Why do my veneers keep staining?

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When my dentist placed my porcelain veneers a couple of years ago I was so happy. I had been so self-conscience about my smile for so long and it was love at first sight when I looked in the mirror. My teeth were so white for the first year or so and then they started to change color. They were staining, so I made an appointment to have them cleaned and they looked really good for a week or so and then it started happening again. I’m not sure why this is happening or what to do about it. I’ve brush at least three times a day and have even tried whitening toothpaste and it doesn’t work!  — Sharon

 

Sharon,
Porcelain veneers are usually very durable, but the top layer is susceptible to scratches. Think about a porcelain sink… it can last for years,  but if you use an abrasive cleaner or a Brillo pad to clean it, that leaves behind microscopic scratches on the surface. Those scratches can collect dirt and bacteria and will continue to stain.

The same thing can happen with porcelain veneers. The dental office should be taking extra precautions when they polish your teeth. It’s unclear whether they’ve done this or not, but some polishing pastes and tools are known to scuff up the surface of porcelain, and any hygienist who is experienced with cosmetic work should know this.  Also, you should not be using whitening toothpaste because it is abrasive.

Once porcelain veneers are scratched, there’s nothing you can do but have them redone. You can stick with professional cleanings on a regular basis to keep the stains at bay and even use a special toothpaste intended for cosmetic work. When you’re brushing at home, use a soft-bristled toothbrush, a gentle cleansing toothpaste and brush often.

If you drink a lot of coffee or tea, or use tobacco either could be causing the staining. Those types of stains usually just sit on the surface and can be brushed away, so brushing frequently will keep your teeth brighter for longer. But odds are something happened that damaged the surface in your situation.

This blog is sponsored by AACD Accredited dentist, Dr. Stephen Doan. Find out more about the services he provides by visiting his La Jolla cosmetic dental website.

What to do with my big front teeth?!

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My front teeth are big! They are long and even worse, they protrude out a little from the rest of my front teeth. I’m tired of looking in the mirror and feeling like Bugs Bunny’s cousin. I know that sounds harsh, but it’s true and I don’t know what to do.

After researching various cosmetic procedures, I’m not seeing a sure-fire fix. Many procedures seem to add something to the teeth and I don’t want mine to look even bigger than they already are.

Could I have those two teeth removed and replaced with dental implants? Any advice is appreciated.  – Sonja

Sonja,
Whatever you do, don’t have your teeth pulled and have dental implants! You don’t have to figure this out on your own… you just need to find a skilled cosmetic dentist in your area that can help you.

Keep in mind that without seeing or examining your teeth, it’s impossible to tell you for certain what will solve your problem, but there are some options based on the information you’ve provided. Upon examination, a cosmetic dentist could go in a totally different direction.

It’s possible to make your teeth look narrower and shorter by carefully trimming them down (on the sides as well as the biting edges) with diamond burs and diamond strips. After that, a spring retainer could be used to align them with your other teeth.

Or, Invisalign could be a great option for re-aligning them, too.

If there’s a lot of trimming needed, a cosmetic dentist may recommend porcelain veneers to cover over the exposed dentin.

Bottom line, don’t let your family dentist try and tackle this for you. You need an expert cosmetic dentist, or you may find yourself in a more expensive fix down the road. Good luck!

This blog is sponsored by AACD Accredited dentist, Dr. Stephen Doan. Find out more about the services he provides by visiting his La Jolla cosmetic dental website.

“AACD-Accredited” dentist botched my tooth… now what?!

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What options do I have in going after an AACD-accredited dentist who did terrible work on my tooth? The dentist sold himself as AACD accredited in several places on his website, so I thought I was making a good choice. I even drove almost three hours just to have him do the work!

What should have been a simple fix has turned into a mess with me leaving with an odd-shaped and dysfunctional-looking tooth. He hurried through and left rough edges where he had removed composite and said I would have to come back. So, I went back and instead of finishing as he should have, he would only “wax” the tooth and in the process of that, he chipped the next tooth over.

After some quick research, I found out that AACD requires only that the dentist pay dues and meet some fairly easy requirements. I question what this dentist actually had to do twenty years ago when he received accreditation, nor what he is required to do to keep it active today. There is a requirement that the dentist maintains ethical standards, but this is obviously not enforced since I see on another review that this dentist has been sanctioned by the state dentistry board for serious unethical conduct. Help? — Victoria

 

Victoria,

Membership in the AACD requires only the payment of dues – you are correct on that part. However, accreditation requires much more. The AACD accreditation standards are fairly stringent and have been for many years. The failure rate for those dentists trying to become accredited is actually fairly high. If this dentist was accredited about twenty years ago, the failure rate was around 60-70% and at that time, there wasn’t a written exam, but a rather difficult clinical exam as well as an oral exam. For the most part, one a dentist becomes accredited they stay accredited based on their knowledge and skill. The test does not, however, determine whether or dentist or cosmetic dentist will adhere to ethical standards.

I would make the AACD office aware of this disciplinary action by the state dental board, and beyond that there’s not much you can do about his accreditation. Whatever the issue was, maybe the AACD didn’t think it was serious enough to remove him. Where you have power is letting the public know about your experience. Leave negative reviews wherever you can – on Facebook, Yelp or Google. If he already has a least one bad review, add yours to it and hopefully others will take it seriously.

This blog is sponsored by AACD Accredited dentist, Dr. Stephen Doan. Find out more about the services he provides by visiting his La Jolla cosmetic dental website.

It tastes like I ate a rotten egg since getting my porcelain veneers!

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Call me crazy, but I can’t help notice a weird (and quite honestly) gross taste in my mouth since getting my porcelain veneers done. It’s like I ate something rotten! I’ve been very diligent about brushing and flossing like my dentist instructed – at least three times a day. Even with all that brushing, the taste is getting worse. I’ve lived with this for a couple of months and don’t know what to do. My dentist says it’s not from the veneers, but something I’m doing different with my diet. I haven’t really changed the way I eat, so I think he is wrong. Any advice? — Rob

 

Rob,

microleakage around a composite filling

This photo, courtesy of Dr. Julie Gillis shows microleakage around a composite restoration on a front tooth, similar to what you would see around a porcelain veneer.

Your dentist should be concerned about this taste you are describing. Has he checked for decay, infection or something else going on in your mouth? If not, he should definitely be running some tests to determine what’s going on. The veneers could be causing the issue if they are not shaped correctly or if there were gaps left between the teeth and the veneers during bonding. Both of these issues can cause bacteria to grow underneath the porcelain and the tooth actually decays where you can’t even see it. This is called microleakage.

I’d suggest a second opinion from an expert cosmetic dentist to see if he or she agrees with what your current dentist is saying, and if so, make an appointment with your primary care physician to see if you can find another cause. However, if the new doctor finds that it’s an issue with your veneers, hopefully they can get it fixed sooner rather than later. You’re absolutely right not to ignore this because if it is microleakage and decay, you risk losing your teeth. It could be that you just need to have the decay removed and the veneers redone, but decay can spread quickly and literally ruin your teeth beyond repair.

This blog is sponsored by AACD Accredited dentist, Dr. Stephen Doan. Find out more about the services he provides by visiting his La Jolla cosmetic dental website.

Can I trust my smile to SmileCareClub?

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I’m considering SmileCareClub to straighten my teeth mostly because it’s more affordable than other options. Does it work or will I be getting what I’m paying for? — Samantha

 

Samantha,
There’s no doubt you can save quite a bit of money over brands like Invisalign. While that can be a good thing for your wallet, it’s best to ask yourself if you’re ok with cutting corners when it comes to your most prized accessory — your smile. With that said, it’s probably safe to say that SmileCare works just fine for the majority of patients, but there are still risks you should consider.

First, if there is a chance that you have gum disease, clear braces will only make it worse. So how does SmileCare tell simply from photographs whether or not you have gum disease? Pictures can only show so much. It takes x-rays and probing of the entire mouth to diagnose gum disease. There may be certain cases that could be diagnosed from photos, but if it isn’t a clear case it’s pretty easy to just give approval.

Another problem scenario could be when the teeth need to be shaved on the sides to make room for crowded teeth to straighten. They have you go to a dentist for this, but it will likely be someone you have never seen before. They may not be invested in your case, and it’s a tricky procedure.

And then there can be teeth that are supposed to rotate but don’t, or other things that could go wrong. So again, while most cases probably work out just fine, most dentists would not recommend it based on the reasons outlined above. There needs to be closer monitoring than just by phone and texted photos to be sure you get the result you desire. Hope this helps… good luck.

This blog is sponsored by AACD Accredited dentist, Dr. Stephen Doan. Find out more about the services he provides by visiting his La Jolla cosmetic dental website.

 

The “Grinch” is trying to spoil my Invisalign Christmas surprise

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I know it’s early to be thinking about Christmas, but I wanted to do something extra special for my wife this year. She has always wanted to try Invisalign and I think it would be a great confidence booster for her, but we’ve never had the money to do it. I think it would be awesome to give her Invisalign as surprise. But there’s a Grinch trying to steal my Christmas and it’s the dental office because they won’t let me purchase it in advance. They say she has to have an exam first, but that would totally blow my whole plan. Since they won’t get on board, I’ve been looking into mail-order options, but I’m not sure what to think because I have no idea of their quality or if they will even work. Any idea why the dentist is being such a stickler on this or if one of the mail-order choices is better than the other? — Matt

 

Matt,

What a beautiful and thoughtful gift idea! Unfortunately, exams are an essential part of determining the proper course of treatment, as well as what the final costs will be. The actual cost of Invisalign treatment will depend on

several things, including:

  • Amount and type of movement needed
  • Number of aligners required
  • Amount of diagnostic work (x-rays, etc.)
  • Patient compliance
  • Special circumstances
  • Insurance coverage
Clear Invisalign alingers

The cost of Invisalign treatment is dependent on many factors; only which can be determined by an examination.

Any of these things can contribute to the number of visits, total time in orthodontics, and the cost of materials. In other words, she really does need an exam in order to determine your costs. Moreover, some types of orthodontic work is better suited to other types of orthodontic appliances. The doctor can’t be sure what course of treatment is best until he does the exam and the two of them discuss it.

As for mail-order options, you need to be very leary of them because many are not legitimate and can even cause permanent damage to her teeth. More reliable, and safer, results will be created if you have the cosmetic work done under a dentist’s watchful eye and care.

Even if you can’t prepay the exact services, the office can probably ballpark what Invisalign will cost for you and may allow you to prepay it with a credit on your account. If, for some reason, your wife isn’t a candidate for the services you prepay, no doubt, they’ll provide a refund, but speak to them in advance, so they know what the money is for. You can also get a general estimate and set aside the funds on your own, and you’ll be prepared regardless.

This blog is sponsored by AACD Accredited dentist, Dr. Stephen Doan. Find out more about the services he provides by visiting his La Jolla cosmetic dental website.

Should my new smile cause so much pain?

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I know the old saying goes, “No pain, no gain.”  So, when I decided on some cosmetic dental work, I figured that a small amount of short-term pain would be worth the benefits of new, beautiful smile. Boy, was I wrong!

I went to Mexico to have lower crowns place as well as veneers on the front upper teeth. It was twelve crowns total and six veneers. While they look great, the problem is I am in so much pain. I’m not talking sore gums or tenderness, but rather extreme pain that radiates through my entire jaw. Plus, there’s one particular tooth that hurts so bad I can’t even bite down or chew soft foods like bread.  My dentist chalked it up to having so much work done at one time and basically said to take ibuprofen for a few weeks. As for the tooth, he said it may have high contact or need a root canal. I’ve been taking 800mg of ibuprofen around the clock, but I can’t keep doing it forever. Is this pain normal and if so, how much longer should it last?  — Mark

 

Mark,

Sorry to hear you’re dealing with so much pain. It’s definitely not normal! Most people can expect a day or two of tenderness and soreness after crowns and veneers, but if you’re having the pain you describe, there’s definitely something wrong.

Taking so much ibuprofen (3200 to 4000 mg per day) for an extended period of time can be damaging to your liver or your kidneys. If you check the maximum recommended dose, you’ll see that you are greatly exceeding it.

Here’s what you need to do first – find an American dentist and have them examine you immediately. Hopefully they can figure out what went wrong so you can get off of the ibuprofen. And if you do need that root canal, have it done here – not in Mexico – no matter how much money it could save you.

While most dentists in the U.S. are competent general dentists, only about half have the skills and capability to do a beautiful smile makeover. In Mexico, you are putting yourself at risk even  with basic general dental procedures, and if you’re lucky, you may find a small handful of dentists who can do good (not great) cosmetic procedures. Here’s to making some gains – without any more pain!

This blog is sponsored by AACD Accredited dentist, Dr. Stephen Doan. Find out more about the services he provides by visiting his La Jolla cosmetic dental website.

Almost 50 and considering Invisalign… am I too old?

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I am just a couple months shy of the big 5-0 and quite honestly, I feel like I am in the prime of my life! My husband and I have a very active social life and we love going to concerts and traveling. I’ve heard that 50 is the new 40, and I believe it’s true, but I’m noticing that there are some things I’d like to change about myself simply because they make me look older than I feel. One thing in particular is my smile. I’ve read about Invisalign braces and it says they are the best option for an adult. I’m afraid people will think I’m crazy because I am too old. Are there other alternatives for older people to fix their teeth? How does Invisalign differ from traditional braces? Does one hurt less/more than the other? I just want to be sure I am doing the right thing and acting my age! — Vera

 

Vera,

Age is just a number and I’d say you definitely have the right attitude! There’s really no age limit for Invisalign – it works for people of all ages. Traditional braces would probably work for you,  but in our experience, most adults prefer “invisible” braces because of how they look – and the ease of removing them for eating and brushing.

Invisalign is invisable compared to traditional braces

Invisalign aligners offer more comfort and convenience compared to metal braces

To answer your question about traditional braces vs. Invisalign: both move your teeth gradually. Metal braces typically require adjustments every month or so, and there is some pain/pressure involved – especially in the first day or so right after the adjustment. Aligners are changed out every two weeks, and because there are only minor differences from one set of aligners to the next, there’s less pressure. You also don’t have to deal with your gums getting cut or poked by wires and brackets. Overall, Invisalign is just a totally different experience.

Orthodontics does not age discriminate. It’s safe and effective as long as your overall dental health is good. Find a dentist or orthodontist that you like and trust, so you’ll feel comfortable talking with them about which one is right for you. Plus, you’ll be seeing that doctor quite frequently over the next year or so, and it’s important that you really like them.

This blog is sponsored by AACD Accredited dentist, Dr. Stephen Doan. Find out more about the services he provides by visiting his La Jolla cosmetic dental website.

I can’t believe I spent a fortune for “Chicklet” teeth!

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I have been self-conscience about my smile for many years and was so excited to finally be able to get veneers on eight of my top front teeth. Unfortunately, my mini-smile makeover wasn’t what I had hoped for. When I look in the mirror, all I see are big, white, bulky teeth. It honestly looks like I went and bought a pack of white Chicklets and glued them on. They are not natural-looking at all! When I told my dentist I was not happy, he pretty much blew me off and said I just need to get used to them. I don’t think I ever will. I just want my old teeth back. What can I do? — Madison

 

Madison,
It’s disappointing to spend so much money and then not get what you expected with your porcelain veneers. You should love them the second you look at them… not have to wait for them to “grow on you.”

There are possibly two reasons for your veneers looking and feeling big/bulky. 1) Your dentist used no-prep veneers or 2) he didn’t remove enough tooth structure when prepping your teeth. Veneers require artistry and skill on the dentist’s part — not to mention, a great lab as well as high-quality materials. That’s how to achieve porcelain veneers that look beautiful and natural. It sounds like maybe this dentist wasn’t the best choice for cosmetic procedures. Whether or not he is a cosmetic dentist, he needs to be concerned that you are not happy with your teeth. Many even stand behind their work with a Beautiful Smile Guarantee to ensure their patients are absolutely in love with their new smile.

It should be fairly simple to correct the issues you are having so that your smile looks amazing. Go back to him and explain how unhappy you are and see if he will work with you so that both of you are satisfied with the end result. Good luck!

This blog is sponsored by AACD Accredited dentist, Dr. Stephen Doan. Find out more about the services he provides by visiting his La Jolla cosmetic dental website.

 

I’m being sued for payment when it’s the dentist’s botched work!

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I was a thumb-sucker as a child and it messed up one of my front teeth to the point it was severely crooked. It didn’t bother me so much growing up, but once I became an adult, it really started to affect my self-confidence. So I decided to have it fixed. I went to my dentist and he suggested a crown.

A few weeks after getting the crown, I started noticing a lot of sensitivity to hot and cold. When I called about it, they said not to worry because that was normal for the first few months. Several more weeks later, it was hurting so bad one day that I ended up going to the ER! From there, my face swelled up and I missed work for a week because I was in so much pain. I ended up getting a second opinion and I was told the tooth was infected and a root canal and new crown would be the only option to fix it. I couldn’t believe it.  Evidently the crown was placed improperly and there was an “open margin.” I saw the x-ray and it is blatantly obvious that it was done wrong and the margin is huge.

To make matters worse, I called my original dentist and explained what was going on and asked about getting a refund since the crown was obviously placed wrong. I was told by the office staff that they had no liability in the situation once the crown was placed. I continued to ask why I should have to pay for a crown that failed due to his error and they wouldn’t budge. Having only paid for half of the procedure, I told her they would not get any more money from me. Today I got a notice saying they are taking me to court, so I filed a counter suit. My dentist’s lawyer basically told me if I drop the counter suit, they will relieve me of the debt I still owe. I refuse to do it because I believe my dentist is in the wrong.

How can he not stand behind his work? I missed work, endured days of horrible pain and have had at least ten appointments between the dentist, ER and doctor. AND I had to pay for a root canal and new crown! Am I out of line to expect a refund?  — Frank

 

Frank,
So sorry you have been through such an ordeal! Based on your information, it would be safe to say that your old dentist is liable because he violated the standard of care. I sounds like he neglected to check the margins for a good fit after seating the crown. An x-ray isn’t typically done, but all it takes is running the explorer around the margins to check for any opening. It’s good that you have the x-ray from your new dentist for documentation.

Unfortunately, in a situation like this, involving lawyers and even going to trial ends up costing more than the money you want back in a refund. It’s just not practical or cost-effective. However, there are some things you can do to pressure your dentist into refunding your money:

  1. Threaten to go to the dental board with your complaint. It’s not like a malpractice suit, but most dentists want to avoid that.
  2. Have your new dentist call and talk “dentist to dentist” and verify that there was a problem with the crown. You will need the expert opinion of a dentist – even better if it’s a cosmetic dentist — to back up any claim of negligence if you do go to trial.
  3. Have a lawyer write a threatening letter. Rather than pay for an entire malpractice case, just having a letter from an attorney can get the dentist to take your complaint more seriously.

Good luck! Hopefully you can put all of this behind you very soon.

This blog is sponsored by AACD Accredited dentist, Dr. Stephen Doan. Find out more about the services he provides by visiting his La Jolla cosmetic dental website.

Introducing Dr. Marie Moeckel

Dr. Doan is retiring and Dr. Moeckel is taking over the practice. 

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