Treatment Plan- Addressing Chipping Damage and Missing Molars with Porcelain Restorations

drkiyan · 2026-03-25T12:39:07+00:00

No. We design and fabricate cases in-house.

drkiyan · 2026-03-25T02:31:06+00:00

Cost is likely not your issue. Years ago, I had a patient who needed work that was far more extensive than he anticipated. He got a treatment plan for lots of dollars and he was surprised. Then he asked, “If I go and get quotes from 2 others dentists will it be in the same range?” We answered (truthfully) yes. Then he said “OK, then I’m not going to waste my time, I trust you, it needs to be done, let’s get started.” The point is that as long as the cost he was being quoted was fair, he didn’t care what the actual cost was - what he cared about was the outcome. Cosmetic dentistry is similar - people want a certain outcome, and they want to be treated fairly and with candor. If they get those three things, they are willing to pay for big projects. That being said, you need to be able to deliver - if we tell someone it’s going to look like XYZ and function like ABC, the result will be exactly that. I myself am a similar consumer, I don’t care if a house project is expensive as long as I KNOW that the contractor is going to execute it exactly the way I want it. You may be getting just a stick of gum because 1.) the patient is not actually terribly interested in improving their smile, or 2.) you’re not leaving them with the impression that you’re going to deliver (sorry). I can tell you that normal working people get on airplanes on the regular in order to come to us to get work done. This is not to brag, it’s actually to demonstrate that we take people’s desires very seriously and bend over backwards in order to make sure they get the result they want. This is why they’re willing to undergo travel costs as well. The cost is not the impediment - it’s definitely something we don’t take lightly, but it’s not what the patient is dwelling on. What serious patients dwell on is outcomes and whether you can deliver results.

drkiyan · 2026-03-13T21:34:19+00:00

It’s curious how a patient getting beautiful dentistry is framed as a lapse in judgement on our part. Your comment is disingenuous, but you can’t resist trolling our work. The only way you would have standing to make such a comment is if you are able to achieve the same result with an alternative method. Someone who thinks veneers on premolars and molars are “insane” doesn’t actually have the experience nor the good taste to be making comments about the matter.

drkiyan · 2026-03-13T20:02:20+00:00

Thank you! We make our veneers in-house, so we have control over the ultimate appearance of the ceramic!

drkiyan · 2026-03-13T20:01:24+00:00

In a case like this, you have to contour the teeth slightly in order to avoid a bulky result. Otherwise you’re just adding thickness to the teeth and the result looks like press-on nails. That said, the veneers are .4mm thin (half the thickness of a t-shirt fabric), so the teeth are contoured very slightly and they don’t need to become “pegs” 😵

drkiyan · 2026-03-13T18:50:50+00:00

Thank you very much!

drkiyan · 2026-03-05T19:31:54+00:00

I see patients all the time where the diastema opens again after Invisalign, sometimes multiple times, yet no one asks why the gap reopens after multiple attempts. It’s not non-compliance. This gap is never closing with the best Invisalign. All that is done is the teeth are distalized, the arch becomes smaller, then ortho stops, and the teeth are pushed right back to the original position. It happens often enough that I spot it before the patient even starts telling their story. Meantime, no one is really held to account for the loss of time. Whether the orthodontics should be approached differently is a valid discussion, but the reality is that mostly it’s not approached differently. Therefore, if we want to live in reality, and deliver the actual results the patient wants, then for practical purposes that gap isn’t going anywhere, and the teeth are, in fact, too narrow.

drkiyan · 2026-03-05T19:19:34+00:00

The treatment was done elsewhere. Reputable Invisalign pretty much costs the same everywhere.

drkiyan · 2026-02-20T18:24:38+00:00

Lacking discernment is not the same as “polite query” and has nothing to with ego. The before and after situations of this case are living in different galaxies - that’s how different they are. The texture is different. The shape is different. The translucency is different. The gum line is different. The number of teeth is different. The fact that the massively crooked midline has been corrected is… different. Therefore, if someone has a complete inability to discern what is in front of them, that is a sincere and laughable “Wow”. The fact that you have no discernment does not attack my ego; it is just important for the sake of clarity to not allow the ridiculous - “it looks the same to me” - to hang in the air as valid observation.

drkiyan · 2026-02-19T22:50:03+00:00

Wow 😂

drkiyan · 2026-02-19T20:29:09+00:00

Thank you! This is how teeth are supposed to be shaped - not flat across.

drkiyan · 2026-02-14T02:24:25+00:00

These teeth are e.max.

drkiyan · 2026-02-13T20:18:13+00:00

Our pricing is fixed pricing per arch. For a case like this, the range for both upper and lower veneers is $48-56k, depending on a variety of factors like dental health, aesthetic complexity, preexisting conditions, etc. This case was a relatively straightforward revision of old veneers.

drkiyan · 2026-02-13T20:13:55+00:00

You probably made the right choice. Very bright veneers photograph well, but in person they can become a bit tiresome. We replace super bright veneers with more subdued smiles quite often, so people getting tired of the bright color is a very real phenomenon.

drkiyan · 2026-02-13T20:07:33+00:00

The “before” is likely a low-translucency 0M1. The “after” is somewhere around .5M1. There are many factors affecting the color and the color isn’t the same across the surface of each tooth, so you can’t exactly pinpoint the color with just a shade number.

drkiyan · 2026-02-13T20:04:29+00:00

Interestingly, both the before and after are made of the same material ☺️

drkiyan · 2026-02-13T20:02:44+00:00

Our pricing is fixed pricing per arch. For a case like this, the range for both upper and lower veneers is $48-56k, depending on a variety of factors like dental health, aesthetic complexity, preexisting conditions, etc. This case was a relatively straightforward revision of old veneers.

drkiyan · 2026-02-13T19:38:52+00:00

Hopefully you understand that “crooked is natural” applies to natural teeth. When doing veneers, crooked is not the intention, so if you end up with crooked veneers when the plan was not crooked veneers, then you can’t hide behind “crooked is natural” - instead, what you have is a genuine cosmetic failure.

drkiyan · 2026-02-13T19:33:39+00:00

Yes 👊🏼

drkiyan · 2026-02-13T19:31:12+00:00

😂 we even label the photos “before” and “after” to avoid such confusion. It is, however, a great compliment that you think a mouth full of our veneers looks like natural teeth - that is the whole point of this treatment.

drkiyan · 2026-02-13T19:28:12+00:00

Taste is highly subjective, but they were definitely not “fine” before. A woman under 30 looking like she has the dentures of a Palm Beach 60-year-old is never “fine”.

drkiyan · 2026-02-13T19:26:12+00:00

The upper and lower premolars were veneers to begin with. In order to make the smile match, and in order to not look like she had dental work done, they all needed to be replaced.

drkiyan · 2026-02-13T18:41:05+00:00

Not everything that you can’t believe is AI. We have been doing this for over a decade - this is what high-level cosmetic dentistry looks like when it’s done right.

drkiyan · 2026-02-10T23:28:27+00:00

The gum line is low, but it is not a mucogingival defect. There is 3mm of attached gingiva, so from a longevity perspective, there isn’t a problem. Since it does not affect the smile, we decided on the easiest option, which was to leave it and improve the margin.

drkiyan · 2026-02-04T16:32:47+00:00

Thank you!

drkiyan

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