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Duluth, GA 30097

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Cavity on Tooth with a Porcelain Veneer

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I have several porcelain veneers. One of the teeth with a porcelain veneer has a cavity. The dentist wants to remove the veneer and place a crown on that tooth. I really think that is overkill. He insists it is the standard procedure. Is that right?

Laurie

Dear Laurie,

A porcelain veneer being placed on a tooth.

I am not flat out saying that your dentist is incorrect here, but I would recommend a second opinion before going through with this. First, a crown would only be necessary for quite a large cavity. I would say at least 20% of your tooth should have decay. If the decay isn’t that significant I question why the dentist is wanting to do a crown instead of a veneer. Some dentists do not have the skill to do porcelain veneers so they steer their patients toward crowns. Here’s the problem with that. If he can’t do porcelain veneers, what are the chances that he can match a single crown to the remainder of your front teeth? Very few dentists can do that well.

I would go see an excellent cosmetic dentist and ask them if the tooth actually needs a crown. If not, don’t get rid of all that healthy tooth structure. When you have porcelain veneers, the most vulnerable place for decay is right at the margin where the porcelain meets your tooth. However, it is not too difficult to prevent that decay. There are two keys. One is the frequency of eating. Your saliva will do a lot of the work if you just don’t snack too much, giving it time to do its job. The second thing is flossing. Making sure to floss every day will get in the margins.

I’m not confident this dentist can give you an attractive result no matter which restoration you end up with. Instead, I would start looking for dentists who do beautiful cosmetic work. One of the things to look at is their smile gallery. If they do not have a smile gallery, they do not do enough cosmetic work. In their smile gallery, specifically look for before and after images of both porcelain veneers and porcelain crowns. If you love the results you see on there, make certain you take one additional precaution and call the office to ask if the gallery is populated with images of the dentist’s own work or stock images. You want it to be work the dentist has done.

This blog is brought to you by Duluth, GA Dentist Dr. David P. Marion.

I Hate My Lumineers

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I had four Lumineers placed. I was pretty specific about how white I wanted my smile. Because of that, I even had my teeth whitened ahead of time. But, when my Lumineers were placed they looked darker than I anticipated. When I asked my dentist about it he told me he had a “natural” stain put on the Lumineers so they wouldn’t look fake. I don’t think they would have looked fake with the color I wanted, so I don’t understand why he did that. He told me to give it a few days and I’d probably like them. I tried but didn’t adjust in my view. I called him back so he had me come in. When I did, he sort of drilled off some of the top layer with the stain to get to the whiter color underneath. Now, they are uneven and the color seems dull. They look awful. Is there anything which can be done to fix them at this point?

Candace

Dear Candace,

woman covering her mouth

I’m sorry for what you’ve experienced with this, especially given this probably cost you a pretty penny. I do have some good news for you, but first let’s go over the reason why this happened. You told him you wanted a very white smile, yet he still put a stain on the Lumineers to make them look natural. This tells me your dentist has not invested in a great deal of training in cosmetic work. That doesn’t surprise me. Lumineers is often marketed to inexperienced cosmetic dentists as being easy to place.

In dental school, dentists are taught they know what is best for the patient. This means you wanted a white smile and he felt it needed to look natural. As the dentist, he thought he knew best. If he’d invested in cosmetic training, he’d know this is different. You are creating the smile the patient wants. Therefore, it is the patient who knows best in these situations.

Second, his drilling of the upper layer. This was the wrong thing to do as you’ve discovered. He should have just re-done the whole case, especially given he didn’t follow your instructions as to what type of smile you wanted. Instead, he takes a short cut which essentially ruins your Lumineers. The bad news is actually the good news as well. Because he damaged them so badly, you are able to get a refund and have this done by a more experienced cosmetic dentist.

If a dentist is serious about cosmetic dentistry they will have a smile gallery on their website. The one thing I would do is call and make sure the before and after images of the work they’re displaying is work they have done themselves and not stock photos. Look at their photos. Do you absolutely LOVE the results? If not, look for someone else. Don’t be surprised if whichever dentist you end up with chooses a different brand than Lumineers. There are several brands of porcelain veneers and Lumineers isn’t know for its quality in aesthetics.

This blog is brought to you by Duluth, GA Dentist Dr. David P. Marion.