January 2023 - Arnold Dental

I don’t know what to do about my smile makeover. I went in telling my dentist I wanted to get a smile makeover and he seemed excited about it because he’d just finished training with Lumineers. I went ahead and got them but now my smile looks chalky and fake. It almost looks like I’ve glued chicklets to my front teeth. I mentioned this to my dentist and he said it is because I am not used to having a pretty smile and if I give it time I will love it. It hasn’t grown on me and now I seemed to have developed a lisp. Is there anything I can do about this?

Belinda

Dear Belinda,

I am so sorry you are having to deal with this after investing your money in what you hoped would be a beautiful smile makeover. As you have unfortunately discovered the hard way, cosmetic dentistry is not a recognized specialty. This means any general dentist can call themselves a cosmetic dentist and do cosmetic procedures. However, that doesn’t mean they have the technical knowledge or the skill.

When it comes to the dental board, if your work is functional that means your dentist has met the standard of care. This is unfortunate for patients who have cosmetic results they are not happy with. In those cases, you have to try and appeal to your dentist’s better nature and hope that he cares about how his patients feel about the results.

A true cosmetic dentist would bond your porcelain veneers on with a temporary try-in paste and then allow you to look at them in a variety of lightings to make sure you are absolutely thrilled with your new smile. If there was anything you didn’t like, not matter how minor, they would go back to the lab to be redone. It sounds like you were never given this opportunity.

The Lumineers brand is often marketed to inexperienced cosmetic dentists as being easy to place because they are considered ultra-thin or no-prep. The problem with that is it will make most smiles look bulky without some tooth preparation. This seems to be the case with your smile.

While I would start by appealing to your dentist’s pride in his work and care about patient satisfaction, you actually have another issue working in your favor. The way he placed the porcelain veneers has caused you to develop a lisp, which means they are not truly function. You have the right to have a refund so that you can go to a true cosmetic dentist to have your smile makeover done correctly.

Once you secure your refund, I would look for an AACD accredited cosmetic dentist. Cosmetic dentists who have earned accreditation are the top in their field and can give you a stunning smile makeover. One you’ll be proud to share with the world.

This blog is brought to you by Lexington, KY Cosmetic Dentist Dr. Fred Arnold.

Admittedly, I haven’t been to my dentist in a while. However, when I went back I expected him to give me the treatments I needed. Instead, I got a lecture and a denial. I’ve lost a couple of teeth recently and wanted to get dental implants to replace them. He told me because I am a smoker he can’t give them to me. I know other smokers and they have dental implants. I told him that and then he blamed my gums. I think this dentist just doesn’t like me. Can he deny me treatment like that? I’m sure I can find another dentist, but I’m just mad now.

Ben

Dear Ben,

I can tell you are frustrated and I’m trying to put the full picture together just based on your statement. It sounds like this is a combination of issues. You said your dentist blamed your smoking and then when you gave him a counterargument, he mentioned your gums. Granted, I was not there and didn’t hear the whole conversation, but there is a connection between smoking and your gums. I’ll go over that with you and then answer your question in case that isn’t what he meant and your first impression is right.

Smoking and Dental Implants

The nicotine in cigarettes restricts the blood flow in your gums. In some cases, smaller blood vessels will completely close off. The problem with this loss of blood flow is it reduces the oxygen to your oral tissues. When dental implants are placed in your jawbone, it is important that the bone integrates with the implant in order for it to remain secure. This process can take months. With restricted blood and oxygen flow, the healing process necessary for this to happen is slowed down dramatically and in some cases never happens at all, leading to dental implant failure.

A second issue is what that restricted blood flow does to your gums. One of the main symptoms of gum disease is inflamed and/or bleeding gums. Unfortunately, nicotine masks those symptoms, which means you can have gum disease and not even know it. Left untreated, it turns into advanced periodontal disease and you can even start losing teeth as a result.

It is possible you have reached this stage. You mentioned you had not been to the dentist in a while so you may not have known that you were dealing with gum disease. Obviously, I have not examined you and do not know if this was what your dentist was referring to, but it makes sense. Does that mean you cannot get dental implants? It depends.

Dental Implant Options as a Smoker

If the issue is just you are a smoker, but your gums are healthy, then you could go forward with the dental implants as long as you acknowledge the risks and that you have a higher likelihood of dental implant failure.
If you have gum disease you do need to address that before moving forward with dental implants. Otherwise, you will continue to lose teeth and your dental implants will fail. There are temporary replacements you can get while you get your gums healthy.
You may want to consider quitting smoking, at least temporarily, to give yourself the best chance of success. Start a few weeks before the surgery and continue until your healing is complete.
Look at alternative tooth replacements such as a dental bridge.

I hope this helps.
This blog is brought to you by Lexington, KY Cosmetic Dentist Dr. Fred Arnold.

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Archives for January 2023

Smoking and Dental Implants

Dental Implant Options as a Smoker