Porcelain Veneers Led to Root Canal Treatments
I had a smile makeover done with veneer crowns. Ten teeth on top and ten on the bottom. After the permanent veneer crowns were put on, I started having some problems. In the first four weeks, I’ve had three teeth have sharp pains. He tried adjusting them, but that didn’t help. He did some x-rays and told me that I have nerve damage and will need root canals. First, he never told me that nerve damage was a possibility. I asked him about that and he said that it is rare and I’m just one of the “unlucky” ones. Now, I’ve had two more teeth start to bother me. I’ve already paid for all of this and now I’m having to pay for root canals too. Should he offer to pay for some of this?
Angie
Dear Angie,
I am sorry that you’ve had this experience. I want to start by clearing up some terms to make sure we are talking about the same thing. You keep saying veneer crowns. There are porcelain veneers and there are porcelain crowns, but there are not veneer crowns. The big difference between the two is the amount of tooth preparation that has to be done.
With porcelain veneers, hardly any tooth structure needs to be removed. In part, that is why nerve damage would be extremely rare. I’m thinking with the amount of damage and root canals you ended up needing, I suspect you were given dental crowns. With dental crowns, much more of your tooth structure is removed as you can see in the image above. This would have a greater risk for nerve damage. However, even then it would take some aggressive shaving of the tooth to do the kind of damage you are talking about.
The fact that he gave you crowns also concerns me. The standard procedure for a smile makeover is porcelain veneers. Do you know why your dentist gave you crowns? Did your teeth already have crowns? Unless you needed crowns, doing them for a smile makeover is an overtreatment. Though, sometimes, dentists who don’t really do a lot of cosmetic work, will suggest them simply because they don’t know how to do veneers.
I would ask him to pay for the root canal treatments. You wouldn’t have nerve damage without his procedure unless there is something else you didn’t mention that would reflect on this situation.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Is a Porcelain Veneer Turning Dark a Dental Emergency?
My daughter had eight porcelain veneers placed after she graduated college. She’s now in a low residency grad program and is having trouble with one of her porcelain veneers. It started when she was out on a bike ride and fell. She chipped one of her front teeth. We went back to the dentist who “fixed” it by sanding down the chipped tooth. That also meant that she had to file down the next tooth too. Fast forward just a few months and my daughter and I both noticed that one of the teeth that he shaved was getting darker. We went back to see him and he said that he is an expert in color and it looks fine to him. Then he proceeded to tell me that I was imagining a change in the color. Fast forward again and now that veneer is turning bluish. We’re both worried that this veneer is going to fall off. She still has two weeks of residency left. Should she go to an emergency dentist or wait until she gets home?
Evelyn
Dear Evelyn,
While something has gone wrong with this porcelain veneer, I don’t think it is a dental emergency yet. It would be best if she waited for the veneer to fall off naturally, even if she is done with residency and back home. Then, once it has fallen off an expert cosmetic dentist can help her to get it bonded back on.
If it gets too unsightly for her and she is embarrassed, the best thing you could do in that case is to have it ground off and then replaced. While it sounds like your dentist did an okay job with the porcelain veneers if she was happy with their appearance before, I’m not sure he’s the best dentist to handle this from here. His attitude toward you bothered me.
If she needs to get it ground off and replaced, just get all his notes on her treatment — he is ethically required to provide those — then get it replaced with another dentist. Preferably one with significant post-doctoral training in cosmetic dental work.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Two Concerns with My Porcelain Veneers
I had porcelain veneers placed about five days ago and love them. That being said, I have two concerns. First, I did not realize I should not be using whitening toothpaste on them. I did that because I wanted to keep them bright, but a friend told me that they can damage porcelain veneers. Did I ruin my new smile makeover? Second, I was only able to get six veneers. I wanted a white smile, which my dentist gave me. But, the teeth next to the porcelain veneers are not white and it is detracting from my beautiful new teeth. If I get my teeth whitened, will it damage the veneers?
Zack
Dear Zack,
I’m glad you wrote. Let’s start with the toothpaste because that has you really worried. While it is true that most-over-the-counter toothpastes will damage both cosmetic dental work, as well as your normal teeth, that damage would happen after some prolonged use. It sounds like you’d just stared using it, so I would not be too worried. So you know, there is one whitening toothpaste that I would recommend which is safe for both your teeth as well as your porcelain veneers–Supersmile Toothpaste. If you want to keep stains off of your teeth, this is the only toothpaste I would recommend.
As for the natural teeth being a different color, there is a fix for that. Technically, your dentist should have addressed this before you had your porcelain veneers were placed. Most smiles are eight to ten teeth wide. Knowing that you were only getting six porcelain veneers, your dentist should have anticipated the color difference. Standard procedure in those cases is to have the patient do teeth whitening before they get their veneers, that way the natural teeth will blend in with the veneers.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Dentist Lied to Me About Porcelain Veneers
I went to a dentist to get porcelain veneers. It’s not my normal dentist who said he doesn’t do a lot of cosmetic dentistry and I’d be better off with someone else for this procedure. I appreciated his honesty. If only all dentists were as honest. The dentist I went to told me he was giving me porcelain veneers. I have texts and emails to that effect. I should have been suspicious when he ground down my teeth and gave me temporary “veneers.” Unfortunately, I continued to trust him. I had two teeth that had already had root canals. One of them ended up getting infected after my procedure. It started bothering me a few days after it was placed, which the dentist assured me was normal and would rectify itself. The pain became so intense that I ended up in the hospital and they had to extract the tooth in order to save my life. The infection had spread and was close to my brain. The hospital also told me that I did not have veneers but crowns. I looked at my texts again. They definitely said veneers. I also looked at their website, which does explain the difference between crowns and veneers. I went to see another dentist after this and he said they are definitely crowns and that the dentist over prepared my teeth, which is why I’m having problems. I feel so angry. Is there any way to get my money back on this so I can get veneers?
Catherine
Dear Catherine,
I am sorry this happened to you. Unfortunately, now that you have had crowns placed on your teeth, there is no way to unring that bell and get veneers. The tooth structure cannot be regrown. As you can see from the difference in tooth preparation, porcelain crowns require much more tooth preparation. Based on your description, it sounds like the dentist you went to was even more aggressive.
While you cannot get porcelain veneers, you can get your money back. In fact, I think you have a decent case for a lawsuit, but that is a lot of time and trouble. A basic tenant of dentistry is informed consent. You gave consent for porcelain veneers. He gave you a completely different procedure altogether. I would start by just asking the dentist for a refund. Let him know that you understand the strength of your position and are willing to go to court, but wanted to give him the chance to do the right thing.
The fact that his website shows that he knows the difference between the two procedures works in your favor.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
MAC Veneers or Lumineers?
I had an accident which damaged the appearance of some of my teeth. In preparation for fixing this, I’ve whitened them. Now I want to get porcelain veneers. My dentist said that MAC veneers are the strongest but Lumineers means no grinding of my teeth. I’m having a hard time deciding. Are there pros and cons to each of these?
Margaret
Dear Margaret,
I am glad that you wrote. I can tell you are trying very hard to do some research and make a wise decision. It was wise of you to get your teeth whitening done first. As for the veneers, I would like to gently suggest you shift the way you look at this. Cosmetic dentistry is not just a procedure, it is also an art form. As an analogy, let’s compare this to a painting. If you were trying to commission a beautiful work of art, would you focus on the brand of paint or on getting the right artist? Well, the artist, of course!
What you want to focus on for your smile makeover is the artistic skill and training of the dentist. While in the hands of a skilled cosmetic dentist, MAC Veneers can look stunning, but if the dentist isn’t skilled, they could end up looking awful. I am a bit concerned about your dentist’s second recommendation.
Lumineers are a brand of porcelain veneers which are highly marketed to in experienced cosmetic dentists as being easy to place. Unfortunately, unless the dentist is highly skilled they end up looking quite bulky. Some disappointed patients have even gone so far as to call them horse teeth. Most skilled cosmetic dentists don’t like this brand because the lab that they require dentists to use is not known for producing beautiful results.
What you want to do is make sure you use a skilled, artistic dentist to do your smile makeover and let them pick the brand. If they’ve done adequate post-doctoral training, then they will know the pros and cons of each brand. Then, depending on what type of smile you were looking toward, they would know which brand can best get those results.
I would start by asking the dentist what type of post-doctoral training they have in creating beautiful smile makeovers. This is not adequately taught in dental school. Then, take the additional precaution of checking out their smile gallery. If they do not have a smile gallery, then I would not consider them a serious cosmetic dentist. If they do, make sure you love the results they get before you move forward with anything.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Floss is Catching on My Porcelain Veneers
I recently got four porcelain veneers and I’m having trouble flossing. My flosser keeps catching on the veneers. My dentist thinks it is fine because my gums cover the problem. I’m just afraid that if we leave it like this, then food and things will get trapped in there. Won’t that leave me vulnerable to decay?
Carolyn
Dear Carolyn,
When you have porcelain veneers placed on your teeth, the margin needs to be completely smooth and flush with your teeth. It sounds like that didn’t happen for yours and you have an overhang. This can happen when the dentist does not get a clean impression at the end of the tooth preparation. Then the lab can’t make smooth finish from the veneer to the tooth.
The overhang not only means that you can’t get your floss there, but that food and other debris will get caught there, as you are concerned about. While there is a risk of decay, I think the bigger risk is gum disease. This really does need to be fixed. When gum disease is left untreated, it leads you bone loss and the loss of your teeth.
If your dentist has a good sense of ethics, they will replace this free of charge. If they refuse to, then you will need to get this fixed for the health of your gums.
You may want to try getting a second opinion. If another dentist agrees that there is an overhang, they may be able to convince your dentist that they need to redo them. Sometimes a dentist is more likely to listen to a colleague than a patient. It shouldn’t be that way, but it can happen.
I’m sorry this happened to you. Cosmetic dentistry is not a recognized specialty, which means any general dentist can do cosmetic work regardless of whether they’ve invested in any post-doctoral training. If you do have to pay to have them done by someone else, make sure they have a beautiful smile guarantee.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
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Mouthwash for Porcelain Veneers
I have some porcelain veneers that I really love. I want to take the best care of them that I can. I’ve made a homemade mouth wash and just want to make sure there is nothing in it that can hurt the veneers.
My recipe is essentially equal parts of filtered water and hydrogen peroxide and some sea salt. As an example, last night I mixed:
4 oz. filtered water
4 oz. 3% hydrogen peroxide
1 T. sea salt
Will this work for me?
Karen
Dear Karen,
I am glad you love your porcelain veneers. There are many patients that end up with a cosmetic dentistry horror story because their dentist did not have the artistic ability to create a beautiful smile. Thankfully, yours did. It is also commendable that you are tying your best to take care of them. Though, I wish your dentist would have given you a list of instructions to do this.
The only problem with your DIY mouthwash is the peroxide. While peroxide is great at killing bacteria, it does not distinguish between good and bad bacteria. The good news is that your mouthwash will not damage your porcelain veneers. Unfortunately, what it will do is create an environment to that will breed candida albicans, a type of yeast. As a result, you will end up with some nasty thrush.
If you really want to use a mouthwash, there are some good over-the-counter mouthwashes. The one thing that you want to avoid is a mouthwash that contains alcohol. This is because it will eventually wear out the bonding that holds your porcelain veneers in place.
While we are on the topic of taking care of your porcelain veneers, I want to suggest you use Supersmile toothpaste. This is specifically designed to safely care for cosmetic dental work and keep them stain free. This includes things like porcelain crowns and dental bonding.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Getting Porcelain Veneers While Pregnant
I am afraid I’ve screwed up big time and need some advice. Three days after completely finishing my porcelain veneers procedure I found out I was pregnant. I looked it up and you are not supposed to have dental work done in the first trimester of pregnancy. Is there anything I can do or is it too late?
Lacey
Dear Lacey,
Take a deep breath. This is going to be okay. Dentists are told not to perform unnecessary dental work in the first trimester of a pregnancy because that is the most sensitive time for the baby and you don’t want to introduce chemicals that can be harmful. Fortunately, for you, the only chemical that should have been used in the porcelain veneers procedure is Lidocaine. This has already been approved for use during pregnancy and is even used in the delivery room. There should be no issues of adverse reactions with your baby.
So you know, you will be better off to schedule any regular dental work during the second trimester, so I’d get that appointment scheduled now. We have already discussed why we avoid the first trimester. We avoid the final trimester for the sake of your comfort, more than any actual safety issues. You’ll be a bit larger because you’ve got a whole baby you are holding on to. This tends to make it less comfortable for you to sit in a dental chair for any length of time.
The exception to avoiding dental work is if you have a dental emergency of some kind. It is important and infections, including dental infections, are treated promptly so you don’t have any lingering bacteria that can be passed to your child. You also want to keep up with your cleanings. Untreated gum disease is linked to low birth weight in babies. So, as much as you are probably exhausted right now and feeling a little nauseated, go ahead and schedule your cleaning.
If you end up dealing with a lot of morning sickness during your first trimester that leads to vomiting, call your dentist and ask about ways you can protect your teeth during those early months.
Congratulations on your new baby!
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Will I Need a Crown to Replace a Porcelain Veneer?
Can a dentist fix a cavity on a porcelain veneer tooth without me needing a new veneer or a crown? My dentist wants to remove the cavity but says I might need a crown instead. Why? I would have three veneers and one crown on my front teeth. How would that look? I am worried that a crown would be noticeable beside three veneers. Thank you. Isaac from Oak Park, IL
Isaac,
Thank you for your question.
Dr. Goebel would need to x-ray your tooth and examine it and your veneer for an accurate diagnosis. Still, we will provide general information.
Matching crowns and veneers
If you need a crown, it will be challenging for a dentist to match it with your other veneers. A dentist must have advanced cosmetic dentistry training to achieve a match.
Do You Need a Veneer Replaced with a Crown?
Whether your dentist must replace your veneer with a crown depends on the tooth’s condition and the cavity size.
Removing the cavity might require losing much tooth structure. When little tooth structure remains, it may be challenging to bond a veneer to it. Even with a crown, a dentist may need to build up the tooth before it can support a crown.
If you want to keep your porcelain veneer, please understand that although family dentists are skilled at keeping your teeth healthy, they have limited cosmetic dentistry skills without advanced training. The results depend on the dentist’s training and experience. It is unreasonable to expect your family to achieve beautiful results.
We recommend scheduling a second opinion with a dentist with advanced cosmetic dentistry training to examine your tooth and veneer to explain your options.
Moline, Illinois, cosmetic dentist Dr. Thomas Goebel sponsors this post.
Help Correcting Overjet and Spaces Between My Teeth
I have multiple problems with my teeth. I have overjet, and some spaces between my teeth are about 1/8 inch wide. Four of my teeth are missing. Also, I have caps on my front center teeth that are yellow, old, and too big. The overjet makes it looks like I am poking out my lips. My top teeth completely overlap my bottom teeth when I close my mouth. If I bite down, my teeth dig into my gums. This is a lot of work that I know my regular dentist doesn’t usually do. He said he could do new caps and then refer me to an orthodontist. I do not feel good about how my crowns will look from my dentist. I prefer not to switch dentists, but is there another way around it if I need cosmetic work and braces?
Loraine –
We understand your concerns. When there are multiple issues with your teeth, if a dentist’s work is not good, it can still detract from your smile. Although braces may beautifully align your teeth, if your dental crowns (caps) do not look natural, you will be unhappy with your smile—and perhaps self-conscious about it.
Over Jet Treatment Options
If you have overjet and want to correct it, a cosmetic dentist will recommend orthodontics before dental crowns or veneers.
- Orthodontics – Braces can correct overjet and the spaces between your teeth.
- Dental crowns – Repositioning your teeth takes priority. Afterward, a cosmetic dentist can replace your dental crowns with natural-looking ceramic crowns.
- Porcelain veneers – If you did not have crowns already, after orthodontics, porcelain veneers could correct flaws in your teeth, including shape and discoloration that teeth whitening will not resolve.
We recommend looking for two or three accredited cosmetic dentists with whom you can have consultations. Make a list of questions that you want to ask during the consultations.
You will learn about your options for closing the spaces between your teeth, resolving the overjet, and what can enhance the shape and color of your teeth. Ask to see photos of cases like yours that each cosmetic dentist has completed for their patients. It will take some time, but it will help you find the best dentist to give you a smile you want.
Dr. Thomas Goebel, a Moline, Illinois dentist, sponsors this post.