Dr. Hall,
My daughter just got her braces off and there were white spots on her teeth. Our family dentist suggested a Zoom whitening treatment for her, and we did that, but the spots haven’t gone away. Did she do something wrong?
Answer:
This is one of the problems with asking general dentists to do cosmetic dentistry. They just don’t know enough to do this right. Zoom whitening is a very effective treatment, but it isn’t for teeth that are uneven in color. Usually white spots are made worse by bleaching treatments, whether it is Zoom or the take-home tray tooth whitening.
There are several possible treatments available for your daughter’s white spots, depending on what exactly they are like. White spots after braces are usually caused by decalcification around the braces because of some oral hygiene problems the patient had while the braces were on. Tooth Mousse is a product that was developed specifically for this problem and actually helps remineralize these spots. There is another treatment called microabrasion that sometimes works, but it tends to make the teeth slightly creamier in color rather than whiter.
I myself would recommend direct dental bonding over the spots. The softened and decalcified enamel would be removed and replaced with composite. This enamel is actually suffering the early stages of tooth decay, so it has become defective and I feel that a direct repair is the way to go.
– Dr. Hall
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
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