The Cosmetic Dentistry Blog

November 13, 2009

Composite and Alcohol

Filed under: Tooth bonding — iowasmiles @ 9:34 am

Where do you get your information that alcohol can dissolve resin veneer cement? A patient told me about this article on your website.
- Dr. Young

Dr. Young,
It’s not that the alcohol dissolves it—it softens the resin. I don’t remember where I first heard it, but I’ve known it almost since I started doing any bonding. It was a frequent source of discussion in American Academy of Cosmetic Dentistry circles, and we advised patients with extensive direct dental bonding to even avoid alcohol-containing mouthwashes.

I also saw the effects in my patients. If they used excessive amounts of alcohol frequently, the composite work would come back looking seriously pitted and worn after only a year or two. It’s not so noticeable if it’s smaller bonding work, but they can ruin a complete composite veneer, for example.

Dr. Hall

Other links:
Read about DURAthin porcelain veneers.
Dr. Abraham Abaie is a Scottsdale dentist.

August 15, 2009

Treatment for a single dark tooth

Filed under: Porcelain veneers, Tooth bonding — iowasmiles @ 8:00 pm

My smile is good except my right front tooth is turning brown. It may have gotten bumped when I was a child but I do not recall. It is not painful. It is solid and fine…just slowly dying. What would be the best procedure to take care of this problem do you think? I don’t smile as much due to the fact it has gotten darker. Dentists here want to do a root canal and cap but that seems a bit extreme. It’s not infected and does not hurt.

Thank you for your time,
- Vicki from California

Vicki,
If your tooth is fine and not infected, then there is no reason to have a root canal treatment. When a tooth is bumped hard enough, it can sever its blood supply, and it will die, develop an abscess, and turn dark. It will need a root canal. But if it’s bumped lightly, often it will later develop thicker dentin and will look dark but will be perfectly healthy.

If the tooth is healthy, it just needs some type of veneer to change the color. But the degree of color manipulation required for a single tooth is difficult for about 98% of dentists. If the dentist is artistic enough, often he or she will prefer to use direct dental bonding, because that way you can see the color as you go. Or, a single porcelain veneer works excellently for this situation also, with the porcelain veneer made by a dental laboratory.

But don’t go to the dentist on the corner for this – the color matching required is too difficult. I’d recommend one of the cosmetic dentists on our list, because they are screened for artistic ability.

I’d expect to pay $1300 to $2000 to get this done right.
- Dr. Hall

May 22, 2009

Will dental insurance help pay for bonding my daughter’s splotched teeth?

Filed under: Braces, Dental insurance, Tooth bonding — iowasmiles @ 4:49 pm

My 13-year-old daughter was born with a lack of tooth enamel. After braces her smile is straight but the two main teeth have two different colors on them – they’re splotchy looking. Will my dental insurance pay for this? It’s Anthem Blue Cross
- Pam in California

Pam,
When teeth are splotchy-looking right after getting braces off and they weren’t that way before, it’s probably because they weren’t really good about brushing their teeth while the braces were on. When you’re wearing braces, it’s a good idea to carry a toothbrush with you, because you need to get all that gunk off after each time you eat, or it will damage your enamel.

And since this is a situation that involves damaged tooth enamel, yes, your dental insurance is probably obligated to pay benefits. But there are a couple of cautions here.

First, your dental insurance is only obligated to pay for repairing the physical damage, and they will probably pay at a very minimal level. Don’t think of them as “covering” the repair, because that implies they will pay for the whole thing. Think of it as that they will “help” pay for the repair. You’ll want this done in a way that looks beautiful and natural. Your insurance is only committed to making the repair be functional.

Second, don’t let your family dentist do this. You want an expert cosmetic dentist. This may cost a little more, but the repair may involve free-hand tooth bonding or even porcelain veneers. You need a dentist-artist, and only 1 or 2 percent of dentists are artistic enough to produce a beautiful result with your front teeth.

- Dr. Hall

Click here to find an expert cosmetic dentist.
Teeth bleaching WILL NOT WORK for these splotches. Read our cosmetic dentistry horror story about how teeth bleaching made splotched teeth worse.

March 10, 2009

What can I do about my discolored fillings in my front teeth?

Filed under: Lumineers, Tooth bonding — iowasmiles @ 8:32 pm

Dr. Hall,
Overall, I love my smile. The only issue I have is discolored fillings in my top front teeth.

They don’t respond to bleach. And when I brush them, they look worse, because you can see the difference in the color between the fillings and the teeth more clearly.

My dentist has talked to me about Lumineers, and I wonder if this would help or if the color of the fillings would show through. What is the best thing for me to do?

- Ana in New Jersey

Dear Ana,
The answer to your question is actually fairly simple. I think you’re making it too complicated. You have discolored fillings because the dentist that did them didn’t know how to make them match your teeth.

There are bonding materials that are used for fillings that have every tooth shade under the sun, and they can mimic your natural teeth in translucency, in gloss, and in texture. So you just need a dentist who knows how to do this. See our dental bonding page to see how beautiful these fillings can be.

Whatever you do, don’t do Lumineers. They will make your teeth longer, and they will be bulky. And if you’re happy with the shapes of your teeth, there is no point to doing Lumineers – that’s overtreatment that you don’t need. The problem is the fillings, so just get the fillings fixed.

Check our list of New Jersey cosmetic dentists. Any one of them that we list would be able to do your fillings so that your teeth will look beautiful. I screen these dentists carefully and am confident of their artistic abilities.

One caveat – if your fillings are so large that they cover maybe 1/3 or more of the surface of your teeth, it may be best to shave down the fillings a little and put regular porcelain veneers over them. But not Lumineers.

Good luck,
Dr. Hall

Related links:
Find a cosmetic dentist close to you.

November 11, 2008

My fillings at the gumline keep popping out.

Filed under: Tooth bonding — iowasmiles @ 2:18 am

Dear Dr.Hall,

I want to thank you for providing a wonderful informative site for FREE to the public. The patients you served during your career must have appreciated your care, talent, and quality of service.

I’m sure you can help direct me with my concerns. I have severe erosion at the gum line of my 3rd, 4th, and 5th teeth back from my center teeth at both top, bottom, left and right sides. I first had bondings done for the erosion areas only and they matched my teeth well and lasted 10-20 years. All my attempts to have them replaced with the same performance and quality have failed. Two years ago I had the majority of them replaced by a young dentist. They began falling out within a month so he replaced a couple and they also fell out quickly.

I’m very skeptical about returning though my family encourages me he will fix it without charge. Do you think it is too late to expect any refund so I can get appropriate help from a Cosmetic Dentist?

Should I attempt bondings again or porcelain veneers? I also have not mentioned that my teeth are discolored from Tetracycline when my adult teeth were developing.
Sincerely, Carolyn from Texas

Carolyn,
Thanks for your question and your kind comments.

The answer to how to restore your teeth is actually quite simple, but dentists who aren’t trained in advanced cosmetic dentistry techniques often don’t know this answer.

Recent research has revealed that these notch-shaped lesions at the gumlines of your teeth are actually caused by FLEXING of the teeth, which is aggravated by clenching of the teeth. They have been given the name “abfraction lesions.”

To get the restorations to stay in, the dentist needs to use a FLEXIBLE restorative material, which is counter-intuitive for most dentists. They think they need to use a very strong, hard restorative, but that type tends to pop out within a month or so.

If your dentist will use a microfill composite for these lesions, rather than a hybrid, that will go a long way toward helping them to stay in. Microfills are more flexible than hybrids. He should use something like Silux Plus, or Renamel. That will bend with the tooth and stay in usually for a number of years, provided that proper bonding techniques are used.

If your dentist is humble enough to take some direction, just sharing this information should be enough. If he isn’t, then you may need to seek out a refund and go to a more expert cosmetic dentist.

As far as your tetracycline stains, that is a more complicated issue. A set of beautiful porcelain veneers would totally transform your smile. But you definitely need a highly artistic, very competent cosmetic dentist for that, such as we recommend on our web site. Check our list of Texas cosmetic dentists. Don’t go to your family dentist for this – it is much too difficult, in spite of what they might tell you.

I hope this is helpful.
Dr. Hall.

Related links:
Dental bonding

January 16, 2008

Dental bonding is wrong color

Filed under: Tooth bonding — iowasmiles @ 10:50 pm

Dr. Hall,
I just had a chipped tooth repaired and the color doesn’t quite match and you can tell it’s a repair. Should I go back to the same dentist to have him fix it or do I try to find another dentist? Also, should I be charged for the redo from the same Dr?
- Jeanie from New York

Jeanie,
I’d give this dentist another chance to match the color and see how it goes. If he has trouble getting it right the second time, then I’d look around for an expert cosmetic dentist. I wouldn’t bail out too quickly, but be ready in case you do.

And there shouldn’t be any extra charge for getting the color right. That’s part of what he should be expected to deliver.

Direct tooth bonding is difficult for general dentists–they generally aren’t really good at color manipulation with these materials. And sometimes they don’t have enough of a selection of shades and textures of material in stock to do the job right.
- Dr. Hall

Additional information:
Click here to find an expert cosmetic dentist.
Click here to ask Dr. Hall a question.

December 4, 2007

Bonding is yellow

Filed under: Finding a cosmetic dentist, Tooth bonding — iowasmiles @ 7:52 pm

Dr. Hall,
I took my 12-year-old daughter to the dentist, and wanted to fix the slight discoloration in her two front teeth. The dentist put composite on the teeth and they were yellow. Yes, she has two yellow front teeth. I went back and told her I couldn’t accept this and she needed to fix it, she shaved off some of the bonding and composite and applied more and again, it’s yellow. It’s peeling off to a certain degree. What can I do, I am scared that this dentist isn’t qualified to correct this problem and now, I’m scared that they won’t be able to fix them. She told me that she may have to do a veener, isn’t she to young for this? What options do I have? Can you simply remove what was put on there? And will the dentist have to pay to correct this problem?
Thanks,
Carol in North Carolina

Carol,
I think you’re on the right track–you need to get another dentist to do this for you, and I would try to get the dentist to pay to correct this problem. But legally you may not be able to force the dentist to do that–you’ll likely have to use whatever persuasion will work for her–sweet talk, a threat of going to a lawyer, whatever you think she’ll respond to.

Direct tooth bonding is an art, and you really need an artist/dentist, as you’ve been learning the hard way. I’d recommend, with the age of your daughter, that you stick with direct bonding. Another dentist should be able to take off the bonding that’s there and fix this right. But, you need an artist.

Don’t let this dentist do porcelain veneers on your daughter. It wouldn’t be unreasonable to have porcelain veneers. If they are done ultra-thin, that could work. But I’m confident this dentist doesn’t know how to do beautiful porcelain veneers either.

You see, dentists take up the profession because they like to fix things. 95% of them aren’t artistic. And on top of that, the training we get in these artistic areas, particularly with color, just isn’t very good. And, to make it worse, even of the maybe 5% who are artistic, most of them don’t bother to get the advanced training they need to be really good at cosmetic dentistry. To protect the public, cosmetic dentistry should be a specialty. But, in order for that to happen it would have to be voted on by the profession. And since the vast majority of dentists think that cosmetic dentistry is no big deal (because they have NO artistic sensitivity), that will never happen. So you have a situation where maybe 1-2% of the dentists can do this work and have it look beautiful.

Check our list of North Carolina cosmetic dentists. They should all know how to take care of this. And don’t rely on advertising to pick a cosmetic dentist. A lot of dentists will advertise that they do cosmetic dentistry, because it’s a very lucrative portion of the business. But they aren’t artists. True cosmetic dentists are rare, and that’s what you need.

Good luck,
Dr. Hall

Click here for referral to an expert cosmetic dentist.
Click here to ask Dr. Hall a question.

September 17, 2007

I’ve been thinking about getting Lumineers, but…

Filed under: Lumineers, Porcelain veneers, Tooth bonding — iowasmiles @ 12:02 pm

Dear Dr. Hall,
It was a blessing to come across your website!

A few years ago I had composite tooth bonding done on 5 of my front teeth because my teeth were very tiny and had some gaps inbetween even after my braces were taken off. I was 15 at the time and needless to say my parents paid for everything. I’m 22 now and even though my smile still looks very decent I notice they’re starting to wear. I have been contemplating getting Lumineers but after reading the horror stories on them I know I’d prefer to just get them bonded again. One thing that has me somewhat scared is that I want to improve my smile but I don’t want people to see too much of a difference. How much would it cost me? What would they do to the bonding I have now?
- Angie in Florida

Angie,
You’ve brought up several good questions. And I hope I haven’t made you too much afraid. All those “horror stories” on the web site have one element in common–the people thought that their family dentist or a general dentist could do cosmetic dentistry. If you go to an artist/dentist, someone who really has that passion for beautiful dentistry and has the training to be able to do it, dentists like we recommend on our web site, you won’t have anything to worry about. Check out our Florida cosmetic dentists. All of them are artists who would do beautiful work.

Now your questions:

What would the cosmetic dentist do? He or she would probably shave down the existing bonding and then re-bond the teeth with composite or with porcelain. From your perspective, it would be very easy. But for the cosmetic dentist, it would require a lot of artistic talent.
And here’s where you would see the difference between a true cosmetic dentist and your family dentist. The cosmetic dentist will make sure you see exactly how you will look before the case is completed. He or she will listen carefully to you, and you will get the color you want, the shapes you want, and everything else the way you want it. A general dentist typically plans out what he or she thinks the teeth should look like and then gives you a quick look just before they bond everything on, and that’s why we get these sad stories of people who get home and don’t like how they look.

How much would it cost? In Florida, I would expect this to cost from $1200 to $2000 per tooth. Check our page on cosmetic dentistry costs for more information.

Will people notice a big difference? I wouldn’t worry about this. I can tell you many stories of people who had major changes to their teeth and their friends could tell they had done something but couldn’t put their finger on it. You’re focusing on your teeth now, but your friends aren’t. They won’t really notice what you have done to your teeth–only that you look better. My strong advice to you is to not hold back but go for the beautiful smile. You can show up with an absolutely stunning smile and the people who are close to you will look at you and say, “What was it–did you get your hair done? Have you lost weight? I can’t put my finger on it, but you look really nice today.” I saw that over and over again in my practice. And I had the same thing happen to me. When I decided to specialize in cosmetic dentistry, I decided to get braces to improve my smile a little. The day I got my braces off, my own family didn’t even notice! I purposely didn’t tell them because I wanted to see for myself if the things my patients had been telling me was true, that people didn’t notice what you had done to your teeth.

Should you just re-do the tooth bonding? I think this would be a mistake. I can’t see any advantage to re-doing the bonding over getting porcelain veneers. The bonding will start to look dull and worn in a few years, and then you’ll have to re-do it again. That’s EXPENSIVE! Since your teeth are too small already, all they’ll have to do to prepare your teeth for porcelain veneers is pretty much to remove the old bonding. And the porcelain will be beautiful for many years, will resist stains, and won’t wear down.

I hope this is helpful.
- Dr. Hall

We thank our advertisers who help fund this site. Our cosmetic dentist referral pages list cosmetic dentists we recommend.

August 11, 2007

A question about my white spots

Filed under: Lumineers, Tooth bonding, Tooth whitening — iowasmiles @ 8:02 pm

Dr. Hall,
When I was a child and my permanent teeth were forming, opaque white spots developed on the tips of my teeth. In my teen years, I had braces to correct the placement of my teeth which I believe contributed to the white spots on the front two teeth. My longtime family dentist has assured me that my teeth are healthy and she advised that since I am young (28) and my teeth are in good condition, I should not try to “fix what isn’t broken.” However, the white spots make me self-conscious about my smile and I have been researching whitening treatments and/or veneers and Lumineers. My question is: Would tooth whitening treatments such as Crest Whitestrips or in-office treatments like Zoom whitening make the white spots more noticeable, since they may be lightened more than the surrounding (unmarked) teeth? Or are porcelain veneers a better choice in this case?
- Lisa in Maryland

Lisa,
Oh, dentists, you have to love them. Your dentist is so typical. It appears to me that she is one of these dentists who chose dentistry because she likes to fix things and is thoroughly steeped in this “fix it” mentality. “Just leave it alone–it looks fine!” That’s what so many dentists think, and the honest ones say it. I admire her honesty. And she clearly cares about you. But don’t ask her to be the one to take care of these white spots.

Whitening treatments won’t help. When you have spots on your teeth, whitening can make them worse, actually. So you are smart to have thought that through. Some dentists would prescribe whitening treatments for you.

Get a real cosmetic dentist–one of our Maryland cosmetic dentists or the Washington DC cosmetic dentist we recommend. If your spots aren’t too large, tooth bonding could be the answer to your situation. If not, a couple of porcelain veneers would cover it up. I couldn’t tell you for sure without seeing your case. You could whiten first and then fix the spots. But if you’re self-conscious, then you should do something. It would be simple, durable. But please go to an expert cosmetic dentist. Don’t be influenced by advertising–any dentist can claim to be a cosmetic dentist, and some of them do that because these are very profitable procedures, but they aren’t artists and really don’t have the extensive training in color management, etc. that they need to do beautiful work.

Then go back to your wonderful, honest, caring, regular general dentist.

I hope this is helpful.
- Dr. Hall

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May 25, 2007

What to do about enamel erosion on the inside of the teeth

Filed under: Tooth bonding — iowasmiles @ 3:10 pm

Dr. Hall,
I have severe enamel erosion on the inside of my teeth. What would protect my teeth better, bonding or caps? Can you recommend a cosmetic dentist in Simi Valley, CA.
-Tami in California

Tami,
For the inside of your teeth, you would need porcelain crowns. Bonding just wouldn’t hold up well enough on the inside of your teeth to do the job.

And good cosmetic dentists are simply not common enough to find one in every community. My recommendation if you’re in Simi Valley is to see Dr. Dell Goodrick in Santa Clarita, which isn’t that far. He does beautiful work. Otherwise, there are also really good cosmetic dentists in Pasadena and Beverly Hills. See our list of Southern California cosmetic dentists.

And for the benefit of other readers, loss of enamel on the inside of your teeth is an unavoidable consequence of bulimia, in addition to a shortening of your teeth. Expert cosmetic dentists are trained to treat bulimia, and they are trained to be extremely confidential about your case.
Dr. Hall

We thank our advertisers who help fund this site. Our cosmetic dentist referral pages list cosmetic dentists we recommend.

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