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Staining Around My Porcelain Veneers

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I have had porcelain veneers for over a year. I was told they are very stain resistant. However, I noticed that the sides are beginning to pick up stains. While I do smoke, as I mentioned, I was told these would stain less than my natural teeth. I like them, but I’m a bit concerned they’re defective because of the staining. Can I whiten them?

Eddie

Dear Eddie,

Porcelain veneer

 

You were correctly informed that porcelain veneers are more stain resistant than even your natural teeth. There are a few reasons that porcelain veneers will pick up stains. Let me say first that teeth whitening will not work. It only whitens natural tooth structure.

One is that the glaze, which protects the veneers, was damaged. This can happen if your dental hygienist uses something like a power prophy jet or acidulated fluoride during your check up. With the glaze compromised, your teeth will begin to pick up stains.

What you described is staining on the sides of the veneers, which is likely the margins where the veneers and teeth connect. Bear in mind that I haven’t examined you, but here are a couple of possibilities.

The first could be that there is a gap between your teeth and the porcelain veneers. These are called leaky margins. It would be a tricky fix, but it would need to be fixed. The stains you would be seeing from that is bacteria that is getting caught between your teeth and the veneers. This can lead to decay.

However, the most likely issue is that what the stain your seeing is more to the composite bonding than to the veneers themselves. This is a much easier fix. They will need to be polished. I would consider this regular maintenance.

Your dentist should have some ultra-fine polishing strips and a special ultra-fine aluminum oxide polishing paste that he or she can use in this area. The composite bonding is more stain resistant, so that is why they pick up stains more quickly. The smoking will add to this, but as long as you keep up with your maintenance, you should be fine.

This blog is brought to you by a shame-free dentist in Kalamazoo, Dr. Susan Dennis.

 

Will Invisalign Fix Misalignment?

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I went to my dentist to tell him I’d like to get Invisalign. He said that it can’t fix misaligned teeth and suggested I see an orthodontist he recommends. I noticed that they have the same last name and did some digging. They’re married! So, now I’m wondering if he’s just trying to throw business to his wife. He benefits from that, too.

Gina

Dear Gina,

Braces / Invisalign comparison

Traditional braces versus Invisalign

I’m glad you wrote. I would be suspicious myself. First, let’s answer your question. Invisalign can definitely treat misalignment. In fact, that is its whole purpose. When it first started, it could only do the most advanced cases, these days it can treat all but the most challenging cases.

There are one of two things going on here. Either you are correct and your dentist and his wife have a sweet deal going on, or you are one of those rare advanced cases that has complications which requires traditional braces.

You didn’t mention anything complicated going on with your bite, so I am going to go on the assumption your dentist isn’t being unethical. Your first step will be to find a new dentist. Look specifically for a dentist who offers Invisalign. Then, have him or her look at your bite. If they give the all clear, then go for it.

As a bonus, the aligners used to straighten your teeth can double as teeth whitening trays. This allows you to both straighten and whiten your teeth at the same time, giving you a mini smile makeover at quite a discount.

I’m sorry your dentist gave you reason to feel he is untrustworthy. In this case, I think it is a good idea to go with your gut and have another dentist evaluate the situation.

This blog is brought to you by a compassionate dentist in Kalamazoo, Dr. Susan Dennis.

How Many Porcelain Veneers are Needed?

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I want to get porcelain veneers in order to have a whiter smile. I’ve been to three dentists and they’ve all told me I needed a different number of veneers. How many are needed for the smile to look right?

Mara

Dear Mara,

porcelain veneers

I am very glad you wrote. First, I want to make sure of something. Porcelain veneers are typically used when you want a complete smile makeover. That would mean changing the shape, size, and color of your teeth or any combination of that.

If the only thing you want to do to your smile is get a whiter one, than it would be much less expensive for you to skip the veneers and simply have your teeth whitened. Plus, any dentist can do teeth whitening well. A smile makeover takes some post-doctoral training as well as artistry on the part of the dentist. Though, you have to be careful there. Any dentist can call themselves a cosmetic dentist even if they don’t have that training because it is not a recognized specialty. You would want to choose your dentist carefully.

So, if you weren’t just wanting to whiten your teeth and did have a complete smile makeover in mind, then the number of porcelain veneers you get would depend on your smile. There is an aesthetic zone, which is simply the teeth that are visible when you smile. For most people that is between eight and ten teeth, though there are exceptions.

There is a way around this if that means more veneers than you can afford. You will want to whiten your teeth before the veneers are done no matter how many veneers you get. This is because you want your bottom teeth to blend in with your new updated smile. That can also help some of the top teeth to blend in as well. Just be aware that the results are not equal to having all the visible teeth veneered.

What you choose, will depend on your goals for your smile.
This blog is brought to you by Kalamazoo Cosmetic Dentist Dr. Susan Dennis.

Can a Teenager Get Invisalign?

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I had a great experience with my Invisalign treatment. My daughter also needs to have her teeth straightened but she is not keen on the whole braces thing. Is it possible for teenagers to have Invisalign treatments to fix their teeth? She’s 15 and her her teeth are in good health, just a bit crooked.

Melissa

Dear Melissa,

Braces / Invisalign comparison

I am glad that you enjoyed your Invisalign treatment. It has an extremely high patient satisfaction rate. As for your daughter, yes, it is possible for your daughter to also straighten her teeth with Invisalign. Before you decide, though, I want you to ask yourself a few questions. You know your daughter better than anyone, so you’ll know if this is a good option for her.

As you know, this treatment is heavily reliant on patient compliance. She will need to wear the aligners for the prescribed amount of time. This will mean leaving them in unless she is having her meals or brushing and flossing her teeth. If you think she is willing to do that, then that is a good sign that she would do well with the treatment. You would also want to make sure that she is not prone to losing things, as she will have to keep up with her aligners.

There is an Invisalign teen program that has additional aligners as part of the program in case they are lost, but it is more expensive, so if you can go with the adult program it will work in your favor.

I don’t know if you kept your last pair of aligners, but if you did, then you can use them as teeth whitening trays. This will allow you to get your teeth whitened at a fraction of the cost. All your dentist will need to do is provide you with the professional strength whitening gel.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Porcelain Veneers Disaster

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I have some problems with my four front teeth. They are crooked and crowded. I was asking my dentist about getting braces and he suggested I have a combination of reshaping, some dental bonding, and veneers placed, which could fix the teeth without braces. That sounded good to me because I wasn’t really looking forward to a mouth full of metal. However, the result did not end up as I expected. After the procedure, the only improvement were the teeth were whiter. The veneers were too short for my smile and everything still looked uneven to me. Plus, he told me that he reshaped some lower teeth (which we never discussed) and charged me for it. There was nothing I wanted to change with my lower teeth. I asked him how I could get what we originally talked about and he said it would take four porcelain crowns along with root canals that would be necessary because of the crowns, but that would be another $6500. I already paid around $9000 for the veneers. I went to get a second opinion. He said that porcelain veneers could have fixed my problem and that he didn’t see any need for root canal treatments. How do I get a refund from the first dentist, because I’m still going to have to pay the second dentist to get this fixed?

Claire

Dear Claire,

porcelain veneers

I’m glad you wrote. These cosmetic dentist horror stories really make me sad and a bit angry. It sounds like your first dentist is lacking some ethics. First, he didn’t give you what he told you he could. Worse, he did work that you never even discussed. That is a huge no-no in the dental field and he can get in a lot of trouble for that. The good news is that last bit could work in your favor.

I would start by just asking for a refund. If he refuses, then I would start by placing some pressure on him by letting him know that you don’t want to be put in a position where you have to write reviews explaining how poorly your work was done and the position you were left in. Mention that you are also willing to go to the dental board, especially because he did work on you that you did not approve ahead of time.

Your next steps from there would be to find an expert cosmetic dentist to look at the work and my guess is they will agree with you and may call on your behalf. Sometimes a dentist, especially one struggling with ethics, is more willing to listen to a colleague than a patient. If that doesn’t work, you would need to contact an attorney. In that case, you would need another cosmetic dentist on your side anyway.

One other thing, before you go how do you know that this dentist will do any better of a job than your last dentist? I would make sure about his skills and training before letting this second dentist do anything on your teeth. I’d start by looking at their smile gallery to see if they produce beautiful results. If they do, the next thing I would make sure of is that they’ll do your veneers as provisionals first. Then, if you don’t like them, you can tell him what changes you want made before they are bonded on permanently. They should be willing to redo the porcelain veneers until you love them. If they’re not willing to do that, then I want you to find someone else.

I don’t know if anyone told you this the first time you had your teeth worked on, but if you want your four front teeth that are having the veneers whiter than your normal teeth, I suggest you do some teeth whitening before getting your next veneers done. Most smiles are more than four teeth wide, they are generally eight to ten teeth wide. Without whitening your teeth, they won’t match the veneers.

This blog is brought to you by Kalamazoo Cosmetic Dentist Dr. Susan Dennis.

Will Zoom Improve My Porcelain Veneers Color?

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I have porcelain veneers. I thought I’d asked for a whiter color than I received. I spoke to my dentist about it and he said it is too late because they are already bonded on. Surely there is something I can do. Will Zoom Whitening work? I hear it is stronger than regular teeth whitening?

Emily

Dear Emily,

Man under a Zoom Whitening light

I’m sorry about your porcelain veneers being disappointing. It sounds like your dentist is more of a bread and butter dentist than someone with good cosmetic dentistry training.

A true cosmetic dentist would try on the porcelain veneers with a temporary try-in paste and allow you to look at them in a variety of lights to make sure you are happy with the results. If you weren’t, then they would re-do them before bonding them on permanently. It sounds like your dentist just bonded them on without giving you a chance to approve them.

Unfortunately, Zoom whitening will not help the color of the porcelain veneers.They will only work on natural tooth structure. Once veneers are bonded on they can’t be changed. However, that does not mean that they can’t be redone. I’m curious if you have documentation about the color you requested as opposed to what you received. That would help. Either way, I would start by asking him to redo them because they are not the color you wanted. Hopefully, he will do the right thing.

If you do have documentation of what you requested versus what you received, then you could take it to another cosmetic dentist and they may be willing to contact them on your behalf. Sometimes dentists are more willing to listen to their peers. Smile makeovers are not adequately taught in dental school, so you’ll want someone with post-doctoral training.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Son’s Front Teeth Damaged

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My five year old son had a bit of a trike accident and that led to some damage to her front teeth. Now one of them is discolored. Is there any way that I can get his teeth back to its original color, such as with a special diet? I’d even be willing to pay for teeth whitening.

Abby

Dear Abby,

A boy smiling and holding a toothbrush proudly.

There really isn’t any way to change the color of his teeth by diet. His teeth are also too small to do anything else. However, the discoloration from tooth trauma would not respond to teeth whitening even if he was an adult. This discoloration is because the tooth is dying. As an adult, he would need a root canal treatment and possibly a dental crown.

Because of his age, I would not stress over this. His tooth will fall out on his own soon enough and make way for the adult tooth that will be coming in with a nice healthy color. Don’t try to get his tooth to come out sooner, you want the root of the adult tooth to have plenty of time to develop and pushing up against that baby tooth is one of the ways it does that.

You may want to take your son in to see his pediatric dentist in order to make sure there isn’t any underlying damage to the adult tooth. If he doesn’t have one yet, I would get him one or take him to see a general dentist who also treats children. In the case of the latter, you’ll want to make sure it is one who is good with children. One way to know that is when they recommend you first bring your child in for a check-up. If it is when they’re a toddler, then great. If it’s not until they are eight years old or more, than I would look for someone else. That is a sign that they “put up” with children but don’t enjoy them.

This blog is brought to you by Portage Dentist Dr. Susan Dennis.

Retainer After Invisalign Treatment

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I finished my Invisalign treatment and am in the process of moving. I’m wearing the last pair of aligners now. Is there a procedure for this? Do I just be done with the aligners or do I need to find an Invisalign provider for some post-treatment?

Dani

Dear Dani,

Braces / Invisalign comparison

Almost everyone needs to wear a retainer for a period of time after their orthodontic treatment. Otherwise, your teeth could shift out of position again. They need time to truly adjust to their correct position. You have a few options. First, you could find an Invisalign dentist who can help you with an Invisalign styled retainer. Another option is to see a regular dentist who can give you a basic retainer. They are simple and any dentist can do them. A third option is to use your final aligner as a retainer, but you’ll need to do it systematically.

First, wear the aligner all the time, as you’ve normally been for a month. Then, try wearing it every night for a couple of months. From there, try every other night. You’ll need to pay attention to whether your teeth are shifting about this point. You do that by noticing if they are a little more difficult to get back in. If that happens, then you need to go back to wearing them every night for a few weeks and then you can try again.

Once they’re stable at that time distance, you can try them again wearing them every few days at night, then eventually once a week. Take each step slowly making sure to check for shifting. Once you feel you’re done, you can stop wearing them, but keep them around to periodically check.

You can also use your final aligners as teeth whitening trays. Just ask your dentist to provide you with the gel and then wear it while you’re doing your retainer time until you have a teeth whitening level you are happy with.

This blog is brought to you by Kalamazoo Cosmetic Dentist Dr. Susan Dennis.

Do You Have to Get Implants If You’re Only Losing One Tooth?

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I understand why dental implants are important if you are losing all of your teeth. But what if you’re just having one tooth extracted? Is there the same risk of facial collapse? I do need to have a tooth extracted. At the moment I cannot afford a dental implant so I’m hoping there is an alternative for me.

Bella

Dear Bella,

Removable partial denture

While you won’t be in danger of complete facial collapse the way you would be if you had all of your teeth extracted, the area where you do extract a tooth will lose bone bone structure in that spot.

If you can’t afford a dental implant in that spot right away, you could get a removable partial denture or even a dental flipper as a temporary replacement.

You will still lose bone in that area, but only in that area. Plus, it will at least hold the space open for a dental implant while you save up for one. If it takes a long time for you to save up, you may have to also save up for some bone grafting. This is a procedure that builds up the bone in that area in order to support the implant.

Depending on the condition of the teeth on either side of the extraction site, a dental bridge may be a good option as well. With this procedure, you would suspend a false tooth between two dental crowns. If either of those teeth are already in need of a crown, a dental bridge would make more sense because you would be taking care of two issues at once.

As an esthetic consideration, if your extracted tooth is visible when you smile, you want to consider the color you will want in the long run. Once the replacement is made, you cannot change its color. So, if you are wanting a whiter smile any time in the near future, you will want to have teeth whitening done before having the replacement made so it can be made to match the color you want.

If the tooth isn’t visible when you smile, then I wouldn’t worry about that at all.

This blog is brought to you by Portage, MI Cosmetic Dentist Dr. Susan Dennis.

Solution for a HUGE tooth gap

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I have an 8mm tooth gap and want to improve my smile. I told my dentist that I didn’t want to get braces, so he is suggesting that I get Lumineers. That’s pretty expensive, but if you think it is a good solution I’ll fork the money over.

Brittany

Dear Brittany,

Invisalign Aligner

I’m very glad you wrote. Whatever you do, do NOT get the Lumineers. First, the size of your tooth gap is large enough to fit an entire other tooth in there. It would take one of the top 1% of cosmetic dentists in the country to get it to look right. I don’t think your dentist is an expert cosmetic dentist. This has more to do with the fact that he is recommending Lumineers.

This is a brand of porcelain veneers that is highly marketed to inexperienced cosmetic dentists as being easy to place. They say this because they can be placed without tooth preparation. Though, most smiles will look bulky without some minimal tooth preparation. Those who are skilled cosmetic dentists often do not like the Lumineers brand. This is because they require dentists to use their lab, which is not known for its beautiful results and would prefer to use their own ceramist.

I don’t think you’re going to need Lumineers or any brand of porcelain veneers for your situation. There are now ways to straighten your teeth without traditional braces. I recommend you get Invisalign. These use clear aligners, as pictured above. No one will even know that you are straightening your teeth, even at a conversational distance. This will allow you to straighten your teeth in half the time of traditional braces.

There is an additional bonus to using Invisalign. The clear aligners can double as teeth whitening trays if you are interested in that procedure, allowing you to straighten and whiten your teeth simultaneously at a fraction of the cost. Your dentist can provide you with the whitening gel that you can wear in the aligners at your convenience.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.