Best Dentist Archives - Stephen D. Doan, DMD

Dentist Said I Can’t Get My Crowns as White as I Want

Posted on March 5, 2022 by writeradmin.

Years ago, I had a bunch of crowns placed on my teeth. I wanted them whiter than they gave me. Now that it is time to replace them I thought it would be my chance to get them the color I wanted, but my dentist said that is not possible. I want a BL1. He said because there are posts in some of my crowns that it is not possible to do anything whiter than the B1 or the posts will show through. This is darker than I want. Is there any way I can get away with an M4 or a BL4? I do want white teeth but don’t want them fake looking.

Pilar

Dear Pilar,

I am not certain this is the best dentist for you. He does not appear to have the skills you need to get the smile you really want. One reason I say this is your dentist is confusing color with transparency. You don’t make a crown more translucent if you make it whiter. If your posts are not showing through on a B1, they won’t show through on a BL1.

However, let us give him the benefit of the doubt… for now. One thing I think you should do is tell HIM what type of smile you want. Tell him the shape, the color, and any other details you want in your dental crowns. In cosmetic work, it is the patient who gets to dictate what they want. Then, when your crowns come in, make sure he only places them using a temporary try in paste. You should get a good look at them in a variety of lights. If you’re not pleased with them, he should send them back to the lab to make the changes you want.

If he is either unwilling to agree to that or unable to make your smile the way you desire, then it is time to switch dentists. If it comes to that, you will be safest with an AACD accredited dentist. These are the best cosmetic dentists in the country.

This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan.

Prosthodontist Versus Cosmetic Dentist – A Cosmetic Horror Story

Posted on November 13, 2021 by writeradmin.

I needed a full mouth reconstruction because of mild TMJ Disorder. The one thing about this I was sort of excited about is the chance to get my teeth to look the way they used to. I even brought him a good picture of my original smile and told him, “This is what I want.” Throughout the procedure, I would suggest things and he’d say, I need to trust him because he’s been doing this for a long time. He is a specialist on crowns called a prosthodontist, so I trusted him. When the unfinished ones came in, they were the completely wrong color. He told me that I picked the wrong color and his choice was better. But, I insisted I wanted it the color I chose. When these came back, the top arch was darker than the bottom arch. I mentioned that to him and he promised that they only appeared that way because these are unfinished and when they were done it would not be that way. That turned out to be not true. When they came in, the top was definitely darker than the bottom. I told him they needed to be switched and he said that they’ve bent over backward for me and nothing seems to please me. I can either take these or leave with nothing. I was in shock. I couldn’t just leave; I’d have no teeth! Then asked if they could just put them in with a temporary try-in paste will I consider my options and they said no and used permanent cement. My mouth looks ridiculous and I spend over $40,000 on this. Is there anything I can do or am I stuck with these? Communication with him is like talking to a brick wall, but one that talks back and is sure it knows better than you. I’ve been crying since this appointment.

Elaine

Dear Elaine,

Cosmetic dentistry is about skill, artistry, and an outlook that cares what the patient wants.

What you are butting up against, which can sometimes be harder than a brick wall, is the prosthodontic mindset. Not all prosthodontists carry this mindset, but I will admit the majority do. You see, they went to extra school to become experts in placing crowns. As a result, they feel confident they are the experts. As a result, they don’t care what you think The problem comes when they think that expertise carries over to the appearance-related side of things. It does not. True cosmetic dentistry is not taught in dental school, nor is it a specialty. If dentists want to develop expertise in the area, they have to voluntarily invest time and money in the training.

The good news is you have leverage here, but you have going to have to be strong and face him. In all honesty, what he did was malpractice. He forced those crowns on you despite multiple efforts and requests on your part to change them. The foundation of dental ethics is informed consent. You didn’t give that voluntarily. He will probably disagree, but consent under duress, which you certainly were under at that moment by being threatened with not having any teeth, is not considered informed consent by any legal definition.

What you want from him is not a refund. Instead, you’ll want him to pay for this case to be re-done by the dentist of YOUR choosing. He will probably argue and refuse. Tell him you will be speaking to an attorney, then go speak to one who understands dental malpractice. I’m fairly confident his malpractice insurance will tell him to give you what you want.

When you do go looking for that dentist to fix this, make sure it is an AACD accredited dentist. These are the top cosmetic dentists in the country.

This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan.

Fluorosis Stain Disaster

Posted on August 14, 2021 by writeradmin.

I have fluorosis stains and went to my dentist to get this “fixed”. He suggested dental bonding. We went forward and I’ve had problem after problem since. First, the bonding does not cover the stains. I mentioned I can still see them and he said to come back in a week and he’ll add another layer. Before that could even happen, they started falling off. Then, he went ahead and added the other layer. It’s a bit better but, again, they’re still falling off. He said I have a bite problem and suggested I get a night guard. I did that, but they’re still coming off. What do I do now?

A.J.

Dear A.J.,

Fluorosis Stains

I’ve posted an image above of some fluorosis stains for those who do not know what we’re referring to and can see how devastating these stains can be to someone. As to what you should do, the first thing I recommend is that you get a refund. You will not get this done correctly through this dentist. He can’t cover the stains properly, he can’t get the bonding correct, and he blames you for his lack of skill. While a mouth guard is a good idea if you are someone who clenches or grinds their teeth, it will not make bad bonding good.

Properly covering fluorosis stains in a way that covers the stains AND gives the teeth the look of a natural translucency you see on natural teeth is one of the hardest things to do. You need an extremely advanced cosmetic dentist. In your place, I would not use anything less than an AACD accredited dentist. This is different than just membership with the American Academy of Cosmetic Dentistry. Accredited dentists have passed stringent technical exams as well as a board of examiners that look at the artistry of their results on actual cases they have done. These dentists are in the top 1% of cosmetic dentists in the world. They can give you a stunning smile, even with fluorosis stains.

Don’t be surprised if they suggest porcelain veneers instead of dental bonding. First, they are easier to work with. More importantly, though, is they last significantly longer. Dental bonding may last a few years, but bonding can last decades.

This blog is brought to you by La Jolla Dentist Dr. Stephen Doan.

Front Teeth are the Wrong Color

Posted on May 31, 2021 by writeradmin.

I had two crowns made for my front teeth. My normal family dentist did them at first, but he was unable to match the shape and contours of my natural teeth. He didn’t feel it was a good enough job, so he referred me to a prosthodontist he knows. They are supposed to be crown specialists. I went to this other dentist with high hopes. One thing you should know is I use nitrous at EVERY appointment. I’m a naturally anxious person and having the nitrous relaxes me enough to allow me to get the dental work done. Whenever there is an important decision to be made, my family dentist always reduces the nitrous enough for me to be lucid and make decisions when the time for that comes. The prosthodontist did that the first time too. I looked at the crowns and decided they were too opaque and chalky looking. He reluctantly agreed to re-do them. The second time, he didn’t really take me out of the nitrous when he said he had me look at them. I do have a recollection of seeing them, but its fuzzy. I don’t remember giving the okay. Once I was completely lucid, they sort of rushed me out of there. Now that I have a good look at these crowns, it is obvious they are grayer than the rest of my teeth. I think they knew that and that is why they did not take me out of the nitrous the second time around. When I called them about it he said, I would either have to pay for two more crowns or he could give me the first pair instead of the second. I feel like I’m being give a choice between ugly teeth or uglier teeth. Is there anything I can do about this?

Maddie

Dear Maddie,

I am sorry that you are even having to fight this dentist. This is one of the differences in mentality between prosthodontists and true cosmetic dentist. While a prosthodontist will have some expertise in the shaping of crowns, they lack the training necessary to make them beautiful. Unfortunately, because they have additional training, they develop an arrogant mindset that they know best. Whatever you do, please do not allow him to do anymore work on you. I don’t think the results will be any better and he will not care.

Dentists with cosmetic training, however, have a different mindset. It is all about creating the smile their patient loves. They would never be satisfied if you weren’t. I would try to get a refund and then get this done again by an AACD accredited dentist. These are the top cosmetic dentists in the country. You may have to get your family dentist on your side in order to secure the refund you need. In contrast to your prosthodontist, your dentist seem to have more integrity and pride in his work. Because he is the one who referred you to this dentist, I am going to suggest you show him the teeth and ask him what he thinks. If he agrees with your that the teeth need to be replaced, he or she may be able to support you in getting that refund. You will love the crowns you get from the dentist with real expertise. and won’t even be able t tell the difference between these and your natural teeth.

This blog is brought to you by La Jolla Dentist Dr. Stephen Doan.

Capping Teeth with a Small Smile

Posted on January 18, 2021 by writeradmin.

I am a bit worried about my doctor’s plan for my smile makeover. I have a small mouth. As a result, my front teeth tilt inward a bit. I wanted to have that fixed as well as whitening them. My dentist is suggesting capping my six front teeth. The teeth are healthy so I am not sure this is the best option for me. I don’t think I want to ground down healthy teeth. Is there another option? I asked him about porcelain veneers instead and he said that would work with my small mouth.

Laurie

Dear Laurie,

I am glad you wrote. Your dentist is going about this all wrong. He is definitely not the best dentist for you in this case. Your reaction is warranted. It is rarely a good idea to grind down healthy tooth structure. His excuse about the size of your mouth holds no water. Dental crowns surround the whole tooth. Porcelain veneers only cover the front of your teeth, which takes up less space.

If the only thing wrong with your teeth is the two front teeth turning inward, you have several options. I would start by seeing an expert cosmetic dentist. They may look at your bite and just suggest Invisalign to straighten those teeth, which is less money than porcelain veneers. You can also whiten your teeth at the same time because the aligners can double as whitening trays. All your dentist will have to provide is the gel.

If it turns out porcelain veneers are your best option, take full advantage of their capacity. They can change more than the color of your teeth. They can also change their shape and size. It is a perfect way to completely remake your smile. In fact, it is the go-to procedure for those wanting that Hollywood smile.

Unlike Invisalign and teeth whitening, though, getting porcelain veneers requires real expertise and artistry. In your place, I would recommend you go to an AACD accredited dentist. These are the top cosmetic dentists in the country.

This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan.