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What Do I Do About White Spots on My Teeth?

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On my front teeth there are white spots. They cover about one third to on half of the teeth. I am hoping to get the rest of my teeth to match the white spots. My doctor had mentioned Zoom whitening. He didn’t do that procedure, so he recommended someone else to us. Unfortunately, when we went to see that dentist he said it would not do what were were hoping for and he didn’t want to take our money for no result. I went back to my dentist and told him what his colleague said. He said he’d be willing to do the teeth whitening himself. He can do the take home trays by sending impressions of my teeth to his lab. This sounds like a good plan, but I’m wondering why if Zoom whitening won’t work will the regular kind?

Crie

Dear Crie,

teeth bleaching trays

Teeth Bleaching Trays

 

I am glad you wrote. I have both good news and bad news. We’ll start with the bad news. What your dentist is suggesting will not work any more than the Zoom would have. The upside here is there is double the amount of good news to bad news.

First, it is obvious your dentist is not just trying to make money off of you. I know this because he sent you to another dentist who did the Zoom procedure. If he wanted to just get some treatment money from you, he would have suggested a procedure he does from the beginning. Because of that, I believe he was making his suggestion in good faith.

Why won’t either  of these procedures work? This is because when teeth whitening does its thing, it whitens teeth evenly. This means the\ white spots will get brighter along with the rest of your teeth. The good news is that this can be fixed. I would start with teeth whitening so that the non spotted parts of your teeth will be the color you want. Then, you can deal with the spots themselves.

If the white spots aren’t on too large of a surface area, then you can have dental bonding done. This uses a composite bonding to match the spots to the remainder of the teeth. If the area is larger, then you will be better served with porcelain veneers. They are more expensive, but they last longer and they can change more than just the color of your teeth. They can also change the shape and size of the teeth.

Both of these procedures (bonding and veneers) have to be done by an expert cosmetic dentist, so I don’t think your dentist has the skills necessary. Teeth whitening is the easiest cosmetic procedure and he didn’t understand how that worked. The ones I’m recommending are quite advanced.

This blog is brought to you by Duluth, GA Cosmetic Dentist Dr. David Marion.

Fixing My White Spots

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I have always had white spots on my front teeth. I’m in my mid-twenties now and really want to have a smile that does not embarrass me. But, when I talked to my dentist about it, he assures me that my teeth are healthy and I should not mess with them. When I brought it up again at my next appointment he sighed and said, “If it’s bugging you that much, just whiten them.” I did, but that seemed to only serve to make the white spots brighter. What do I do now?

Kelly

Dear Kelly,

Before and After Dental Bonding repairing a chipped tooth

 

When I read your story, I rolled my eyes. Your dentist is likely a decent family dentist but he has no idea what he is doing when it comes to cosmetic dentistry. As you discovered, teeth whitening is not the correct solution for this. When you whiten your teeth, it does so evenly. This means that while your teeth will whiten, so will the spots.

There are two possible solutions for you with this depending on how severe or widespread your white spots are. If there is just a small amount of white spots on the tips of your teeth, then you could get away with dental bonding. The example shown above is of dental bonding used to repair a chipped tooth, but it can also be used to cover white spots.

If you are looking at a larger surface area, then you would be better served with porcelain veneers. This can cover the whole surface of your teeth. It can also do more than even out the color if you were interested in that. Veneers are the go-to for celebrity smile makeovers. They can change the shape, size, and color of your teeth. However, they are more costly than bonding.

One thing to be aware of is that you will not want your current dentist to do either of those procedures. Both are advanced cosmetic dentistry. As he doesn’t even understand basic teeth whitening principles, which is the absolutely easiest form of cosmetic dentistry, he is not qualified to do the advanced procedures. Otherwise, you will end up with a cosmetic dentistry horror story.

This blog is brought to you by Duluth, GA Cosmetic Dentist Dr. David Marion.

Can You Whiten Teeth to be as White as Eyeballs?

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I have a question that you will probably think is super weird, but I promise I have a good reason. Is there a way I could use teeth whitening to match my teeth to something like my eyeballs? I know, don’t laugh. But, I do need to know.

Harriet

Dear Harriet,

Teeth Whitening trays

I can’t promise I didn’t chuckle a little, but I love this question. In fact, it’s one of the most unique questions I’ve ever received. While it is possible to whiten your teeth to match the whites of your eyeballs, that would probably depend on how white they are. There are limits to what teeth whitening can do. One thing you you will find is that it is hard to get an exact match using that method because your teeth will continue to whiten for a week or two after you stop using the whitening gel.

If you are looking to get an exact match for something, then you would have better success with porcelain veneers. This can create a color match much more accurately. One thing to be aware of though is that while any dentist can do teeth whitening, porcelain veneers are an advanced procedure. It would require you to find a dentist who has invested in post-doctoral training in cosmetic dentistry. Dental school will not be enough.

The upside to veneers is they are what people use when they are looking for a complete smile makeover. It can change everything about your smile including the shape, size, and color. The downside is they are more expensive than teeth whitening. If you’re okay with getting it close and don’t want to change anything else about your smile then you can save money with teeth whitening. It all depends on what your goals are.

I hope this helps you.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Does She Need a Root Canal Because of Crest Whitestrips?

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Years ago, I had a tooth with trauma that knocked it back a bit. I had it fixed by an oral surgeon. Eventually, it turned dark. The gum is also a bit recessed. I asked my dentist about whitening my teeth. He doesn’t do the teeth whitening procedure but did recommend I get some Crest Whitestrips and said that they do whiten teeth slowly. I got a box and used it for seven days. That’s when the formally injured tooth started aching. I stopped using the whitestrips and still another week later it was still hurting. I went to see him and he ran some tests and it appears this tooth now needs a root canal treatment. Was this because I used the whitestrips?

Sandy

Dear Sandy,

teeth bleaching trays

Teeth Bleaching Trays

Usually Crest Whitestrips are too weak to do any damage, which is why they are available over the counter instead of through a medical professional. However, this tooth had some additional problems and the whitening gel may have thrown it over the edge.

Your dentist had a misunderstanding of how teeth whitening works. When you whiten your teeth, it whitens the teeth evenly. This tooth, which needed the root canal treatment would not have been affected. This would only make it look worse compared to your other teeth.

As you are going to get a root canal treatment, you will need a dental crown. Please don’t have this crown done by your current dentist. Teeth whitening is one of the easiest cosmetic procedures there is and he did not understand that at all. Getting a dental crown to cover a dark tooth will take a much more advanced cosmetic dentist.

Look for someone with a smile gallery and post-doctoral training in cosmetic work. Then look at the procedures on their smile gallery that are similar to your needs. When they do the crown, they should try it in with a temporary try-in past. You should be able to look at the crown in several types of lighting to make sure it matches well and you love the way it looks. If you don’t, they need to be wiling to redo it.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

How to Get a Cheap Smile Makeover

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I went to my dentist about my discolored teeth. He’s suggesting I do composite bonding on them to make them look better. I had a chip repaired with that once and the bonding does not quite match the rest of my tooth. I’m assuming it will match if he puts it over the whole tooth. The only thing I’m worried about is the dental bonding that I have is already stained and I’ve only had it for a few years. Does this mean I have to get it done again every few years? I was looking at porcelain veneers, but they are super expensive. Is there any way to get a cheap smile makeover that looks good?

Sammie

Dear Sammie,

Images before and after a dental bonding repair.

I would not have all of your teeth covered with composite bonding. As you noticed, it doesn’t last very long. Plus, if your dentist could not match the chip repair to the rest of your tooth, there is little chance that your smile makeover will look nice. I have some other suggestions for you instead. First, if the only thing wrong with your teeth is discoloring, then the easiest (and cheapest) treatment is to have teeth whitening done. Of course, you will have to have the dental bonding replaced.  I would not have that done by your dentist. If the first repair didn’t match the tooth, the next one is not likely to either.

Directly above is a picture of a chipped tooth repair done correctly. You can see that there is no way to tell the difference between the dental bonding and the rest of the tooth. This is what a correctly done bonding repair would look like. You will want to have the teeth whitening done first. This is important. That way the dental bonding replacement can be made to match your new, shiny white teeth. This is the way I would recommend getting your smile upgraded if the only thing wrong with your teeth is the discoloration.

Complete Smile Makeover

If there are other things about your smile that you want to change, then porcelain veneers are the way to go. They can change the shape, size, and color of your teeth all at the same time. As you mentioned, this is not cheap. If do decide you want this, I would not try to find the cheapest dentist. I would try to find the best dentist. What you’ll want to do is save up for it. When well taken care of, porcelain veneers can last your lifetime.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

How Can I Get REALLY White Teeth?

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I went to my dentist asking about teeth whitening. He does not do the procedure himself but told me that Crest Whitestrips work. I’ve been using them for a while now. While I can tell they are making a small difference. It is very small. I’m looking for a way to get my teeth very white. Is there another product that will do that?

Sandy

Dear Sandy,

teeth bleaching trays

Teeth Bleaching Trays

I am glad you wrote. While your dentist is correct that the over-the-counter product, Crest Whitestrips, will whiten your teeth, as you have experienced it does so very slowly. This is because any product you can purchase over-the-counter cannot be very strong for safety reasons.

There are two ways to get really strong teeth. The first is professional teeth whitening. When you have your teeth whitening done, you are under the care of a medical professional who keeps an eye on things. That allows you to get a much stronger gel, which you give you faster results.

A second option is to get porcelain veneers. These are generally used for a complete smile makeover. It’s what all those film stars use in Hollywood. The big benefit to these is that they can change more than your color. They can also remake the size and shape of your teeth, which can completely remake the character of your smile. This is a much more expensive procedure than teeth whitening. You should also be aware that though just about any dentist can do the teeth whitening procedure with no problems, it takes post-doctoral training for a dentist to be able to do porcelain veneers.

The good news is that nothing will get your teeth whiter than persistence using teeth whitening trays. It’s okay that your dentist does not do the procedure. For this, you can go to another dentist to have the whitening done and then return to your dentist for your general dental work.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

 

Teeth Whitening or Fillings First?

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I have a canine tooth that needs to have a dental crown on it. My teeth are kind of yellow so my dentist told me if I wanted to get them whitened I should do it before I have the dental crown made because the color for that cannot be changed once it is done. Something I am wondering about, though, is all the fillings I have. They are silver and probably need to be replaced anyway. Some of them are visible when I smile. Should I replace the fillings first with those white ones and then bleach my teeth to match them or should I whiten the teeth and then get the fillings done?

Bridgette

Dear Bridgette,

Teeth Whitening trays

 

I would start with the teeth whitening. It is nearly impossible to get teeth whitening to an exact match to a color. But, you can whiten your teeth to a color you love and then the composite fillings as well as the canine dental crown can be made to match.

I want to give you a couple of precautions. The teeth whitening itself is easy and just about any dentist can do it. The canine you want to be more careful with. First, make sure that your dentist uses a porcelain crown. These are much more natural looking. A metal-based crown will be too opaque and, eventually, will give you quite an unsightly gray line at the gumline. In order to ensure your dentist is able to properly match your dental crown, make certain that he or she uses a temporary try-in paste and then allows you to look at it in several different types of lighting. If you don’t like the crown, your dentist should send it right back to the lab in order to make any changes that you need.

Replacing Amalgam Fillings

One other very important piece of information. Silver fillings are made mostly of mercury. You want to be certain that whoever switches out your fillings knows how to do a sanitary amalgam removal. This will prevent you from inhaling any mercury vapors or swallowing any pieces of mercury. As you know mercury is a toxin and people have serious health repercussions from mercury poisoning.  This is actually why so many patients are anxious about their silver fillings and want to replace them, though the American Dental Association still considers them safe.

I recommend seeing a mercury-free dentist in order to have them removed and then ask him if they know how to do a sanitary amalgam removal.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Covering Tetracycline Stains if You Can’t Afford Porcelain Veneers

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I have had very discolored teeth since my childhood. They said it was because of some medication I took as a child. When I was in high school my parents spent practically everything they had to get me dental bonding. Now that I am older the bonding is completely worn out. I know the better solution is porcelain veneers, but I cannot afford that. Dental bonding is not much less. Is there any chance there are newer procedures that have improved which could help me get a prettier smile without porcelain veneers?

Mandy

Dear Mandy,

teeth bleaching trays

Teeth Bleaching Trays

 

The medication you took as a child was likely tetracycline. If taken while your teeth are still forming, then it can cause brown stains on your teeth. If you cannot afford porcelain veneers to this and you have existing bonding you have options, but it depends on how the dental bonding was done.

If the dental bonding was placed over intact enamel, then there are sandpaper disks that can be used to remove the outdated bonding. It’s not too hard to do if they have training. In fact, some states will allow a dental hygienist to do it. If your state allows that, the fee should be a bit lower, which could save you more money.

Once the old bonding is removed, have your dentist make for you some custom-fitted teeth whitening trays like the ones pictured above. Then you will simply use some professional strength teeth whitening gel in the trays. You will have to be persistent and it will take a while, but you can get your teeth significantly whiter. They won’t be as beautiful as they would with well done porcelain veneers, but you will no longer be embarrassed by your teeth.

Be aware you will want to stick with the tray and gel approach. Don’t let your dentist talk you into something like Zoom Whitening or Laser teeth whitening. While these are stronger, you would require so many treatments that it would quickly get too expensive. Just persevere with the gel and you will get results.

If, however, the dentist removed some of your tooth enamel before placing the dental bonding, then there is no other solution except for porcelain veneers. In that case, I would just wait and save up to have the porcelain veneers done. Don’t try to save money by using just a basic family dentist. Save up to do it right. Make sure the dentist has post-doctoral porcelain veneers training. I’d also check their smile gallery to make sure they can produce artistic results. Tetracycline cases are one of the most advanced cosmetic cases a dentist can do so you want to make sure they have the skills to do it well.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

My New Dental Crowns are Turning Yellow

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I had very white teeth and was ready to take the next step in improving my smile by getting a smile makeover. I spoke to my dentists and he suggested six porcelain crowns on my upper front teeth. I selected the whitest color available to me. Yet, when the crowns were put in, they did not seem to be the whiteness I had intended for them. Now, to top it all off, the dental crowns are starting to turn yellow. I haven’t even had these a year yet. Can I whiten them along with my teeth? How do I keep them from turning yellow again?

Melody

Dear Melody,

Extended shade guide

First, I want to make sure your dentist is using the updated shade guide. Before teeth whitening, the whitest shade was B1. Now, with the popularity of teeth whitening, the shade guides have been updated and BL1 is now the whitest. That may be the issue with the color discrepancy.

That doesn’t, however, explain the new staining. If your crowns are truly porcelain crowns they should be very stain resistant as long as the glaze on the porcelain is intact. This leaves me to wonder if something happened during one of your dental appointments to damage the crowns. Two possibilities are if the hygienist used an acidulated fluoride or a power prophy jet.

With the acidulated fluoride, it will etch the surface of the crowns, leaving the crowns very susceptible to staining. The power prophy jet can remove the glazing, causing staining take place even faster. Unfortanately, teeth whitening only works on natural teeth, so that would not be a good solution for you. The first step is to find out if the glazing has been damaged. I recommend seeing a good cosmetic dentist who can examine your crowns and ask them to give you an idea of why these are picking up stains.

One other quick question. I’m curious as to why your dentist chose crowns for this smile makeover. The standard for that type of procedure is porcelain veneers because it removes much less tooth structure. Was there damage to these teeth that required crowns?

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Teeth Whitening and Brown Spots

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I have had brown spots on my front teeth ever since my adult teeth came in. I have good hygiene. I’ve been told the spots are from a fever I had as a child. Under the supervision of my dentist we have tried every single over the counter whitening product available. Unfortunately, all it does is make the area around the brown spots whiter which makes the spots look even darker. My dentist is suggesting that she grind off the brown spots now. I’m a little worried about this plan. First, I’m sure it will hurt. Second, she is not certain how much of the tooth she will have to remove. Do you think if we tried professional strength whitening, we’d have any more success? She doesn’t offer teeth whitening but would be willing to refer me. I think I’d rather try that first than the grinding thing.

Maria

Dear Maria,

before and after a dental bonding repair

While I am sure your dentist has the best of intentions and is trying to help you, she is out of her depth here. Please don’t let her expirement on your teeth any longer. Teeth whitening, even professional teeth whitening will not work in a situation such as yours. As you discovered with the over-the-counter whitening products. The bleaching ingredients only work on natural tooth structure. That is why you ended up with those mixed results.

The solution to this is some gentle microabrasion on the brown spots and then to cover the area with dental bonding. This is a composite resin that is shaped and bonded to your teeth. Unfortunately, your current dentist will not be able to do this. Teeth whitening is the most basic (simple) of the cosmetic procedures. On the other hand, dental bonding is an advanced cosmetic procedure that requires a significant amount of training.

In your place, I would look for someone with post-doctoral training in cosmetic dentistry. Be sure and ask to see before and after images of dental bonding cases they have personally done to ensure that they can make the results look blended and natural.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.