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Advanced cosmetic and general dentistry

How to Resolve Gum Irritation from Porcelain Veneers

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Last year, I got six porcelain veneers in Costa Rica from a dentist trained in the US. The veneers were 1/3 the cost of the quotes I got from US dentists. My smile looks pretty good, but the veneers still irritate my gums a bit. My smile is broad, so I would like to add two to four more veneers. How can I find an affordable US dentist to match the veneers at an affordable rate? I may need to have the six existing veneers repositioned to reduce the irritation. Thanks!  Alma from NV

Alma,

A porcelain veneer held next to a tooth

Porcelain veneers can close a tooth gap after you achieve good oral health

When a dentist places veneers that do not replicate the natural tooth contour, your gums can become irritated and inflamed. Excess cement or bulky edges create pressure and food traps, contributing to the development of gum disease.

What Can a Dentist Do If Veneers Irritate Your Gums?

If porcelain veneers irritate your gums, your dentist can do the following:

  • Remove any excess bonding material that irritates the tissue.
  • Replace poorly fitting veneers with ones designed to match the tooth’s natural contour.

Addressing the fit of the veneers reduces gum inflammation and prevents long-term damage.

How Many Veneers Do You Need for a Complete Smile?

If a patient wants to enhance the teeth across the width of your smile, a dentist should plan for at least eight veneers. Sometimes ten or twelve are needed to achieve a balanced, natural appearance. Limiting treatment to six teeth often falls short of producing a complete smile transformation.

Can You Get High-Quality Cosmetic Dentistry at a Discount?

Expert cosmetic dentists invest in specialized training and use the best materials. Because of this, they rarely offer cosmetic work under discounted insurance fees. Choosing bargain options may save money initially, but it can lead to costly corrections later. Although you saved money by getting six veneers in Costa Rica, unfortunately, you will incur additional expenses to resolve the gum irritation. Look for a dentist with credentials from the American Association of Cosmetic Dentistry.

Lowell, Massachusetts, accredited cosmetic dentist Dr. Michael Szarek sponsors this post. Read how Dr. Szarek strives to give his patients the best dental care in Lowell.

Are Two Porcelain Veneers Enough to Close a Gap?

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I want two veneers for my front teeth because they are protruding, and a gap is forming. I wore braces as a teenager. Now that I am in my 60s, my teeth are shifting a bit. My dentist wants to do six veneers instead of two. I think it’s overtreatment. Can two veneers soften the look of the teeth that stick out? Thanks. Kyleigh from TX

Kyleigh,

Without an exam, we can’t determine whether two or six porcelain veneers would be best for you. However, we can share insight to help you understand the reasoning behind your dentist’s suggestion.

Possible Reasons for Recommending Six Veneers

There are typically two motivations behind recommending more veneers:

  • Your dentist may believe a broader treatment plan will yield better cosmetic results—and may also come with a higher cost.
  • On the other hand, your dentist may be committed to quality outcomes and unwilling to deliver a result that might not meet their standards.

A dentist may prefer not to do small-scale veneer work (e.g., just two veneers) if it risks poor aesthetic blending with the natural teeth.

How Bonding and Retainers Can Minimize a Tooth Gap

For adults with a gap between their front teeth, many cosmetic dentists use composite bonding to widen the teeth and close the space. If the gap eventually returns, the bonding can be redone. However, for lasting results, patients often need a retainer to hold the teeth in place.

Retainer needs vary. Some people only need one temporarily. Others—especially those with recurring gaps—may need long-term retention. Based on what you’ve shared, it appears that consistent retainer use is essential to prevent a recurring gap.

Do You Still Need to Wear a Retainer?

Gradually reducing retainer wear can help you figure out whether it’s still necessary. Follow this progression:

  • Begin by wearing your retainer full-time.
  • Shift to nighttime wear only.
  • Then wear it every other night.
  • Each time you put it back in, check for tightness or pressure.
  • Pressure means your teeth have shifted—go back to more frequent wear.
  • No pressure? You can try increasing the interval between uses.

In some cases, an orthodontist may bond a permanent retainer to the back of the teeth to prevent movement for the rest of a person’s life. That may have been a smart option in your situation.

Lowell, Massachusetts, accredited cosmetic dentist Dr. Michael Szarek sponsors this post. Read how Dr. Szarek strives to give his patients the best dental care in Lowell.

Trouble Finding a Dentist to Make My Dark Root Canal Tooth Look Better with a Crown

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I had a root canal at age 13 after an accident. The tooth turned darker over the years.  I’ve had no success finding a dentist who can hide the dark tooth. Now my gums are irritated above the newest crown (August 2024), and the tooth still looks dark.

Would an all-porcelain or porcelain-layered crown with zirconia core be best? I know I shouldn’t insist on a specific crown type, but I don’t want to spend the next five years searching for a new dentist and a crown that finally looks good. Thanks. Filipe from CT

Filipe,

When seeking cosmetic dental work, it’s essential to remember that it seamlessly blends science with artistry. Many dentists are technically proficient, but only a select few possess the artistic eye needed to create truly natural and beautiful smiles. These “artist” dentists are typically eager to showcase their work. My strong recommendation is to actively look for dentists who feature an online smile gallery or portfolio. Browse these galleries and confirm that the results genuinely impress you and reflect the quality you desire.

You might notice that dentists emphasizing “affordable dentistry” often highlight their participation with many insurance networks. However, top-tier cosmetic dentists find it challenging to operate within the financial constraints of discounted insurance plans. Their commitment to using premium materials and collaborating with the finest dental labs to produce exceptional, high-quality dental restorations often conflicts with the reduced fees offered by insurance providers. In my conversations with many leading cosmetic dentists, I’ve found that they either participate in very few insurance plans (perhaps one or two) or choose not to participate at all, to avoid compromising their standards of care.

Why Choose a Cosmetic Dentist Over Specific Dental Materials?

New dental crowns

Skilled cosmetic dentist use high-quality materials and artistic techniques to produce natural-looking results.

An excellent cosmetic dentist, working in collaboration with a skilled ceramist, can achieve a beautiful outcome using various materials, including layered zirconia, e.max, or feldspathic porcelain. Rather than focusing on the specific material, consider this analogy: if you were hiring a painter, would you primarily ask about the brand of their paints to judge their skill? Probably not. You’d evaluate their finished artwork. Similarly, with cosmetic dentistry, the most crucial thing to assess is the dentist’s track record of producing beautiful, natural-looking results.

Below are tips for finding a skilled cosmetic dentist.

  • Review Smile Galleries: Actively seek out dentists with online smile galleries to assess their artistic capabilities with dental crown cases like yours.
  • Understand Insurance Participation: Advanced cosmetic dentists may have limited or no participation with insurance plans due to their commitment to high-quality materials and lab work.
  • Prioritize Results Over Materials: Focus on the dentist’s portfolio and the aesthetic quality of their previous work, rather than getting caught up in the specific type of material they use.

Lowell, Massachusetts, accredited cosmetic dentist Dr. Michael Szarek sponsors this post. Read how Dr. Szarek strives to give his patients the best dental care in Lowell.

 

Is Zirconia Dust from My Crowns Causing an Allergic Reaction?

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My dentist has ground down all ten of my dental crowns to balance my occlusion. The first round of adjustments was so intense that my gums and lips broke out in hives. The crowns are made of zirconia, so could I be allergic to the dust from the grinding process? My mouth is still irritated, but more concerning is that my bite is still off.  I am frustrated and wonder whether I should ask for a refund and get crowns from another dentist. Thanks. Ezra from WA

Ezra,

We’re sorry to hear about your frustrating experience with new dental crowns.

Can You React to Zirconia Dust?

While it’s possible to have a temporary reaction to zirconia dust, any symptoms should subside once the dust clears. Grinding down zirconia can be a challenging procedure due to the material’s toughness, especially when adjusting your bite. We haven’t seen any confirmed cases of true zirconia allergy. Your symptoms sound more like burning mouth syndrome, which is often triggered by stressful dental experiences.

Why Resolve Bite Issues with Crowns?

It’s a concern that your bite is still off after having ten crowns placed. A proper bite, where your teeth mesh harmoniously, is crucial for comfortable chewing and overall jaw health. An imbalanced bite can lead to jaw muscle spasms, headaches, and other issues associated with TMJ disorder. I recommend seeking a second opinion, as your current dentist may be out of their depth with this complex issue.

New dental crownsUnderstanding the intricacies of bite alignment isn’t typically covered in standard dental school curricula. Dentists who specialize in this area usually attend post-graduate institutes.

Consider finding a dentist who has completed training at one of these reputable institutes:

  • The L.D. Pankey Institute in Florida
  • The Dawson Academy in Florida
  • Spear Education in Arizona
  • The Las Vegas Institute for Advanced Dental Studies in Nevada

The ongoing stress from your unharmonious bite is likely contributing to your hives. Getting a second opinion from a specialist can help resolve these issues.

 

Lowell, Massachusetts, accredited cosmetic dentist Dr. Michael Szarek is the sponsor of this post. Read how Dr. Szarek strives to give his patients the best dental care in Lowell.

My New Zirconia Crowns Are Solid White and Look Fake

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I got new zirconia crowns to replace my old ones. I know which is worse – my old yellowing or solid white zirconia crowns that look like I put fake teeth over mine. I’m embarrassed. My dentist says the crowns are solid white because they are monolithic, and I asked for white teeth. Why didn’t he warn me about how the crowns would look?

I plan to ask for a refund, but I’ve seen two dentists who say they can replace the crowns. How do I know what results to expect? My anxiety is making it difficult to sleep. I never thought that getting new crowns would be this stressful. Ben from San Antonio

Ben,

We understand your anxiety and frustration.

Since zirconia comes from a ceramic block, the lab can’t customize it to mimic our natural teeth’s variations in color and translucence. So, a lab ceramist will veneer zirconia with porcelain when placed in the smile zone. Blending various colors when applying porcelain paste to the crowns helps reproduce a tooth’s appearance is called layered zirconia. Monolithic zirconia, without porcelain layers, is inappropriate for a front tooth because it will not look natural. Additionally, your dentist placed your crowns too far forward, detracting from your smile.

How Can You Find a Cosmetic Dentist for Natural-Looking Crowns?

You can find a cosmetic dentist for natural-looking crowns by researching dentists’ technical skills and artistic ability.

  • Look for Accreditation: Find an expert cosmetic dentist accredited by the American Academy of Cosmetic Dentistry. To achieve accreditation, dentists must pass demanding written and clinical examinations that confirm to the examiners their comprehensive knowledge and the artistic capability needed to create a beautiful smile.
  • Ask to See Before-and-After Pictures: Some expert cosmetic dentists have chosen not to go through the AACD’s accreditation program. However, all such experts should be able to show you photographs of their beautiful work with dental crowns. Ask to see pictures of similar cases a dentist has completed.
  • Avoid Making Cost a Priority: While some highly skilled cosmetic dentists charge premium fees, many have fee structures comparable to local dentists. High-quality cosmetic dentistry requires the finest materials and the best dental laboratories, requiring dentists to invest the time to achieve a beautiful result. So, if you’re searching for cheap dental work, it’s unlikely to be beautiful.

Lowell, Massachusetts, accredited cosmetic dentist Dr. Michael Szarek sponsors this post. Read how Dr. Szarek strives to give his patients the best dental care in Lowell.

Dental crowns before and after photos by Lowell, MA, dentist Dr. Michael Szarek

Dental crowns by Lowell, MA, accredited cosmetic dentist Dr. Michael Szarek