Archive for the ‘Find a Cosmetic Dentist’ Category

Teeth bleaching is making my teeth look worse.

Wednesday, June 16th, 2010

I am in a really frustrating position. I am 24 years old, and ever since my adult teeth came in, they have had brown spots on them. I take really, really good care of my teeth, but my dentist said that they are like that because I had a very high fever as a young child, and that episode caused the discoloration.

I just graduated from college, and am trying to start my new professional life. I feel like these ugly teeth are really making a bad impression, but don’t know what to do about them. Under the guidance of my dentist, I have tried just about every over the counter teeth whitening product there is. I don’t have very much money, and though the kits are not individually expensive, they are starting to add up. So far, all that has accomplished is to make my teeth look even worse. The spots seem even darker than they did before.

Now my dentist wants to “try an experiment” (her words). She wants to use a grinder to wear away the front of my tooth until the discoloration is gone. I do not claim to be any kind of dental expert, but this sounds like a really bad idea! She admits that she does not know how much she might have to take off, and I am having horrible visions of what the end result of this might look like.

There has to be another way. What about professional whitening? I am tired of making a bad first impression. I am hard-working, well educated and meticulous, but my teeth send exactly the opposite message! Please help me get this figured out.

Thanks a lot,

Gretta in Belhaven, North Carolina

Dear Gretta,

You are smart to be cautious, especially when your dentist uses a phrase like “try an experiment”. From the sounds of things, you need to seek a new dentist. Your dentist clearly does not understand the basic principles behind teeth bleaching, and letting her conduct her “experiment” with grinding could lead to catastrophe.

I strongly suggest you seek the services of an experienced, expert cosmetic dentist, even if you have to drive a fair distance to do so. Please trust me that it will be very worth your time and effort to put this matter in the right hands.

As you have noticed, your smile is a huge part of the first impression you make on people, and you are at a point in your life where that first impression is incredibly important. If at all possible, I would advise you to invest in porcelain veneers. You do not mention any issues with any of the rest of your teeth, so it is possible that getting veneers for only those teeth that are discolored could make a dramatic difference in your smile.

If porcelain veneers are not a possibility, dental bonding may work just as effectively to deal with the discolored spots on your teeth.

You need the advise and guidance of an expert cosmetic dentist to make the decision about which course of treatment to pursue. Use caution, and ask about the dentist’s training and credentials. A truly expert cosmetic dentist will be a member of the American Academy of Cosmetic Dentists at the very least, and preferably accredited through them.

What can be done about fluorosis stains?

Sunday, February 28th, 2010

I am looking for guidance. My 12-year old son has severe fluorosis stains on his permanent teeth, and he is very self-conscious. His bottom teeth are extremely blotchy and yellowish, and his top front teeth (central and lateral incisors) have very dark stains. His left lateral incisor is quite jagged on the outside edge. He has braces right now, so we do not plan on doing anything for a while, but our dentist doesn’t seem as concerned as we are about the staining and has not given us a satisfactory plan of action for dealing with the stains when the braces come off.

Am I overly concerned with these stains? My son is so embarrassed by his teeth. He almost never smiles. I want to do something about that.

Annette in Colorado Springs

Dear Annette,

Many general dentists are not well-equipped to be sensitive about self-esteem issues. If your son’s teeth are physically sound and functioning properly, then your dentist may not be concerned with what they look like. After his braces come off, I strongly suggest you seek the help of an accredited cosmetic dentistto help you address the staining. If the staining was uniform, I would suspect some other cause of staining and recommend bleaching, but the blotchiness you describe does sound like fluorosis.

If your son’s teeth have not fully erupted, it might be possible and prudent to do some direct tooth bonding to provide a short-term fix for the staining. If his front teeth have fully erupted, porcelain veneersare probably the best choice for dealing with fluorosis stains as severe as those you describe. There is no minimum age for placing porcelain veneers, so if you are working with a highly skilled and experienced cosmetic dentist who can factor in the degree of current and future tooth eruption, your son could have veneers placed right away.

Can you seal a gap in a porcelain veneer?

Monday, February 4th, 2008

I had porcelain veneers placed four years ago. All of them look great except one which started leaking and became slightly senstive every now and then. I went to my dentist who told me there’s no cavity and the gap is around 30 microns. My question is could this gap be fixed? The fact that it gets sensitive bothers me a lot. Thank you for kind reply.
- Al in Massachusetts

Dear Al,
Yes, you can fill and seal this gap, but it requires special porcelain bonding techniques that most dentists aren’t familiar with. To be properly sealed, the porcelain has to be etched and primed, and the enamel does, also. Then a clear sealant can be bonded into the gap and it should be taken care of.

If you go to someone who is a sustaining member of the American Academy of Cosmetic Dentistry, like Dr. Goldstein is, that insures that they will have the knowledge they need to do something like this.

Related information on Dr. Goldstein’s web site:
Porcelain veneers
A list of Dr. Goldstein’s credentials in cosmetic dentistry
Tooth bonding