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Brian LeSage, DDS, FAGD, FAACD

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Archives for December 2020

All I want is no-prep veneers, but dentists won’t do it

I am trying to find a dentist to give me no-prep veneers. Last month, I had three consultations with top cosmetic dentists, and none of them would agree to do no-prep as I asked. They basically said that I wouldn’t like the results. Not that I’m going to take legal action, but isn’t this a patient rights issue? After reading some patient stories online about tooth preparation and seeing pictures on Instagram of people recording their porcelain veneers’ journey, I’m concerned. Their teeth look like tiny toothpicks after preparation! Although I want veneers, I don’t want my natural teeth butchered. How can I find a cosmetic dentist to do no-prep veneers? Thank you.  Alma from Nevada


Thanks for the inquiry. You have the right to request no-prep veneers, and you might find a dentist who will give them to you with the understanding that you might not like the results. But if you visited three top cosmetic dentists who agree that no-prep veneers are not the best option for your case,  there is probably a good reason. Dr. LeSage would need to examine your teeth to discuss your case, but consider some of the facts below.

What Are No-Prep Veneers?

No-prep veneers are porcelain veneers that a dentist bonds to the fronts of your natural teeth without altering your tooth structure. No-prep veneers differ from minimal preparation when a cosmetic dentist removes minimal front tooth enamel before bonding on veneers.

Minimal preparation can help a veneer fit well from the gumline to the edge and look natural—not bulky. A cosmetic dentist minimally prepares a tooth by removing a fraction of a millimeter of tooth enamel—not by filing, cutting, or grinding down healthy tooth structure.

Not Every Patient Is a No-Prep Veneer Candidate

Although porcelain veneers are an ideal solution for many smile makeovers, advanced cosmetic dentists agree that not every patient is a candidate for no-prep veneers. Without preparation, it might be impossible to use porcelain veneers and achieve the smile you want.

  • Veneers add to tooth structure – Veneers as thin as 0.3 mm add a little thickness and length to your teeth. Unless you have small teeth, veneers can make your smile look thicker or a bit bulky without preparation.
  • Tooth shape – If a tooth is crooked, a portion of it sticks out. A cosmetic dentist must trim back the tooth to get a beautiful result after bonding a veneer to it. Without preparation, a veneer will cause the tooth to stick out even further.
  • Margin between the veneer and tooth – In many cases, if a tooth is not prepared, after the dentist bonds a veneer on, there is a bump where the porcelain begins. Without a smooth margin between the veneer and tooth, you can expect a slight bulge at the top of all your veneers.

Porcelain Veneers with Minimal Preparation

Dr. Brian LeSage of Beverly Hills has a published porcelain veneer classification system in the Journal of Esthetic and Restorative Dentistry. Advanced cosmetic dentists like Dr. Lesage minimally prepare teeth to preserve tooth enamel, ensure a firm bond between your teeth and veneers, and achieve lifelike results. Dr. LeSage leaves a minimum of 80% tooth enamel when preparing teeth for veneers. If you choose an accredited cosmetic dentist, you can avoid aggressive preparation as you have seen in photos in online articles and on social media. Read our post about what happens when a dentist over-prepares teeth for veneers.

Evaluate Your Smile Goals

We understand that you don’t want tooth preparation for your veneers. Below are a few questions to ask yourself to help you make an informed decision.

  • Do I fully understand how my smile will look with or without preparation for porcelain veneers?
  • Am I willing to accept the predicted results if I refuse preparation?
  • Am I open to reaching an agreement with an advanced cosmetic dentist for minimal preparation?
  • Have I asked about other cosmetic dentistry options for achieving my smile goals?


Before-and-after minimal prep porcelain veneers from Beverly Hills dentist Brian LeSage

Dr. LeSage placed eight porcelain veneers on this patient’s upper front teeth

Best wishes.

This post is sponsored by Dr. Brian LeSage, an accredited Fellow of cosmetic dentistry in Beverly Hills.

My dental bonding keeps falling off

My dentist applied bonding to my teeth to cover fluorosis stains, but the color was uneven, and I could still see the stains through them. About four hours after I got home from the dentist, the bonding fell off four teeth. When I returned to my dentist to fix the bonding, I also told him that the color was weird, so he added another layer of bonding. This time the bonding fell off in less than a week. My dentist said that the problem exists because my bite is off, and I need to wear a mouth guard at night to cushion the bonding. That didn’t help. Now my dentist’s explanation is that bonding is a temporary fix, and it will only last about five years. I don’t understand why he didn’t explain all this before I agreed to get bonding. Besides that, I am starting not to trust my dentist. If I switch dentists, can I get a refund? – Geoff from Montana


It’s appropriate to switch dentists because you didn’t receive what you paid for—dental bonding to conceal fluorosis stains and enhance your smile. And the results of your dentist’s work are a basis for getting a refund.

Getting a Refund from Your Dentist

You can get a refund from your dentist if you can prove that your dentist did not meet the standard of care they promised. In your case, you paid for dental bonding to conceal fluorosis stains. Your bonding was faulty in several ways:

  • It didn’t match your natural tooth color
  • It didn’t conceal the fluorosis stains
  • It fell off

When you request a refund and state the above reasons for it, your dentist should readily give you your money back.

If our dentist refuses to issue a refund, you have options:

  • Present your case to a peer review committee
  • File a complaint with the state dental board
  • Inform your dental insurance company
  • Hire an attorney

What Are Fluorosis Stains?

Fluorosis stains are discolorations in teeth that can occur if you consumed too much fluoride as a child while your teeth were still developing. Fluorosis stains can be mild, moderate, or severe.

  • Mild fluorosis stains – Slight white spots on teeth might not require any treatment.
  • Moderate fluorosis stains – Stains can cover the entire front surface of teeth and make them look blotchy.
  • Severe fluorosis – Unsightly brown stains dominate the teeth.

Getting Treatment for Fluorosis Stains

A dentist needs advanced cosmetic dentistry training and artistic talent to conceal fluorosis stains. As a dentist applies dental bonding, they can see the results firsthand. Your dentist should have noticed that the color is off and the bonding was not working as intended. And a regular family or general dentist won’t have the needed bonding materials and shades in their office to give you beautiful results.

Mild to moderate fluorosis – When fluorosis stains affect the tooth enamel only, a cosmetic dentist might take theses steps to conceal it:

  • Grind out the discoloration
  • Apply a base layer of composite that has come opacity
  • Overlay the base with translucent composite
  • Polish the composite to a natural-looking gloss

Severe fluorosis – A cosmetic dentist will spend more time etching the teeth before concealing the stains. These steps follow:

  • Apply a liquid bonding agent and cure it with a light
  • Apply composite over the cured bonding agent and harden it
  • Polish the composite

Porcelain Veneers for Fluorosis Stains

Depending on your case, some cosmetic dentists might recommend porcelain veneers to conceal fluorosis stains. The condition of your teeth and the extent of the stains affect treatment recommendations.

We recommend that you schedule consultations with two accredited cosmetic dentists. Look for accreditation with the American Academy of Cosmetic Dentistry (AACD) or the American Academy of Dental Esthetics (AADE).

  • Ask about your treatment options
  • Ask to see the dentist’s before-and-after patient photos of cases like yours
  • Ask what results you can expect


Dr. Brian Lesage, an accredited fellow of cosmetic dentistry in Beverly Hills, sponsors this post.

Before-and-after composite bonding photos

Before-and-after composite bonding photos from Dr. Brian LeSage

My dental bonding keeps falling off

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

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