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Porcelain Veneers and Teeth Whitening

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I need to whiten my teeth. Well…I want to whiten my teeth. What worries me is that I have porcelain veneers on only four of my teeth. It’s the teeth next to the porcelain veneers that need the whitening. My smile is about eight teeth wide. I wish I had the money to do more veneers so they’d all match but I didn’t. I want to whiten the teeth to match but I’m worried that the whitening gel will hurt the porcelain veneers. Will I damage them if I use something weak like Crest Whitestrips?

Corinne

Dear Corinne,

teeth bleaching trays

Teeth Bleaching Trays

I am glad you wrote. I wish your dentist would have whitened your teeth before doing your porcelain veneers. That is pretty standard operating procedure when a person can’t get enough veneers to cover the width of their smile. The good news is, while it won’t be as easy, it is still possible to get them whitened.

Crest Whitestrips will not do any damage to your porcelain veneers. In fact, neither will professional strength teeth whitening. If you decide to use the Whitestrips, you need to be aware of some limitations. First, they’re not very big. In fact, they’ll only cover your first six teeth. With four of them being veneered, that would mean you are wasting a significant amount of whitening. With them being only a fraction of the strength of professional whitening, I don’t think you’d be truly satisfied with them.

My suggestion would be to have your dentist make you custom fitted trays that can be shaped around your porcelain veneers. This will enable you to whiten those teeth at full strength, while under the care of a professional. Plus, you can keep the trays and use them for touch-ups every couple of years. Then, you’ll only need the inexpensive gel.

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

Pain with Teeth Whitening

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I’ve been whitening my teeth for several weeks with a home whitening kit. The last few days, though, I’ve started having a zing of pain that lasts for several seconds and then stops. It is always on the tooth where I had a dental bonding repair quite a few years ago. Could the teeth whitening be eating away at the dental bonding?

Nadia

Dear Nadia,

teeth bleaching trays

Teeth Bleaching Trays

I am sorry for the pain you are experiencing. The good news is I do not think teeth whitening is damaging the dental bonding. There has never been any evidence that whitening gel does any damage to bonding agents and it both have been around for a while, as well as used together. The more likely scenario is that a part of your dental bonding has come off leaving part of the tooth exposed and sensitive.

I am assuming that you are doing this home teeth whitening under the supervision of your dentist. My recommendation is you pause the whitening for a few days, call your dentist and let him know what is going on. He can track down where the exposure is and place a protective agent there to re-cover the spot. Then you can continue with your teeth whitening as you normally would, but this time pain free.

You should be aware that dental bonding doesn’t last as long as something like porcelain veneers. For something like a small chip repair, that is fine. Just know that you will need to replace it at some point or it will begin to pick up stains. When it does, teeth whitening won’t fix it. The whitening agents only work on natural tooth structure. The bonding will just have to be replaced.

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

Can You Over Whiten Teeth

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My dentist told me that I’ve whitened my teeth so much that it has become impossible to match my teeth to dental work. I need a dental crown on a lateral incisor and he said my teeth are too white to get a good match. Shouldn’t he have warned me about that? He’s the one doing all the whitening.

Melissa

Dear Melissa,

Old Vita Shade Guide

Based on what you have said, my guess is that teeth whitening is the only type of cosmetic dentistry that your dentist actually does. Here is why I think that. When dentists match a tooth to a color for dental work they use a shade guide. For years, there was only one type of shade guide (pictured above).

Then, in the 1990s, teeth whitening became massively popular. One thing people don’t realize about teeth whitening is that not only does it remove stains, but they can also make the teeth whiter than their most natural white color. As teeth whitening gained in popularity, dentists began noticing that patients’ teeth were whiter than the whitest shade on the shade guide.

Updated shade guide

Updated Shade Guide

Fortunately, as this happened more often, the shade guides caught up. They added an extension that matched the new whiter shades of people’s teeth. Dentists who do a lot of cosmetic work, have the updated shade guide (pictured directly above).

While I am aware that you can just tell your dentist about this updated shade guide and get your crown matched that way, I do not think that will be your best option. This tooth will be very visible when you smile. You will want a dentist with cosmetic skills to match this tooth exactly. It requires more than just the initial shade match. Your dentist will have to give the ceramist instructions that add tints and stains around the tooth to help it mimic the variations in a natural tooth. If he doesn’t even have the correct shade guide, then he will not be able to create a good shade map for the ceramist. You will be better off having your dental crown done by a dentist who does a lot more cosmetic work.

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

Luster Premium Teeth Whitening

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I received an advertisement for Luster Premium Home Whitening. It’s a little cheaper than what my dentist’s office quoted when I called them so I am wondering if it actually works and if it is safe.

Emma

Dear Emma,

teeth bleaching trays

Teeth Bleaching Trays

I periodically review these type of things at patients’ requests. While they all have downsides in comparison to professional teeth whitening, most of them have a valid whitening ingredient. In the case of Luster Premium, that is not true. There is not a valid whitening ingredient in this product. The only whitening that takes place with this is due to a pigment in their “super whitener” — zinc oxide. This sticks to the teeth and makes the teeth look temporarily whiter. It does not actually whiten them. The pigment wears off. I am convinced that the positive reviews they have are from people who saw the whitening difference from the pigment and wrote the review not realizing it would quickly wear off.

If cost is the only thing keeping you from getting teeth whitening done by your dentist, you could put some money aside every few weeks or possibly talk to your dentist to see if he or she is open to allowing you to have a payment plan with them. If they say no and you are anxious to do it right away, an over the counter product that works is Crest Whitestrips. It is much weaker than the type of whitening you would get with your dentist but it will work. Another issue is it will only cover the front six teeth. Most smiles are at least eight to ten teeth wide. If that is you, you can use extra strips.

Honestly though, by the time you purchase enough kits to get your teeth really white, you would have spent less money if you would have just saved up and had it done right with your dentist. Plus, you can keep the whitening trays and, in future years, when you need a touch up you will just need to purchase the gel which isn’t nearly as much money.

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

Opinion of Premium Home Whitening Kit

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I keep seeing advertisements for a Premium Home Whitening Kit. I would love to whiten my teeth but my dentist is sort of high in cost. I wondered if this kit actually works and if so, is it safe?

Laura

Dear Laura,

teeth bleaching trays

Teeth Bleaching Trays

I’ve looked into this kit. It has one great thing going for it and one issue that sort of underwhelms the benefit. First, the great thing. It uses a whitening ingredient of 36% carbamide peroxide. This is a valid whitening ingredient and will whiten your teeth.

The downside to this kit is the bleaching trays. These are sort of DIY trays and they will not fit well. That means saliva will get into the trays, which will dilute the whitening ingredient, in turn rendering it less effective. In addition to that, it will allow the diluted gel to leak out of the tray making it where you are getting even less of the whitening effect.

If you look at the image above, you can see the type of teeth whitening trays your dentist would prepare for you. These are custom fit to your bite, which keeps the whitening gel in and the saliva out.

Bottom line, you would have to use quite a few kits to get the same benefit you would out of going to your dentist. My suggestion is you speak to your dentist. Tell him that you would love to whiten your teeth but are having trouble meeting his price. It’s very likely he would allow you to pay it out.

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

White Spots After Braces

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My daughter had braces for almost three years. When they were removed, we noticed white spots on her teeth. We spoke to our dentist about it and he suggested we just have her teeth whitened to even it out. The problem is, it didn’t even them out. Her teeth are whiter, but so are the spots. What do we do now?

Lacey

Dear Lacey,

A professionally-made take-home custom tray for teeth whitening.

While I am certain your dentist meant well, he does not really understand how teeth whitening works. As you have discovered, teeth whitening will whiten the tooth structure evenly. It is not designed to even out color.

Let’s start with what those white spots are and then I will give you the next step to take. When you have white spots after braces, those are decalcification spots— pre-cursors to decay. This is fairly common after braces, especially in children and teenagers because those metal wires and brackets are difficult to get around when you are brushing your teeth. That is just one of the reasons I often recommend Invisalign to my patients instead of braces. These do not have any metal wires and brackets. Plus, they are removable, which makes oral hygiene a breeze.

The correct way to deal with these is to have a cosmetic dentist gently remove the white spots with some microabrasion. Then, he or she will recover the area with a composite dental bonding. I am going to suggest you don’t go to your regular dentist for this. It is a rather advanced cosmetic procedure, way more advanced than teeth whitening. Plus, it has to be done freehand. You really need someone who has expertise to do this. One thing to do is check out their smile gallery. Look specifically at their dental bonding cases. If you like the results you see, that will be a safe dentist for you to see. One word of caution. Double check that the images are cases the dentist has done and not just stock photos.

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

Whitening Porcelain Veneers

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My coffee drinking habit seems to have stained my porcelain veneers. Would having teeth whitening done get them to look as white as they used to? If not, is there something I can do? I used to be so proud of this smile.

Becky

Dear Becky,

A porcelain veneer being placed on a tooth.

The type of glaze used with porcelain veneers is glass-like and quite stain resistant. Even drinking coffee should not have affected them. If they are picking up stains, it means they are damaged in some way. There are a couple of ways this could have happened.

First, if you’ve been using something abrasive on them while brushing your teeth, such as baking soda or over-the-counter whitening toothpaste. Because of their abrasiveness, these will scratch the glaze that protects your porcelain veneers, leaving them vulnerable to stains. A second possibility is that your hygienist used something to damage the glazing, such as a power prophy jet or acidulated fluoride. If it was something your dental office did, they are responsible to make this right. As such, they should replace them so that you have the glaze back.

If you are the one responsible, then you will need to be the one that fixes this. Teeth whitening will not whiten anything except your natural tooth structure, so that won’t help you. What can be done is either to replace them or to have your dentist polish them up. This will remove the stains and make them more stain-resistant. But, you’ll have to be careful because they will not be as stain-resistant as they were originally.

Your dentist should have talked to you about proper maintenance. It does not sound like that happened. The best toothpaste for cosmetic dental work of any kind is Supersmile Toothpaste. It is specifically designed for porcelain type work. Rather than using an abrasive to help whiten your teeth the way over the counter whitening toothpaste does, it removes the stains chemically using a protein pellicle. I highly recommend it.

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

Tanda Pearl Teeth Whitening System

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I have TMJ disorder and have noticed that my jaw hurts more when I am whitening my teeth. I recently read about the Tanda Pearl Ionic Teeth Whitening System. It touts to work in 5 minutes a day. I think that would really help my jaw pain. Have you seen this system? Is it legitimate?

Mary Grace

Dear Mary Grace,

teeth bleaching trays

Teeth Bleaching Trays

I am sorry you have been having jaw pain. One thing I am wondering is whether you are doing your teeth whitening through your dentist? If so, did he make a custom-fitted bleaching tray for your procedure? If not, that is the very first thing I would talk to him or her about.

As for the Tanda Pearl System, I looked into this. Its main ingredient is a peroxide gel. That is a viable teeth whitening solution and the same basic ingredient you would get with any other whitening system. There are some differences to consider before making your decision.

The “Ionic” Technology

Something that niggles at me about this is that they provide zero information about their special technology. There does not seem to be anything special about it. If it did work, they’d make more money marketing it to dental offices, but they don’t do that. This makes me wonder if they don’t want it looked at too closely because it is only there for psychological reasons. I don’t like it when companies or even medical practitioners manipulate patients. They could leave that light out altogether and save their customers money.

The Whitening Period

They say it will whiten your teeth in five minutes use each day. Sure, that could happen. It could happen equally with another system as well. Essentially, the longer you wear the whitening gel, the faster your teeth will whiten. There is nothing magical about the amount of time. If your jaw aches, I would wear your current trays for less time until you have a chance to visit your dentist about your bleaching trays.

The Tanda Tray

I placed a picture above of the type of bleaching trays your dentist should have provided for you. Notice there is a separate tray for each arch of your teeth. The Tanda system is different. It uses a single tray for both arches of your teeth. You have to bite down on it in order to keep it in place. In my opinion, that will increase the pain you are experiencing in your jaw, not help it.

Another thing to consider is you bite down to “create” your trays with Tanda Pearl. This will not be a tight fit. That means that whitening gel will leak out, which weakens its effectiveness. Saliva will also leak in, which (again) weakens the gel.

Your safest option is to talk to your dentist about the pain you are feeling and see if you can get to the bottom of it.

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

Bleach Your Teeth With Clorox?

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My dentist has this Zoom machine for whitening teeth, but I want to whiten my teeth at home and wondered if it is possible to use Clorox Bleach to do it. I was considering rinsing my teeth with it. Will that work?

Dan

Dear Dan,

teeth bleaching trays

Teeth Bleaching Trays

That is interesting. While it could probably whiten your teeth, one thing you should be aware of is that Clorox is a base, such as lye. It’s a rather powerful base at that. This means it can burn living tissue. Believe it or not dentists use it in root canal treatments to do just that.

The active ingredient in household bleach is sodium hypochlorite. This can be used to clean out the organic debris left in a tooth canal all while simultaneously disinfecting it. Rinsing with it regularly inside your mouth is a bad idea because it can burn or damage your gums and inside of your cheeks.

If your goal is to bleach at home, talk to your dentist. There are professional teeth bleaching trays that will allow you to do this. Your dentist will custom-fit them to your bite and provide you with the professional strength whitening gel. You will have all the benefits of at-home whitening without the inherent danger that comes from using Clorox or another household bleach.

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

Can’t I Just Rinse with Peroxide to Whiten My Teeth?

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If the teeth whitening gel is made from peroxide, can I just rinse with the hydrogen peroxide I get at the store? Aren’t they the same thing?

Carl

Dear Carl,

teeth bleaching trays

While it is true you could get some mild whitening effect from the peroxide you buy in the store, it will be very mild. There are two reasons for this. First is the strength. The peroxide you get at the store is 3% in strength. The minimum strength you should be getting from professional teeth whitening is 22%. Some are even stronger.

The second issue is absorption. In order for the gel to make any real difference, it would have to stay on your teeth for a minimum of 15 to 20 minutes. That is a long time to try to rinse. It is also the reason dentists will provide you with bleaching trays. You can put the gel in the whitening trays and wear them for as long as is comfortable. The longer you wear them, the more effective they are.

Many patients will wear them overnight because this gives the most bang for their buck. In addition to having them on for many more hours than you would normally tolerate during the day, you also will gain effectiveness. Because your saliva production goes down at night there will be less dilution.

Just remember, no matter what type of teeth whitening you do, it will only whiten your natural tooth structure. If you have any dental work, such as a dental crown, that will stay the same color. After you reach the level of whitening you want, if the dental work is visible, you’ll want to replace the crown. This way your crown can match your new brighter, whiter color.

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