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.

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.

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.

Should My Dentist Be Able to Match My Implant Crown?

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I want your advice as to whether I am being too picky. I had a dental implant made for a tooth that could not be saved after an accident. It’s a front tooth so I want it to match the other front tooth. My dentist has tried three different implant crowns, but none of them have matched. She’s frustrated with me and thinks I should just be grateful I have a tooth because “It is not her fault my tooth is between two dental crown shades.” Am I being too picky? Isn’t there a way to blend two shades together to make something closer?

Amy

Dear Amy,

I’m glad you wrote. You are definitely not being too picky. Plus, it was unfair of your dentist to push this off on you as if you were at fault for her lack of skill by not making her job simple enough for her. My suspicion is she does not have much training in cosmetic work, which is absolutely necessary to match a front tooth.

Color map a cosmetic dentist would createWhile the standard shades that your dentist referred to are adequate for back teeth, they do not quite cut it for front teeth as you have discovered. Your front teeth are exposed to direct light, which reveals all the variants in your teeth. The problem isn’t your natural shade color. There isn’t a shade that directly matches any tooth. When your teeth are hidden away toward the back, close is good enough.

For front teeth, your dentist has to pull out any artistry and color theory training he or she has received. Yours hasn’t. When a dentist needs to match a front tooth, they will draw out a “map” of your tooth, similar to the one to the one here, then mark for the ceramist the various tints and stains needed to give the tooth the correct blend.

It’s pretty apparent your dentist does not know how to do this and I don’t think she’s going to invest in the training needed. My suggestion is you pay for the dental implant but ask for a refund on the implant crown, so you can get it done properly somewhere else.

Discuss the procedure with any potential new dentist to make sure they are willing to do this properly. Here are some things to consider. Ask them if they will use a temporary try-in paste for you to approve the look and match of the porcelain crown before bonding. If they say no, move on. If they say yes, ask them how many times they’re willing to re-do it to make sure it is an exact match. The only acceptable answer should be as many times as is necessary.

It would be a miracle for even the best cosmetic dentists to get a perfect match the first time when it comes to a front tooth. Most will require two or three try-ins, so don’t panic when the first one doesn’t necessarily work. Just know you will get a tooth you can be proud to show.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.
Click here to learn more about smile makeovers.

A Pretty Smile after 23 years in Dentures

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I’ve had removable dentures for 23 years. A friend of mine recently got dental implant dentures. These look so much nicer than my teeth and she can eat anything she wants. Is it too late for me to have a pretty smile? I’ve spent my lifetime embarrassed by it.

Elaine

Dear Elaine,

Older couple with nice smiles

I’m sorry you have been embarrassed by your smile. The great news is it is never too late for you to get a beautiful smile. The key is in the dentist you choose. Doing a smile makeover is not taught in dental school. As a result, it is up to the dentist as to how much post-doctoral training they receive, if any, in creating beautiful smiles. Additionally, there is some natural artistry that is necessary as well, as with any art.

As to the dental implants themselves, because of the length of time you have been in dentures, there will be significant bone loss. That will have to be addressed in order for you to have a successful chance for true retention of your dental implants. The integration with the bone is imperative. The best way to address this is to have a bone grafting done. This will build back up the missing bone that you will need for osseointegration.

Once that is healed, you can have the implants placed. There will be a second period of healing necessary after the implants are placed. From there, you can have your dentures anchored to the new implants. This is known as implant overdentures, sometimes called implant-supported dentures.

Finding the Right Dentist

With the right dentist, you can have a gorgeous smile you will be proud to share with the world. However, choose carefully. The first thing you will want to do is make sure they have the training they need to place dental implants. Take a look at Dr. Cheek’s qualifications to get an idea of the type of training you want in your dentist.

Once you are assured they are qualified to place your implants, be certain to look at their smile gallery. This will give you an idea of what type of results they can provide you when it comes to creating a beautiful smile for you.

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

Whitening Brown Spots

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My dentist has been trying to help me whiten the brown spots on my teeth because she knows they are a source of embarrassment for me. They’ve been there since my adult teeth came in when I was much younger. We started with over the counter whitening and that didn’t work. It actually made the spots worse. Now she is offering to grind off the brown spots, but she isn’t sure how much surface will have to come off. If that does work, would the next step be dental crowns or would professional teeth whitening be more effective than what I used over the counter, which honestly was about every brand out there. I’m not sure what to do.

Malorie

Dear Malorie,

A woman placing teeth whitening trays on her teeth

Your dentist certainly seems well-intentioned, but she has no idea what she is doing with this. In fact, she’s experimenting on you without the knowledge she needs in cosmetic work, including teeth whitening which is one of the most basic procedures in that aspect of dental care.

Any teeth whitening, including professional teeth whitening, will not work for your situation. Instead, because it whitens your teeth evenly, it will make the brown spots more obvious.

The type of treatment you need for the situation you are in will be either dental bonding or porcelain veneers. Both of these are advanced cosmetic procedures that will require a dentist with advanced training. Porcelain veneers and more expensive than dental bonding but will last significantly longer and can do more. They are the go-to procedure for complete smile makeovers.

Where do You Find a Dentist who is Qualified to do Advanced Cosmetic Work?

Because there isn’t a recognized specialty in cosmetic dentistry, it is difficult for patients to know who is qualified. Sadly, they do not teach how to do smile makeovers in dental school. For a dentist to learn how to do these procedures they have to invest in post-doctoral training. You want a dentist who has made this investment. But how do you find one?

My suggestion is to look for a dentist who has attained accreditation with the American Academy of Cosmetic Dentistry (AACD). AACD accredited dentists have passed stringent exams as well as had to prove their artistry with before and after photos of a large and specific number of cases they have performed.

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

Lumineers to Whiten Teeth?

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I wanted to get my teeth whitened and talked to my dentist about it. He told me he was just certified in Lumineers and that could whiten my teeth while fixing a tiny chip I have on one of my teeth. The chip has never really bothered me until he brought it up. For some reason, it never occurred to me people will notice the chip. Now suddenly it worries me. However, the price of Lumineers is pretty high. Is there another option?

Beth

Dear Beth,

Teeth Whitening Trays

You definitely don’t want to move forward with your dentist’s plans. Not only is it a massive overtreatment, but you are likely to end up with a smile that is worse than what you started with. Lumineers is a brand of porcelain veneers that is highly marketed to inexperienced cosmetic dentists as being easy to place. While they don’t necessarily require tooth preparation the way other brands do, that doesn’t mean the dentist will know how to create a beautiful smile. While he is Lumineers certified, all that means is he attended a seminar. That doesn’t actually provide any training in doing smile makeovers.

Fortunately, I don’t think that is at all necessary for you. If your teeth need whitening, the logical procedure would be teeth whitening. Duh. This is significantly less expensive. As for the chipped tooth. It may not be as noticeable as you think. Your dentist is in your mouth up close. He is supposed to notice every little detail. If it didn’t bother you before I wouldn’t let the dentist’s comment change that.

before and after dental bonding

That being said, I realize sometimes once something gets our attention, it is hard to let go. The simplest and most affordable solution if you decide something has to be done is to have tooth bonding done to it. This is where a cosmetic dentist will hand sculpt composite resin onto the tooth to fill in the missing part. The image directly above shows what this can look like. However, you should be aware this procedure requires a skilled cosmetic dentist. Before I let anyone try it, I’d ask them to show you some before and after pictures of cases they’ve done to make sure they are up to the task.

If a dentist offers an option for a virtual smile consult, that can help you find out what they can do for you.

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

Cosmetic Dental Work and Teeth Whitening

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When it comes to cosmetic dental work, you really need to go to a dentist who has invested time in the requisite training to create beautiful smiles. There isn’t a recognized specialty in cosmetic dentistry where you are officially now a cosmetic dentist. Any general dentist can do cosmetic work. This is where most of those smile makeover horror stories come in.

Let me illustrate with a proper understanding of teeth whitening. Most people understand that bleaching your teeth can get rid of years of stains, such as the pigments picked up from staining foods and beverages. However, it will also whiten the natural pigment of your teeth.

Unfortunately, many family dentists who dabble in cosmetic work don’t understand this either. Dentists traditionally used the shade guide seen directly below.

Classic shade guide

This matches the natural pigment of teeth and darker with various levels of staining. However, when people started whitening their teeth, that changed the rules. The lightest shade was now too dark to match to the new colors now being seen on teeth. The problem comes when a dentist inexperienced in cosmetic work doesn’t understand this.

A patient comes in for a smile makeover and decides on porcelain veneers. They tell their dentist they want a very white smile. The dentist picks the lightest shade on the guide thinking he’s safe. When the veneers are placed, they are much darker than the patient’s natural teeth. Why? Because he or she has done teeth whitening.

Getting Your Smile Done Right

So how does a dentist get the right color? A true cosmetic dentist will invest in the updated shade guide, seen directly below.

updated shade guide

This allows the cosmetic dentist to get a better match. This, of course, isn’t enough to give you a beautiful smile, but it’s the bare minimum for a match. Before seeing any cosmetic dentist, make sure you look at their smile gallery first. Just make sure they posted actual cases the dentist has done and not just stock photos. If the before and after pictures don’t blow you away, don’t waste your time.

If you do like the photos, then its time to check their reviews. This one way to find out what type of chairside manner the dentist has and how good they are at listening to their patient’s desires for their new smile.

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

Best Dentist Won’t Treat Me

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I’m in a group of friends who have much bigger budgets than I do. There are times that is uncomfortable. They want to take trips as a group that cost more than I really should be spending. They’ve all gone to this fantastic cosmetic dentist and have been encouraging me to go as well. The guy is the best cosmetic dentist in our area. I saved up and was finally ready to go. Truthfully, I was thrilled. They’ve all got some beautiful smiles and I felt like I’d finally have one too. When I went there, I had a good experience… at first. I loved his treatment plan. We’d do ten porcelain veneers on my top teeth after whitening the rest of my teeth. Unfortunately, the price was way more than I was anticipating. I asked about alternatives and he essentially said, if I don’t do his treatment plan, I don’t deserve to be there. I left humiliated. I don’t want my friends to know what happened, but still want to get an improved smile. Do you have any recommendations?

Patricia

Dear Patricia,

blonde woman giving a thumbs up in a dental chair

Being the best dentist requires more than just creating beautiful smiles. You have to treat your patients with respect. You have to give them options and work within their budget requirements.

My guess is, because he recommended ten porcelain veneers, you have a wide smile. However, you can save money by whitening your teeth and then doing six veneers. Yes, ten would be ideal, but you can still get a stunning smile with less. The teeth whitening will ensure the teeth match. Not everyone can do the ideal treatment.

I’ve known patients who’ve had just two veneers done and were perfectly thrilled with their teeth. There are always options. Always.

Finding a Cosmetic Dentist Who’ll Work with You

I’m going to suggest you look at other dentists. He likely won’t be the only dentist who gets beautiful results. Check out the smile galleries of some local cosmetic dentists in your area. Pick the top few whose work you’re thrilled with. Then, check out your top contenders on the review sites. You’ll want to make sure these dentists have a good chairside manner and work well with patients.

Some things to look for is a dentist who advises but listens to his patients; a dentist who listens to his patient’s desires and helps them achieve the smile goals they have without shaming them about their budget.

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

Invisalign or Porcelain Veneers?

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I’m ready to fix my smile. I’ve been going back and forth between Invisalign and porcelain veneers. I’ve heard that the Invisalign fixes your teeth without anyone knowing and it’s much less expensive than the porcelain veneers. But the porcelain veneers should be faster. Is there a significant difference in their results? Are the porcelain veneers worth the extra cost?

Amaya

Dear Amaya,

Which procedure you get depends on two things. First, what your needs are for your smile. Second, the skill of the dentist you are working with. Let’s go over what each of them do.

Invisalign

Invisalign Aligner

Invisalign Aligner

Invisalign is specifically orthodontic related. If your teeth need to be straightened, this is the procedure to go with. It will straighten your teeth without anyone even knowing you are doing orthodontics.

It has an additional cosmetic benefit, too. The aligners used to straighten your teeth can also double as teeth whitening trays. This allows you to straighten and whiten your teeth simultaneously, thereby saving you both time and money.

Both of these procedures are fairly simple and will not require your dentist to have done extensive post-doctoral training in cosmetic work.

Porcelain Veneers

single porcelain veneer being held up by a dental tool

A Porcelain Veneer

This is more for those going for a total smile makeover. Porcelain veneers use tiny wafers of porcelain to completely remake your smile. They can change the shape, size, and color of your teeth simultaneously. While they can’t straighten your teeth, a skilled cosmetic dentist can make them appear straight.

This is the go-to procedure for celebrities to get their Hollywood smile. However, this does require some expertise on the part of the dentist. Unfortunately, smile makeovers aren’t taught in dental school. A dentist has to invest their time after they graduate learning the procedures, as well as developing their artistry. Without that, I’m afraid you’ll be sorely disappointed in the results.

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