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Did The Ultrasonic Scaler Damage Her Veneers?

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I have six porcelain veneers. In that time, I’ve had two cleanings. Each time, within a couple of days of the cleaning, I ended up with a veneer fractured. I asked what they’re using during my checkups and they told me it was a  magnetostrictive ultrasonic cleaner. Is this a common problem with these cleaners?

Dana

Dear Dana,

porcelain veneer being held up near a tooth

 

There are two different types of scalers  used in dental work. The first is a piezoelectric, and the second is magnetostrictive. The magnetostrictive scaler has been around for decades. While it is more gentle than the piezoelectric scaler, it is very dependant on the technique of the hygienist using it. Without proper technique it can cause more damage than the other scaler.

You said your porcelain veneers were fractured. For that to happen, your hygienist would have had to used the tip of the scaler on the surface of your porcelain veneers. That is completely unacceptable. That is a basic understanding. I do not believe that you should stay with this dental practice.

When you have cosmetic work done not only does it need to be created and placed by an expert cosmetic dentist, but the upkeep needs to be done by a practice that understands how to do it safely. My suggestion is that you ask them to replace the damaged veneers and then find a dentist who has trained their staff on how to care for your cosmetic work.

Two other things that can damage your veneers are acidulated fluoride as well as a power prophy jet. Never let a hygienist use them on any dental work. Not just veneers, but dental crowns too. They will take the glaze right off your dental work and they will look matte and pick up stains very easily.

I’m sorry this happened to you, but i think a skilled cosmetic dentist can fix everything.

This blog is brought to you by Duluth, GA Cosmetic 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.

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.

My Dentist Said I Can’t Get the White Crowns I Want

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A decade ago, I had nine crowns placed on my front teeth. At the time the dentist couldn’t make them as white as I wanted, I guess because the technology wasn’t there. I know it is now because I see friends with very white crowns. I am about to replace them and told my dentist that I wanted them very white- like Hollywood white. He suggested a B1, which looked white, but when the temporaries were placed on my teeth they were not as white as I was expecting. I told him that I was hoping for whiter, but he assured me that is the whitest they can get because I have posts in the crowns. Any whiter and the posts will show through. Is there any way around this?

Elisabeth

Dear Elisabeth,

Blonde woman with a beautiful smile.

 

In order to get the beautiful, white result that you want, you are going to need an expert cosmetic dentist. I’m a bit concerned your dentist is in over his head. I say this because he is confusing color with translucency. Having a whiter color on your porcelain crowns does not make the tooth more translucent. You said that your posts were not showing through at a B1. If that is the case, then they will not show through at a BL1, which would give you a super white color.

Ask your dentist if he has ever done one of these crowns with the BL1 shade before and ask to see before and after images. If he hasn’t or he cannot show you the images, then I would say to look for another dentist who has the experience and artistry that you need for a successful outcome that will make you proud to smile.

I would ALWAYS look at the smile gallery of a dentist with whom you are considering having cosmetic dentistry done. If they don’t have a smile gallery, they are not serious cosmetic dentists. It is in your best interest to move on to someone else. Also, make sure you tell the dentist what YOU want in the smile. They should only put them in with a temporary try-in paste for you to get a close look at in a variety of lightings. Only when you are pleased should they get bonded back on, no matter how many try-ins that requires. Settle for nothing less.

This blog is brought to you by Duluth, GA Cosmetic 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.

Cavity on Tooth with a Porcelain Veneer

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I have several porcelain veneers. One of the teeth with a porcelain veneer has a cavity. The dentist wants to remove the veneer and place a crown on that tooth. I really think that is overkill. He insists it is the standard procedure. Is that right?

Laurie

Dear Laurie,

A porcelain veneer being placed on a tooth.

I am not flat out saying that your dentist is incorrect here, but I would recommend a second opinion before going through with this. First, a crown would only be necessary for quite a large cavity. I would say at least 20% of your tooth should have decay. If the decay isn’t that significant I question why the dentist is wanting to do a crown instead of a veneer. Some dentists do not have the skill to do porcelain veneers so they steer their patients toward crowns. Here’s the problem with that. If he can’t do porcelain veneers, what are the chances that he can match a single crown to the remainder of your front teeth? Very few dentists can do that well.

I would go see an excellent cosmetic dentist and ask them if the tooth actually needs a crown. If not, don’t get rid of all that healthy tooth structure. When you have porcelain veneers, the most vulnerable place for decay is right at the margin where the porcelain meets your tooth. However, it is not too difficult to prevent that decay. There are two keys. One is the frequency of eating. Your saliva will do a lot of the work if you just don’t snack too much, giving it time to do its job. The second thing is flossing. Making sure to floss every day will get in the margins.

I’m not confident this dentist can give you an attractive result no matter which restoration you end up with. Instead, I would start looking for dentists who do beautiful cosmetic work. One of the things to look at is their smile gallery. If they do not have a smile gallery, they do not do enough cosmetic work. In their smile gallery, specifically look for before and after images of both porcelain veneers and porcelain crowns. If you love the results you see on there, make certain you take one additional precaution and call the office to ask if the gallery is populated with images of the dentist’s own work or stock images. You want it to be work the dentist has done.

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

Expert Tips on Teeth Whitening

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A few years ago, I had my teeth whitened, but they have since picked up more stains. I’m a heavy coffee drinker and knew that would be an issue. Now I need a dental crown on one of my teeth and my dentist wants to schedule me for next week. It’s visible when I smile so I did some research. It seems like it is better to whiten them again before I get the crown placed, but I can’t tell how long I need to get them the right color again. Can you advise me?

Amanda

Dear Amanda,

teeth bleaching trays

While I am going to give you some advice on teeth whitening, I am a little concerned about a couple of things I’m inferring from what you wrote. First, you are having to do this research on your own to figure out what to do. This is unfair to you. Your dentist is supposed to have this training already. He should have advised you that if you wanted to touch up your teeth whitening to do it before getting the dental crown made. One thing we can be grateful for is you figured it out. That’s fantastic! Too many patients don’t and end up having to pay for their crown to be re-done to match the teeth they whiten after the procedure.

A second concern I have is your dentist can’t advise you on the best way to touch up. These two things combined lead me to conclude that he doesn’t have the cosmetic training and skills to do a porcelain crown on your front teeth. These take a lot of skill to not only get to look beautiful, but to blend in with the remainder of your teeth. You may want to ask to see some before and after pictures of cases he’s done similar to yours to see what type of results he gets. If he doesn’t have a smile gallery with photos of his work, then he doesn’t do much cosmetic work and you should see someone else for this procedure.

How Long to Whiten Your Teeth

The basic principle is the longer you can wear your bleaching trays (with the gel in them, of course), the faster your teeth will whiten. The minimum you should leave them in is 15 minutes. The maximum is overnight. While you sleep, your saliva flow goes down which allows the gel to stay in the trays longer, giving you maximum whitening. Some dentists will tell you that you need a special gel made for nighttime whitening, but that isn’t the case. They all contain peroxide. You can wear them during the day as long as you want as well, as long as you are not developing sensitivity.

Once you’ve reached the level of whitening you want, give your teeth a week or two to settle before having the crown made. Oxygen bubbles will still release in your teeth for this amount of time after you stop whitening.

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

Full-Mouth Reconstruction Horror Story

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I had twenty-year-old veneers that needed to be replaced. My new dentist said what I really needed was a full-mouth reconstruction. I trusted him but am now having serious doubts about this whole thing. The temporaries never felt right. Ever. I complained about them multiple times and he kept telling me that they were fine and things would be different when the permanents were in. Well, it’s not. I’m in pain and can’t even keep my mouth closed normally. My mouth is so dry I’ve been sucking on popsicles and drinking water non-stop. I feel like a water balloon and am miserable. I went back to the dentist complaining but he says he met all the check points and I’m just not used to crowns yet. Please tell me what to do? What is a reasonable amount of time for me to get used to this?

Gina

Dear Gina,

woman smiling with dentist behind her

You are in serious trouble here. This dentist has messed up big time. First, I’m trying to figure out why the full-mouth reconstruction was necessary to begin with. You said your porcelain veneers were old and need to be replaced. Fine. Do you know what the solution to that is? Replacing them with new porcelain veneers. A full-mouth reconstruction is a major overtreatment and one he hasn’t done correctly.

Your Dentist Blew it

When dealing with this type of case, which involves putting dental crowns on every tooth, the temporaries are worn to make sure everything occludes well and your bite is comfortable. If your bite was comfortable before but painful now, he did something wrong. Combine that with the fact you can no longer close your mouth when it is in repose and it sounds like your dentist opened up your bite too much. This is serious.

I don’t care if he says he met all the checkpoints. He didn’t. One of the first things to check is whether or not the patient can close their mouth normally and comfortably. So, either he is a liar or he doesn’t know what the checkpoints are. Neither of those bode well for either of you.

Your case needs to be re-done from the beginning. Please, for the love of all that is good, don’t allow this dentist to re-do it. Get a refund and get a different dentist to re-do your case.

Finding a Reconstructive Detnist

The first thing I’d like you to do is click here to read Dr. Marion’s professional bio. This is the type of dentist you will need to fix this properly.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.