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Can You Have a Beautiful Smile with Enamel Hypoplasia?

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I have enamel hypoplasia and am horribly embarrassed whenever I smile. In fact, I avoid smiling in public as much as possible. Is there a solution for someone in my position?

Deanna

Dear Deanna,

I am glad you wrote. There are great ways to get a beautiful smile, even if you have enamel hypoplasia. Which treatment you use will depend on the level of hypoplasia you are dealing with.

Mild and Severe Enamel Hypoplasia

For those who may not be aware of what Enamel Hypoplasia is, let me explain. Most of the enamel of your teeth is developed before birth and goes until about the age of twelve. Hypoplasia is a defect where the enamel on the tooth never fully develops. This can happen as a genetic defect or as a result of disease during the tooth formation stage of development.

If you have mild hypoplasia, this may manifest as white spots on your teeth. There are other causes for white spots on teeth, one of which is decalcification, which is a precursor to tooth decay. The solution, whether it be hypoplasia or decalcification would be to have composite dental bonding done.

Severe hypoplasia is characterized by thin, pitted enamel. In many cases, you can see the dentin of the tooth. In these cases, I only recommend porcelain veneers as the solution.

Either Procedure Requires an Expert Cosmetic Dentist

Whichever procedure you choose, it is important that you choose an expert cosmetic dentist. Many patients are not aware that cosmetic dentistry is not a recognized specialty. This means that any general dentist can do it regardless of the amount of training they have. Because it is not taught in dental schools, the additional training is a must.

In your position, because hypoplasia is such a challenging case for a smile makeover, I would only go to an dentist who has achieved accreditation with the American Academy of Cosmetic Dentistry. AACD Accredited Cosmetic Dentists are in the top 1% of their field. They’ll be able to give you a smile that is stunning.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

Not Sure I Can Afford a True Cosmetic Dentist

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I was about to get a smile makeover when I did some research and realized my dentist would not do a good job for me. I decided to go to a AACD accredited cosmetic dentist. I’ve got a list of dentists in my area who are qualified. I went to see one of them and he quoted me over $100,000. He said I have bite problems which will need to be fixed and he’ll do veneers where possible. I can’t afford that. Is that what I’m going to face with all of them? Should I give up on this dream?

Lindsey

Dear Lindsey,

Woman Covering her mouth

You don’t have to spend your life hiding your smile.

I wouldn’t give up on your dream just yet. That price seems like he was quoting you for a full-mouth reconstruction. It’s even on the high end of cost for that. You didn’t mention any TMJ symptoms, so that might no be what you need. I’m going to suggest you get a second opinion.

You should also be aware there can be a large disparity between the different amounts cosmetic dentists charge. I’m going to give you an example of two cosmetic dentists I’m aware of two dentists in the Florida area without giving their name. We’ll call one Dentist A and the other Dentist B.

Dentist A is on the high end of fees. He has patients who travel from all over the world to see him. He’s highly skilled and provides beautiful smile makeovers. Dentist B is also highly skilled and creates beautiful smile makeovers, but his fees are in the median range. But guess what? When dentist A needs his teeth worked on or touched up he goes to see Dentist B.

Prices vary. In your place, I’d find a list of the AACD accredited dentists in your area and get consultations until you find one whose treatment plan and price match what you can do.

If You Can’t Find an AACD Accredited Cosmetic Dentist

Very few cosmetic dentists have actually reached accreditation. If you can’t find one in your immediate area you feel you can work with you have two choices.

Choice #1: Find one in a nearby state and travel to get your smile makeover.

This, of course, increases the cost because you also have to budget for travel, but it is an option. When I mentioned Dentist A above, he will have celebrities and other patients fly in from other states and countries. Because of that, he has hotels he works with that help accommodate his patients. Not everyone can do that, which leads me to option 2.

Choice #2: Find a dentist recommended by mynewsmile.com

Not every great cosmetic dentist has reached accreditation. It takes a long time. That doesn’t mean they don’t have the skill requisite to giving you the smile of your dreams. The mynewsmile.com website screens cosmetic dentists who wish to be listed for both technical skill and knowledge as well as their artistic abilities. Any one of them can give you a gorgeous smile you’ll be proud to share, whether you get porcelain veneers, porcelain crowns, or a mix of both. In fact, most of them have a beautiful smile guarantee.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

Will My Smile Have to Be Perfect for Porcelain Veneers?

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I’m about to run for office. My teeth aren’t in the best-looking shape. I need to get a smile makeover because I know your smile makes a huge difference in how people view you. What I don’t want is that perfect, fake looking Hollywood smile. Is it possible to make sure the smile looks attractive without looking fake? Or would I be better served with a different procedure?

Steven C.

Dear Steven,

One of the incredible things about porcelain veneers is how completely flexible they are. While most patients go into this procedure wanting a celebrity smile, they can be made to order. So, your teeth can be made whiter and straighter, but you can also custom design some natural looking “flaws” to give them character. It will look like you have natural teeth which you take great care of.

The shape you make your teeth will have the biggest impact on your appearance. If you make them slightly boxier, they’ll appear more masculine and authoritative. Longer teeth are more youthful looking. The key to getting just want you want is choosing the right cosmetic dentist. They’ll sit with you and discuss exactly what look you’re going for and then work with you to design it. The best cosmetic dentists are equal part technically adept and artists.

So how can you be sure you’re getting the best cosmetic dentist? The easiest way is to look for someone in your area who is accredited with the American Academy of Cosmetic Dentistry (AACD). Accreditation is different than membership. Any dentist can join the AACD, but accreditation requires passing stringent exams as well as demonstrating artistry in your work through actual cases.

Very few dentists reach that level, but the ones who do are true artists. Like Dr. Rothwell, many of them have a beautiful smile guarantee, so you can feel confident you’ll get what you went in for.

As far as other procedures, composite bonding can do something similar, but not as well as porcelain veneers and they won’t hold up nearly as long.

I hope this helps.
This blog is brought to you by Dr. Bonnie Rothwell.

Does President Trump Wear Porcelain Veneers?

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I was looking at President Trump during a speech and wondered if he’s wearing porcelain veneers? I’m sure he must do some kind of tanning, but wondered if the teeth were natural. They seem awfully white for a guy his age.

Melissa R.

Dear Melissa,

Donald Trump Porcelain Veneers

Well, you’re certainly right about the color of his teeth. They’re whiter than the brand new teeth you see on a pristine toddler. And, if you compare it with his teeth from his younger years, they’ve certainly lightened with age, which is the opposite of what nature tends to do to us. It’s possible to get it that shade with teeth whitening, but in the case of President Trump, I know he achieved his look with porcelain veneers.

If you’re interested in the whole story about when he got them, you can read about it on Dr. David Hall’s website. But, there’s an important lesson about to be learned about cosmetic dentistry in his case. President Trump knew the importance of a highly qualified cosmetic dentist. Even though he went to the “dentist to the stars” who’d done a number of famous smile makeovers, President Trump tested his resolve to see how passionate he was about doing the case correctly.

In the president’s case, it was a matter of insisting on more veneers than President Trump wanted to do. As you can see from the picture above our president has a wide smile. That requires more than the standard six veneers if the case is to be done well. If the dentist had compromised, President Trump’s teeth would never have matched.

If you’re planning on doing cosmetic work, teeth whitening can be done by just about any dentist. If you’re looking at a more advanced procedure, such as porcelain veneers, then what dentist you get is imperative. So, let’s say you can’t get to the “dentist to the stars”, how are you supposed to find an advanced, artistic cosmetic dentist? My best recommendation is for you to find someone who is accredited by the American Academy of Cosmetic Dentistry (AACD). Accreditation and membership are two different things. Anyone can be a member, but you have to pass stringent qualifications to become accredited.

This blog is brought to you by Dr. Bonnie Rothwell.

Can I exchange more metal based crowns for porcelain veneers?

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I have these horribly ugly dental crowns. I talked to my new dentist about it and he said it’s because they are metal based. He said to get pretty ones, they’d need to be all porcelain. I’ve also heard about porcelain veneers that they can give you a great smile. Could I get those? They’re both porcelain.

Mandy F. – Little Rock, AR

Mandy,

While porcelain veneers are great for a smile makeover, they can’t replace your dental crowns. When you get dental crowns, your teeth have to be ground down. Your teeth don’t get ground down for veneers, so there isn’t enough tooth structure left for them.

That doesn’t mean you can’t get a gorgeous smile makeover if you want one. The all-porcelain crowns can be shaped any way you want. Then, on the non-crowned teeth, you could get veneers.

You’ll only need the front six to eight teeth re-done and then do teeth whitening on the rest. However, do the whitening first. Once your teeth are the color you want, then you get the veneers/porcelain crowns to match the new color.

This blog is brought to you by Dr. Rothwell.

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