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My Porcelain Veneer Lost It’s Shine

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My new porcelain veneers are looking good, all except for one. This one had a small divot. I called my dentist about it and he agreed to fix it. When I went in for the repair, he ended up buffing it out. Now the tooth is uniform, but it no longer shines like the rest of them. Am I being too picky?

Evelyn

Dear Evelyn,

A single porcelain veneer being placed on a tooth

The glaze on porcelain veneers is essential.

No, you are not being too picky. When your dentist buffed out your divot, he simultaneously removed the glaze from that porcelain veneer. It sounds like your dentist forgot to re-polish it when he was done. Though it’s very likely he just doesn’t know how so he skipped that and hoped you wouldn’t notice. Unfortunately, without the glaze on your porcelain veneers, they will begin to pick up stains quickly. The glaze is essential to keep your veneers beautiful and stain free.

Unlike natural tooth structure, you can’t just whiten porcelain veneers. Only natural teeth respond to teeth whitening. The veneer will stay the same.

The Correct Way to Polish Porcelain Veneers

There is a way to polish a porcelain veneer in a way that will get it very close to its original shine. It requires your dentist have special equipment and some knowledge. He’ll need diamond polishing instruments and polishing paste, as well as an ultra-fine diamond polishing paste to end with.

If our dentist is willing to try this, tell him I recommend Brasseler’s Dialite porcelain polishing system. This should be done free of charge to you because he is the one who damaged the veneer. Plus, he’s developing a new skill on you. If he’s not willing to do that, then he’ll need to replace the damaged veneer.

This blog is brought to you by Grosse Pointe Woods Dentist Dr. Theodore Hadgis.

The Problem of a Collapsed Bite

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I have great difficulty in speaking certain letters, plus my smile is embarrassing. It is almost impossible to see my teeth, even when I smile. You can’t see them at all when my mouth is in repose. I don’t know what is causing it but I want to fix it. I also have tremendous jaw pain. The only time I get any relief is when I wear my nightguard. It is also the closest I come to having “teeth” you can see. Is there anything I can do to fix my smile? Will porcelain veneers be a good solution?

Carl

Dear Carl,

Man grabbing the side of his jaw in obvious pain and in need of a dentist

I’m glad I’m getting to deal with this question now instead of after a dentist had a chance to play around with this and cause severe problems. It sounds like what you’re dealing with is a collapsed bite along with some pretty severe TMJ Disorder complications. Porcelain veneers will be too thin to build up your bite. What you need is a full-mouth reconstruction with dental crowns which can build up the bite, done by a dentist who has had extensive TMJ training as well as expertise in cosmetic dentistry to make it look beautiful as well.

The best postdoctoral schools for this type of training are:

  • The Las Vegas Institute for Advanced Dental Studies
  • The Pankey Institute
  • The Dawson Academy

I’m going to highly suggest you find a dentist who has thoroughly studied at one of these institutions. Generally, an AACD accredited dentist will have the qualifications you need.

Additionally, the dentist want to build up the reconstruction reversibly. What I mean by that is your dentist will need to do it first using nothing but temporary restorations. It will need to continue that way until you are certain things are correctly done. That means your restorations are occluding well, they feel completely comfortable, you can speak properly, and the teeth are visible when you smile.

Once that is achieved, they can make the permanent restorations out of the temporary ones.

This blog is brought to you by Grosse Pointe Dentist Dr. Theodore Hadgis.

Dentist or Oral Surgeon to Remove Teeth?

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I haven’t been to the dentist in years, which has left me with many broken and decaying teeth. I’m thinking of getting them removed and then getting dentures. Should I go to an oral surgeon or a dentist first for that?

Bruce

Dear Bruce,

Woman asleep in dental chair from dental sedation

If you’re getting dentures, it is always best to go to a dentist who does the extractions and the dentures. This will eliminate any communication issues. Pre-denture surgery isn’t complicated, but you want a dentist who does it normally and not as a special case for you. You can find that out by calling their office and asking them how they normally handle someone who wants full dentures.

You have dental anxiety. That’s not news to you, I’m sure. However, to make this less traumatic for you, I’m going to suggest in addition to what I mentioned above that you also look for a dentist who does sleep dentistry. This way there will be no anxiety and no pain for you.

Consider Sedation Dentistry before Giving Up on Your Teeth

There are consequences to removing all your teeth for complete removable dentures. The most serious is the inevitability of facial collapse. I’m going to recommend, before you settle on dentures, that you first try to save as many teeth as possible. This will be a huge benefit to you in the long run.

cu sil partial dentureOne thing you can do is get this Cu Sil Partial denture. It leaves room for your natural teeth, then if a tooth happens to need extraction at a later date it is fairly easy to pop a new false tooth in there.

The more teeth you save, the better.

You’ll find having dental sedation allows you to get more work done in one sitting. And, like the denture preparation extractions, it will allow you to have it done without anxiety or pain.

Many patients who have suffered from dental anxiety their whole lives, find this changes the way they view the dentist. For the first time, they’re able to get the regular oral health care they need.

This blog is brought to you by Grosse Pointe Woods Dentist Dr. Theodore Hadgis.

Porcelain Veneers are Gray

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I’m about to cry. I paid a fortune to get a beautiful smile with porcelain veneers and I’ve got anything but. I have four veneers and three different colored teeth. My original teeth are yellowish. Then, there are the four porcelain veneers. The two front teeth were fine at first, but now have turned a grayish color and it hasn’t even been that long since they were placed. The other two have stayed their original color but one of them is crooked. She (my dentist) said she’s going to fix that one. Great! But, when I mentioned the graying teeth she said she’d thicken those veneers for me. I’m worried about that. Won’t my teeth look even more different from one another? What do I do?

Elaine

Dear Elaine,

A single porcelain veneer being placed on a tooth

The biggest thing you are up against here is a dentist who is in over her head. Doing smile makeovers aren’t taught in dental school. I’m sure she had good intentions, but to be skilled in these procedures takes years of post-doctoral training and practice. She doesn’t seem to have invested in this training. This is obvious to me from a few factors in how she handled your porcelain veneers case.

Let’s start with the visible original teeth. You said they’re yellowish, which I’m assuming is their regular color. You obviously want any teeth which are visible when you smile to match the color of your porcelain veneers otherwise your smile will look ridiculous.

To accomplish this, some dentists will put six to ten veneers, depending on the width of the patient’s smile. However, not every person can afford that. A second option is to still get four veneers, but whiten your teeth before having the porcelain veneers done. At least that way, they’ll be the same color and will blend much better. This can be done in one appointment with Zoom Whitening.

Next, you said one of them is crooked. It seems to me that you had to point that out to her and now she’s going to fix it. Why didn’t your dentist notice one was crooked and fix it on the spot? Why send you home with a crooked veneer? Was she just hoping you wouldn’t notice?

The graying teeth could be dangerous. Whatever you do, DON’T allow her to add bulk to your veneers. If it were underlying color showing through, they wouldn’t have looked fine at first. Even if it was underlying color, adding bulk is the wrong solution. In that case, you prepare the tooth slightly deeper and then add an opaquer to make them the same depth and equal in color.

Yours weren’t originally gray looking, but turned that way. What I think you have going on here is some microleakage. It sounds to me as if the bonding isn’t strong and some things are getting between your veneer and your natural teeth. This is going to lead to decay.

Fixing a Disastrous Smile Makeover

I don’t think your dentist can handle this. I’m going to suggest you ask for a refund and go to a true cosmetic dentist. Go to aacd.com and see if there is an accredited cosmetic dentist in a reasonable distance from you. The accredited part is important. These are the top cosmetic dentists in their field and can give you a stunning smile.

If you can’t find one at a reasonable distance, you can also try mynewsmile.com This site doesn’t allow dentists to just pay to be listed. Instead, they check the cosmetic training of the dentists, as well as ask to see some of their work to ensure they achieve beautiful results.

The dentists they list are highly skilled with an artistic eye and can also give you a gorgeous smile you’ll be proud to share.

Best of luck to you!
This blog is brought to you by Grosse Pointe Woods Dentist Dr. Theodore Hadgis.

If My Bite is Off Do I Have to Have Crowns?

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I was at my dentist for a regular checkup. He told me my bite was off and wants to crown every tooth. I know I needed some fillings after my braces were taken off, but a crown on every tooth seems extreme. Plus, my braces have only been gone for a few years. How off could my bite really be?

Amanda

Dear Amanda,

Diagram of TMJ

In extreme TMJ cases a full-mouth recontruction is necessary

Something seems fishy to me here. Crowning every tooth is called a full-mouth reconstruction. There are times when a full-mouth reconstruction is necessary, but that is generally reserved for extreme cases of TMJ Disorder. I don’t think that’s what you have. How can I say that without examining you?

Your dentist gave no specifics and said your bite is “off”? What does that mean? Everyone’s bite is off to one degree or another. That doesn’t mean they have severe problems or even any problems. If your bite was off enough to require such a drastic treatment, the complaint would come from the patient, not the dentist.

I’m going to recommend you get a second opinion from a dentist who’s invested a lot of time and training for TMJ Disorder. Look for a dentist who has studied at the Las Vegas Institute of Advanced Dental Studies or the Pankey Institute. These institutions are well known for their TMJ training.

If Your Bite Does Require a Full-Mouth Reconstruction

Let’s say the second opinion dentist tells you your dentist was right and does need this invasive of a treatment. In that case, I want you to look for two qualifications in the dentist who actually performs the procedure. The first, we’ve already discussed. They need significant TMJ training.

However, getting the bite correct isn’t enough. Your smile is the first thing people notice about you. You’ll want your first impression to be one of a beautiful smile. Because of that, it will require an artistic cosmetic dentist. Ideally, you’ll want a dentist who is accredited by the American Academy of Cosmetic Dentistry. AACD accredited dentists are the best cosmetic dentists in the country and can make you a stunning smile.

Though it’s a tall order to find a dentist with both of those qualifications, I wouldn’t settle for anything less if you really do need to get a dental crown on every tooth.

This blog is brought to you by Grosse Pointe Woods Dentist Dr. Theodore Hadgis.

Helping My Son Through Dental Trauma

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I’m a bit of a wreck and don’t know how to help my son. He’s totally terrified to go back to the dentist and after what he experienced, I can’t say I blame him. We were at his checkup and the dentist noticed a cavity. He offered to fill it then because he had time in his schedule. I felt that was convenient so I agreed. Then, he asked me to leave the room. I was a little hesitant because I’d always been there for my son’s appointments and it was his first cavity but agreed. The assistant explained to me that some children do better when their parents aren’t in the room. I didn’t feel right about it but left. A few minutes later I hear my son screaming. He’s no longer in the dental chair and the dentist is screaming at him. I grabbed my son and held him but he couldn’t do anything but cry. The dentist left without a word and his assistant told me the son bit down while the dentist was drilling. We left because I didn’t want him anywhere near my son. I know he’ll need a crown now, but he’s so afraid of the dentist I don’t think he’ll cooperate. Do you have any advice?

Karen

Dear Karen,

person cowering behind a chair

There’s a Solution to Dental Anxiety

Reading between the lines I feel you’re blaming yourself for this. Don’t. You couldn’t have known what was going to happen when you left the room. You trusted your son with a medical professional and everything should have been fine. With regard to your son biting down on the drill. I have no idea why your dentist wasn’t using a prop on your son. This is a basic precaution that completely eliminates the risk of a patient biting down.

In addition, yelling at your son was unacceptable. Not only is it unprofessional, but he was dealing with a frightened child. That will only make the situation worse.

Getting Back to the Dentist after Dental Trauma

I’m going to suggest you see a dentist who uses sedation for your son. This will allow him to get treatment without anxiety and without pain. There are two levels of dental sedation available. The first is nitrous oxide. It uses a simple gas your son will breathe in with a nosepiece. This is best for patients with mild anxiety. Once the procedure is done, they will switch the gas to oxygen and he will be good to get on with his day within minutes.

It may be all your son needs. However, given your son’s experience, he may need something stronger for this first procedure back.

If that is the case, I’m going to suggest oral conscious sedation. This is a pill they can give your son before his appointment. It will completely relax him. When adults take it they’re required to have someone drive them to and from their appointment as well as stay with them afterward until they are lucid again.

Because he bit down, it is very likely he’ll need a dental crown now instead of a filling. Typically, children receive stainless steel crowns. This is because they usually receive crowns on molars. However, if it is on a visible tooth you may want to invest in a porcelain crown so he doesn’t feel like his smile is embarrassing. I hope this helps.

This blog is brought to you by Grosse Pointe Woods Dentist Dr. Theodore Hadgis.

Cosmetic Dentistry Versus Facelift

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My upper lip has lowered over the years and now it is difficult to see my teeth when I smile, if you can see them at all. It really bothers me. I’ve done some research on having my lip lifted. It can be done, but it is challenging, not all cosmetic surgeons will even do the procedure, and there are scarring issues. I’m not sure I want to do that if there is a better option. I asked my dentist if I can approach this from the inside by having some type of cosmetic work to make the teeth longer so they show when I smile. He wasn’t sure because he doesn’t do cosmetic work. Is this do-able or do I need to go for the lip lift?

Celine

Dear Celine,

Grosse Pointe Porcelain Veneers

Porcelain veneer

I’m glad you wrote because this is very do-able. I’m going to suggest you have a smile makeover done with porcelain veneers. Not only can these make your teeth look longer, but they can completely remake your smile, including the shape, size, and color. Celebrities aren’t born with those perfect stunning smiles, they have this exact type of smile makeover done.

The picture above shows a single porcelain veneer. These are tiny wafers of porcelain which are designed to the shape and color which best flatters your face and smile, all while giving you the smile of your dreams. I’m sure you’ve already figured out that your dentist won’t be the best one to provide this procedure for you.

I’m sure he is a fine family dentist, but doing smile makeovers isn’t taught in dental school. It requires the dentist to invest in post-doctoral training to learn both the technical and artistic skills requisite to creating stunning smiles.

Finding an Expert Cosmetic Dentist

There isn’t a recognized specialty in cosmetic dentistry, therefore any dentist can call themselves a cosmetic dentist. This makes it tricky for the patients to know who has the real skills and who doesn’t. To help patients with that problem along with aiding dentists in getting the skills necessary, the American Academy of Cosmetic Dentistry began an accreditation program.

Dentists who are AACD Accredited (which is different than just being a member) can provide you with a smile you’ll be proud of for the rest of your life.

One thing I’d like to suggest is you get your bottom teeth whitened so that they won’t look drastically different than your new smile on your top arch. You can do that gradually with at-home teeth whitening or in one appointment with Zoom Whitening.

This blog is brought to you by Grosse Pointe Woods Dentist Dr. Theodore Hadgis.

Do I Have TMJ?

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Lately, I’ve been having some pretty bad pain in my jaw and it is sometimes popping when I chew. I’m worried I have TMJ. Is there a way to know or is there something else wrong? If I do have TMJ, what’s the solution?

Kathy

Dear Kathy,

Jaw pain can be a sign of TMJ

It does sound like you have a symptom of TMJ Disorder. I’m going to list out some more symptoms because all of these different signs put together can help the dentist know what is the underlying cause of your TMJ disorder in able to find the most conservative solution for you.

Symptoms of TMJ Disorder

  • popping when chewing
  • Your jaw locks up
  • migraines, especially in the morning
  • pain in your jaw

Often, people develop TMJ from teeth grinding or clenching. They don’t even realize they are doing it because it more often happens at night while they are sleeping.

Some evidence if you are doing this is tooth pain (unrelated to decay) and worn down teeth. If you see a dentist regularly, they should be warning you if they see your teeth showing signs of wear.

Other times TMJ disorder is caused by a misaligned bite which has to be repaired by orthodontics, such as Invisalign.

Finding a TMJ Dentist

There isn’t a recognized specialty in TMJ so any general dentist can call themselves a TMJ Dentist. However, you want to make sure they have the necessary training to diagnose and treat you correctly. It does take an investment in post-doctoral training. There isn’t enough training for it in general dental school.

For instance, if you look at Dr. Hadgis’ TMJ Specialist page, you can see he did extensive training with the Las Vegas Institute of Advanced Dental Studies (LVI). There are other good schools as well, such as The Dawson Academy and the Kois Center.

It’s imperative they have invested in this. We’ve seen too many horror stories where dentists who didn’t have the requisite training, ended up destroying someone’s bite, causing them to need a full-mouth reconstruction.

This blog is brought to you by Grosse Pointe Dentist Dr. Theodore Hadgis.

Dental Sedation Fears After Sexual Assault

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I need to have my wisdom teeth removed but really want to use dental sedation to have it done. The problem which is causing me some mild terror about that is I have recently been sexually assaulted by someone drugging me. I couldn’t do anything about it. I was essentially paralyzed. I’m terrified dental sedation is going to feel the same way and I’ll have a panic attack. I’d also prefer to have my mom with me just as an extra precaution.

Chloe

Dear Cloe,

Woman asleep in dental chair from dental sedation

First, let me express how sorry I am that this happened to you. It’s horrific the things we humans do to one another sometimes. I want to assure you that dental sedation isn’t anything like the drug you were assaulted with. Instead of paralyzing you, it just makes you very relaxed and sleepy. However, you are still able to communicate and move.

While some sedation dentists may balk at having anyone additional in the operatory, I’m sure if you explained your situation they’d allow your mother to be in there with you.

With this sedation, you’ll need your mother to drive you to and from your appointment anyway, so she might as well stay in there with you. If the dentist has a problem with this, that will be the time to find another dentist. Anyone with an ounce of empathy would understand your feelings.

The Ideal Time for Wisdom Teeth Extractions

When you have impacted wisdom teeth, it’s safest to remove them in your late teens to early twenties. When you wait, the bone gets more calcified making it harder to remove. This also increases the risk of complications.

A second danger is for the impacted wisdom teeth to end up infected. This is considered a dental emergency and will need to be taken care of right away.

That will give you less control over who treats you and the circumstances in which the procedure is done. It will be much better for you both physically and emotionally to be proactive and get this taken care of as soon as possible.

This blog is brought to you by Grosse Pointe Woods Dentist Dr. Theodore Hadgis.

6 Keys to Getting Porcelain Veneers That You’ll Love

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I am considering porcelain veneers. It is their permanency that is making me nervous, though. They are bonded to my teeth and I won’t be able to just take them off. What if I don’t like them? I visited one dentist who showed me digital before and after pictures of myself, but what if the real thing looks bad? What options will I have? – Jules

Jules – Before a true cosmetic dentist bonds your porcelain veneers to your teeth, you will be given plenty of opportunities to say what you do or don’t like about your smile makeover.

Choosing a Dentist for Porcelain Veneers

Grosse Pointe Porcelain Veneers

Porcelain veneer

Much of the success of your smile makeover is dependent on the artistic ability and experience of the dentist. We cannot stress enough the importance of finding a skilled cosmetic dentist—preferably an accredited cosmetic dentist—for a smile makeover with porcelain veneers.

The results will be long-lasting and amazing. Otherwise, you can end up with veneers that you don’t like. After veneers are bonded to your teeth, the only way to improve your smile is to have the current veneers removed and replaced with new ones.

What Do Cosmetic Dentists Do Differently?

Experienced cosmetic dentists don’t take shortcuts. They closely adhere to a series of steps that ensure you’ll love your smile makeover with porcelain veneers.

  1. Communication – When you schedule a consultation with a cosmetic dentist—and we suggest that you schedule with two different dentists—you and the dentist will discuss your smile goals. The dentist will quickly look at your teeth and let you know if porcelain veneers might be an option. Of course, an examination will be needed to make the final determination.
  2. Smile gallery – An experienced cosmetic dentist will be able to show you many photos of his or her own patients for whom porcelain veneers were used to provide a smile makeover. The photos will help you make decisions about your own smile design.
  3. Digital model – You’ll be shown a virtual model of your smile. You will be invited to say what you do or don’t like about the virtual model, and changes will be made accordingly.
  4. Wax model – A wax model of your porcelain veneers will be made for you to examine and try on for the look and feel of your porcelain veneers.
  5. Temporary veneers – Provisional, or temporary, porcelain veneers will be made for you to wear. Provisional veneers provide a precise model of the finished product.
  6. Try-in – When your porcelain veneers are ready, they will be secured to your teeth with a temporary try-in paste. It’s likely that you will love the way they look and feel, but if you don’t your cosmetic dentist will send them back to the laboratory. The veneers will be adjusted or completely remade. Unless you love the results, they won’t be bonded to your teeth.

Throughout the smile design process, Dr. Hadgis encourages his patients to let him know if they have any hesitation about the look and feel of their veneers. All of these steps ensure that when you receive your porcelain veneers, they will be exactly what you wanted. You should expect the same care from the cosmetic dentist you choose.

If you take time to find a highly skilled cosmetic dentist, it is likely that your fears about getting porcelain veneers will be erased.

This post is sponsored by Grosse Pointe Woods, IL accredited cosmetic dentist Dr. Ted Hadgis.