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Beverly Hills Institute of Dental Esthetics
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Brian LeSage, DDS, FAGD, FAACD

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exquisitely beautiful smile.
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Do I Need a Veneer or an Onlay for a Cracked Tooth?

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My first premolar cracked, and I wonder if I get a veneer for it instead of a crown. The tooth has a filling, so my dentist referred me to an endodontist to remove the filling and assess the tooth. However, the specialist didn’t remove the filling; she just recommended a crown. So, when I returned to my dentist last Tuesday, he tried to mend the crack. I asked my dentist about a porcelain veneer instead of grinding down the tooth for a crown, but he said I needed a crown or an onlay. Is a crown or an onlay the only way to repair a crack? I don’t want my tooth ground down to a peg if it’s unnecessary. Thanks. Helena from Spokane, WA

 

Helena,

Unfortunately, without seeing an X-ray, we cannot answer the question about your tooth. Tooth cracks vary from affecting the tooth’s surface and enamel only to extending beneath the enamel and into the tooth pulp. The crack location on a tooth and whether it is horizontal or vertical also determine your treatment options. However, a tooth crack is not a fracture. A dentist or specialist must treat a tooth to prevent it from fracturing into pieces that move independently.

What Is the Treatment for a Cracked Tooth?

Tips of dental forceps holding a porcelain veneer next to a tooth

A porcelain veneer can conceal a minor tooth crack

Dentists treat an extensively cracked tooth with an onlay or a dental crown. If a tooth crack is minor, depending on which tooth cracked,  a cosmetic dentist may use dental bonding or a porcelain veneer to conceal the crack. However, a dentist or endodontist must ensure a cracked tooth is healthy enough for restoration. Internal tooth damage needs root canal treatment.

Ceramic onlay for a cracked tooth

An onlay is a custom ceramic, composite, or gold restoration covering most of a tooth’s chewing surface. Only dentists with advanced cosmetic dentistry training can provide a comfortable onlay that fits snugly on your tooth and looks completely natural. Depending on the tooth’s condition and the location of the crack, a cosmetic dentist will explain your options for an onlay.

Dental crown for a cracked tooth

A dentist must grind down your tooth to accommodate a dental crown. Tooth preparation can further weaken the tooth. Many skilled cosmetic dentists prefer restoring your tooth with an only rather than a crown whenever possible.

We recommend scheduling a consultation with an accredited cosmetic dentist to examine your tooth and X-ray. The dentist will discuss how to treat the tooth, preserving as much structure as possible. Get tips for selecting a cosmetic dentist who can give predictable results with porcelain veneers or other treatment options.

Dr. Brian LeSage, a Beverly Hills accredited Fellow of cosmetic dentistry, sponsors this post.

Can I Trust Smile Makeover Before and After Pictures?

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Are smile makeover before and after pictures reliable? I had a consultation with a dentist who took pictures of my smile and then showed me after pictures. The way my smile looked in the after pictures was not much better than it is now. I am afraid to move forward with the dental work. My teeth are crooked and too small. I am concerned about spending thousands of dollars for a new smile that is just okay. What can I expect? Thank you. Montana from NM

Montana,

Thank you for contacting Beverly Hills Institute for Dental Esthetics regarding your smile makeover. Dr. LeSage would need to examine and x-ray your teeth to determine their condition and listen to your smile goals before explaining treatment options.

Can You Trust Smile Makeover Before and After Photos?

Whether you can trust smile makeover before and after photos of your face and smile depend on several factors, including:

  • Your explanation and the dentist’s understanding of your smile goals
  • The technology the dentist uses
  • The dentist’s skill in transforming your smile
  • The dentist’s artistic ability
  • The collaboration between your dentist and the ceramist who crafts your restoration
  • The quality of materials used for your smile makeover

Can You Trust a Smile Makeover Photos of a Dentist’s Patients?

Before your smile makeover begins, you can expect a cosmetic dentist to show you before and after smile makeover photos of their patients. You know you can trust the photos and the dentist’s ability to give you a natural-looking smile makeover by verifying their training and credentials in cosmetic dentistry. Look for training and accreditation in the American Academy of Cosmetic Dentistry (AACD) or the American Academy of Esthetic Dentistry. According to the AACD, dentists who achieve accreditation demonstrate the highest levels of these qualifications:

  • Continuing education
  • Experience
  • Ability

How to Select a Dentist for Your Smile Makeover

You can select a cosmetic dentist for your smile makeover by taking these steps:

  • Ask friends or family members for referrals.
  • Check each dentist’s credentials on the AACD’s or American Academy of Esthetic Dentistry’s website.
  • Look on the dentist’s website for evidence of how active they are in continuing education.
  • Look for before and after smile makeover photos on each dentist’s website.
  • Schedule a consultation with at least two cosmetic dentists to discuss your goals and concerns.
  • Ask the dentist how many cases like yours they have completed.
  • Take notes to compare each dentist’s credentials, experience, ongoing training, treatment recommendations, and smile gallery. Ensure you are comfortable with the dentist’s chairside manner and communication style.

Beverly Hills accredited fellow of cosmetic dentistry Dr. Brian LeSage sponsors this post. Visit Dr. LeSage’s smile gallery for examples of his work, including smile makeovers.

Smile makeover before and after photos from Beverly Hills accredited fellow of cosmetic dentistry Dr. Brian LeSage.

Dr. LeSage of Beverly Hills gave his patient a beautiful smile makeover with porcelain veneers!

 

 

Will Teeth Whitening Work on Bonding?

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Can you tell me which teeth whitening brands will work on dental bonding? I’ve tried Crest strips and another brand, but my whitening still looks dingy. Instead of wasting money trying different brands, I hope you can tell me which ones will get the best results. I got the bonding in 2016 when I lived in Omaha and want to refresh it. Thanks for your help. Bryce from Walkill, NY

Thank you for your question, Bryce.

Will Teeth Whitening Work on Bonding?

Teeth whitening will not work on dental bonding, whether it is a premier over-the-counter brand or professional whitening from a dentist. Bleaching gel penetrates natural teeth to break down stains, but it will not remove bonding discoloration. Read about the effects of abrasives on bonding in our post, Will I Need New Dental Bonding Again?

What Are the Effects of Trying to Whiten Dental Bonding?

If you try to whiten dental bonding with bleaching gel containing carbamide peroxide or hydrogen peroxide, the gel may whiten your natural teeth while leaving the bonding unchanged. Any bonding discoloration or stains will become more noticeable after your natural teeth are whiter.

What Is the Treatment for Dark or Stained Dental Bonding?

Depending on the condition and age of your dental bonding, a skilled cosmetic dentist may be able to polish it and improve its appearance. Otherwise, the dentist will recommend replacing your bonding. If you want whiter teeth and dental bonding, speak with the dentist about whitening your teeth first. After your teeth are as bright as you wish, the dentist will blend dental composite to match your tooth shade and translucence.

The benefits of replacing dental bonding include the following:

  • Requires less removal of tooth enamel than porcelain veneers
  • Matches the shape, shade, and characteristics of adjacent teeth
  • Looks natural
  • Conceals tooth discoloration that will not improve with bleaching gel

Read our post that compares porcelain veneers with composite veneers.

Request a Dental Bonding Consultation

Schedule consultations with two advanced cosmetic dentists to discuss your options for improving your dental bonding. Dentists apply bonding by hand while you sit in the dental chair. Advanced cosmetic dentists have the training, instruments, materials, and artistic talent to blend the bonding seamlessly with your natural teeth—even if you decide to bleach them before bonding.

 

Beverly Hills accredited Fellow of cosmetic dentistry Dr. Brian LeSage sponsors this post. See examples of his beautiful results in his smile gallery of patient photos.

Dental bonding before and after photos of Beverly Hills Dr. LeSage's patient.

Dental bonding before and after photos of Dr. LeSage’s patient. See his smile gallery for case details.

Can I Get Dental Implants at My Age?

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Can I get dental implants at my age? I’ve worn dentures since I was 55, and now I am 73. I never thought about implants until seeing local TV commercials for a dental practice that does implants. I have longevity in my family, and if I live as long as my parents did, I have another 20 years of life. I am physically active, and dentures have never fit my lifestyle. Implants seem to make sense. Have I waited too long? Thank you. Sanford T.

Thank you for your question, Sanford.

Dr. LeSage would need to evaluate your oral health, and an oral surgeon or periodontist must take a 3-D CT scan of your teeth and jaw to determine if you qualify for implants. Still, your age alone will not prevent you from getting dental implants.

Do You Qualify for Implants at Your Age?

If you are in good oral and overall health and can maintain excellent oral hygiene, you likely qualify for implants in your senior years.  Consider a few facts about long-time denture wearers and dental implants:

  • Jawbone shrinkage progresses when all your teeth are missing, and the pressure from dentures on the jawbone accelerates shrinkage.
  • An implant dentist or surgeon will measure your bone volume and determine if you need grafting.
  • Bone grafts take about four months to heal.
  • It takes about four months after implant placement for your bone and implants to fuse. Meanwhile, you can wear a temporary denture.
  • When your jawbone and implants fuse, your dentist will expose the implants and allow time for your gums to heal around them.
  • Your dentist will take impressions of your mouth for custom dentures and attach them when they are ready.

What to Expect if You Receive Dental Implants

Lower implant denture

Implant overdenture

Implant-supported dentures have these benefits:

  • Stability – Your dentures will stay in place all day, even when you speak and eat.
  • Maintenance – Implant dentures are easy to clean with nonabrasive toothpaste and a soft-bristled toothbrush. You can flush out debris beneath the dentures with a water flosser.
  • Facial appearance – Implants stimulate your jawbone and prevent premature facial sagging. Quality dentures and implants will give your face a gentle lift if you already have some facial sagging.

We recommend scheduling appointments with at least two cosmetic dentists to discuss your concerns and learn about your options for supporting your dentures with implants.

 

Beverly Hills accredited fellow of cosmetic dentistry Dr. Brian LeSage sponsors this post.

How Can I Get My Rough Teeth Edges Smoothed?

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I wore Invisalign for 13 months, but I still have rough teeth edges. I did not expect Invisalign to correct the edges, but I thought my general dentist would. However, my dentist says the edges don’t look bad. But I want them to look good, and I am uncomfortable with leaving them that way. I am a 44- year-old human resources professional and want my smile to look its best, and this look falls short. How can I convince my dentist to do something about my rough teeth edges? – Thank you. Keiko from NV

 

Keiko,

Although your dentist thinks your teeth edges look okay after Invisalign treatment, you can get them reshaped. We understand your goal not only to straighten your teeth but to have an appealing tooth shape.

How Can You Get Rough Teeth Edges Smoothed?

You can get rough teeth edges smooth with a procedure called enameloplasty. It is also referred to as cosmetic contouring or teeth filing. A cosmetic dentist can reshape your tooth enamel and polish your teeth afterward.

Who Can Reshape Your Rough Teeth Edges?

A clear orthodontic aligner like Invisalign for info on rough teeth edges after treatment

After Invisalign treatment, a cosmetic dentist can smooth rough teeth edges

You can trust an advanced cosmetic dentist to smooth your rough teeth edges. When a dentist changes the length of our teeth, it can affect your bite (the way your upper and lower teeth meet). But a cosmetic dentist understands how to smooth your edges and without causing bite problems.

How Does a Dentist Smooth Rough Teeth Edges?

A cosmetic dentist can smooth rough teeth edges with these steps:

  • Use a dental instrument, such as a sanding disc or burr, to remove a small amount of tooth enamel from each tooth
  • Shape each tooth
  • Polish your teeth

Sometimes, a cosmetic dentist will add composite bonding to fill in the sides of some teeth to improve their overall shape.

How Long Does It Take to Smooth Rough Teeth Edges?

Smoothing rough teeth edges takes about 30 minutes, depending on how many teeth are affected. During your consultation with a cosmetic dentist, they will give you a time estimate.

Does It Hurt?

Smoothing rough teeth edges is painless because a skilled cosmetic dentist will only remove a small amount of tooth enamel. And tooth enamel does not contain nerves. However, let your dentist know if you have dental anxiety, and they will explain your options for sedation.

Dr. Brian LeSage, DDS, an accredited Fellow of cosmetic dentistry in Beverly Hills, sponsors this post. Dr. LeSage is accredited by the American Academy of Cosmetic Dentistry and the American Academy of Esthetic Dentistry.

Do Porcelain Veneers Ruin Your Teeth?

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Porcelain veneers are custom shells of dental porcelain that can renew your smile. A dentist adheres veneers to your teeth with dental bonding. Still, many people wonder: Will veneers ruin your teeth?

Do Porcelain Veneers Ruin Your Teeth?

Porcelain veneers do not ruin your teeth. However, not all dentists use the same technique when preparing teeth for veneers. So, if a dentist aggressively prepares your natural teeth for veneers, it can drastically change their structure and appearance.

Dentists with advanced cosmetic dentistry training understand when to use no-prep veneers versus conservative preparation. But these techniques do not ruin your teeth:

  • No-prep veneers – A dentist bonds veneers to your natural teeth without preparing them. This option works best if your gums do not recede and your teeth require minimal alignment or reshaping.
  • Conservative preparation – A cosmetic dentist may recommend minimal tooth preparation to correct imperfections in your teeth and help your veneers fit precisely on your teeth and around your gumline. Still, a conservative dentist will limit tooth preparation to the enamel and not touch the dentin (the layer beneath tooth enamel).

Biomimetics and Porcelain Veneers

Biomimetics studies the function and structure of nature and mimics it in developing materials, machinery, or processes. Many cosmetics dentists use biomimetics when working with a dental ceramist to craft your porcelain veneers. Mimicking natural teeth preserves as much of your tooth structure as possible and provides you with beautiful veneers that will not ruin your teeth. Instead, your teeth will be healthy and function well.

What Is Minimal Preparation for Porcelain Veneers?

Minimal tooth preparation for veneers is a method that affects tooth enamel only. If a conservative dentist recommends tooth preparation to achieve the most natural-looking results, they will only remove a fraction of a millimeter of tooth enamel.

See the article, Establishing a Classification System and Criteria for Veneer Preparations, in the Compendium of Continuing Education in Dentistry, June 2019. In the article, Brian LeSage, DDS, defines four classes of porcelain veneer preparation and how they affect your teeth and the lifespan of your veneers.

Dr. LeSage’s tooth preparation classifications include:

  • Class I – No-preparation or practically prep-less veneers
  • Class II – Minimally invasive or modified prep-less veneers
  • Class III – Conservative preparation
  • Class IV – Conventional preparation

Additionally, Dr. LeSage published Update to Preparation Design 1 and Clinical Concepts Using the LeSage Veneer Classification System in the Journal of Esthetic and Restorative Dentistry Volume 32, Issue 2, February 25, 2020.

Choosing a Dentist Who Will Not Ruin Your Teeth with Veneers

You can choose a dentist who will not ruin your teeth with veneers by scheduling a consultation first. Select at least two dentists with advanced cosmetic dentistry training—preferably accredited cosmetic dentists. During your consultations, include these steps:

  • Discuss your concerns
  • Ask if and how the dentist will prepare your teeth for veneers
  • Ask how much tooth enamel the dentist would remove for your case
  • Ask to see before-and-after patient pictures, including tooth preparation photos

Summary

Porcelain veneers do not ruin your teeth. But not all dentists use the same techniques when preparing your teeth for them. Look for a dentist with advanced cosmetic dentistry training and a conservative approach to preparing your teeth for porcelain veneers. Read our post on how to get porcelain veneers without regrets. It explains how to find an experienced cosmetic dentist and get your questions answered before asking for veneers.

 

Accredited Fellow of cosmetic dentistry Brian LeSage, DDS, of Beverly Hills, California, sponsors this post. Get details about porcelain veneers and tooth preparation on Dr. LeSage’s website.

If you live in the Beverly Hills area, schedule a consultation with Dr. LeSage.

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

Actual patient photos of porcelain veneers from Dr. Brian LeSage

Do Porcelain Veneers Ruin Your Teeth?

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

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