This is the Art Beauty podcast where we tell the real truth about the fake shit.
Hi everyone.
I'm over a two day.
My fabulous co-host is Dr.
Stephanie Dumanian.
She is a cosmetic dentist and owner of the very posh Park Lex 60 Dental.
Welcome to the show.
Today, Amber.
Thank you so much for having me.
It's such a pleasure to be here with you today.
I am so, so excited to talk to you today because,
you know, I think so many people,
you know, a smile is the first thing
we notice when we look at a person, for better or for worse.
And I think there's been some people
who have made themselves very famous by not having a perfect smile.
Right. Tom Cruise comes to mind Madonna with The Gap.
But I do think more and more people are looking to get that,
you know, quote unquote, movie star smile.
And so I know her nerves are a very popular way to do that. But
there's a lot we need to know before we go down that route.
Right.
And I'm happy to answer all those questions. Yes.
There's a lot to work through on this call. So.
So do you find that you're doing a lot of veneers these days?
Well, I married a cosmetic dentist.
I will tend to, you know, a variety of different needs
that patients have from very basic things to more involved things.
But I do do a lot of veneers.
People really seek that treatment out for our office because they know
that we do very realistic and lifelike cosmetic work.
So yes, we do a lot of veneers.
What else?
Like what are the hottest things going on right now in cosmetic dentistry?
You know, it hasn't really changed that much over the years.
I think veneers are a really big one and Invisalign is another really big one.
Of course, whitening is always popular, but I'm sure we're going to get into today
what causes shadows and teeth and the appearance of darker teeth
and veneers is really a very easy way to get those results very quickly.
Amazing. So let's get right into it.
What are veneers?
So veneers are restorations that fit
over the fronts of teeth and they don't just have to fit over the front
if there's other issues going on.
Sometimes we wrap around the back,
but it's essentially something that we're doing to change the appearance
of a tooth and add a layer of protection, generally speaking.
And the ones that we do in my office are exclusively made out of porcelain.
But if you go to other offices,
they may be also offering composite veneers, for example.
We just don't do those in our office.
But the porcelain veneers are the ones that we are are doing and the lab
that we use is hand, making them to create a natural and lifelike appearance.
Okay, so just give me so much information there.
So we are essentially for people who might not know, you're essentially
like creating a structure that's going over an existing tooth.
You know,
you mentioned before the porcelain or composite.
Are those the only two types of veneers for the most part.
For the most part, those are the two types, of course.
So why?
Why only porcelain in your office is one better than the other?
I mean, porcelain is the top of the line.
You know, it's going to last the longest.
It's going to look the most lifelike and it's not going to wear down with time.
Composite veneers have a tendency
to stain, to chip, to have a very matted look to them.
And so a lot of patients are coming in with composite on their teeth.
They have bonding on their teeth to begin with.
If they're unhappy with that, they've had patched up over the years
and they're ready for something more permanent and cosmetic.
So let's talk about why would somebody come in for veneers?
What are some of the things that we can fix with veneers?
There's a lot that we can do with veneers, and
there are many different reasons to seek veneers.
And sometimes my patients come in not expecting
that we're going to have a conversation about veneers in the first place.
I would say that most people that reach out to me want a healthy smile
and people want it to look healthy as well.
So if we're seeing chipped teeth,
if we're seeing yellow teeth if we’re seeing bleeding gums,
these are all examples of something that we associate with being unhealthy.
So for bleeding gums, it's simple.
We're doing dental cleanings, things like that, but
now we're talking about a chipped tooth or discolored tooth.
We really need to mask that.
And so sometimes I'm getting patients coming in with chipped
and broken down teeth and we need to talk about why is that happening?
Because if we just put a veneer on there without addressing someone's bite
they're going to break that veneer the same way they broke that tooth.
So a lot of times when your work is rehabilitated,
so we're changing someone's bite to give them something that is going
to be functional and beautiful and predictable in the future.
They want to stop breaking things.
And so veneers is a way that we can do
that reconstruction, the really natural way and functional way.
So can you actually just get you know,
I thought that with when it came to veneers,
it was sort of this all or nothing thing either we are doing all of the teeth
on the top, all of the bottom, sort of like you would do like maybe
a bridge as opposed to just like a one off.
Can you just veneer, one or two teeth?
We can absolutely talk about that.
I have been here for a patient, just one tooth.
It's very difficult to get an exact match.
It was someone who had broken
just that one tooth and she knew that it would not match like.
Exactly.
And truthfully, it came out excellent.
But I still know it's there, so it's in the back of my mind.
But generally speaking, we want to do different segments
where the smile ends, the symbol, the smile ends basically,
and there are different places for that.
So I would say the front four teeth are one stream of the smile
behind the canine is another scene.
And then the corner of the lips.
When you smile, your biggest smile, that's your third scene.
So those are places where we are hiding the scene of the veneers, basically.
So if we're doing the front four or the front six, we can absolutely do that.
I'm usually doing the six, even if it's not for cosmetics
for a bite issues, right.
So if someone has chipping, I want to include those canine eyes
because it's going to give me a better bite.
But if someone has a good bite
and they're doing it just for cosmetic, I can do the front four.
What you need to keep in mind is the more veneers
I do, the less I need to prepare the teeth.
And I'm sure we're going to talk about this a little bit more.
But usually when we're placing veneers, we need to remove some enamel
to place something on top.
If I'm doing the front for teeth, I need to fill the frame of the smile.
I cannot now bring four teeth forward.
They're going to look back.
They're going to look too far forward.
So if I now want those front teeth to fit perfectly in front of those canine teeth,
I need to remove as much tooth as I'm going to be adding in porcelain.
But if I'm going all the way to the false in the mouth all the way back,
I can bring everything forward
unless there's one tooth that so far forward and out of alignment.
I would bring that one tooth back in, but the rest of the teeth
I can just add on top and I can do a virtually prep list of them here
and maintain all of that enamel for that patient.
So the more I do, the more conservative I'm actually being, if that makes sense.
Wow. You're kind of blowing my mind right now and maybe would help
for you to explain to myself and to everybody listening
what is the process of of sort of, you know, coming in and getting veneers?
How how are they applied?
Yeah.
So every office functions a little differently.
Some things will be the same, some things will be different.
It's really important for me to understand why someone wants to do veneers.
What are they looking to change?
Right, because there's a lot of things that we can change with veneers
to a certain extent.
It can even be almost like a nonsurgical cosmetic procedure
because it can change certain appearances of our face,
which we can come back to later.
But at that first visit, I want to know what you're looking for.
And we're going to take photos, we're going to take models.
And a lot of times I'll even do a mock up in the mouth.
So I'll show you if I bring your teeth out more,
if I widen your smile, what is that going to look like with your face?
Right.
Because you can show me pictures of people who smiles you think are attractive.
But if that doesn't suit your
face, then it doesn't really matter, right?
So at that visit, we would work out those details.
Excuse me.
Assuming someone's ready to commit to the treatment,
I send those models off to the lab
and they will design and engineer with me
what those veneers are going to look like.
We'll use that as a template going forward to the final results.
So the next visit would be what I call the preparation visit.
And at that visit with Nomura,
we would try in this template and we would prep back from that.
So basically,
if I'm adding to all these teeth, I really don't need to prep the tooth.
I can just kind of polish it a little bit, get rid of any sharp edges,
take them all. So that's the lab.
And now I make a temporary based off of that template that I was given by the lab.
So you're going to test drive your smile before you get the final results
soon.
So so is that a very common thing where the lab
will send back sort of this temporary
veneer before you put it on the full one?
You know, I think it depends on the office.
I know someone who went and got veneers in another office
and she was very recruited.
Her teeth were too far back.
She had no lip support and she really needed to be brought out forward.
And she called me hysterical because they cut her teeth down to almost nothing.
And it was very aggressive.
I think that if you're going to someone who's a reputable doctor,
that's the protocol that they're going to use.
So it's really important that you do your research
and you make sure you're going to the right place,
but you want to test drive those veneers before you get the final.
And I usually have patients come in a few days later, we check your bite,
we go over shades selection and we make adjustments right?
So if you want your front teeth to be a little bit longer, a little bit shorter,
making those adjustments after the fact, when you leave my office, you're tired.
You're not.
I like everyone to come back to the fresh mind. Not at all.
And and really discuss what we like and if we want to change anything.
And then I can relay those messages to the lab and make sure
that the final veneers that come in are just perfect.
Okay, so then once you the final ones, how, how are those
being, you know, installed, for lack of a better term?
They're they're basically glued in.
It's a resin material that's like cured.
To get it to stick
is actually not very different than if you got a gel manicure, for example.
So it's something that goes on liquid underneath.
And when the UV light hits it, it hardens and that veneer is going to bind
to the tooth.
And the strength of that bond is really strong.
If we can stay really conservative.
So back in olden days when I used to do veneers,
they would do a lot of preparation.
And now we're realizing that the more enamel we have, the stronger the bond.
So the more conservative we can be, the better, not just for the tooth,
but also for that veneer that's going on top.
So now, you know, you've mentioned this a few times.
You know that people are removing your natural teeth
in order to sort of fit the veneer.
How much are we talking about here?
How much tooth gets removed?
And does that make this a very permanent solution?
It is permanent in the same way that a bonding would be semi-permanent
as well, or it's rather long term at least, because nothing lasts forever.
But it is intended, as you know,
if you're getting veneers, you're going to have veneers again
in the same way that if you had bonding, you're going to have bonding again
because you can't remove that bonding without removing some 200 years.
And the amount that we need
to remove really depends on what we're trying to achieve cosmetically.
So for some people, I don't remember anything.
I really don't remember anything.
For others, I'm not moving anywhere between point five and 1.3 millimeters.
And then I would say if I'm being aggressive,
I could be removing up to two millimeters.
But those are some very, very unique situations
where someone has a very dark tooth, maybe it's had a root canal,
it's really dark and I need more porcelain
to block out the natural shade of the tooth underneath it.
But generally speaking, these juniors are like a contact lens.
They are very, very thin.
And for that reason I really don't need to remove more than a millimeter of enamel.
And that's when the more aggressive side, to be honest.
So, you know, I always like to ask, when we have an expert, it's clear
that you, you know, are sort of at the top of your game.
You know, you take a lot of care and a lot of thought into your patients.
I love this idea that you sort of have them try before they buy or rather
not before they buy because they've already bought them.
But at least try, you know, a temporary before they install the full things
that there is a period where you can go back and make changes if needed.
And what are things, you know, that people who
maybe can't come to your office, you know, what are some of the things
that they should be aware of and asking their dentists before getting,
you know, veneers to make sure that that they're not that
they're going to get the best results or the results that they're hoping for?
Absolutely.
I would say look at photos before and actors are going to tell you a lot.
If the style of this dentist is your personal style,
there isn't one right way to do this.
There's just a lot of different styles.
I'm sure you watched on TV
and you see people that, you know, have had veneers, right?
Those teeth are really, really white.
I have some patients who come into my office and they go
when I get veneers, I don't want it to look like toilet
bowl, white teeth, you know.
And there are other people who are like,
I want the widest possible teeth you can give me.
I want it as wide as this piece of paper.
So it's really important that someone is following your personal style.
I like to do very lifelike veneers and I like to prep minimally,
so check out those before and after photos.
I would also say, you want someone who's going to give you models, show
you models of what the teeth are going to look like ahead of time,
a mock up or something that you can try it in your mouth.
They can even do a mock up chair side.
So when you get to the dentist, you can say, What would that look like?
Can you show me a few teeth?
That's something that I always do.
I take a picture with the patient and I show them picture of their face with it.
Actually, a picture of their face without it.
And I think that's the easiest way to see
what are we changing with the shapes of the teeth?
And is that something that will match your face?
We always have certain parameters that we follow,
which is why I like to try things in some months now.
It's not just about the teeth, but it's about how did you fit in with the smile?
Does it follow the curve of the left? Right?
Do we have the right amount of length?
And then that's why I like patients come back a few days later
about making sure that they're happy with the cosmetics, but also fanatics.
Phonetics is another really important part.
So I'd say ask for before and after pictures
and ask if they could do a little trial. Smile for you.
Because a trial smile is really going to help you understand this.
Doctors esthetic and if they understand the shape of your face
and things are going to enhance your smile and your beauty.
You know, it's funny you've mentioned tooth color quite a bit,
you know, and I know at the beginning we kind of tapped on
why people might come in.
When would you?
You know, it seems to me, especially some some
from some of the before and after is I've seen that you've done that.
When you have, you know, a very noticeable smile with teeth that are maybe
misshapen or, as you mention, cracked or,
you know, they look like.
Well, actually, I would say it's widely.
Known or worn.
Broken or worn.
When would you go with, like, for example, braces in Invisalign versus,
you know, or just whitening versus going veneers?
Absolutely. Absolutely.
So whitening works well when you have good quality enamel.
So you want enamel that's nice and shiny so and doesn't have that matte appearance.
Sometimes you'll see people that have like
it almost
looks like their teeth are see through and the under layer of the tooth is showing
or they look very matte, sort of like etched, etched marble.
Those are going to be difficult teeth to white.
And so the best way to whiten those teeth is going to be with a laminate
because they gloss enamel or their enamel quality is pretty poor.
So the layer under the enamel is really what's yellow and that's coming through.
So instead of light reflecting off
of, it's used a lot of light being absorbed into that tooth.
So it is only going to give minimal results
if we have teeth that are misshapen or misaligned.
Your lips also going to cast a big shadow on those teeth.
So if we do whitening your teeth for The Fighter,
but they're not going to look as white
because you're getting some shadow being cast in those areas.
And so in those situation, you know,
veneers would work out better, but there are a lot of situations
in which whitening will work.
And I actually also have a lot of patients who choose
to do a combination of Invisalign and veneers
because they want the case to be minimally prepped.
So in some cases, if I have people that have really small teeth,
I will do Invisalign.
I will open spaces up around those teeth, and this way
the veneers will just slide on top.
And I've done that.
A lot of times it takes longer.
But if people are concerned
about the enamel quality, that's one option that I will often do.
And then also sometimes people
don't want to get veneers top and bottom and the bottom teeth are crooked.
So I'll do a little Invisalign, straighten those out,
do a little whitening on the bottom, and then do veneers to kind of
round everything out and just enhance the smile.
So I happen to know, you know, I have,
I have something called embrace, which are sublingual or lingual
braces, rather lingual braces, which means they are on the back of my teeth.
And I was amazed because my teeth didn't have a lot to move and shift.
But even just small, small shifts can actually like push,
you know, where your sort of lips fall.
And that's what you're mentioning.
What are some of those other you know, you and I have discussed offline
some of the other benefits that people get from having veneers.
Oh, yeah, absolutely.
I mean, Amber,
you're all about beauty, so this is the perfect time to talk about it.
We are basically slowing down the aging process
or even reversing it slightly with veneers.
So let's talk about the way that people age over time.
And so something that you'll notice a lot is that
people tend to get a thinner, more flat lip, okay?
People tend to get these deep nasal labial folds and they tend to get saggy cheeks.
And the other thing you'll see with people who really don't care
for their smiles is and this is an exaggeration,
but if you were to kind of like pull your lips in like this, but notice
that the space between your nose and your chin gets closer together.
And when you do that, imagine just squishing all this together.
You're going to deepen those lines and your cheeks
are going to feel a lot heavier.
So when we're doing veneers
and it
acts like a rubber band for the lip in a nice way, right?
So it's kind of like lifting curtains a little bit.
It's going to fill out your lip if they're done properly,
so you're just going to get a bit more support.
It's not going to be a lot and it's not going to be extreme.
We'll get a bit more support.
These nasal labial folds will just soften a bit and it'll lift your cheeks.
And so all of those changes that we're seeing really help
to kind of slow down the aging process.
If you've ever seen someone who has gotten veneers that's, you know, perhaps older
or has really worn down teeth where you don't see them at all,
all of the sudden when they get veneers, now they've got their teeth
showing a little bit and their lip is automatically getting bogged down.
Anyone who's got short, worn down teeth, that lip just sinks in
and we don't see teeth anymore.
And it's actually a big reason I'm doing veneers right now is for people
who kind of done a little too much lip filler and they've lost their left
and they like the lips that they lose their teeth.
Sorry, they like the lip filler, but they're noticing
the more that they do, they can't see their teeth anymore.
So I'm
doing a lot of veneers in those instance because we've got to bring back the teeth.
Right, because right there, talking without teeth. Wow.
I mean, it's absolutely incredible what you can do.
You know, I think back to, you know, the veneers of old and endless.
And like you said, you know, we've all seen somebody who it's
really obvious whether it's like that chick lit smile.
But I think technology has come a long way
when it comes to veneers.
Can you run us through any any, like,
tips that we want to
consider before we go in to get these?
Yeah, I would say look at Inspo photos for sure.
Like you want to look at photos online and give examples of what you like,
but as important as what you like is what you don't like.
Find those photos of the patient's teeth that you do not like, right?
Because you may not exactly able to explain what it is that you like.
A smile that's clearly really beautiful and appealing.
But pick the ones that you don't like, right?
Pick the ones where people have had
cosmetic work, where
you think that someone might like this, but you personally don't like that.
It's important that the doctor you're seeing understands your personal style.
I think that's really the easiest way to accomplish that.
You want to make sure that they have a good lab
and you may not know that, but like I said,
looking at before and afters really give you a clear indication in there.
You want to see some variation of the smiles that they're doing.
Not every smile looks exactly the same. Why?
To make sure that those changes are happening with different patients face
shapes, smiles, age, whatever their demographic might be.
But like you want to make sure that they have different smiles there
because everyone has a different smile.
And as I like to say,
when patients come in, sometimes they go just to do what you think is right.
And I always say, Well, give me some guidelines,
because there is not one thing that is considered beautiful.
There's an umbrella
in which I have to follow a certain set of guidelines,
but I want to know what it is that you like.
And so we'll go through pictures of different teeth
and we'll look at those and we'll see.
Do you prefer that your your front to your front centrals are a little bit longer
or do you like things to be like a little more even in that smile?
Like all these different things are what we'll discuss.
So make sure that whoever you're seeing, take a look at those before
and after as they really are very telling and they can tell you a lot.
But don't be afraid
to bring inspirational photos or the ones that you don't like with you.
Now, I have to just put this out there because you
you've told me that you have fixed veneers from other people.
So, you know, let's say we're out there, we get veneers
and we hate them.
What do I know?
Oh, goodness. What do we do?
Is it.
I think it's fixable, right?
It's fixable, but it's a process.
And I do charge more to replace veneers
that were done before because it's a lot more work for me.
I am very conservative in removing the old veneers
because I don't want to remove more tooth structure.
That's what's under there.
So it's a slow and tedious process, but it absolutely can be done.
I do it quite a bit
and and yeah, usually in those situations
we're making sure to have a clear conversation about why
that patient doesn't like those veneers and what they're hoping to achieve the
second time around.
It may be obvious to me what I don't like about them,
but it's really important that I know what they don't like about them
because people will surprise
you and their expectations and what they're looking for
in the most important part of this whole process is clear communication.
So make sure you find a provider that you can communicate with
and that is listening to your concerns and what you're looking for.
You know, I think we've gone over a lot of the pros of veneers
that we're fixing to shape.
You know, it's something
that can be pretty instantaneous, not instantaneous, but very, very fast.
You don't have to wait for the length of, let's say, you know, braces.
You can kind of fix a lot of things much quicker.
What are some of the cons, in your opinion?
I mean,
the most obvious one that I think people notice is the cost.
They're incredibly expensive.
And I mean, the same way I shop for anything else.
If nothing, it's too cheap. I'm running away, right?
Because you get what you pay for. And I always like to say
cheap is expensive because then you're paying to fix it.
So you're paying double
veneers are really expensive.
There are different labs,
different quality labs out there and the one I use is is very pricey.
So that's really the main thing is the cost.
I mean, I think even in
I happy to be in New York City, which is a very expensive area
and I see prices anywhere from 1200 to 5000 for porcelain veneers.
Is that worth or for the whole house?
Wow, you've got it. Okay.
And most people are getting, what, like a minimum of six?
I know you said you could do one, but what is the average?
What is the average?
Most of my patients who come in are usually doing about ten.
When I would say somewhere.
Yeah, but I would say usually, you know, we can get away with doing six.
I've done four, I've done eight.
It really depends on what the patient's looking for.
So I would say four is probably the minimum,
but people are coming in for a smile transformation.
They're probably going to want to look at doing ten on the upper
and maybe on the bottom, but that I find that most more people start on top
and they usually
come to see me a few hours later and I really want to do the bottom two.
So okay.
But we're looking, you know, at that price.
You know, listen, we know New York is always more expensive.
So you're looking at like, you know, almost $50,000 for that beautiful smile.
But like you mentioned, getting it in porcelain with a good lab.
Hopefully you don't have to do it again.
Or at least the person is going to last a lot longer than the composite would.
It will?
Yeah, it'll absolutely last a lot longer.
It'll be better for your teeth.
It's an investment.
And I find that it really changes people's lives.
I mean, I've had patients who come to me and they change careers.
They get married, they're just so much more confident.
And there are a lot of people who feel that their smile doesn't
reflect who they are.
So this is a really great way to just give someone
the self-confidence they deserve.
I mean, people spend a lot on other things and people want to spend
on their own health.
It means a lot to them and it's really rewarding
and it's something that they see every day.
So it is an expense for sure, but anyone who's done it really
feels that it's worth it.
Amazing.
I want to thank you so much.
I feel like we could talk about this days and.
I need to talk to you for days.
So I adore you.
You're the voice. And great tips.
I always love Blessed Again.
And oh, thank you so much.
And you know what?
Listen, I care about my T, so I really believe, you know, like you
said, I went and
I'm almost a year into wearing braces now and it was minimal fixes, but for me,
it was so worth it, not only for the cosmetic,
but as you mentioned, you know, you're adding support back to your your mouth.
You know, that's going to affect your gums if you have a weird bite
that can really affect your overall dental health down the road.
So while there is a great cosmetic reason for a lot of these things,
if you are able to support your
your teeth and your gums and your bones in your mouth better,
you know, you're going to put off other problems down the road
as or at least that's what my orthodontist sold me on.
Well,
he has told you the right thing.
Yes. You know, and truth of the matter is that forum follows function.
And if you're functioning well and you're feeling good,
they're beautiful teeth, too.
So I totally agree with him.
And you look great.
And it's progressing so nicely. It's been so nice to see.
And yeah, I'm excited for the final results.
You and me both, sister.
So listen, I know that you are here in New York City.
If people want to come in and see you,
what's the best way for them to get in touch with you and find you?
Absolutely.
So, as our practice suggests, Park Lex 60 dental is on
60th Street between Park Avenue and Lexington.
You can give us a call.
Our number is two.
One, two, two, two, three, 1030.
You can also follow us on Instagram at park like 60 dental.
And lastly, you can email us hello at Park 60 dental dot com.
So feel free to reach out and we are looking forward
to answering any questions you may have and helping you get that perfect smile.
And let me just tell you what I happen to know.
I happen to know Stephanie personally.
So I know that she is responsible
for a lot of celebrity smiles, which, of course, we cannot mention here.
We're going to keep people.
But you're in really good hands if you go there.
Thank you so much for being on the show with us.
Thank you, Amber.
I appreciate it. I'll see you soon.
I'll see you. Soon.
And of course, if you have questions, whether you pass along to Dr.
Dumanian, I'm always happy to do that.
You can write us at Hello at our podcast dot com.
You can find us on Facebook, Instagram and podcast our and YouTube at Art
Beauty podcast.
And as always, we'll see you next Tuesday, hopefully with a brighter, more
beautiful smile.
Thanks, everyone.
Thank you.
All right.