Cosmetic Dentistry Orange County | Huefner Sensational Smiles Blog

There are many reasons why patients choose to have cosmetic dentistry and especially porcelain veneers or porcelain crowns on front teeth. Sometimes because the teeth are crooked or worn or because they have numerous old fillings are common answers. But the most common reason is that they want “whiter, brighter teeth” and that bleaching didn’t give them what they wanted. Thus once you’ve finally decided to have cosmetic dentistry with all-porcelain crowns or porcelain veneers, then comes the very important decision, “what color do you make your new porcelain veneers?”
Do you want them to match the color of your other teeth as they are now? Probably not, especially since your teeth have most likely stained and darkened over the years. If you are like most people, you’ll want your new porcelain veneers lighter in color than they are now, which will help make you appear younger and healthier, but not too white or “fake looking”.

Here is a photo of a typical dental shade guide on the right, showing the sixteen basic shades going from darkest at the far right, to lighter shades on the left. These are the “natural” colors. Ten years ago most almost all porcelain veneers were made in one of those shades. But today, with bleaching and porcelain veneering, most people want their teeth whiter than those more “naturally” colored shades. On the left you’ll note the four new “bleaching shades”, which are whiter than the shades that occur naturally.
Today it is very typical for our patients to bleach their lower teeth and then do their porcelain veneers on their upper teeth in one of the four bleaching shades. At this time shade “020 or BL2” and “010 or BL1” are our most popular for smile makeovers involving 6-10 upper porcelain veneers.
Although the color of the porcelain is very important, I remind our patients that it is not the only thing that determines how white or natural your smile appears. The “translucency” or “opacity” of the porcelain veneers is a huge factor in allowing or not allowing light to partially pass through the porcelain veneers to appear natural. Real teeth have that translucency, and in general, unless the underlying teeth are extremely dark, some translucency is what we want in porcelain veneers or crowns on front teeth to mimic with the life-like and vital look of real teeth.
This doesn’t happen with opaque porcelains or with porcelain over metal (gold) crowns. The opacity, which often appears “life-less” is what so many patients object too when they see dentistry that they think looks “fake”.
But with semi-translucent porcelain veneers, which are bonded over natural teeth, the teeth can look whiter than natural teeth but still look extremely natural because of the “translucency factor”. Most of the smile makeovers with porcelain veneers that we place are done using MAC Empress Porcelain, which has beautiful life-like translucency, great colors and looks extremely natural even in the bleaching shade range. This is why so many of our patients go into the 020 (BL2) or 010 (BL1) shades and their veneers still look “real”.
Our patients always have the final decision on what color to make their porcelain veneers, but for those who want their porcelain veneers to be in the older and darker natural shades (in one of those sixteen shades on the right) I remind them that the color of their new porcelain veneers is permanent and they won’t lighten or darken over the years. With so many people bleaching their teeth and doing things to enhance their image, wanting to make themselves look younger and more attractive, we’re seeing society as a whole more and more often choosing one of the four bleaching shades on the left.
Color is very subjective, but our main criteria for shade selection is that the patient is happy with the choice of their new porcelain veneers. Here are photos of four ladies, each choosing a different color for their new porcelain veneers:


Although these colors may not show up very good on your computer monitor, each of these patients decided on a unique shade. The first lady on the upper left want her teeth to look natural, and not too white. The second lady on the upper right wanted a “white-bright” smile. The third, on the lower left, had only four porcelain veneers and after bleaching the rest of her upper teeth, wanted the four veneers to match the rest of her natural teeth. The fourth lady, on the lower right, was a little older and her entire life had wanted “white teeth!”. Thus, she chose an opaque “Hollywood white” shade.
Regardless of the color chosen by the patient (not by the dentist), our goal is for the patient to be happy with their new porcelain veneers or all-porcelain crowns and the color they choose. That is the most important thing, that the patient is very involved in the treatment choices and happy with the end results.

Dr. Norman Huefner, General and Cosmetic Dentistry, Laguna Niguel, CA

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Anyone considering cosmetic dentistry with porcelain veneers should be aware that there are different ways that they could be made, right? But how many different ways and how does one choose the best design and shape for their face and smile? There are approximately 25 different shades (colors), three different surface textures (how the light reflects off of the front of the veneers), several different porcelain types which each has different translucencies (ability of the light to pass through the veneer to render a “life-like” appearance), several different lengths and shapes that each veneer/tooth could be made and at least 60 different documented smile styles. Do the math and you’ll note that there are probably 30,000 different ways that your cosmetic dentist could create your new smile. This can be pretty confusing. So how do you know you’re getting the best combination for your face and smile?

Mrs. U.S.-Globe Jill Frick and her “Enhanced” smile style with ten porcelain veneers by Dr. Huefner.
The short answer is for you and your cosmetic dentist to communicate on a very high level so that your expectations can be met. Your cosmetic dentist wants your input because he/she certainly wants you to love your new smile. Success is dependent on the skill, care and judgment of the dentist, but also on the ability of both the patient and dentist to communicate and work together on deciding key issues. This article concentrates on one of the huge variables that there is, choosing the smile style. Most cosmetic dentists will involve the patient in this selection process, but offering input and suggestions to help guide the patient in the selection based on the shape of the face, age, personality type and other factors. There are three commonly used “smile guides” that cosmetic dentists have available to them to show patients. Dr. William Dickerson’s “LVI Smile Library” (12 different styles), Dr. Loren Berland’s “Loren Library” (18 different styles) and Dr. William Dorfman’s “The Smile Guide” (36 different styles). One question a patient might ask their cosmetic dentist is which smile guide does he use and specifically what smile style does he recommend? If the dentist is experienced in cosmetic dentistry you should be able to see one of these guides and the cosmetic dentist should discuss by name a smile style that he/she advises using. There are different acceptable variations in shape that each porcelain veneer can be made. For example, the four front teeth (incisors) could be either square at the corners, square at one corner and rounded at the other, or rounded at both corners. Similarly, the cuspids or eye teeth (third tooth back) could be pointed, rounded or flat. Combining these different shapes each produces significantly different smile styles. Here are three examples from the Loren Library:

The design above is round, round, pointed. It is very youthful and oftentimes used when the patient has a very round face.

The above is a design quite the opposite, square, square, flat. It is a much older and oftentimes much more masculine smile style.

This one is in between the first two, being square, square-round, round, and is a very popular design.
Here are two popular smile styles from the Dickerson “LVI Smile Library”:

This is the “Enhanced” smile style, very popular with many of the beauty pageant contestants that I’ve created porcelain veneers for over the years. Note that the second teeth from the center are a little shorter than the front teeth. This is a youthful effect we call “the gull wing” that really looks nice on females. See first photo in this article with of Mrs. U.S.-Globe and the “Enhanced” smile style I used with her 10 porcelain veneers.

The “Hollywood” style above is a little more “toothy” and works well for males and especially those wanting to show off a little more teeth.
It is important that both the patient and cosmetic dentist be aware of the differences in tooth shapes and smile styles and have active communication between each other in choosing the best smile style for the patient’s new porcelain veneers.

Dr. Norman Huefner, General and Cosmetic Dentistry, Laguna Niguel, CA

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