Poorly Done Smile Design: Smile Makeover Gone Wrong

Are you considering a smile design procedure but worried about the potential for a less-than-perfect outcome (a poorly done smile design)? Rest assured, you’re not alone. Many people experience apprehension when considering cosmetic dental treatments, particularly when it comes to something as visible and personal as their smile.

Fortunately, advancements in dental technology and techniques have made it easier than ever to achieve a stunning, natural-looking smile. From advanced imaging tools to cutting-edge materials, modern smile design procedures offer numerous benefits for patients seeking to enhance their appearance and confidence.

In this article, we’ll explore what a smile design procedure entails and how to identify signs of a poorly executed treatment. We’ll also discuss the key factors that can affect the outcome of your smile design, including the skill and experience of your dental provider, the quality of the materials used, and the overall approach to the procedure. With this knowledge in hand, you’ll be better equipped to make an informed decision about whether a smile design is right for you, and what to look for when selecting a provider.

As technology advances, we have access to increasingly durable materials that can mimic the appearance of natural teeth. At the same time, there are now a wider range of shades available for resins and ceramics, including whiter hues.

Moreover, the latest materials are designed to be more conservative, requiring little to no grinding of the teeth to preserve more of the natural structure. As a dentist, it’s exciting to witness these developments and how they improve our profession.

However, despite these advancements, the reality in our daily practice can be quite different. While we have the tools to create beautiful, natural-looking smiles, a poorly executed smile design can still result in disappointing outcomes for our patients. This is why it’s essential for dental professionals to stay current with the latest techniques and materials, as well as to take a comprehensive approach to each patient’s unique needs and goals. By doing so, we can ensure that our patients receive the highest level of care and achieve the stunning, confident smile they desire.

Patients often struggle to differentiate between dental professionals who prioritize celebrity clients over ethical patient care, which can lead to less ethical professionals gaining popularity and fame. It can be challenging for patients to determine whether a costly treatment is truly of high quality or if it’s simply overpriced due to a dentist’s salesmanship skills, and it’s concerning because these low-quality treatments can have long-term negative effects on oral health.

As a dentist, it is heart-wrenching for me to witness patients coming to my practice with tears in their eyes. They share their regretful experience of receiving a smile design treatment at a popular place for celebrities and social media influencers. Unfortunately, the treatment has left them bleeding, unable to eat, or with a smile that does not fit their facial features. Similarly, it is disheartening to see patients with shattered self-confidence due to a poorly executed design that they received at a place that offered a cheap promotion. As a practitioner who values my patients’ well-being, I feel compelled to educate you on the various signs of a badly performed smile design.

1. First sign of a poorly done smile design: the teeth have an improper occlusion.

After a smile design procedure, it’s common to experience a sensation of something new in the mouth when closing it due to the addition of new materials. However, it’s important to differentiate this feeling from the impression of teeth not aligning or the inability to properly chew food, which may indicate that one tooth is higher than the others.

If the issue of an imbalanced bite is not addressed, it can result in more serious dental problems. For instance, the tooth that hits first may become weakened over time and can eventually fracture. Moreover, an uneven bite can lead to complications with the temporomandibular joint (TMJ) which connects the jawbone to the skull, leading to discomfort or pain in the jaw, difficulty opening and closing the mouth, and even chronic headaches.

Fortunately, correcting an imbalanced bite is a simple and effective procedure that can be done in a dental office. The dentist will first identify the tooth that is hitting first and use a special paper to mark the area of the bite that needs to be adjusted. The tooth or teeth that are hitting first will be carefully polished down until the bite is even and balanced. This will not only prevent further dental problems but also improve the overall function and comfort of your teeth and jaws.

2. Whenever you brush your teeth, there is bleeding.s

Poorly Done Smile Design

It is never normal for teeth to bleed during dental cleaning, especially after a smile design. This can happen when the dental material used to create the new smile design takes up the space where the gum should be, leaving tiny spaces where food particles can get stuck, leading to bacteria buildup and inflammation.

To fix this issue, the dentist needs to carefully smooth out the line between the gum and the tooth, ensuring that it is completely free of any irregularities. If the gum has become significantly inflamed, the dentist may need to perform a gum cut to restore it to its normal state. In addition, the dentist may prescribe toothpastes and/or mouthwashes that help to reduce inflammation and prevent bleeding. It is important to maintain good oral hygiene and attend regular dental checkups to prevent any further bleeding or inflammation.

3. Inserting a fingernail between the tooth and the gum.

This issue is closely related to the previous issue and is actually the most common problem that I encounter in my daily practice. Often, in order to improve the appearance of the tooth closest to the gum or to maintain the size of the gum for aesthetic reasons, dentists apply resin or ceramic to the gum, resulting in overcontouring. This not only causes dental bleeding but can also lead to tooth decay in the future.

To resolve this issue, it is important to sculpt this area until the fingernail can easily pass through, and if the aesthetics are not satisfactory due to the thinner appearance, a small dental carving or gum contouring can be performed to create space for resin or ceramic while maintaining proper adaptation of all restorations in the mouth.

4. The dental floss frays

Sometimes dental floss can become frayed due to gaps in the resin or ceramic, which may require additional polishing with a miniature sandpaper-like tool. It is important to note that not all problems with dental restorations are a result of poor treatment. In fact, issues like these are quite common and can usually be resolved during a quick 10-minute follow-up appointment. The key is to promptly inform your dentist of any concerns so they can be addressed before they lead to further issues, such as impeding proper oral hygiene.

5. All teeth are aligned perfectly without adhering to their natural anatomy.

It’s important to understand that each tooth has its unique anatomy that should be respected. While I do believe in accommodating patient preferences as much as possible, as long as they don’t compromise the health or function of their teeth, unfortunately, some dentists prioritize speed and profit over the patient’s best interests. This can lead to a “cookie-cutter” approach to smile designs, where teeth are made uniformly straight without taking into account the patient’s facial structure or natural smile. As a dentist, my focus is always on advising the patient on the best options for their individual needs and desires, while still respecting the anatomy of their teeth for optimal health and function.

6. They don´t shine

dientes sin brillo

As previously mentioned, the technology available to us today is remarkable, and as a result, we have access to tools that can make teeth incredibly shiny, almost like a mirror. While one might assume that the shine is purely for aesthetic purposes, it actually serves an important role in oral hygiene. A smooth surface is less hospitable to the bacteria that cause cavities and bad breath to cling to, making it easier to maintain proper dental hygiene.

7. Black shadows are seen after a while

If black shadows appear after some time, it could be due to maladaptive areas that were not corrected during the smile design process, resulting in cavities or the accumulation of pigments from certain foods or drinks like coffee and wine. To avoid any further complications, it is important to have a dental X-ray taken to confirm if there is any underlying issue before proceeding with a carving to remove the dark areas. This step ensures that the procedure is done correctly and efficiently to achieve the desired result.

8. The tooth has been excessively carved.

tallado demasiado

In the same way that there are situations where carvings are not performed as they should be, as explained above, there are also instances where the dentist may not prioritize preserving the tooth and may perform excessive carvings, resulting in irreversible damage to the tooth. This is known as an exaggerated tooth carving.

9. There is a bad odor

mal aliento

If the issues mentioned earlier persist and are not addressed, you may also experience bad breath, which is not your fault. Bacteria that remain in areas with poor polishing or overcontouring are responsible for the persistent bad odor. This can be quite uncomfortable for you. If you are reading this blog, chances are you have seen famous people on social media who have lost teeth due to poorly executed smile designs. This may have made you apprehensive about getting a smile design done or having someone you know go through the procedure.

After reading this article, you now have the necessary knowledge to ensure that your smile design treatment is performed correctly. You can ask your dentist the necessary questions to ensure that your treatment is successful, or you can return to your dentist to improve any issues in the design that may have been missed.

It’s important to note that poorly made smile designs won’t immediately cause dental damage. It can take weeks or even months for cavities to form and cause serious damage to the nerves or gums. However, excellent dental hygiene and regular check-ups with a dentist can help prevent these issues from becoming bigger problems. Additionally, periodic cleanings every 4 to 6 months are essential to maintaining good oral health.

Remember, while a bad treatment can be caused by a poor dentist, you have the power to prevent it from becoming a more significant issue. Don’t hesitate to have your restorations polished in a 30-minute visit to your dentist to address any minor problems before they become major ones. By staying informed and taking care of your oral health, you can ensure that your smile design treatment is a success.

As a final piece of advice, I want to emphasize the importance of trusting your instincts when it comes to your smile design. If you have any doubts or concerns about the treatment you have received or are planning to receive, don’t hesitate to schedule a second opinion appointment with another dentist. It’s better to be safe than sorry and risk losing a tooth forever due to a poorly executed treatment by a bad dentist, regardless of their level of fame or expertise. Remember that your dental health and well-being are at stake, and you have the power to take control and make informed decisions about your smile design.


Dra. Sara Pelaez Monsalve

Aesthetic dentistry with more than 14 years of experience in the field. Founder of Clinica Viena and Viena Kids (clinic focused on pediatric dentistry). Professional focused on patient care, on the application of best practices and high-quality world-class treatments.

Leave comment