Archives for August 2020

Spent 30k on a smile makeover that looks like a smile mess up

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I received a smile makeover in February 2019. My mouth is small, and my front upper teeth were tilted slightly inward. I also had an overbite and 3 missing back teeth. My dentist put crowns on my front teeth and did mini implants for the back teeth.

Wallace and Gromit

Wallace and Gromit
Donovan says his smile makeover looks like Wallace’s smile

The smile makeover that I was hoping for cost me $30k. I didn’t get a makeover – I got a messed-up smile. My front teeth are too large for my small mouth and face shape. And my overbite is worse, so I try not to smile. I included a picture of Wallace & Gromit so you can see how my smile looks. I’m too embarrassed to send you my smile photos, but it looks like Wallace’s smile. I look goofy when I smile. Although I had problems with my teeth before, I’ve never felt so bad. Some rude people asked me if my dentures are too big. I would never ask anyone something like that about their teeth.

Unfortunately, I made the wrong decision about when to ask my dentist for a smile makeover. Two months after I received it, I had a long-term assignment in Asia. I had to leave my assignment there due to COVID-19, and since then, I haven’t been able to see a dentist. Now I must do something about my teeth. The pandemic is stressful enough. Now I’m on Zoom almost every day for work, and people think I’m in a bad mood because I’m not smiling. But it’s my teeth that are causing the problem. Although I think that I know the answer to this issue, I would like to know my options. Thanks for your advice. Donovan from Mississippi

Donovan,

Thanks for attaching the photo. We weren’t familiar with Wallace & Gromit before you mentioned them. As you hinted, you probably know what must happen to correct your smile; a cosmetic dentist will need to redo it.

Our advice is about ensuring you select a skilled cosmetic dentist.

You’ve learned that a competent family dentist isn’t a skilled cosmetic dentist. An artistic cosmetic dentist has advanced training and experience in aesthetics and has creative talent. Look for a dentist with credentials from the American Academy of Cosmetic Dentistry or the American Academy of Esthetic Dentistry.

It can be challenging for a dentist to correct the mishap to your teeth, so if you want an attractive smile makeover this time, don’t compromise on choosing a dentist who can design a smile that functions well and looks fantastic. Schedule consultations with at least two cosmetic dentists before choosing one. Take notes during the consultations to help you make an informed decision.

Can You Get a Refund for a Bad Smile Makeover?

You might be able to get some of your money back for the lousy smile makeover. Work with your new cosmetic dentist to help you do it. If your previous dentist did work that was technically sound but doesn’t look good, it will be challenging to get a refund unless your teeth look awful.

Although you didn’t mention problems with the function of your teeth (e.g., with your bite or pain), if they are present, it will be easier to get some of your money back.

Three options that can help you get a partial refund

Some options that might motivate your previous dentist to refund you at least partially for your botched smile makeover include:

  • Strong leverage – File a malpractice suit if a malpractice attorney agrees you have a case.
  • Moderate leverage – Threaten to complain to the dental board.
  • Weak leverage – Leave a negative online review on the dentist’s Google or social media pages

 

Best wishes on your search for a new dentist and getting your smile and confidence back.

This post is sponsored by Steven Brooksher, DDS, a Baton Rouge dentist and accredited member of the American Academy of Cosmetic Dentistry.

Why do some of my veneers fall off every week?

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I started going to my dentist in 2015, and last October, I decided that I trusted her enough to get porcelain veneers. That was a huge mistake because my veneers regularly fall off. I asked for veneers because one of my front teeth was shorter than the others, a few teeth were chipped, and I wanted a brighter smile. My dentist explained that I needed veneers to protect my teeth and limit the cracks I have in them from grinding. My dentist made a custom nightguard to protect my veneers from grinding.

Before I agreed to veneers, my dentist explained that she would need to prepare my teeth first, but she ground my front upper teeth down to stumps. When I saw my teeth, I almost cried, but she reassured me that the veneers would look and feel so beautiful that I wouldn’t remember the preparation. She placed temporary veneers, and I wore them for two weeks. I did love the look and thought that my dentist was right about how much I would love my smile.

Everything was going well with my porcelain veneers the first week, but in the middle of the second week, a veneer popped off. I called my dentist’s office, and they were quite accommodating. I went to the office in the afternoon, and my dentist bonded the veneer on my tooth. But every week at least one veneer falls. I’ve noticed that the veneers that pop off the most have a ledge on the backside of them. Also, my breath smells terribly just before a veneer pops off. Over the winter holidays, we had family visiting, and I had three veneers missing. I tried not to smile so that no one would notice my tiny ground-down teeth. I keep glue in my purse just in case a veneer comes off.

This is an ongoing issue. Last week, I received a call from my dentist’s office to come in for my dentist to try something different. I’m beginning to think that I’m my dentist’s first porcelain veneers patient. I’m stressed out about this daily. How are my veneers going to last 20 years as my dentist promised? I know this can’t be normal because porcelain veneers are too popular. People wouldn’t get them knowing they would fall off regularly.

Can my teeth be fixed? Am I going to need dentures? Our family will be moving at the end of summer, and I’m afraid that a dentist in our new location won’t want to try to fix the mess my dentist made. Is there anything I can do?

Also, I want to ask about the combination of Ativan and nitrous oxide. My dentist gave me Ativan. I take one pill the night before my appointment and another about an hour before going to the office. While she works on my veneers, I breathe in nitrous oxide. I’m out of it for the rest of the day and sleep through the next morning. I am only slightly anxious about my appointments, and I’ve only had anxiety since I received these botched veneers, but is this sedation too heavy? – Andreja from Mississippi

Andreja,

We are sorry to hear about the trauma your dentist is causing and the horror story with your porcelain veneers. Porcelain veneers are meant to improve your smile and quality of life, not make you dread smiling.

No, the things you are experiencing are not typical. You have had an awful time with what should have been an enjoyable experience. Your dentist did several things wrong. And what has happened to you might be classified as malpractice.

Your dentist prepared your teeth for crowns

Your dentist prepared your teeth for porcelain crowns—not veneers. As the photos below show, a dentist only reduces about a half-millimeter of enamel from the front of a tooth to prepare it for a veneer. But when you’re receiving a crown, a tooth is tapered all around. And you describe it as a stump. Your experience says that your dentist doesn’t know how to do porcelain veneers and isn’t familiar with bonding technology. Your options for correcting the situation are limited.

Side-by-side photos of upper front teeth with porcelain veneer preparation and porcelain crown preparation

The crowns don’t have proper retention form

If a dentist prepares a tooth correctly, conventional dental cement will keep a crown in place. Bonding technology isn’t required. But your dentist hasn’t been able to do that. Although Dr. Brooksher would need to examine your teeth, we guess that they are shorter than the teeth shown in the photograph. Your dentist so aggressively prepared your teeth that crowns won’t stay on. She grossly violated the standard of care, and she’s liable. Your crowns are getting loose in function. Saliva and bacteria are getting under the crown, which causes an awful smell and taste.

Your sedation

You described having mild anxiety about dental visits. We can’t explain why your dentist gives you Ativan because it lingers in your bloodstream. The term, serum half-life, represents how long half the dose of a medication is still in your bloodstream. After 24 hours, half the Ativan dose is still in your bloodstream, and it can take a couple of days to go away completely. Most dentists use triazolam, which lasts about three hours after a dental appointment. That’s plenty of time.

How can you resolve it?

We think that your dentist is legally liable for damaging your teeth. She should pay for another cosmetic dentist to correct your teeth and restore your oral health. But she should also compensate you for over-treatment that could affect you throughout life. Before you relocate, start searching for a competent dentist in your new location who can correct your teeth. The new dentist can confront the dentist who damaged your teeth. Her malpractice insurance should cover the cost of restoring your teeth, and your case shouldn’t need to go to court. But if you take your case to court, we think you would receive a substantial award.

Accredited cosmetic dentist, Steven Brooksher, DDS of Baton Rouge sponsors this post.

Depressed and discouraged about my teeth

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I’m depressed about my teeth. I need advice from someone who cares. At a young age, I started having extreme problems with my teeth because our family was poor and rarely had insurance. My teeth were crooked and bucked. I also had lots of cavities and toothaches.

As a teenager, I had several root canals. Dentists who didn’t care did much of the work. One dentist started a root canal on a front right tooth but didn’t complete it because we lost our insurance and couldn’t afford it. There was a hole in the back of the tooth, and the tooth eventually turned gray and broke in half. I was 19 years old, had no money, and had a broken front tooth. It was devastating for my self-esteem.

I found another dentist within 12 miles of our house, and I rode the bus to the office and cried to him about my teeth. He agreed to help me. My front teeth were crooked, so the dentist did a bridge to replace the broken tooth and make the crookened ones look better.

When I got married at age 25, we finally had insurance. There were so many issues with my teeth that it was challenging to keep up with them. My left front tooth became abscessed, so the dentist did a new bridge that extended from one eye tooth to the other. Then two years later, I needed a bottom ridge. Between that, I still needed root canals and crowns.

Last year, a toothache in a bottom left tooth started to become intense. Another dentist was filling in for my regular dentist, and she said that an abscess was forming on a tooth that had a root canal, and I had a sinus infection. She gave me antibiotics and referred me to an endodontist. The endodontist said that he didn’t see a problem. I returned to my dentist, who agreed that she couldn’t find anything wrong. Sounds suspicious, right?

I still have a toothache in the bottom left tooth. Sometimes the pain is intense but goes away. I didn’t have any pain throughout the winter, and then it came back about three weeks ago. I felt like I had an earache, so I went to my primary care doctor. She examined my ear and said it’s okay. My husband recently lost his job, so we received help from the state and state-sponsored insurance. It’s so difficult to find a dentist who cares.

I finally found a dentist who saw me for less than ten minutes and said I have TMJ. He said that I needed a $400 mouthguard, and other than that, there was nothing he can do. Although I might have TMJ, I have a failed root canal that no dentist can find. I’m convinced that one dentist saw the problem, and the rest either can’t see or don’t want to be bothered.

The pain feels like a horrible earache that extended into my jaw, throat, and chest. Sometimes I feel stabbing pain. I don’t have a fever, and my primary care doctor said that my bloodwork shows ho sign of infection. I’m depressed and worried about what can happen if a dentist isn’t able to find the infection. On top of that, I’m embarrassed to smile. At 35 years old, I have missing, chipped, and cracked teeth that look terrible. And the two bridges look like someone set them in my mouth without trying to make them look halfway natural. I’ve thought about taking the bridges out, but I’m afraid of damaging my teeth and being toothless.

I’ve also thought about dentures, but my husband and friends say that’s a bad idea because it would cause even more problems. I’m sorry for emptying my life’s story on you, but I almost feel hopeless. I was so happy when I found Dr. Brooksher’s website. I’ve looked at most of the pages on it, and it seems like your office cares about people and how they feel about their teeth. Do you think I should get my teeth all pulled out and accept whatever happens? Thanks for your help. Ryleigh from MS

 

Ryleigh,

Like you, many people have teeth that seem to fall apart faster than a dentist can restore them. We know it’s discouraging to you, but it also concerns a dentist who cares. Although some dentists don’t care, many of them do. They are not dentists for the money; they became dentists to help people.

From your description, it seems that you’ve seen dentists who care but are also discouraged by seeing your situation. Some might judge your situation and think that your oral health condition means that you don’t care, so they might not care either. We are confident that you can find and understanding dentist who is willing to help you without extracting all your teeth and giving you dentures. What can you do to improve your oral health and find a dentist to help?

Stop the Cycle of Tooth Decay

Practicing good oral hygiene is one step in preventing tooth decay. But other factors can help.

  • Toothbrushing – Although many people think that toothbrushing is the best way to prevent tooth decay, toothbrushing only cleans the smooth surfaces of teeth. It doesn’t clean cracks, crevices, contact points, and other areas that are vulnerable to decay. Liming what you eat, discussed below, prevents decay more than toothbrushing does.
  • Flossing – Multiple scientific studies show that flossing helps prevent gum disease and interproximal (between the teeth) decay.
  • Saliva – The greatest defense is in your saliva. Saliva contains decay-fighting antibodies and remineralizes small spots of decay in teeth. If you strictly limit the number of times you eat each day, it will maximize your saliva’s effectiveness.

Limit What You Eat

Limit eating to three times a day—three main meals and two snacks. Brush your teeth two to three times a day, and floss between your teeth before bedtime. Limiting how often you eat daily gives saliva time to repair the small spots where decay begins. Most people who reduce the number of times they eat daily also reduce the number of cavities and their growth rate. People who are strict about it can be cavity free eventually.

What’s Next?

Photo of woman sitting back in a dental chair with her eyes closed; for information on Baton Rouge sedation dentistry during tooth extraction.

Sedation dentists are often empathetic toward patients with poor oral health

Don’t give up.  Keep looking for a dentist. Call offices and ask if you can get an office tour or meet the staff and dentist. When you find an office and dentist that makes you feel comfortable and isn’t overwhelmed by your oral situation, start a treatment program with them.

Find a dentist who will try to save—not extract—your teeth. And keep as many teeth as possible. Bone shrinks where teeth are missing. And the only way to prevent shrinkage is by replacing the missing tooth with a dental implant. Keep in mind that dentists who do a lot of sedation dentistry are used to seeing people with “bombed-out mouths” and tend to be more empathetic.

Steven Brooksher, DDS, of Baton Rouge sponsors this post.