Anyone knowledgeable about Cosmetic Dentistry?

[BillyIdol]

Thank you for any help that you could offer.

My teeth are OK. And my smile is OK. But I am getting irritated with the color. I becoming very hesitant to smile because I don't like the yellow. Well....just do Zoom whitening right? Well, the problem is that I have crowns on my front two upper incisors. So...the color will be off, unless I have them changed to the right color (new crowns). I also cracked a lower right molar, and I guess I have to do a crown there also. I was recommended to do a gold (base) crown on the lower right molar.

Well, I got all fascinated by "Extreme Makeover" (for the body, not the house), and started learning about Dr. Dorfman (dentist). I guess Dorfman is absolutely at the top of his game. He invented Zoom whitening and BreathRx for bad breath. I went over to Dorfman and just said that I wanted a whiter color to make my smile look better, but that I was open to other suggestions. He suggested 6 Porcelain veneers, 2 crowns, Zoom whitening, and orthodontics (clear tray stuff) done on my lower front teeth all for about $25,000. This just wasn't teeth whitening, but a complete smile makeover. I've seen some of the stuff he has done on Extreme Makeover and it is amazing. This guy works for perfection. They over have a rep from the dental lab come over to make sure that each tooth shape/color is just perfect. Some Dorfman is charging $1800 per Da Vinci porcelain veneer or crown.

I went to a "cut rate" place, and they were charging $1300 per veneer/crown, so for $500 more per crown/veneer I can go with Dorfman. I'm leaning towards Dorfman.

Or I could go with my primary care dentist. Just get Zoom whitening, and then replace the 2 crowns in the front and the lower right crown for the molar. And then forget the orthodontics. This would cost me $1000 total because she is almost like family. I guess the thing is that if I have these crowns done on the front teeth, and I eventually want the Dorfman crowns, I'm worried about LOSING TOO MUCH DENTAL STRUCTURE BY GETTING TOO MANY CROWNS DONE.

I guess my questions are simple:

1-I wonder how controlled the Zoom whitening is. Can you go too white? How white should you go? I don't want this to be arbitrary. I want it to be artistic.

2-Is it advisable to have a crown done, and then want to do another one later? How much tooth structure do you lose?

3-I have always dreamed about having a nice smile, but $25,000 for a smile makeover seems steep compared to the "stop gap" measure of Zoom whitening and 2 new crowns in front plus 1 right lower crown for molar.

4-If a molar is "cracked", do you always need to do a crown?

5-Anything I'm missing or haven't thought about?

6-25k path or 1k path? What say you?


John

 

[steveny]

This stuff tastes pretty bad and you have to apply it more often

 

[DocL]

I won't give you specific recommendations, however being that I do a lot of Zoom and cosmetic procedures there are a lot of variables that cannot be determined via a bulletin board thread. I can tell you that a lot of those "Extreme Makeover" dental cases did have a lot of compromises and in my opinion the final results looked terrible.

Now, based on the very limited information you have provided, maybe you should seek a second opinion from another dentist. If his treatment plan is consistent with your current dentist, I would have your current dentist do the treatment. I will tell you that when a patient like yourself starts to ask these types of questions I usually defer treatment until I know they have reasonable expectations. I will usually close these conversations by asking the person to choose two out of three options: Cheap, Fast, or Good. Pick two, because you aren't going to get the third.