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Puerto Vallarta News NetworkHealth & Beauty | June 2006 

Open Wide - At Your Own Risk
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To find a qualified dentist or a dentist who does good aesthetic / cosmetic dental work:

Check with dental schools, other dental specialists, and dental societies for referrals.

Ask for alternative treatment plans in writing - including the costs, benefits, and risks of each.

Also ask about the life expectancy of the work and their guarantees.

Ask to see before and after photos of the dentist's clients - make sure the work is the dentist's own work, and be sure to ask how much tooth-reduction will be needed for the procedure you're interested in.
Want a Dental Makeover? Beware of the Hidden Dangers

There's no denying the importance of a dazzling smile, and nowadays just about anyone can have picture-perfect teeth. Temporary snap-ons can give you a celebrity look.

You can even order teeth to look like those worn by specific celebrities, like the Gwyneths - as in Paltrow, or the Julias, as in Roberts.

But for a permanent fix, you need veneers.

You generally hear about the cosmetic dentistry successes, but you don't hear about the disasters.

Susanne Brown experienced a dental disaster with her veneers.

Brown, a former model, rarely smiled - even in her modeling days - because she didn't think her teeth were very attractive. She opted for veneers, which provide a thin shell of porcelain, almost like a fake fingernail, on the front surfaces of the teeth. Veneers can hide myriad imperfections, which in Brown's case were minor gaps.

"I know when you go to the dentist, you're going to have some pain. Take a couple of Tylenol and that's it. But I was in pain for over a month," she said.

The reason? Susanne had badly infected gums. The problem with her veneers, according to our expert, was that the restorations just didn't fit.

Dr. Ronald Goldstein, a leading expert in the field of cosmetic dentistry, said the fit is critical.

"It had to be a perfect fit. If it sticks out from the tooth then the gum can't heal properly and bacteria can get in and there is disease. Functionally, it's a disaster," he said.

It's taken a year of treatment to get Susanne's gums back in shape. But they won't fully heal until each of the 18 laminates on her teeth have been replaced. Problems like Susanne's are all too familiar to Goldstein, who sees them when patients come in seeking help.

How big a problem? Goldstein said it's huge. He estimates it to be between $10 billion and $12 billion a year. "It's staggering," Goldstein said.

"20/20" saw examples of jobs gone wrong pictures you won't see on any makeover show.

"Dentistry is an art and a science. You can't just have the art. You can't just have the science. It's a combination of both. So function becomes paramount," said Goldstein.

Cindy Fowler's problems with her veneers began almost as soon as the work was done.

"I got on a plane to fly to Istanbul and I was just miserable. I was sitting there with my hand over my mouth. I couldn't drink anything, and it hurt to talk. And I kept thinking this will go away, this will go away," she recalled.

But it didn't go away, and Cindy soon noticed something else.

When Cindy went to Dr. Goldstein's office she found out something even more upsetting, something most people may not be aware of. Her teeth had been aggressively ground down to apply the laminate.

While many dentists use this aggressive technique, the experts we spoke to said it's often unnecessary and can lead to extreme sensitivity and even root canals. And when the teeth are filed down to such a degree, experts said, the veneers may not last as long. Cindy's laminates flaked off easily when they were being redone.

The dental office responsible for Cindy's veneers said that both tooth decay and previous work made the tooth reduction necessary, and it claimed that faulty adhesive materials might be to blame for the cracks. But the experts we spoke to said they could see no reason for that much tooth reduction.

Another thing to keep in mind if you're considering veneers: It's a lifetime commitment. Veneers, on average, cost about $2,500 per tooth and last about 10 years.

One young woman "20/20" learned about had had veneers placed on her teeth when she was just 18 years old. Almost all her teeth were veneered and were ground down so much that she soon needed five root canals, stabilizing posts and crowns to replace her front teeth.

"When you start doing this at a young age. Think about how many times they're going to have it done. So, the more conservative we can be and the longer we can get that restoration to last, the patient benefits and that's what we want to do," Goldstein said.

So while veneers can do wonders to brighten your smile and your life, a skilled dentist is key. But don't rely solely on ads when making that choice because any dentist can claim he or she is a cosmetic specialist. There is no certification needed. As for those enticing after pictures you might see on the walls or in albums in the dentist's office, it turns out they can be very easy to come by.

"20/20" had a gum specialist who had never done cosmetic work before place an order on the Internet for client photos. Sure enough, he got a batch of before-and-after pictures of patients he'd never worked on. They even came in an engraved album complete with a sample cover letter that could easily lead you to believe the work was his.

So be sure to do your homework and ask who did the dental makeovers. Otherwise, you could end up with a look and a smile you never bargained for and a mouth full of very bad work.

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