Friday, September 30, 2011

Are you sure I don't need veneers?

Friday. Oh yeah.

My wife and I are going to the UF vs. Alabama game tomorrow. It is supposed to be in the high 50s in Gainesville. We have a bunch of friends that got a party bus and are getting a driver. The game is at 8pm. They thought the 2am car ride back would have really stunk, so they thought the bus would be a good idea. I concur. My wife and I look like real world travelers lately. We really aren't, but we saw this chance and we took it.

Hey did you see “Modern Family” this week? Oh my gosh, it is so funny. When the dog looked into the camera, I totally lost it. "He drowned Cam!" Great stuff. Please tell me you guys like this show. Because if you don't, I think to further this relationship, we are going to need to go to counseling.

Okay, it is Friday, so I won't keep you.

Did some really good dentistry this week and got some pictures. I had a girl come in for a "cosmetic evaluation." A 22 year old with diastemas (spaces between her teeth for all you non-dentists out there). Her dentist had sent her to the orthodontist. He found her to be quite good orthodontically, so he sent her back to her dentist and recommended veneers. She had heard great things about me and she wanted me to do the veneers. She was hell-bent on the fact that she needed $7,200 to fix some diastemas.

I took a look at her and asked her where she got this notion that she needed veneers. She told me the story again and I told her, "First of all, you don't need veneers. So let’s talk about how we are going to make you happy with your smile for a ton less money."

(these are her before photos)

We talked (what a concept), and I told her that I thought I could do what she was looking for by putting some composite on her teeth and the she wouldn’t even know it was there. And you know what was funny? I almost had to talk her out of veneers. She was so brainwashed! I had to convince her that spending $7,200 was a tad too much at this time.

She came in Wednesday, this time with a parent, and they both told me exactly what they wanted. I listened and told them I knew what I was doing. I knew what she wanted and I knew it is going to be great.

It is hard to tell from the photos, but she has a very gummy smile. The first thing I did was make them a bit longer with a bit of electrosurge. This also was going to make her teeth less stumpy.

If you look at her befores again, her composite veneer is not great but it is not horrible. The issue with it is that it is the wrong size, it is so monochromatic and it is too flat. It is not breaking up the light, not looking very natural.

I started closing her diastema. I then removed her old composite veneer. This was very challenging because of all her colors. Now, I don't know if I am the only one that does this, but I take an opaquer (made by Kerr) and put it under the composite.
I make clouds of the stuff around the incisal edges and down the sides and cure it. When the composite is cured over the top of it, it looks like it is natural.

I ended up doing 5 sides (I charge what I would charge for a three surface anterior filling, which is about $190 and one composite veneer for $500). I didn't charge her for the electrosurge because I didn't want to pile it on. I worked about 1 hour and 40 minutes, and I think $1,400 was enough. Plus, I had fun doing it.

Okay, now the after photo stinks. It never looks good on the day of the appointment. I am tired, the patient is tired and everyone wants to go home. Things never look that good. The tissue looks torn up and they are oozing. But this picture actually gives me everything I am looking for.

This photo is not the end photo because I have rescheduled her in 10 days to touch things up. I told her to look at them and tell me what she thinks and tell me any changes she wants. But it also gives me a chance to look at my work and see what changes I want to make.

The embrasure space needs some work on #9. The gingival 1/3 of #9 has some weird color. I tried to blend a couple of colors and it didn't come out well. Get this - the gingival color is B-1. The other color is one of the WHITE shades.

It thought the embrasure stuff turned out fantastic. The canines sometimes have a weird look to them when you are adding to the mesials, but I thought these looked great. She is coming next Friday to touch things up. I will take some photos and I hope they turn out better.

All in all, a good case. I was happy, she was thrilled. She didn't get ripped off and she has treatment that will last her for at least a decade.

What do you think?

Have a great weekend.


P.S. Third Middle School football game yesterday. We were on the wrong end of a 31-19game. My 91 pound starting defensive back had 5 solo tackles last night. So proud.


Sabina said...

I think you did a good job out of talking her out of $7,200 veneers!

Garger said...

Veneers are thin, semi-translucent “shells” typically attached to your front teeth. Veneers are customized from porcelain material and permanently bonded to your teeth. Veneers are a great alternative to otherwise painful dental procedures to improve the appearance of your smile.
Common problems that veneers are used for:

Spaces between the teeth
Broken or chipped teeth
Unsightly, stained or discolored teeth
Permanently stained or discolored teeth
Crooked or misshapen teeth

Veneers are a great aesthetic solution to your smile that may even help you avoid orthodontic treatment. Subtle changes to your smile can be achieved with veneers, and in most cases, veneer application is completed in only two office visit

reddroadfamilydental said...

In Today’s life Porcelain veneers are the instant way to perfect white teeth. It fixes the bad, crooked or stained teeth easily. Without the use of braces you can also close the tooth gap. In order to seal or bond the dental veneer to your teeth, dentist will remove a very small amount of enamel from the surface of the teeth that will be treated.

Veneers El Paso Tx


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