The Cosmetic Dentistry Blog

July 22, 2009

Dentist struggled with my tetracycline stains

Filed under: Tooth staining — iowasmiles @ 9:30 pm

I had crowns put on my upper 8 front teeth and lower 6 front teeth. I had tetracycline stains. He kept trying to re-do the crowns, but they never looked right.

The first set of crowns looked really bad—thick yellow and badly contoured. The second set looked much better. The bottoms were still somewhat yellow but we were going to put them on and try to use a liner on the bottom to block out the yellow. He tried different colored liners and they made the crowns look blue or gray. So he made another more opaque set of crowns. They look like the porcelein a sink is made out of. I let him put them on because I figured if he tried again I don’t know if they would look better or worse but the front upper 4 look particularly bad. The lab tried to make them look more “natural” and blended some translucent color and it looks like gray streaks and spots. I didn’t notice to what extent until I got home and looked at them more closely.
- Kim from California

Kim,
I don’t know what to tell you, except that I hope other people learn from what happened to you. Tetracycline stains are very difficult to treat, and most dentists don’t have a clue about how to go about it. It appears that your dentist had never done tetracycline stains before. Very few have. And the whole thing just bombed.

You don’t need crowns for tetracycline stains – only porcelain veneers. Crowns require grinding the whole tooth down. Porcelain veneers just need the front of the tooth shaved a little. And it’s tricky to block out the intense dark color of the stain and still get the tooth to look natural. Dentists either don’t block it out enough, and the teeth look gray, or they block it out too much and they look like a toilet bowl. And it sounds like your dentist’s laboratory was also taking it’s first attempt at dealing with tetracycline stains.

You may be able to get your money back. You can try. My advice is not to be confrontational. First thing I would do, however, is find a qualified cosmetic dentist from our list of excellent cosmetic dentists in the Los Angeles area, and see what they think. Then I would go for getting all your money back and starting over. You can have a beautiful smile, but you need a genuine cosmetic dentist to do it.
- Dr. Hall

Related links:
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January 6, 2009

Tetracycline stain, and no money for porcelain veneers

Filed under: Tooth staining, Tooth whitening — iowasmiles @ 6:39 pm

Dr. Hall,
I had bonding applied to my teeth and now they are chipping and dulling? Medicines I had when an infant caused my teeth to be discolored and gray.I do not have money for veneers. Is there a new whitener that will help?
- Tami in Wisconsin

Dear Tami,
You have tetracycline stains. Tetracycline, if you take it before the age of about 12 when your permanent teeth are forming, will deposit in the dentin of your teeth and will show up as a dark brown or gray stain, sometimes in bands.

It’s risky to have these treated by a general dentist or a dentist who does some cosmetic dentistry. You really need a lot of training and experience to mask out these stains with porcelain veneers.

But, if you can’t afford veneers, and if you have existing dental bonding on the teeth, you have two reasonable choices, in my opinion:

  1. If the bonding was placed over your intact enamel, then I would have your dentist remove this bonding with sandpaper disks. In many states, this could be done by a dental hygienist, at probably a lower fee. Then I would have your dentist set you up with a home tooth whitening tray and the strongest home bleaching gel that you can tolerate without your teeth getting sensitive. Then I would bleach every night for a couple of months. Your teeth will lighten and look much better. Not as good as porcelain veneers, but definitely better.
    Don’t try to do this with over-the-counter whitening products. They will be a waste of money because they are no where near strong enough for tetracycline stains. You need the strongest stuff money can buy.
    And don’t do the laser tooth whitening or zoom whitening. Yes, these are more powerful, so they would be faster. But if money is an issue, these power bleaching techniques that are done in the dentist’s office get to be really expensive, especially with the number of appointments you will need. With the home trays, you can do the extended treatments on your own time, at just the expense of the refills. If your dentist charges too much for the refills, you can find them cheaper on EBay.
  2. If the dentist who put the bonding on removed some enamel before putting it on, then I would bite the bullet and start saving for an expert cosmetic dentist to do eight or ten porcelain veneers. Meanwhile, I would have someone smooth out the bonding. Dental bonding, done well, is going to cost a lot of money, and will be several times more expensive over the long run than porcelain veneers because it begins to look crummy in one or two years, where porcelain veneers, which may cost anywhere from 10% more to twice as much initially, will last many years and look great for all that time.

Good luck,
Dr. Hall

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July 26, 2008

Should I have crowns for tetracycline stains?

Filed under: Tooth staining — iowasmiles @ 7:45 pm

Dr. Hall,
I have severe tetracycline stains and have had porcelain veneers for 18 years. They have always been gray, but better than what I had. My teeth are almost black underneath. My dentist brought in the lab specialist that makes the veneers and both have decided to do the crowns. Do you think this is a wise choice?
- Ann from Louisiana

Dear Ann,
Very bad choice, doing the crowns. You don’t need crowns. You need this done by an expert cosmetic dentist. Tetracycline stains are very difficult, and your family dentist simply doesn’t know how to do this. Don’t let them grind your teeth down to stubs.

They recommend crowns because your dentist isn’t a genuine cosmetic dentist, and your laboratory technician isn’t one who specializes in cosmetic dentistry. You don’t need crowns, and even with the crowns, I’m afraid that you will end up ones that look opaque and fake. Only one or percent, maybe two, of dentists can do this beautifully for you.

Your teeth can be beautiful – they can sparkle and be white, natural, and fabulous looking. All it takes is a little effort to find a REAL cosmetic dentist. See the photos of tetracycline-stained teeth on our web site and you will see what the beautiful possibilities are.

And check our list of Louisiana cosmetic dentists. I have carefully screened every dentist listed on that page to make sure they can give you beautiful results. If you aren’t that close to one, believe me when I say it would be worth a drive of several hours, if it needs to be that, to have a beautiful smile instead of one that looks sort of mediocre. Don’t you think so?

Please, for your own sake, do this right. This is way over the head of the vast majority of dentists, which is why you’ve suffered with gray teeth for the past eighteen years.
- Dr. Hall

May 20, 2008

My porcelain veneers didn’t stay white

Filed under: Porcelain veneers, Tooth staining — iowasmiles @ 8:23 pm

Dear Dr. Hall,
I had porcelain veneers placed on my teeth originally in 1987. I had them replaced with new veneers in February of 2008. The new veneers started off white in color, but ALL have now become gray and dingy. The dentist thinks too much enamel was removed in ‘87 and seepage of dentin is occuring underneath the new veneers discoloring them. She wants to replace them now with some sort of partial crown. Is this the only procedure left open to me to mask the dark color of my teeth from seeping through? I do not want more of my tooth taken away, and I am curious why in 2008 veneers cannot be made opaque enough to mask Tetracylcine staining and REMAIN white. What other option do I have besides partial crowns? I really just want to redo the veneers, but she is making me feel like every shade of veneer I try will yield the same result. Is this true?
- Amy from California

Amy,
I’m glad I caught this question to hopefully save you from trouble.

I am VERY suspicious of what this dentist is telling you. Something went wrong and she is trying to blame the first dentist. She says that seepage of dentin is occurring? I don’t know what she’s talking about. Because too much enamel was removed in 1987? This sounds crazy. These sound like made-up reasons to me. This problem is from something SHE did wrong, not the 1987 dentist.

You definitely need a second opinion from a true cosmetic dentist. I wouldn’t let this dentist do anything more on you. You DON’T need crowns.

Porcelain veneers can mask tetracycline stains. Absolutely. See the photos on our web site. That’s what you should expect. And the color of the veneers shouldn’t change AT ALL after they’re placed. But very, very few dentists know how to do this. And it sounds like your current dentist is one of those who don’t know how to treat tetracycline stains.

You’ve got some excellent cosmetic dentists in San Diego. See our page of Southern California cosmetic dentists and pick one of them and see what they can do.
Dr. Hall

Related links:
Ask Dr. Hall a question
Click here for referral to an expert cosmetic dentist.
Can you bleach teeth with tetracycline stain?

May 8, 2008

Will dental insurance help pay to fix my tetracycline stains?

Filed under: Dental insurance, Tooth staining — iowasmiles @ 9:28 pm

Hello Dr. Hall,
I was wondering if you can tell me if medical insurance would cover the treatment of my teeth from tetracycline damage? My teeth are very weak and sensitive. I am afraid to bite into anything because I have chipped my front teeth before and I was hoping that because my teeth were damaged due to tetracycline to treat multiple infections due to asthma when I was a child. Please advise.
Thanks
- Jessica from Idaho

Dear Jessica,
It would sound reasonable that medical insurance would cover treating the side effects of a medical treatment like tetracycline teeth stains. But in reality, the medical policies usually list exclusions of any dental work. I have not heard of a case of medical insurance helping to pay for any treatment of tetracycline teeth stains.

But if you want to get a more authoritative answer as regards to your particular medical plan, I would call the insurance company and ask.
- Dr. Hall

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December 21, 2007

Taking tetracycline and teeth are staining

Filed under: Tooth staining — iowasmiles @ 7:54 am

Dr. Hall,
I’ve been on tetracycline for about 2 years. The dermotologist gave me this for acne. I went to my dentist for a clean recently and they say I have stains on the back sides of my front teeth. They are brown lines. Its from the medicine right? How can I get rid of this problem before it get worse?
- Mindy in Pennsylvania

Dear Mindy,
It’s possible that the staining you’re getting on the backs of your front teeth is from the tetracycline you’re taking, but I doubt it.

Tetracycline stains your teeth by getting absorbed into the enamel and dentin while your teeth are forming, so you need to be under the age of 13 for it really to have an effect. Though there is one study that showed that minocycline, a particular variety of tetracycline, can cause stains in teeth after they’re already formed.

If it’s true tetracycline stain, it’s absorbed into your teeth and needs to be bleached out or covered over with dental bonding or porcelain veneers.

The best at-home stain prevention you can do is to use Supersmile toothpaste. I’d try that and see if it helps keep the stain off.

- Dr. Hall

Related information:
Tooth whitening

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