Archive for the ‘Choosing a Cosmetic Dentist’ Category

What’s the best way to screen a cosmetic dentist?

Wednesday, September 28th, 2011

What is the best way to find and screen a dentist specializing in cosmetic work specifically porcelain veneers in the city I am living, namely Dallas, Tx?
- Sam from Dallas

Sam,
There isn’t a really good way for a lay person to screen for a good cosmetic dentist. Celebrities find them by reputation, because in celebrity circles, many of them have had smile makeovers, and they quickly discover who the good cosmetic dentists are. But for most of us who don’t circulate with those people, there isn’t a really good way. You can ask to see photographs of their work and you can screen out some of the bad ones that way, because they won’t have any photographs. But you still leave yourself open to being burned. I have seen that happen. We have many people walking into our office very disappointed with the cosmetic dentistry they have received.

There is an excellent website, however, that is run by an accredited cosmetic dentist where they list recommended cosmetic dentists by reputation, by examining photographs of their work, and by checking educational credentials, and I believe they list several excellent cosmetic dentists in the Dallas/Fort Worth area. The site is www.mynewsmile.com. You can check it out.

Dr. Rota is their recommended cosmetic dentist for Colorado Springs, and when he got listed, he had to document several cases and answer questions about them before they would accept him onto their list, so we know they aren’t like other referral websites where a dentist can just pay a fee to get listed.

This blog is sponsored by Colorado Springs cosmetic dentist Dr. Joseph Rota.
See pictures of his porcelain veneer work.

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Porcelain Veneers and Dental Cleaning

Monday, January 3rd, 2011

I recently had veneers placed on my front teeth (in September) in New York State. We recently moved to Florida and am scheduled for my first cleaning since getting the veneers. I am concerned that my dentist here will not clean them properly, so what should I be prepared for. I certainly don’t want them to harm the finish on the veneers. Will using a scaler harm the finish?
- Martha from Florida

Martha,
There are two big no-no’s that a dental hygienist can do to ruin your porcelain veneers. The first way is by using a power spray to clean the teeth. The Prophy-Jet by Dentsply, that sprays sodium bicarbonate on the teeth to clean them, will destroy the glaze, and it will be expensive to fix that. Many hygienists are oblivious to this damage because when they’re through with the appointment, the veneers look beautiful and clean. But with the glaze gone, porcelain veneers will start to pick up stain after the patient leaves the office, and they’re never the same again.

The second way is by administering a standard fluoride treatment. They usually give fluoride treatments only to children, but some hygienists like to give them to adults. The problem is that the standard fluoride used in these treatments is acidulated, meaning that it contains small amounts of hydrofluoric acid. While this greatly helps the teeth absorb the protective fluoride, it will etch porcelain, which again will break the glaze and cause it to stain more easily. It can also remove some tinting on the surface of the veneers, altering the color of the veneers. Dentists who know better will keep a supply of neutral fluoride on hand to avoid this problem.

Beyond that, it is always best, if you have porcelain veneers, to have them maintained by an office that does a lot of them. There are other smaller things that are important that will be carefully followed by offices where they are passionate about cosmetic dentistry. Scalers can be used, but ultrasonic scalers have the potential to chip the margins of the veneers. Coarse polishing pastes can cause extra wear on the bonding composite between the porcelain and the tooth. Those are finer points. The key thing is to stay away from any of the power sprays like Prophy-Jet or similar devices and the acidulated fluoride.

This is the blog of Colorado Springs dentist Dr. Joseph Rota.

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All the dental work is different colors.

Monday, November 29th, 2010

I recently had root canals and 7 porcelain with metal crowns done on my upper teeth, in addition to upper and lower valplast with metal removable partial dentures. I told my dentist that tooth #7 looked slanted and she used a tool to reshape the bottom of the tooth. She also did tooth #8. I told her that the two teeth now feel rough, not smooth. A very uncomfortable feeling.

Then on tooth #10 the crown is wider, shorter and whiter than my other front tooth. She sold me a zoom whitening pen to whiten my natural front tooth. 2 months later and no change in color, she tells me I lost enamel on that tooth and wants to do a porcelain crown. With the work that was done on my front teeth, they don’t match in shade or shape. My partials are also a different shade. Can they be redone without a extra charge? 10 months later and I have 3 different shades of teeth when I smile. I contacted my insurance company and they said she was already paid for the work. Any advice on how to correct the work that has been done?

Thank you.
- Catherine from Brooklyn

Catherine,
I’m not sure I’m following everything that’s wrong with your case. Depending on exactly what’s wrong, there may not be a lot you can do about your situation.

If your dentist can’t match colors well, or the teeth she makes have funny shapes, that’s not something you can force – you can’t make her get it right.

Here’s the problem. Dentists are trained to fix things. And the whole profession is concentrated on fixing things so they work. The problems you are mentioning are mostly issues you have with how the work LOOKS. But if the work she did is functional, then it’s generally considered to be within the standard of care and you have little legal recourse.

For most dentists, appearance-related issues aren’t critical. If your teeth are basically white and lined up basically straight, then for many dentists that is good enough.

What you seem to be telling me is that you want your smile to be beautiful. But to get beautiful cosmetic dentistry, you have to pick a dentist that is on your same wavelength and for whom the appearance of the work is a high priority. In other words, you want an artistically-inclined dentist, a cosmetic dentist. Once the work is done, you really don’t have any legal ability to force the dentist to make it be beautiful.

Then, being in Brooklyn, I’m not sure there are any excellent cosmetic dentists in Brooklyn. There are some excellent ones in Manhattan, and some in Queens, but for some reason, the good cosmetic dentists may not want to open practices in Brooklyn.

Now, as far as your particular problems. The smoothness shouldn’t be a big issue. It isn’t really hard to polish porcelain, though it’s possible your dentist doesn’t know how to do that. I would start by asking her to do that, if she can.

In summary, I would recommend that you get a second opinion from an excellent cosmetic dentist in Queens, Manhattan, or on Long Island, letting them take a look, and tell you what can be done to fix what you have. I’d check with the website www.mynewsmile.com – they recommend cosmetic dentists all over the country. It may be that another dentist can work with you to persuade your dentist to give some kind of refund or partial refund, and you can have some of this work re-done. From what you’ve told me, I don’t have a lot of hope that this dentist of yours can make this work beautiful. Some dentists simply can’t.

Links: Read about getting porcelain crowns in Colorado.

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What are the best porcelain veneers? And how do I pick a cosmetic dentist?

Thursday, April 15th, 2010

What are the most strongest but yet natural looking porcelain veneers that you would recommend. We have empress right now but are cracking. What questions do we ask the dentist to determine their expertise?
- Yvonne in New York

Yvonne,

Empress is an excellent, beautiful, long-lasting material for porcelain veneers. If your Empress veneers are cracking, I would guess that it’s not because of the material but because of the way it was bonded – that’s usually what makes veneers crack. But even then, the beauty and functionality only start with the material and come much more from how it is used. Would you commission a work of art based on the brand name of paint that the artist uses? Or on the type of clay he or she uses in their sculpture? Or would you tell your artist, once you have chosen them, that you want them to only use a certain brand? No – you pick the artist based on the quality of the work that you see, and you let them use the brand of materials that they are most comfortable with. And what brand of baseball glove catches balls the best? Isn’t that a lot more dependent on the player using the glove than the brand of the glove? Cosmetic dentistry is the same. The quality of the work depends on the technical ability of the dentist and on his or her artistic talent. Leave the choice of the material up to the dentist – that’s my advice. They know what works best in their hands, and every excellent cosmetic dentist has a passion for creating beautiful work that will still be beautiful five, ten, twenty years from now. They will take photos of it and show those photos to their colleagues.

And cosmetic dentistry is art. It includes expertise, but knowledge alone isn’t enough. The dentist has to be artistic in order to create a beautiful smile. You might be interested in reading an excellent post about what is a cosmetic dentist. That may get you a little more perspective on this issue.

That post comes from the website of a referral service that recommends excellent cosmetic dentists all over the country. They pick dentists based on the quality of their work and their credentials. The reason this referral service is so helpful is that there really aren’t any foolproof questions people could ask or things they could look for. In order for Dr. Rota to get listed by them, he had to disclose all his credentials and then submit a CD of detailed photographs of his cosmetic dentistry. These were examined by the trained eye of an experienced cosmetic dentist, and then they were willing to recommend him for Colorado Springs. I’d suggest checking this website for who they recommend in your part of New York.

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