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Brian LeSage, DDS, FAGD, FAACD

Imagine yourself with an
exquisitely beautiful smile.

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Archives for September 2020

What are my options for a front tooth that’s turning dark?

For the past four years, I’ve seen my left lateral incisor get progressively darker. I’ve been concerned that if the tooth is dying, I’ll need an extraction and dental implant. My endodontist tested the tooth with ice and electric current and said the tooth is still alive. An x-ray shows a faint horizontal fracture. The endodontist said I can get a root canal, but it would weaken the tooth. The other option is to get some cosmetic work done to hide the dark color. What are my options for cosmetic dentistry? Thanks. Justin from Las Vegas


Diagram of a two dental implants - before and after crown placement

If your tooth is healthy and can be saved, you won’t need a dental implant

Did the endodontist say your tooth is infected? If it isn’t infected, a root canal treatment is not necessary. Although Dr. LeSage would need to examine your tooth, it’s unlikely that it’s fractured. A fractured tooth would be dead. And root canal treatment would further weaken the tooth and make it susceptible to leaking and root canal failure. Based on what you’ve described, you’re not in danger of requiring extraction and a dental implant.

What’s Causing Your Tooth to Turn Dark?

If you’ve had trauma to your mouth in the past, it can cause a tooth to turn dark. A traumatized tooth builds a defense, or secondary dentin, that shrinks the tooth pulp, darkens the tooth, and makes it less sensitive to cold or other stimuli.

What Are Your Options for Cosmetic Dentistry?

When a tooth is turning dark, a true dental artist can use a porcelain veneer or direct composite to conceal the discoloration. This is artistic work that you shouldn’t entrust to a family or general dentist.

Color matching – Precise color-matching skills are required to match your surrounding teeth.

Conservative treatment – A cosmetic dentist is trained to make your tooth dark tooth look natural and match surrounding teeth. You won’t need bonding or veneers on multiple teeth to accomplish that.

A family or general dentist doesn’t have the training or experience to color match teeth with veneers or dental bonding. Some dentists recommend placing crowns on several front teeth. Avoid that option.

Look for a cosmetic dentist with credentials from the American Academy of Cosmetic Dentistry or the American Academy of Esthetic dentistry. You’ll receive seamless results, and you won’t be able to tell that your tooth was dark.

Brian LeSage, DDS, a cosmetic dentist in Beverly Hills, sponsors this post.

No smile makeover with these porcelain veneers

I have four upper teeth that are misaligned and crowded. I went to a dentist for a smile makeover, and she recommended cosmetic dentistry as a faster solution than braces. The dentist said she would use bonding on my left lateral incisor, a porcelain veneer on my right lateral incisor, and shape my teeth for an even smile. She completed the word and said she shaped my lower teeth, which we never discussed. Her fee was almost $10,000.

One veneer is too small and has a gap near the gumline. And my teeth are still crowded and uneven. My dentist said that she overestimated what a veneer and bonding would do for my teeth, and now I need porcelain crowns and root canals for an additional $7000.

I quickly dismissed myself from her dental chair. I scheduled a second opinion with another dentist who says that he would recommend four veneers, but no root canals or crowns. His cost is $5200.

I would like to know how to get a refund from the dentist who did the veneer and bonding before giving away $5200 if this second dentist has a mistake in judgment. Thanks. Garland from Oregon



We’re sorry to hear about your experience with a dentist who didn’t produce what she promised. You should be entitled to a refund. But you don’t sound confident about the second dentist either. How do you know that he will complete your smile makeover correctly? Dental schools don’t teach how to produce beautiful smile makeovers with porcelain veneers.

A Third Opinion or Cosmetic Dentistry

We strongly recommend that you get a third opinion. Look for a dentist with advanced training in cosmetic dentistry and porcelain veneers. Check for credentials with the American Academy of Cosmetic Dentistry or the American Academy of Esthetic Dentistry.

Getting a Refund from Your Dentist

Porcelain veneers before-and-after photos from Beverly Hills cosmetic dentist Dr. Brian LeSage.

Actual patient photos of porcelain veneers from Dr. Brian LeSage

Before you request a refund, it helps to have the backing of an expert cosmetic dentist who will document the problems with the first dentist’s work. Dentists are often sensitive to what their peers say about their work. Ask your new, experienced cosmetic dentist if they are willing to call your former dentist and explain why a refund is appropriate.

Additional options to help motive the dentist to issue a refund include:

  • Posting negative online reviews
  • Reporting the issue to the state dental board
  • Hiring an attorney

Best wishes.

Brian LeSage, DDS, FAGD, FAACD, of the Beverly Hills Institute of Cosmetic Dentistry, sponsors this post.

No smile makeover with these porcelain veneers

“Because of your smile, you make life more beautiful.”
– Thích Nhất Hạnh

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