porcelain crowns Archives

Is a Broken Porcelain Veneer a Dental Emergency?

Posted on August 30, 2024 by writeradmin.

I’m pretty frustrated with my dentist at the moment. I have eight porcelain veneers. Yesterday, I had one of my front porcelain veneers split horizontally and fall off. I was able to preserve the pieces and rushed to my dentist’s office. They said it was not a dental emergency, but I told them I was not leaving with one of my teeth off. They used a temporary glue and scheduled me to have a dental crown done to replace it. The temporary glue doesn’t feel like it was done right. The tooth feels a bit uncomfortable and you can see the crack. I have two questions. First, why doesn’t he consider this a dental emergency. Second, do I HAVE I get a dental crown? The tooth is healthy and I was hoping they could just replace the veneer itself.

Jen

Dear Jen,

I am sorry this happened to you. While it isn’t technically a dental emergency, I think most skilled cosmetic dentists would consider it an aesthetic emergency. They would give you a high priority in getting this fixed.

As for your second question, I would not let your dentist replace this with a dental crown. If nothing is wrong with your tooth, then there is no reason why he could not replace your porcelain veneer.

My guess is that the dentist does not have the knowledge and skills he needs in bonding chemistry. It’s best to remove all the old bonding material so that you are starting with a nice fresh surface. However, if the tooth is properly treated that is not completely necessary.

If your dentist doesn’t understand everything needed with porcelain veneers and is suggesting dental crowns, then my concern is he’s falling back on dental school training instead of cosmetic training. Those are very different. Almost always, dentists who suggest that you get a crown when you don’t actually need one is not a skilled cosmetic dentist.

This is important to know, because it is not an easy thing to match a single crown to porcelain veneers. If he’s not a skilled cosmetic dentist who truly cares about appearance related care, and he obviously isn’t based on how he treated your emergency, then you will not end up with a beautiful result.

My suggestion is that you find an expert cosmetic dentist and have them replace your porcelain veneer. Your dentist is obligated to share all your records with whichever dentist you chose, so you would not be starting over. The best cosmetic dentists are AACD accredited. That is different than just being a member of the organization. You want accreditation.

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

Can I Get Porcelain Veneers If I Have Two Dental Implants?

Posted on August 21, 2024 by writeradmin.

I hate the way my smile looks, and really want a smile makeover. A friend who had one, that turned out gorgeous, said they used porcelain veneers. I have two teeth that have been replaced with dental implants. Am I able to get porcelain veneers with that? Will they put the veneers over the crowns or will those teeth have to stay the same?

Andrea

Dear Andrea,

You can always get a smile makeover! Porcelain veneers, when done well, are the best way to get that gorgeous Hollywood smile. You don’t want the dentist to put the porcelain veneers over the crowns, though. The Lumineers company used to advertise something like this telling people it was a way to save their old, ugly crowns, but it was a bad idea for three reasons.

First, it takes just as much work to place veneers over crowns as it does to just remake the crowns. Second, veneers do not bond to porcelain nearly as well as they do to natural teeth. Third, you double your risk of failure because now both the underlying crown can fail as well as the insecure bond between veneer and crown.

What you want to do instead, is have porcelain veneers placed on all of the teeth you want veneered EXCEPT for the ones with dental implants. Then, have the implant crowns replaced to match the porcelain veneers.

Who Should Do My Smile Makeover?

You need to be very careful who you have do this for you. Smile makeovers are an advanced procedure which is not adequately taught in dental school. Your case is even more complicated because you are having to match crowns and veneers together.

What you need is an expert cosmetic dentist. A challenge you will face with this is that cosmetic dentistry is not a recognized specialty. Any general dentist can call themselves a cosmetic dentist. Unfortunately, as I mentioned earlier, dental school isn’t enough to get really skilled in cosmetic procedures. In order to develop the artistry and expertise necessary, a dentist would have to invest significant time and money in post-doctoral training. Few do this.

So, how can you find the ones who have? One of the easiest ways to do this is to go to the website for the American Academy of Cosmetic Dentistry (AACD.com). They have an accreditation program. In order for a dentist to get AACD accredited, they have to pass stringent exams that shows their technical expertise. Additionally, they have to demonstrate their artistry before a board of examiners on a large number of cosmetic cases. Very few dentists get through this. In fact, I would say those that do are in the top 1-3% of cosmetic dentists in the world.

If I were in your place I would look for an AACD accredited dentist. On the AACD website is a find a dentist link. Just make sure that you check the box that shows you’re looking for someone who is accredited.

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

Best Dentist for a Recovering Bulimic?

Posted on December 14, 2022 by writeradmin.

I am bulimic but am in therapy for it. I am doing a bit better and am slowly getting my life back together. One of the things that really bothers me is the consequences my teeth have faced because of my actions. My therapist suggested a full smile makeover and I have some money that has been donated to me for the process, so money will not be a problem. What would be the best dentist for me? A cosmetic dentist? A crown specialist? Are there dentists who specialize in teeth damaged from my situation? I’m not sure which way to go and I want to do it right.

CeeCee

Dear CeeCee,

Congratulations on your progressing recovery. It sounds like you are doing well if your therapist is suggesting you get your teeth worked on. It is also exciting that you have someone who donated the funding for your procedure. I’m thrilled for you. While there is not a dentist who specializes in eating disorders, there are highly qualified cosmetic dentists that can give you a beautiful smile.

The one thing you need to be careful about is the dentist you choose. Most patients do not know that cosmetic dentistry is not a recognized specialty. Any general dentist can call themselves a cosmetic dentist regardless of the amount of training they’ve received. Smile makeovers are not taught in dental school, so the dentist would have to invest in post-doctoral training.

In your place, I would look for a dentist who has been accredited with the American Academy of Cosmetic Dentistry. In order to be AACD accredited a dentist has to pass stringent exams as well as demonstrate their artistry and technical ability on a large number of cases. They are hands down the best cosmetic dentists in the country.

Because of your bulimia, you will probably need a combination of porcelain veneers and crowns. But, be assured, you will be in good hands.

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

Her Dentist is Suggesting a Massive Overtreatment

Posted on January 30, 2021 by writeradmin.

I already have one dental crown and three porcelain veneers. The dental crown has a problem with a black line showing at the gumline and the porcelain veneers are starting to show their age. My dentist has suggesting crowning every tooth because it can make my teeth look whiter as well. They’re showing some aging as well. I want a pretty smile, but I am worried about that gray line thing. Having it on one tooth is bad enough. What if all the crowns get one?

Lindsey

Dear Lindsey,

I am glad you wrote. The answer to your question is an easy one, but there is a much more serious issue here that needs to be addressed. If I understand correctly, the only reason your dentist wants to place crowns on every one of your teeth is because those teeth need whitening? Why not just do teeth whitening? Crowning the teeth to whiten them is a massive overtreatment. Dental crowns would require grinding down those teeth. If they are healthy, you would not want to remove their structure.

There is another issue here. The procedure for crowning every tooth is called a full-mouth reconstruction. It is one of the most advanced procedures in dentistry. So why is your dentist suggesting that instead of teeth whitening? This is just a guess, but teeth whitening will bring your dentist a few hundred dollars, while a full-mouth reconstruction would bring him in upwards of $30,000. I’d hate to think your dentist is milking you for fees, but it is either that or he’s using you as a guinea pig to practice a difficult procedure.

This is dangerous for you. If the procedure isn’t done properly, by someone with advanced training in reconstructive dentistry. Without that, you are very likely to end up with TMJ Disorder and a lifetime of jaw pain and migraines.

The Better Treatment Option for You

My suggestion is you get as far away from this dentist as possible. So, what suggestion do I have for your procedure? I’d like you to take these steps:

First, have teeth whitening done. This will get all your teeth the color you will want for the replacement cosmetic work.
Second, replace the dental crown and porcelain veneers.
You want to replace the porcelain veneers with veneers. That is because you do not want to remove any more tooth structure than necessary.
With the dental crown, you want to make certain that whatever dentist you end up with, places an all-porcelain crown to replace your old one. The reason for the gray line at your gumline is because you currently have a metal-based crown. These always end up with that gray line.

Who Should Do This Work?

For both the porcelain veneers and the porcelain crown, you will want an expert cosmetic dentist in order to ensure you end up with beautiful results. My first choice for any type of cosmetic work would be to get an AACD accredited dentist. These are the top cosmetic dentists in the country.

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

My Porcelain Veneers Keep Popping Off

Posted on October 29, 2020 by writeradmin.

I’ve been crying for the last year. I had a decent smile that just needed an upgrade. I had some chipped teeth and the color was showing its age. I opted for eight porcelain veneers. The problem is they keep falling off at the rate of one to two every couple of weeks. Combine that with the fact that the dentist ground my natural teeth down to tiny dark nubs and you can see why I don’t like going around without my veneers. She always glues them back on but it is getting where I just can’t go anywhere without fear. The holidays are coming up and I am wondering if there’s any way to fix this. She blames my grinding but I wear a mouthguard for that. Is this normal? I don’t know if this information help but the ones that fall off the most have a ledge on their backs.

Penny

Dear Penny,

No, not only is this not normal, but I also believe it is malpractice. There are a couple of major things wrong here. First, you said you opted for porcelain veneers. Your description tells me that what your dentist actually gave you are porcelain crowns. This is a gross misrepresentation. Not to mention the unnecessary damage she’s done to your teeth.

Porcelain Veneer Tooth Preparation

When your teeth are prepared for porcelain veneers, hardly any of the surface tooth structure is removed.

Looking at the picture on the left you can see the depth limiting tool most dentists will use to make sure they only remove what is necessary. For porcelain veneers, only about half a millimeter is removed from the tooth structure. Your description goes way beyond that. Plus, veneers don’t have backs to them. They only go over the front of your teeth and hug the sides just a bit. Placing porcelain veneers, along with doing smile makeovers, isn’t taught in dental school It is up to the dentist to invest in that type of post-doctoral training. It doesn’t sound like your dentist did.

Here is an example of typical tooth preparation for a porcelain crown. I’m guessing your dentist went even deeper because of the lack of retention.

While placing porcelain veneers isn’t taught in dental school, dental crowns are supposed to be a basic standard for dental care. The fact that she can’t even keep those in, gives me serious doubts about her basic abilities as a dentist.

Because she gave your porcelain crowns instead of veneers, she not only violated ethics by doing a different procedure than you agreed to, but she unnecessarily removed tooth structure, which weakens your teeth and puts them at risk of needing a root canal treatment or even breaking.

Where to Go From Here

I think your dentist needs to pay for this to be done properly by a qualified dentist. The first thing I want you to do is see if there is an AACD accredited dentist in your area. Those are the top cosmetic dentists in the country. They’ll be able to create a stunning smile for you, even with porcelain crowns. Then, approach your dentist about this issue. If she gives you trouble let her know it is that or you’ll have to go to court, where she’ll not only have to pay for the repairs, but will likely have to pay other types of compensation as well. I’m fairly certain her insurance company will tell her to bite the bullet and pay to get this fixed. Make sure that YOU pick the dentist, not her.

If you can’t find an AACD accredited dentist in your area, your next stop can be mynewsmile.com. This site prescreens cosmetic dentists for their technical skill as well as their artistry. If they’re listed, they’re skilled. Many are also either accredited or on their way to accreditation. Most of them even have a beautiful smile guarantee.

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

Porcelain Veneers and Teeth Grinding

Posted on July 26, 2018 by writeradmin.

I told my dentist I was ready to get porcelain veneers. I’ve been saving up for years. Now that I have enough, he tells me I’m not a good candidate because I grind my teeth. He said that’s bad for porcelain veneers and I should get crowns instead. I’m really disappointed. Is there any way around this? I don’t think crowns will be as pretty.

Karyn

Dear Karyn,

There are a few problems with what your dentist told you. Let’s address your teeth grinding first. It appears as if your dentist knows you grind your teeth but has taken no steps to protect you from the consequences. It’s not likely you could stop it on your own. Most people do it in their sleep and have zero knowledge of even doing it.

You’re in need of a mouth guard. The same damage he was saying would happen to your porcelain veneers is currently happening to your natural teeth. For that matter, it will also destroy the dental crowns, just like anything else.

Why Your Dentist is Saying No to Your Porcelain Veneers

My guess is your dentist doesn’t feel qualified to place porcelain veneers. He likely hasn’t done much (if any) of his continued education in cosmetic procedures. I wouldn’t recommend you do any form of a smile makeover with him, especially not porcelain crowns. First, you’d be grinding down healthy tooth structure. Second, he’ll probably do a horrible job. You’d have functional crowns but your smile won’t be the gorgeous smile you’re hoping for.

Even worse, what he’s suggesting is a full mouth reconstruction. it takes some advanced knowledge of how your bite fits together. If he doesn’t get it right, and he probably won’t, he could mess your bite up so horribly that you’re in pain for years with TMJ Disorder. You’d have to live with jaw pain, migraines, and sometimes you might not even be able to eat.

Finding the Right Dentist to Place Your Porcelain Veneers

What you need is to find an AACD accredited dentist. That’s different than membership. Those who reach accreditation have to pass stringent oral and written exams as well as demonstrate their artistry on a large number of cases they’ve personally performed. It’s not an easy achievement. They’re among the best cosmetic dentists in the country. They will give you an absolutely gorgeous smile. In fact, most of them have a beautiful smile guarantee.

This blog is brought to you by Dr. Fred Arnold.

Emergency Dentist Won’t Repair Crown

Posted on September 5, 2017 by writeradmin.

I had a dental crown made just four months ago. It’s given me all sorts of problems and I’ve been back to the dentist at least twice a month to have it adjusted since then. Though we never got it feeling good, I finally gave up and decided I’d just have to live with it. Yesterday, a big chunk of it broke off. I needed to get it taken care of and just wasn’t sure I trusted the dentist who did the crown anymore so I went to an emergency dentist. She did squeeze me in but said the crown has to be replaced. I just wanted it repaired. I’m not sure I want to spend all that money all over again. Shouldn’t a crown last longer than this? Why won’t the emergency dentist repair it instead of just expect me to purchase another one? Also, I never liked how the crown looked. Is there a way if I have to get a new crown that I could get one that looks more natural?

Amber S.

Dear Amber,

I can certainly understand why you don’t want to pay for another crown, especially after just four months! It’s very possible your emergency dentist suggested that simply because the crown is too damaged to be repaired. I also understand why you weren’t too keen on going back to a dentist that couldn’t seem to get your crown correct. I’m suspicious that possibly the poor placement of the crown led to its breaking.

At a minimum, a dental crown should last 5 years. Yours only made it four months and that’s with it never feeling comfortable. I’d say you were definitely entitled to a full refund. Then, you can have the crown re-done without extra cost. Plus, you can choose a different dentist.

If you liked the emergency dentist, you could let her do the new crown. Or, you could start from scratch with another dentist. It’s the dentist you choose which will make the biggest difference in how the crown looks.

You’ll want a skilled cosmetic dentist to do the work. You should also make sure you like the crown before it is permanently bonded on. Any decent cosmetic dentist would have no problem with that.

You can look for a dentist who is AACD accredited or check the mynewsmile.com website. They recommend skilled cosmetic dentists in your area. You just input your zip code.

This blog is brought to you by Dr. Fred Arnold.