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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.

Should I Restore All Of My Teeth?

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I went to my dentist in order to get a smile makeover. However, he is suggesting that I restore all of my teeth using dental crowns. I’m not sure about doing that with all of my teeth. I just wanted the ones you could see. It seems like a lot of money for teeth you can’t see that are healthy. What do you think about this situation?

Dustin

Dear Dustin,

An image of a porcelain veneer being held up to a tooth.

Please don’t go forward with this. What your dentist is wanting to do is known as a full-mouth reconstruction. This isn’t something that is used for a smile makeover. This is done either because your teeth are ground down to nubs or because you have serious TMJ Disorder. You mentioned neither of these.

Another concern I have is that you were just wanting a smile makeover. This is typically done with porcelain veneers. The fact that your dentist is suggesting a smile makeover with dental crowns tells me that he does not have training in porcelain veneers. Rather than tell you that, he is steering you toward a procedure that he does know. This means that he is unlikely to be able to provide a beautiful result for you.

There is something even more dangerous with this, too. Like a smile makeover, a full mouth reconstruction takes advanced post-doctoral training. While with cosmetic work, the training will focus on getting it to look natural and beautiful, with a full-mouth reconstruction, your dentist will need both the cosmetic training as well advanced training on occlusion (how the teeth meet together). There are countless horror stories on badly done full-mouth reconstructions that led to people having TMJ Disorder.

I do not think this is the best dentist for you. I want you to find a dentist who has post-doctoral training in cosmetic dentistry and provide you with porcelain veneers instead of dental crowns. You will not need them on all of your teeth either, just the ones that are visible when you smile. Though, they will likely suggest that you have teeth whitening done first. This way the lower teeth will blend in with the teeth that have the veneers.

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

Dental Bonding Staining in a Few Weeks

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I had dental bonding done on a few of my upper front teeth about three weeks ago. They have started staining. I don’t know if it is because I drink coffee and soda. My dentist never mentioned staying away from those. I have a couple of questions. First, can the dentist get the dental bonding looking like it did a few weeks ago? Second, if I use something like Supersmile toothpaste, will it keep those type of stains off or do I need to stop drinking them. Please say I do not need to stop drinking them.

Melody

Dear Melody,

Before and After Dental Bonding repairing a chipped tooth

I am glad that you wrote. While it is true that dental bonding is more susceptible to stains, it should not be staining this quickly. My guess is you had a regular family dentist do this who does composite fillings and thought the bonding would be the same. Here is what I think happened. Bear in mind that I have not examined you, but I’m trying to think about what could cause this.

Composite used in dental bonding is a blend of resin and inorganic fillers. Their are different types of fillers and which one your dentist uses makes a big difference. Some of the particles in the fillers include silica, quartz, and glass, and they are in particles of different sizes.

Hybrid composites are stronger because of the size of the particles, but these cannot be polished to a good shine. Microfills can be polished to a high luster that mimics tooth enamel, but they’re very small and, as a result, not very strong.

Most family dentists only carry the hybrid, high-strength composite fillers. Expert cosmetic dentists will stock a variety of fillers that contain both the hybrid, as well as the microfills.

When expert composite dentists are doing aesthetic bonding, they will combine the two. They’ll use the hybrids on the interior of the tooth for strength and then cover the surface with the microfills so they can have a high polish.

My suggestion is that you go back to your dentist and see if he can polish it up. If he can’t, then I would go to an expert cosmetic dentist to have it done.

If the bonding is on a small surface, like for a chipped tooth or a tooth gap, then stick with the bonding. However, if you have large surfaces of the teeth covered in bonding, I suggest you switch to porcelain veneers. It would be a more beautiful option that lasts many years longer.

As for Supersmile Toothpaste, it is the only one I would recommend for cosmetic dental work. It is very good at safely removing surface stains. If yours are more internal, it won’t do anything for those.

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

Should I Go to Costa Rica to Have These Dental Crowns Done?

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I need to get twelve crowns redone that I had for a smile makeover. I noticed I can get all twelve of them done for $6000 if I travel to Costa Rica. Is it possible to get close to that price in the United States?

Drew

Dear Drew,

Dental Crown Being Placed on a tooth

I am glad you wrote because you did something that could ruin your life. Here’s the deal with dental tourism. Sometimes it works and you save some money. However, in many cases, you end up with some serious problems.

Here are just some of things I have seen go wrong from people who have traveled to Central America for their dental care:

  • Their teeth became hypersensitive and hurt constantly.
  • Their crowns looked very pasty and fake.
  • The dentist used material that they were allergic too.
  • The porcelain in their crowns just started to chip away after they got home.
  • Their crowns fell off.
  • They ended up with a nasty infection. With one of those, it cost them part of their jaw.
  • They ended up needing a root canal treatment.
  • Their tooth broke off under the crown.
  • They ended up with TMJ Disorder because the crowns threw off their bite.
  • They lost the tooth that was crowned.
  • The crowns were placed in a way the negatively impacted their speech.

Sadly, this is not an exhaustive list. But, that is not the worst part. The worst part is that you have zero recourse. In most of those countries, there is little to no regulations that require the dentist to do any of the things that are required in the United States, including simple things like sanitizing their tools after each patient. Otherwise, it is completely up to the dentist. Many of those countries also have a corrupt government. One patient I know of made on online complaint about the dentist when she went to see another dentist who told her the work was criminally negligent. As a result, their government put out a warrant for HER arrest. She had to flee the country. Apparently, it is a felony in that country to speak against the reputation of a Costa Rican Citizen unless they have been convicted of what you’re saying about them.

As for getting care in the U.S. for a comparable cost, it is possible, but I would have serious questions about why that dentist is so much under the standard fee. It could be because they are new and trying to draw in new patients. That is not necessarily a bad thing. We all start somewhere. It could also be because they are terrible at their job and they have to keep drawing in new patients because they can’t keep their old ones.

I am a bit curious as to why the dentist who did your smile makeover used dental crowns. The standard for that is porcelain veneers because it does not require grinding down your teeth.

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.

 

Fixing a Broken Lower Front Tooth

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I fell during a track meet and broke part of my lower front tooth. It’s a small chip, but it is a bit ragged and hurts my lip. My dentist tried repairing it but the bonding (what I think they called it) just keeps falling off. My mother doesn’t think there is anything else they can do. I’m hoping there is some new medicine or technology that can just help the tooth regrow. Do you know of any new things?

Amaya

Dear Amaya,

Images before and after a dental bonding repair.

The problem you are facing is that the edges of the bottom teeth hit the upper incisal edges every time you close your mouth. While a bonding repair is the correct repair for a chipped tooth it requires the dentist to know about occlusion. This takes post-doctoral training and not many dentists invest in this training.

This can be repaired with either composite bonding or with porcelain veneers. The problem you are up against is that you need an expert cosmetic dentist to do the work. When done right, it will not fall off and your mother will not have to keep taking you back and forth to the dentist to get it placed back on.

If you can, either you or your mother should look for a dentist who has studied at one of these schools:

  • The Dawson Academy
  • The Las Vegas Institute for Advanced Dental Studies
  • The Pankey Institute

There are others, but these are three great ones that have special training in both TMJ Disorder and occlusion. Then, you’ll need to take the additional step of looking at their smile gallery to see what type of cosmetic work they do. Look at both bonding and porcelain veneer cases. You’ll want them to be something you find beautiful.

I hope this helps you.

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

Fixing Enamel Hypoplasia

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I have had enamel hypoplasia for as long as I can remember. I’ve always been embarrassed by my smile as a result. For my Christmas present, my husband said I could have any cosmetic dentistry procedure I need that will make me more comfortable smiling. I am so freaking excited!! The only problem I have is that I do not know what procedure I need to get. Do you have a recommendation?

Madilyn

Dear Madilyn,

Examples of mild and severe enamel hypoplasia

What an exciting present for you! There is no better feeling than a smile that makes you feel confident. For the benefit of those who may not be aware of what enamel hypoplasia is let me give a basic rundown. Enamel hypoplasia is a either caused by a genetic defect or disease that happens during the development of your teeth. The result is that the enamel on  your teeth do not fully develop. The results can vary between  some decalcification, such as on the left or deep pitted teeth, such as on the right.

There are two good treatments for enamel hypoplasia. Which you get depends on the severity of your particular case. If you are dealing with mild hypoplasia, then dental bonding is a perfectly good solution. If you want your teeth whiter, make sure you have teeth whitening done before the bonding. Once the dental bonding is completed, the color can’t be changed.

If, however, you have more severe hypoplasia, then you will want to get porcelain veneers instead. While dental bonding can just be placed on the specific spots where your enamel is affected, porcelain veneers will cover the entire front surface of your teeth.

Regardless of the procedure chosen, you will need someone with post-doctoral training in cosmetic dentistry. These are both advanced procedures. You would be wise to take a look at their smile gallery. This will have before and after images of their work. You want to feel excited about the type of results they get.

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.