Full Mouth Reconstruction for White Teeth

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I have one dental crown and 3 porcelain veneers. The tooth with the crown had a root canal treatment, so it was already there. The gumline by this crown is showing a black/gray line. The veneers are starting to show their age as well. I asked my dentist about replacing these. He wants to do crowns on all my teeth because they’re not very white and this will take care of both issues at once. My concern is the choice. Why crowns instead of porcelain veneers?

Patty

Dear Patty,

tooth bleaching trays

I just want to make sure I’m understanding you correctly. Your dentist wants to crown all your teeth because they aren’t very white? Really? I have so many concerns about this. First, the solution for teeth that aren’t very white is to do teeth whitening. Not only does that preserve all of your tooth structure, but it is also significantly less expensive.

You brought up one of my second concerns. Why crowns instead of porcelain veneers? I can tell you why. Dentists who aren’t comfortable doing porcelain veneers, will steer their patients toward dental crowns. Here is the problem with that. Smile makeovers are not taught in dental school. Porcelain veneers should be a basic skill for any cosmetic dentist. However, there are plenty of cosmetic dentists who do them, but do them badly. You don’t want that either.

When you have a dentist already letting you know he can’t do porcelain veneers, run away from that dentist doing any cosmetic work on your teeth.

Crowning all your teeth is known as a full mouth reconstruction. This is one of the most advanced procedures a dentist will have to do. Not only is there the cosmetic aspect of it, which your dentist has already hinted he’s not qualified to do, but getting the proper occlusion of your teeth also takes significant post-doctoral training, which I doubt he has. If it is done wrong, you could end up with TMJ Disorder and a lifetime of pain and migraines.

My suggestion is you let him do the teeth whitening and then find a cosmetic dentist to replace the crown and veneers. Look at their smile gallery to see what type of results they get in order to get an idea of their skill level. Though, make sure it is their own work and not just stock photos. If they don’t have a smile gallery, they are not a cosmetic dentist at all.

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

Are Dental Implants Possible After Years of Dentures?

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I’ve had dentures for a little over twelve years. I’m finally in a financial place where I can get dental implants. Is it too late for me or is it still a possibility? Are there any extra steps I need to take to make it possible?

Aimee

Dear Aimee,

Before and After Facial Collapse

You can get dental implants regardless of how long you have had dentures. However, as you suspected, there is a procedure you’ll likely need before that is able to move forward.

When your teeth were removed, your body recognized that. In an effort to be as efficient as possible, it begins to resorb the minerals from your jawbone to use elsewhere in your body. After ten or so years, you are dealing with facial collapse and will start to find it difficult to even keep your dentures in place.

What you’ll need to do in order for this to work for you is to have a bone grafting procedure done. This will build back up the missing bone structure. Once that happens, you are ready to start your dental implant procedure. In your case, because you have complete removable dentures, you’ll get what is known as implant overdentures. This will place four to six dental implants and then anchor your dentures to them.

One thing to be sure of is that your dentist is experienced in placing dental implants. They’ll need to have had adequate post-doctoral training in this procedure. Don’t just go to any dentist. One other thing to be careful with is dentist/oral surgeon relationship. In Dr. Cheeks’ case, she works with a periodontist and oral surgeon on-site.

What you don’t want to do is go to the oral surgeon first without consulting with the implant dentist. If you do, it is possible the implants will be placed in the wrong place and you’ll end up with a dental implant horror story.

The great thing about a new smile procedure is it gives you a chance to obtain a smile you will be proud of for years to come. It will be helpful to take a peek at the smile gallery of whichever dentist you are planning to use, just to make certain they know how to create beautiful smiles.

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

If you’re interested in seeing what we could do for you, you might want to take advantage of our free Marietta remote smile consult service.

Crowns or Veneers for Tetracycline Stains?

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I have tetracycline stains that I am ready to get fixed. I’ve seen two dentists— my regular general dentist and a local cosmetic dentist. My dentist suggested porcelain crowns. He’s done a crown for me before and it looked very nice and natural. The cosmetic dentist suggested porcelain veneers. The cost for the dental crowns is half the price of the porcelain veneers. I want to do this right. These teeth have bothered me for years. But, is there a significant reason to spend the extra money for the porcelain veneers?

Ellie

Dear Ellie,

single porcelain veneer being held up by a dental tool

A Porcelain Veneer

I’m glad you are asking questions. The first thing you need to know is there isn’t a recognized specialty in cosmetic dentistry. Just because a dentist calls themselves a cosmetic dentist doesn’t mean they are better. Nor does the fact that they charge more. That being said, I wouldn’t have the crowns done.

Tetracycline stains are one of the most difficult types of cosmetic cases a dentist can work with. They have to make the porcelain opaque enough to cover the stains while translucent enough to still look natural. When it comes to tetracycline stains, the porcelain crowns are an overly aggressive treatment.

The teeth have to be ground down quite a bit in order for there to be room for the dental crowns. This weakens the teeth and puts them at risk of breaking. Often dentists inexperienced in treating these type of stains recommend the crowns because they aren’t confident in their skills doing porcelain veneers. So the fact that your dentist wants to do the much more aggressive crowns is a red flag.

Additionally, there is no guarantee after you unnecessarily grind these teeth down that the crowns will be good enough. I know you said he’s done a crown for you before and you were happy with it. However, doing one crown is very different than dealing with a smile makeover, especially when tetracycline is involved.

Recommended Treatment for Tetracycline Stains

Most cosmetic dentists will suggest porcelain veneers. This can change anything and everything about your teeth— the shape, the size, the color. This is the go-to procedure for celebrities who want a smile makeover. It can do more than cover your tetracycline stains. It can give you the smile you’d always dreamed of having, not only covering the stains you are embarrassed by, but giving you a superstar smile.

Check the Dentist’s Results

I highly recommend you don’t just choose between these two dentists. You have a world of dentists available to you. But be careful in your choice. This is a very difficult cosmetic dentistry procedure, and it may be hard to tell if the dentist has enough skill to do this right. What I would suggest is to ask to see before and after smile gallery photographs of tetracycline cases they’ve personally done. If they can’t show you that, keep looking for another cosmetic dentist.

You also need to insist they do a temporary try-in of your porcelain veneers when they’re done. There is a try-in paste which will allow you to see the veneers on your teeth without bonding them. This enables you to look at them in various lighting and determine if they are what you wanted. If you’re at the right dental office, the dentist will be willing to send the case back to the laboratory and not bond them on if you are at all hesitant about how they look.

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

My Porcelain Veneers Make me Look Like Bugs Bunny

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I don’t know what to do. I think I made a mistake begging my dentist to give me porcelain veneers. I could tell he wasn’t keen but I felt desperate to get a smile which didn’t bother me. My teeth are short and stubby. I wanted to make them longer. Now they’re way too long and bulky. I honestly feel like bugs bunny. Can this be fixed?

Samantha

Dear Samantha,

a porcelain veneer being placed

In every profession, including dentistry, there are different strengths and weaknesses with each person. For some dentists, they prefer to focus on the general dentistry aspects of keeping teeth healthy and repairing them when they aren’t. Others invest time in learning cosmetic skills.

However, even among those who like to do cosmetic work, there are different levels of artistry. No two dentists smile makeovers will turn out the same.

It sounds like your dentist prefers the general work, but deferred to your desire for longer teeth. His heart was in the right place but he didn’t have the skill set needed to make it work.

My guess is, because you said they looked bulky on top of too long, your dentist tried to do it with Lumineers. This is a brand of porcelain veneers which tends to be highly marketed to inexperienced cosmetic dentists as being easy to place.

Unfortunately, without the proper tooth preparation (which they tell the dentists isn’t necessary) the results tend to be bulky.

Fixing Badly Done Porcelain Veneers

Once dental work is bonded on, it’s permanently on. The only way to “fix” them is to have them redone. Now, you choose the correct solution to your problem. Porcelain veneers will absolutely give you the smile of your dreams. However, to truly get that smile, it will have to be through a different dentist.

Your dentist tried. He likely tried his best. But, if cosmetic dentistry isn’t his thing, his best will never be enough to give your smile the right results. It doesn’t mean you have to switch dentists. You’ll just have to see a different dentist for cosmetic work than your normal dental work.

Look up some cosmetic dentists in your area. Make sure they have post-doctoral training in cosmetic dentistry. You can do that by looking on their website or just calling their office and asking. After that, check out their smile gallery. Are the smile makeovers they’ve posted on there gorgeous? Would you be excited if that were your smile? If not, look at a different dentist.

The final step will be to check their reviews. What type of experience did other patients who’ve used their office have? Were they satisfied? From there, schedule a consultation. We offer, here at Cheek Dental in Marietta, a complimentary remote consultation.

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