Cosmetic Dentistry Mistakes

The following are several questions I have received from patients during their “Smile Consultations”. There are many unfortunate cases like some of these in which the general dentist, who may be a nice person and very knowledgeable in general dentistry, does not appear to know the subject of Cosmetic Dentistry or Prosthodontics very well, and the dentist ends up "practicing" cosmetic dentistry on the patient. In many cases, these unfortunate patients now have no legal recourse after their cosmetic dentistry mistake, because the dental care they received was average care for general dentists, even though it was far short of the standard of care for expert cosmetic dentistry.

By no means do I intend to imply that dentistry as a profession in the United States is in bad hands. The level of general dental care and expertise in the United States is very high. But there is clearly a problem with patients being able to get excellent cosmetic dental care from general dentists.

And keep in mind that these cases are only a sampling of this type of complaint that I have seen coming though my practice.

“…Porcelain Veneers Look Gray!” Dr. Parajon explains that true cosmetic dentists know how to use “Opaquers” to block out the underlying color of dark teeth.

“… six porcelain veneers placed. Several months later, one of them cracked!”

The dentist replaced the cracked veneer, but the replacement veneer is much thicker and whiter than the other five. Dr. Parajon explains the concept of “Emergence Profile, Emergence Angle, and Custom Shade Matching”; helped both general dentist and patient on an agreeable refund and the veneers were replaced for the same cost and restored her beautiful smile. Look at her smile now, you be the judge of the drastic difference from the before and the after.

“...patient wants her bonding replaced but her dentist says that the new bonding will be amber colored and she should have caps instead!” Dr. Parajon showed her how bondings, in the hands of an expert cosmetic dentist, can look beautiful and can be as white as she wants. It comes down to the knowledge of biomaterials in dentistry.

“...female patient from London, England went to a dentist for a new smile, but his porcelain veneers have began to yellow after only two months!”

Dr. Parajon questions if the porcelain veneers are really made of porcelain and in fact composite resin was used instead of porcelain. Patient flew into California to visit family and had her New True Porcelain Veneers done at our office witin one week. Look at the drastic change in her smile! The patient was ecstatic to see the difference.

“…patient asked her dentist to give her the whitest veneers possible. But the veneers she got are actually darker than her own bleached teeth.” Dr. Parajon tells her that general dentists often don't know the full spectrum of colors that are available in cosmetic dentistry materials and that there is no limit as to how white she can have her veneers. We changed her veneers to a nice natural looking white color of teeth.

“…patient has had upper veneers for seven months, and they are starting to get a yellow tinge. Dr. Parajon tells patient that he suspects the new veneers were not made out of porcelain. Properly done porcelain veneers, that are really made out of porcelain, are very color-stable.

“…patient had a one tooth bonded, and now he wants to bleach his teeth.” Dr. Parajon tells him that his bonded tooth will not bleach and that he should have bleached first and bonded after that.

“a patient is having 6 crowns done on her top teeth and the patient is concern on how are these teeth going to look like and how is her current general dentist be able to fix her uneven bite plane. After the first appointment, the they were going to do lumineers or porcelain to metal crowns, but the patient came in for a second opinion because she wants Empress crowns.”

Dr. Parajon expresses some grave reservations about how this case is proceeding and recommends to do a “Diagnositic Waxup” so that the patient becomes well informed and is able to see the final proposed result in a 3-D model. The patient became a patient of our office and had only two porcelain veneers done; the two laterals after ZOOM whitening at our office. In this case, we were able to save and incredible amount of expense to the patient and achieved the nice change she was looking for.

“…a lady had a porcelain veneer and a porcelain crown done on her two front teeth. While they looked okay in the office, and she signed a paper in the office that they looked fine, when she goes into outside light, they look different in color!” Dr. Parajon explains the concept of color “Metamerism” that her general dentist maybe doesn't understand.

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