smile makeover Archives - Susan M. Dennis, D.D.S

Sensitivity to Novocain

Posted on December 3, 2024 by writeradmin.

I want to get a smile makeover with porcelain veneers. The one thing that has me hesitant is that I am highly sensitive to Novocain. A friend of mine said that when she had hers done that her hands began trembling as soon as they put the topical agent on her teeth, and her heart raced the whole time. I’m worried about this.

Stacey

Dear Stacey,

Novocain won’t cause shaking but it can contain epinephrine which might. However, the amount of epinephrine is so small that I find it doubtful.

A more likely scenario is that she was nervous. Your body produces more epinephrine in your system when you are fearful than what would be found in the medication.

Dental fear can also interfere with the effectiveness of Novocain. This is because it will increase your metabolism and, in some cases, burn off the numbing medication. In cases of dental work, I would recommend a sedation dentist in order to relieve the patient of both pain and anxiety.

However, in the case of a smile makeover, especially porcelain veneers, I would not use anything stronger than nitrous oxide. This is because you will need to look at your porcelain veneers with a temporary try-in paste before approving them and agreeing to have them bonded on permanently.

When you use nitrous oxide, the dentist can change the gas from nitrous to oxygen. Within a few moments, you will be as lucid as you were when you came in. Other, stronger types of sedation will make you too sleepy to make any real evaluation of your veneers. You could end up with a cosmetic dentistry horror story. There are plenty of them.

This brings me to my final point. Make sure whoever does your smile makeover has post-doctoral training in cosmetic dentistry. Legally, any dentist can call themselves a cosmetic dentist because it is not a recognized specialty. However, only a small number of them have invested in the training.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Did Ultrasonic Scalers Damage My Porcelain Veneers?

Posted on November 14, 2024 by writeradmin.

For my past few cleanings, they also used an ultrasonic scaler. Two of my upper porcelain veneers fractured within days of my appointment. Could the scaler have done this? Are there different types of scalers? Is one more likely to damage porcelain veneers than the other? I think my dentist told me that they use a magnetostrictive scaler, which they said is the most gentle.

Laura

Dear Laura,

There are two types of ultrasonic scalers – piezoelectric and magnetostrictive. Cavitron by Dentsply is one of the more popular versions of the magnetostrictive scalers. While it is true that this type of scaler is more gentle than the piezoelectric ones, they are more dependent on the technique of the person using it. When used correctly, it is perfectly safe for both teeth and dental work, including porcelain veneers. However, if the hygienist’s technique is off, it has greater potential to do damage.

It’s possible for the veneers to be chipped, but you said your porcelain veneer fractured. The only way I can think of to crack a veneer with a Cavitron would be for your hygienist would have had to use the scaler’s tip directly on the porcelain veneers. This is not something that any hygienist with a clue of what he or she was doing would allow to happen. If your hygienist did that, I would switch practices right away, as well as having them pay for the replacement veneers.

You also would not want one who causes nicks on your teeth or veneers or even creating a roughened area. They should place a high priority on protecting both your teeth structure as well as any cosmetic work.

If a dental office does cosmetic dentistry, they should also be training their staff on how to clean them. For example, they should never use either acidulated fluoride or a power prophy jet on your cosmetic work either.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.
Click here to learn about smile makeovers.

Can My Teeth Whiten to Match My Eyeballs?

Posted on November 4, 2024 by writeradmin.

I have an odd question. I like everything I wear to match. I even make sure my shoes, purses, and jewelry match. What I’m wondering is if I can even get my features to match. I’m getting a series of colored contacts and would like to know if I can get my teeth to match the whites of my eyeballs by whitening them. Will they get that white?

Alison

Dear Alison,

Tooth bleaching trays

The answer to that question really depends on how white your eyeballs actually are. While teeth whitening can get your teeth very white, there will be limits. Plus, it is hard to get an exact match to something. This is because the gel will keep whitening for up to two weeks even after you stop using it. That makes it difficult to predict when to stop the whitening procedure.

The good news is that there is a way to get an exact match to your eye balls if you want. In that case, I would get porcelain veneers. These can be made to order and can change anything about your smile that you would like. This includes changing the shape, size, and color.

Be aware there are some precautions to take. Teeth whitening is the most simple procedure available, which means that pretty much any dentist can do it. Porcelain veneers, however, are different. They are an advanced cosmetic procedure which requires post-doctoral training to do well. Additionally, you will want someone with artistic talent. They’re creating a smile for you.

While cosmetic dentistry is not a recognized specialty and any dentist can technically call themselves a cosmetic dentist, smile makeovers are not adequately taught in dental school. A dentist really does need to get additional training. There are way too many cosmetic dentistry horror stories from patients who had it done by an unqualified dentist. Make sure you check out their smile gallery in order to get an idea of the type of result they achieve. If they don’t have a smile gallery, that is a sign you need to look elsewhere.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Did I Harm My Baby By Getting Porcelain Veneers?

Posted on August 17, 2024 by writeradmin.

I did not know I was pregnant when I got porcelain veneers. It was in the first trimester of my pregnancy and I’ve heard that is the most dangerous time. Did I cause harm to my baby?

Selena

Dear Selena,

First, congratulations! How exciting that you are having a baby. I’m glad you wrote. The porcelain veneers procedure you had will not have harmed your baby. It is true that we do not recommend dental work in the first trimester. This is because during that time period, the baby is the most vulnerable to foreign substances. But, here is the good news.

The only foreign substance generally used in the porcelain veneers procedure is a local anesthetic. The most commonly used of these is Lidocaine. This is one of the few medications that has been proven safe to use in pregnancy. In fact, it is even used during labor and delivery.

One thing you don’t want to do when you are pregnant is to avoid the dentist. Keeping your oral health up is the best thing you can do for your baby. I’d plan ahead and schedule your regular cleaning. The best time for that is the second trimester. You don’t have the worries of the first trimester and you will be much more comfortable in the dental chair than you will be in the second trimester. This way you can avoid any dental emergencies.

Though, if you do end up with a tooth infection or something similar, please do get it dealt with no matter what trimester you are in. You don’t want to pass any bad bacteria on to your baby from an untreated tooth infection.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Sedation and a Smile Makeover Disaster

Posted on August 16, 2024 by writeradmin.

I am at my wits end. About three years ago I went in to get porcelain veneers. Since then it has been nothing but a disaster. It seems like every few days they keep falling off. When I went in the dentist assured me that they wouldn’t take much tooth structure off. but when they fall off what is left of my teeth looks like tiny little nubs. The dentist always puts them back on but I live in a constant state of fear that another one will fall off. Plus, every time she has to put them back on she gives me an Ativan which knocks me out for the whole day. I never get to see what anything looks like until I wake up. Is it normal for the porcelain veneers to be popping off so much?

Annette

Dear Annette,

I am sorry that this happened to you. You, indeed, have what I would consider a cosmetic dentistry horror story. It sounds to me that what your dentist provided for you was not porcelain veneers, but porcelain crowns. I’ve posted an image above that compares the tooth preparation of a dental crown with a porcelain veneer. As you can see, the veneers only remove a few millimeters of tooth surface from the front of the tooth. However, for porcelain crowns, a great deal of structure is removed around the entire tooth.

Often, dentists who do not have a great deal of cosmetic dentistry experience, will point their patients toward crowns instead of veneers in order to save themselves the embarrassment of admitting that they do not know how to do the procedure. While not in the best interest of the patient, that is a bit better than what your dentist has done. Your dentist gave you crowns and told you they were veneers.

What confounds me is how your dentist is not able to even keep those in. Dental crowns are one of the first big procedures dentists are taught in dental school and no one should have graduated without being able to successfully place one. It sounds possible that he over prepared the contour of the area and that is causing them to fall off.

A third thing that bothers me here is the dental sedation. It is not typically used for cosmetic work because we want the patient to be able to look at and approve the work before it is permanently bonded on. Even if you were to have dental anxiety and need some sedation, I would lean toward a nitrous oxide, which gets you back to normal quickly. Then, even if you needed something stronger, like oral conscious sedation, Ativan is a bad choice. It has a serum half-life of 24 hours. I think you’d find most sedation dentists use something that has a half-life of three hours, so you are not useless for a full day afterward.

I think, because you were misled about what you were getting for your smile makeover AND the work is so poorly done it won’t even stay in your mouth, that your dentist should pay to have this fixed by a dentist of your choosing. Just make certain you choose an expert cosmetic dentist this time.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Do You Need Additional Procedures with Porcelain Veneers?

Posted on June 15, 2024 by writeradmin.

I am a bit confused. I went to my dentist for a smile makeover, asking for porcelain veneers. Here are the problems I am wanting to address. My teeth have discolored over the years and one is a bit longer than the other due to a fall I took in elementary school, and one of the front teeth is a little crooked, not much at all, just enough where I want it dealt with. My dentist is suggesting I get Invisalign first to straighten the one front tooth, then teeth whitening, then porcelain veneers. Do I really need all those extra procedures? I was under the impression that the porcelain veneers could make the front teeth look straight and they would be made any color I wanted, even very white. Am I missing something?

Lainey

Dear Lainey,

I am glad you wrote and can help here. Yes, you are correct that a skilled cosmetic dentist can use porcelain veneers to make teeth look straight. Invisalign should be completely unnecessary in your situation. If the issue with the front teeth is as minor as you say and your dentist does not feel comfortable using veneers to address that problem, then he is not a skilled cosmetic dentist. I do not recommend pushing him into doing it, though. You will not like the results. Instead, I’d find an expert cosmetic dentist who can do the job without needing to resort to orthodontics.

The teeth whitening, however, is a different story. Unless you are planning to place a porcelain veneer on every tooth, which would be very expensive, then you will want to whiten your teeth before having the porcelain veneers placed. Yes, the veneers will make your teeth whiter, but if the ones that don’t have the veneers on them are not whitened, you will end up with an odd looking smile where they can tell that you have some “false” teeth placed. Most smiles are eight to ten teeth wide. If you’re getting that many veneers, you may not need the upper arch whitened. When we smile, people see our upper teeth. When we talk, however, people see our lower teeth. You do not want those a vastly different color than your smile. Whitening them will make your smile makeover cohesive and natural looking.

I hope this helps. It’s actually significantly less expensive to whiten and then place veneers on the upper teeth, than it is to place veneers on every tooth.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Should I Get Invisalign or Porcelain Veneers?

Posted on April 10, 2024 by writeradmin.

I have wanted to improve my smile for years. I have one tooth that is a little crooked and my teeth are discolored. I was hoping to get porcelain veneers but my dentist said because of the crooked tooth, I would need to get braces first and then the porcelain veneers. I’m not too keen on the extra time and money that would require. If that is the case, is there a way to get my teeth white with Invisalign as well? I know that porcelain veneers can change the color but I’m guessing Invisalign just straightens them.

Tammy

Dear Tammy,

I am a bit concerned that your dentist is suggesting you would need braces before doing your porcelain veneers. Bear in mind as you read this that I have not examined you. However, if all you have is a slightly crooked tooth, then porcelain veneers can be placed and make the tooth look straight. It can also change the color, as you mentioned, but also the shape and size of the tooth. This is why they are used for complete smile makeovers.

If all that is wrong with your teeth is the crooked tooth and discoloration, then you could save yourself a lot of money by using Invisalign paired with teeth whitening. The Invisalign aligners can double as teeth whitening trays. All your dentist would need to provide you with is the professional strength teeth whitening gel. In most cases, Invisalign works in a fraction of the time it takes traditional braces to straighten your teeth. Unless there were other things about your teeth that you want to change, or you are in a super hurry, this is the route I would go.

On the other hand, if there are other things about your teeth that you want to change, then porcelain veneers will be the correct choice. That being said, I would not recommend you pressure your current dentist into doing them. The fact that he was pushing your toward braces tells me he is not very comfortable with his skill level using porcelain veneers. This means you will not get the beautiful result you are likely hoping for. You will need to find a different dentist with significant post-doctoral training creating porcelain veneers. Also, make sure he or she is willing to use a temporary try in paste and allow you to get a good look at the veneers in several different types of lighting. Only if you are absolutely in love with them, should the dentist do the permanent bonding. If you’re not thrilled, they should go back to the lab in order to make the changes needed.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Mouthwash and Porcelain Veneers

Posted on February 18, 2024 by writeradmin.

I have porcelain veneers and want to take good care of them. I generally use a homemade mouth wash. The ingredients are:
8 OZ FILTERED WATER
8 OZ OF 3% HYDROGEN PEROXIDE
2 TBS SEA SALT.

Is this safe to use on my porcelain veneers?

Benny

Dear Benny,

Nothing in that mixture will harm your porcelain veneers. I am a bit concerned the hydrogen peroxide. While that is a good way to kill bacteria in your mouth, it does not distinguish between good and bad bacteria. With constant use, other microbes will continue to grow in your mouth unchecked because there is not the right stuff there to keep it in check. One of those microbes is candida albicans. This will lead to an oral yeast infection and make you very uncomfortable.

If you use this mixture periodically, instead of daily, you should be okay. If you decide to use an over the counter mouthwash, just be certain that it does not contain any alcohol. That will eat away at the bonding on your porcelain veneers and put them at risk.

As for things you can do to care for your veneers, aside from keeping up with your dental appointments and daily oral hygiene, I recommend using Supersmile Toothpaste to clean your veneers. It is specifically designed to safely work with dental work.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.
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Don’t Be Fooled By 360 Veneers

Posted on October 31, 2023 by writeradmin.

I went to my dentist to ask about getting e.max veneers and he suggested that I would be a much better candidate for 360-wrap veneers. I was a bit nervous about the 360 part because I did not want much tooth removed. I specifically asked about that and the dentist told me hardly any and I’d have nothing to worry about. Unfortunately, not only was that a lie but this whole procedure has been a disaster and I have been left afraid to leave my house for fear of another tooth falling off.

It started with the temporaries. After just two days, two of them fell off while I was brushing my teeth. I went back and my dentist bonded them back on. Then, they came out again, plus another one, a few days later while I was out to eat with friends. Again, I went back to the dentist. They assured me that this would not happen once the permanent 360-veneers were placed. This turned out not to be true. I’m facing the same issues with the “permanent” ones. Plus, each one that has fallen off has left me with a tiny nub underneath, which is certainly not what they told me would be the case. I’m afraid to go anywhere and with the holidays approaching, I’m terrified I am going to lose teeth at the family gatherings, two of which are out of town and I will not be able to get to my dentist to rebond them. Do you have any advice for me?

Candice

Dear Candice,

I am so sorry this happened to you. The first thing you should know, but I think you’ve figured out, is your dentist did not give you 360-wrap veneers. In reality, there is no such thing. What he provided for you was dental crowns. Plus, he lied to you about the amount of structure that would have to be removed. Obviously, the man is ethically challenged.

Why would he suggest crowns when porcelain veneers are the standard for a smile makeover AND what you requested? The most common answer to that is he is not skilled in porcelain veneers, which takes extensive post-doctoral training, while every dentist has training in dental crowns from dental school. Rather than admit he can’t do them, he steers you to a different procedure with some creative phrasing (ie. lying). You should also know that he’s not a very skilled dentist even with dental crowns. While things can go wrong with any case, most dentists go their entire career without a single crown falling out, let alone the incredible number you’ve had fall out. A basic premise of a successful dental case is that the dental work actually stays in your mouth.

I would start by approaching him about these issues and tell him if he will pay for you to have this re-done by a dentist of your choosing you won’t take this any further. You do have recourse because of the poor dental work as well as the deciption. You could talk to the dental board, the insurance company, the Better Business Bureau, and even bring a malpractice suit against him. If you end up with the last option, make sure the lawyer knows that your teeth are now at a greater risk of breaking and needing to be permanently because of their being ground down for crowns.

It is always helpful to have a dentist look at your case and document what is wrong with it. My suggestion is you get an expert cosmetic dentist to do that.

Again, I am terribly sorry this happened to you.
This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Solution for a Crooked Tooth

Posted on September 30, 2023 by writeradmin.

I have been looking for a solution to a crooked tooth. I’ve been to three dentists and each of them has suggested something different. Thus far I have been told to get braces, get porcelain veneers, and even to remove the crooked tooth and get a dental implant. I suppose my situation is more complicated because all my teeth are straight except for this one tooth. I feel like each of the dentists I have spoken to have given me the procedure THEY want to do. I’m hoping as you are not anywhere near my city and I can’t get traatment from you, that I can get an unbiased opinon from you. What should I do about this one crooked tooth?

Emile

Dear Emile,

For one crooked tooth, I see two good options for you. However, whatever you do, please do not allow them to remove this crooked tooth. Unless there is something seriously wrong with that tooth that you haven’t mentioned, that suggestion is the most aggressive, unnecessary overtreatment I have heard in a while.

Valid Option One— Invisalign

I know someone suggested braces. I don’t know if that was traditional braces or not but I do have a better option for you if that was the case. There have been incredible advancements in orthodontics these days. My suggestion, if you want to actually straighten the crooked tooth, is to use Invisalign.

Instead of metal wires and brackets that traditional braces use, Invisalign uses clear aligners. These are invisible even at a conversational distance. No one would even know you were straightening your teeth. They also have the hidden benefit of allowing you to whiten your teeth at the same time, if that is something you are interested in. The aligners can double as teeth whitening trays. Simply ask your dentist to provide you with the whitening gel and you can apply it while you wear your aligners. It’s like getting a mini smile makeover.

Valid Option Two— Porcelain Veneers

This option will not straighten the crooked tooth, but it can make the tooth look straight. Porcelain veneers use tiny wafers of porcelain to completely remake your smile, including the shape, size, and color. It is what celebrities use to get that Hollywood smile. Unless you want to place porcelain veneers on at least eight to ten teeth, depending on how wide your smile is, you will need to do teeth whitening as well. Don’t let any dentist do this. You need someone with advanced cosmetic dentistry training and artistry.

If you are on a tight budget, then Invisalign is the better option for you. If money is not an issue, then you can do either one. I’d only suggest porcelain veneers, though, if there are other things you want to change about your teeth. I would not consider it worth the cost just to fix one tooth.

This blog is brought to you by Kalamazoo Cosmetic Dentist Dr. Susan Dennis.