Cosmetic Dentistry FAQ’s

Here are some questions that website visitors are asking:

What kind of maintenance is required for porcelain veneers?

I’d like a new smile, so I am considering porcelain veneers, but I am concerned about the long-term maintenance costs they require. What can you tell me about that? Thank you

—Michelle
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Michelle,

There really isn’t any special maintenance cost—just keep up with your regular checkups.

If you’re not in the Phoenix area, it may be difficult to come back to us for your maintenance care, but if that isn’t practical for you, ask Dr. Chal for a recommendation for a dental office close to you that would be qualified to give good maintenance. Dr. Chal knows many other cosmetic dentists around the country.

And we can’t take responsibility for what other dental offices may do. There are some things that a dental hygienist can do to damage your porcelain veneers—such as using an ultrasonic scaler, or sodium bicarbonate power polishing equipment. This can destroy the glaze on the porcelain. Your veneers will look fine when you leave the dental office, but they will begin to pick up stains.

What if I need my porcelain veneers replaced? Is
that a difficult process?

I had porcelain veneers on my front teeth due to enamel erosion. This was about 10 years ago. Since then my gums have receded, thus leaving a bigger gap than before. I’m conscious of this and are considering new ones. My question is would it be a difficult process to remove my veneers and what does it entail?

—Sarah
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Sarah,

Replacing porcelain veneers is the same process as getting them in the first place. Since porcelain veneers bond to the tooth and become just like your enamel, removing them is the same process as shaving down the enamel. About one-half millimeter, which is approximately the thickness of a fingernail, is shaved from the fronts of the teeth, and then an impression is taken of this, and a model made. Our master ceramist then creates the veneers on this model first, and then Dr. Chal bonds them onto your teeth.

The only difference if you already have had veneers is that Dr. Chal makes sure that the old veneer material is completely cleaned off. If your current veneers are thicker than a half of a millimeter, Dr. Chal will just remove the remaining veneer material until he is down to your natural tooth structure. For an experienced cosmetic dentist like Dr. Chal, who knows how to tell porcelain from enamel, this is a fairly straightforward task. If a gentle blast of air is used, tooth structure won’t dry out, where porcelain will, and it will look frosty. Dr. Chal can set his handpiece to blow dry air as he works, thus making this part of the procedure fast and simple.

Are DaVinci Veneers the best?

Answer: DaVinci Veneers are made by DaVinci dental laboratories in West Hills California. They are best known for their sponsorship of the Extreme Makeover series, and they do some beautiful work.

However, great cosmetic dentists tend to form a close working relationship with one master ceramist, and together they form a team that creates beautiful smiles. This is the case with Dr. Chal. He has been working with ceramist Rick Durkee for 25 years, and they have a synergy between them, excellent communication, and extremely high standards for their work. Rick works out of a laboratory in Dr. Chal’s office and has the chance to personally meet you as he is creating your dental work. Thus, everything is beautifully customized to your expectations. Click here to read more about this on-site laboratory. Also read the grateful testimonials and see photographs of the work Dr. Chal and Rick Durkee have created together.

What about MAC Veneers?
I saw advertising saying that they’re the most beautiful porcelain veneers.

Answer: MAC Veneers are made by Microdental Laboratory in Dublin, California. While this is an excellent laboratory, they don’t have a monopoly on beauty.

One of their advertising claims is that more cosmetic dentists use their laboratory than any other. We don’t doubt the truth of that claim. They are a very large laboratory with many technicians. But it is still a small percentage of cosmetic dentists who send their porcelain veneer work there.

What you will typically find with the world’s best cosmetic dentists is that they have a single master ceramist that they work with to create their beautiful smiles, and this is the case with Dr. Chal. He and certified dental technician Rick Durkee have worked together for over 25 years, and have created many beautiful smiles. Mr. Durkee works in an on-site dental laboratory and has the opportunity to meet the patients personally and hand-craft smiles of stunning beauty.

If you have questions about MAC Veneers or any other type, Dr. Chal will be happy to answer them.

I have dark tetracycline stain on my teeth. Can this
be bleached out?

Answer: Tooth whitening will make your teeth a little bit lighter, but won’t get them to a normal white color. With whitening alone, you will still have grayish-brown teeth.

The best treatment for tetracycline stain is porcelain veneers. But you definitely need the expertise of a highly-trained cosmetic dentist.

Here are some of the problems we have seen in porcelain veneers that were done over tetracycline stain, and then we had to replace them because the patient was unhappy:

  • They were made too translucent, and the very dark stain showed through.
  • They were made too opaque, and the teeth looked pasty and fake.
  • They were made thin at the edges, creating a dark halo effect.
  • The teeth weren’t covered adequately between the teeth, leaving dark triangles showing between the teeth.

Tetracycline antibiotic, when taken while the teeth are forming, will deposit in the dentin of the tooth, leaving the tooth a dark brown or gray. What surprises many dentists who haven’t treated these stains before, is that the stain tends to get darker the deeper they go into the tooth. The color has to be opaqued out, and then a translucent layer has to be placed over the opaque layer to re-create the natural appearance of the teeth.

Dr. Chal has treated many tetracycline stain cases with beautiful results. He and his master ceramist, Rick Durkee, CDT, have worked together for 25 years, and they know what they are doing. Please see Dr. Chal’s smile gallery for photographs of his beautiful results, and testimonials from grateful patients.

What if I have a problem with grinding my teeth, can I still get porcelain veneers?

Answer: If you grind your teeth, yes, that is a problem that complicates getting porcelain veneers. But that doesn’t mean they won’t work for you. However, the grinding needs to be addressed, and if they aren’t done properly, you will be at high risk of breaking them off.

Sometimes we can limit the length of the veneers and this will solve the problem. We can also restore your canine teeth so that they protect the front teeth from breaking off (this is called canine-protected occlusion). Sometimes wearing a nightguard will protect the veneers.

Human occlusion is very complicated. The teeth move in complex patterns, and the shapes of all the teeth interact. The shapes of the back teeth do affect whether or not you grind your teeth and whether or not you may break off dental work in the front of your mouth. It’s hard to make a general statement that “grinding your teeth” means you can’t have a new smile. We’d need to do a comprehensive examination before we would know how to solve your problem. But I’m confident that one way or another we can give you the beautiful smile you really want.

What’s a porcelain fused to metal crown, and should
I have one on my front tooth?

Answer: Porcelain isn’t strong enough to serve as a dental crown. It requires some kind of reinforcement – being bonded or fused to something stronger underneath.

The most common crown procedure taught in dental school uses porcelain fused to metal. The metal gives strength. But the problem is that the metal is an opaque gray color. Therefore, white opaquers have to be used under the porcelain to create a tooth-colored crown. Therefore, porcelain fused to metal can never have a lifelike translucency.

In addition, they will get a dark line at the gumline over time. Sometimes the dark line can be hidden by the gums, but often the gums will recede over the years and expose the line. This is very noticeable and ugly.

In recent years, technology has been developed for bonding a porcelain crown directly to the tooth. The bonding procedure lends strength, and there is no metal understructure and thus no opaquers need to be used. These all-porcelain crowns can be made to look exactly like a natural tooth so that, even up close, no one can tell the difference from a natural tooth. This is what we prefer to do for our patients. Why have an ugly front tooth when you can have a beautiful one?