I had old composite bonding on my teeth and needed them replaced. I decided to go with porcelain veneers instead because my dentist said they’d last longer and look better. I’m not thrilled with the results. One of the canines seems crooked to me. Plus, one of my front teeth has a tiny strip that’s a different color. I think it’s my natural tooth showing through on top. I mentioned both of these things to my dentist and he said everything looked fine to him. I feel like I’m being a problem patient. Am I being overly realistic? Will the spot with the exposed tooth develop decay?

Laura

Dear Laura,

I think your dentist is still developing as a cosmetic dentist. It’s not a recognized specialty. That leaves it up to the dentist to invest time and money in training to gain both skill and artistry.

It’s also a completely different mindset. In dental school, we’re taught the dentist knows best. Cosmetic dentistry is different. It’s about the smile the patient wants. If you’re not happy with it, your dentist should fix it. You paid for a beautiful smile, and that’s exactly what you should get. And since you’re the one who has to live with it, you’re the judge of whether or not it is beautiful, not your dentist.

As for developing decay where you can see your natural tooth, unless there is a bit of a ledge where bacteria can get trapped, I don’t think you have anything to worry about. If there is a ledge, that will be a problem.

I know you feel like you are being a problem patient, but think of it more as helping your dentist become better at cosmetic dentistry.

Getting Your Dream Smile Makeover

Dr. Imam uses a digital smile design to help ensure patients will love their new smile before any preparation is even done on your teeth. The computer program helps plan the makeover. As an example, it would figure out exactly how wide and long each tooth should be in the makeover to obtain the smile you want. It will then allow him to print out a digitally altered photograph of how the result will look, so that you will know exactly what it will look like before any work is done and can request any changes.

Ask your dentist to re-do the teeth which you’re unhappy with. Hopefully, he’ll be open to learning how to create a smile that you’re proud to show off. Every cosmetic dentist starts somewhere. Re-doing the case will help both of you. When the porcelain veneers are ready, your dentist should try them on with a temporary try-in paste. You should get to look at them in different lights and approve them before they are permanently bonded on.

This blog is brought to you by San Antonio Cosmetic Dentist Dr. Imam.