reconstruction and it requires putting a dental crown on every tooth, you will need a dentist with an additional qualification. Because this treatment is a combination of fixing your bite and creating a new one, you’ll need someone who is also skilled in cosmetic dentistry. I’d look for someone who has reached accreditation with the American Academy of Cosmetic Dentistry.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

Solution for a Gigantic Tooth Gap

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I have a rather large tooth gap. My dentist said it is about 9mm. I want to fix it and whiten my teeth at the same time. My dentist said he was just certified in Lumineers and can place those on my teeth to close the gap. Is this a good solution? I want to make sure for two reasons. One, it’s expensive. Two, he is new at it.

Joey

Dear Joey,

Invisalgin Aligner

Inviaslgin Aligner

I want you to run away from the recommendation your dentist gave you as fast as you can. Here are just a few reasons why. First, Lumineers are simply a brand of porcelain veneers. This particular brand is highly marketed to inexperienced cosmetic dentists as being easy to place because there is no prep. In all honesty, there is no such thing as no-prep veneers. Your teeth will have to be etched no matter what brand you use.

Second, certification in Lumineers simply means they have attended a seminar. It does nothing to develop their skill or teach them artistry.

Thirdly, your particular case would require a dentist who has tremendous skill, experience, and artistry in placing porcelain veneers. The size of your gap is enough to fit an entire tooth into. In order to make this look natural, it will take some technical expertise not available to your dentist.

Invisalign is a Much Better Solution

In your place, I would have Invisalign done. These use clear aligners to straighten and align your teeth. You can see a picture of one of the aligners above. These will close the gap without anyone even knowing you are wearing orthodontics. They are invisible even at a conversational distance. Additionally, they are much more comfortable than traditional braces and work in half the time.

Not only will using Invisalign cost significantly less than getting porcelain veneers, but the aligners can double as teeth whitening trays, saving you even more money. Your dentist can just provide you with the whitening gel, which you can wear in your aligners at a convenient time for you. This allows you to straighten and whiten your teeth at the same time.

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

Do You Have to Quit Smoking for Dental Implants?

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I want to get dental implants to replace some missing teeth. My dentist said he won’t place them unless I quit smoking. Is this really necessary or is he trying to force his own agenda on me?

Kevin

Dear Kevin,

An image of a dental implant crown being placed in three stages

I don’t think your dentist is trying to force an agenda on you. Instead, he’s trying to give your dental implants procedure the best chance at success.

The Risks of Nicotine with Dental Implants

  • The Reduction of Blood Flow

Any form of tobacco, including cigarettes, vaping, smokeless tobacco, or dipping restricts your blood vessels. In some cases, it cuts off the blood flow completely.

  • Poor Osseointegration


    • One of the keys to a successful dental implant procedure is when the implants fully integrate with the bone. With reduced blood flow, this hinders healing which slows down the integration. This will lead to a loose implant which will fall out.

    • Increased Risk of Infection

    Because your reduced blood flow hinders healing, it increases your risk for infection at the implant location. The leading cause of dental implant failure is an infection.

    Options for Dental Implants When You Smoke

    Obviously, you can accept the risk and move forward. You will be able to find a dentist willing to provide the procedure even while you smoke.

    On the other end of that spectrum is to quit smoking. You can talk to your doctor about options to aid you in that process. There are options to help with the withdrawal symptoms.

    Another possibility is to meet somewhere in the middle. You can quite for several weeks before the surgery and during the healing time. Then, when everything is secure, you can smoke again. However, you may find during that time period that you don’t really need that tobacco as much as you thought you did.

    A Cosmetic Consideration with Dental Implants

    Smoking causes serious tooth stains. Often, patients want to get a whiter smile when they’re replacing their teeth. You may want to consider getting your teeth whitened before having your implant crowns made. This way they can match the porcelain crowns to your new, whiter tooth color. Giving you a youthful, healthy looking smile.

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

Tri-Colored Porcelain Veneers

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I’m really disappointed in my porcelain veneers. I spent a fortune and now I have three different colored teeth. My natural teeth are yellowed. Then, I have four porcelain veneers, but two of them have splotchy gray patches. They look to be from underneath the veneers and shining through. Will teeth whitening help this?

Vera

Dear Vera,

a porcelain veneer being placed
Porcelain veneers are a great option for smile makeovers…when done by an artistic cosmetic dentist

There are a few things going on here. The biggest issue is you have a dentist in over his or her head with porcelain veneers. Smile makeovers aren’t taught in dental school. In order to do it well, dentists have to invest years of post-doctoral training on their own time to become skilled.

Your dentist has made three pretty basic mistakes, which tells me they didn’t do that.

Porcelain Veneers Mistake #1

You said you were provided with four porcelain veneers. You also said that you can see your natural, yellow-stained teeth. This means you were not given enough porcelain veneers. Most smiles require six to eight porcelain veneers. Wider smiles will require ten.

Sometimes, getting fewer porcelain veneers is the choice of the patient, even though the dentist recommends more. Often, this is for budgetary reasons. When that happens, there is a good solution. This leads me to the next issue.

Porcelain Veneers Mistake #2

When you don’t have enough porcelain veneers to cover the teeth which are visible when you smile, the most affordable solution is to have your teeth whitened.

This makes the teeth white and closer to matching what your veneered teeth will look like. This would have kept your yellowed teeth from standing out against your veneers because the stains would be gone.

Porcelain Veneers Mistake #3

The two veneers you have which have splotchy gray stains sounds to me like they’re not bonded properly. This causes what is known as micro-leakage. When the veneers aren’t bonded on properly it allows things to get between the veneer and your teeth. This shows up as blotchy stains.

If this is the case, you have a very good case for a refund. This isn’t functional for you. Not because of the unattractiveness of the veneers, but because of the danger of decay. You have food and other bacteria getting trapped in there. Your teeth will develop cavities as a result.

Where to Go from Here

The first thing I want you to do is ask your dentist for a refund. If he or she refuses, then I want you to get a second opinion from another cosmetic dentist. If they confirm you have micro-leakage, then it will be easy for you to get a refund and get the case done properly.

Decide whether you want to have more porcelain veneers placed on the visible teeth or get your teeth whitened instead. If you decide on teeth whitening, get that done first.

I hope this puts your mind at ease.

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

Two Complaints about CEREC Crowns

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I’m not understanding my bill. I’ve had regular crowns before and know their price. Those crowns take two appointments, They also require a temporary crown which is more material. Why is it when I got a CEREC crown, which is done in one appointment and doesn’t require a temporary crown that they charged me the same amount. Secondly, the stupid thing doesn’t match my teeth like my other crowns do. So it costs the same and looks fake. Great. Tell me why this is an advancement?

Dan

Dear Dan,

porcelain block for CEREC crwons

There are a couple of misconceptions here I hope will help you with your questions.

The Cost of CEREC Crowns

While I can see where you would think, because of the reduced appointment and lack of temporary crown, that the CEREC crowns would cost less, there is something you’re not considering. The technology isn’t cheap. They cost dentists at least $100,000. That’s a lot of money. Yes, they’re saving on lab fees, but they’re still having to pay for the CAD-CAM technology.

The Appearance of CEREC Crowns

It’s easy to misunderstand what makes a dental crown look beautiful and natural. While some materials are easier to work with, it’s not the material which creates the natural beauty of the crown.

It’s the skill of the dentist.

You want a dentist who has invested time and training in creating beautiful smiles. Look at their smile gallery. This will give you some idea of what type of results they get.

Unfortunately, there’s not a way for you to get a refund unless the dentist is willing if the crown is functional. You can ask him for one, but it is completely up to him.

Talk to your dentist about how you feel about the crown’s appearance. He may be willing to re-do it.

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

Smile Care Club Versus Invisalign

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I’m really wanting to straighten my teeth but don’t have a ton of money. I keep hearing about this smile care club. They advertise heavily on Facebook. It seems much more affordable than Invisalign. Is it safe? Does it do the same thing?

Carol

Dear Carol,

Invisalgin Aligner
Inviaslgin Aligner

Smile Care Club is what boils down to a “do it yourself” Invisalign treatment. The biggest difference is you are not under the care of a dentist. That’s where you’re savings comes from. That’s also where the risk comes.

For the majority of cases, Smile Care Club will work fine. However, there can be problems. One big problem patients run into is gum disease. If someone has gum disease, getting any type of clear braces treatment will aggravate it. You will need the help of a dentist in order to make sure you can keep your teeth.

With these companies, you essentially just submit pictures to see if you “qualify”. However, only certain cases of gum disease can be diagnosed from pictures. Most would require both x-rays and probing.

There are two other issues which can pop up. The first is if the teeth need some mild shaving because of crowding. They will send you to a dentist for this. However, that dentist isn’t personally invested in your case. It can be tricky to get the right amount of shaving done on the sides while maintaining the proper shape of your teeth.

Another issue is if teeth don’t rotate the way they were supposed to. That also needs dental intervention.

Bottom line. You could save money as long as everything goes perfectly. If there are any side issues, you could end up with a disaster.

A Side Benefit of Invisalign

One thing patients will love about Invisalign is the ability for the aligners to double as teeth whitening trays. This allows you to whiten and straighten your teeth at the same time, essentially giving you a mini smile makeover.

However, that will need to be under the care of the dentist in order to protect your gums.

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

TMJ Problem or Cavity

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I’ve never had a cavity before so I don’t know what they feel like. Lately, I’ve been having pain at the back of my mouth with a couple of my molars. It comes and goes. I thought it might be a cavity but I was asking a friend about it and she said that hers was that way because of TMJ problems from grinding her teeth. I know I do that because my dentist said I do. So, how do I know if my problem is a cavity or TMJ?

Alana

Dear Alana,

An illustration with a close up of a TMJ Joint
The Temporomandibular Join

I will say first I am more than a little concerned your dentist told you that you were grinding your teeth but didn’t explain the importance of it being dealt with or suggest a treatment.

The grinding of your teeth will wear them down to little nubs until you’ll either need them crowned or they will begin to crack. Additionally, it will begin to wear down your the joint that is the center of TMJ Disorder.

He should have suggested you wear a nightguard. This is such a simple fix. He custom fits a special nightguard for you to wear while you sleep. Most people who grind their teeth, do so at night and don’t realize it is happening. Wearing the guard protects your teeth from the grinding motion.

Leaving TMJ Causes Untreated

If you don’t get a nightguard, eventually you will need what is known as a full-mouth reconstruction. This means every tooth will have to be crowned. It is a very expensive procedure and only a handful of dentists have the training necessary to do it right.

Simple prevention now will save you a fortune.

Cavity or TMJ

As to your original question. The only real way to know if you have a cavity is to go in and have it checked. Your dentist will do x-rays as well as a physical examination.

The earlier you catch a cavity the better. A filling is better than a crown. A crown is better than an extraction and tooth replacement.

My recommendation is you go in to see your dentist and eliminate a cavity. From there find a TMJ dentist who will give you the proper solution for your grinding.

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

Am I Being too Picky about these Porcelain Veneers?

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Amelia

I had four porcelain veneers placed on my front teeth. The veneers themselves looked good. The teeth next to them stood out a bit so I plan on whitening my teeth to help that. My big concern is with one of the front veneers. I noticed on the drive home it had a strange divot that went across the middle of the veneer. I turned around immediately and went back to see what I needed to do. He told me not to worry and that he’d fix it right away. He did some kind of repair and it felt smooth again. Now it is a couple of days later and that part looks more dull than the rest of the tooth. Am I being too picky? It does bug me but I don’t want to be “that” patient.

Dear Amelia,

single porcelain veneer being held up by a dental tool

You are not being too picky. In fact, it sounds like the repair your dentist did on your veneer has damaged it. It’s possible he just sanded the area around the divot a bit to make it even. Unfortunately, that will have the devastating result of taking off the glaze of the veneer in that area.

The glazing is what protects it from picking up stains. This needs to be repaired or replaced. I’d do it now, while the faulty “repair” is fresh in his mind. If you wait too long he could try to blame you for the damage.

Have this Dentist Replace Your Porcelain Veneer

There is a repair that can be done on this using diamond polishing equipment. Unfortunately, I don’t think your dentist will know this technique. It’s quite advanced. Your dentist isn’t an expert cosmetic dentist, so you’re better off just having him replace it.

I’m not just being arbitrary in saying that. All the things you mentioned above are evidence. First, the number of porcelain veneers he gave you. When a dentist is doing a smile makeover, they’ll make sure as many of the teeth visible when you smile are covered as possible.

At a minimum, that means six teeth, unless you have an unusually narrow smile. Patients with wide smiles often get ten. Granted, there are sometimes financial considerations and patients can’t afford to cover each visible tooth. In that case, your dentist will make sure you whiten your teeth, before you have your smile makeover done. Yours didn’t even tell you to do it at all. You had to come up with that.

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