Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

June 15, 2016

My composite bonding is turning yellow


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Hello Dr. Hall, 9 months ago I had dental bonding done on my four front teeth. There is quite a bit of composite on each tooth because I have been re-doing it every 3 or 4 years for 20 years. My question to you is, I see a bit of yellowing, is it possible to just polish them to try and whiten them again since they were done just 9 months ago? Thank you for your time!
– Linda from New Jersey

Linda,
One of the big differences between composite bonding and porcelain veneers is that the porcelain is very hard and stain-resistant (it resists stains better than tooth enamel), and composite is much softer and much more susceptible to stains, so it has a much shorter lifespan.

The good news is that with the composite bonding, usually those stains can be polished out, depending on the type of stains.

Composite is susceptible to two types of staining. The first type, the type that can be polished away, is a surface discoloration. The surface of the composite will get tiny scratches in it and become roughened which causes it to attract stains of all kinds. A good polishing will get rid of the scratches and the accompanying stain and restore gloss to the surface. Below is an example of this type of staining. You can see that the surface of the two front teeth has a matte finish from all the tiny scratches, as contrasted with the gloss of the adjacent natural teeth:

dental bonding with yellow staining

Photo courtesy of Dr. Robert Soto, San Francisco, CA

But composite will also absorb stains into the actual substance of the material. Composite is composed of inorganic filler particles such as quartz or glass bound together in a plastic matrix. Certain colored liquids, such as coffee, tea, cola drinks, or highly pigmented fruit juices, will actually penetrate the plastic part of the material and become a part of it.

dental bonding stained yellow

Photo courtesy of Dr. Mark W. Langberg, Southfield, MI

This type of stain will not come out with polishing. But this staining also occurs more slowly and can take a couple of years to become noticeable. At the right is an example of this type of staining. You can see that the composite has retained its gloss. The discoloration is coming from deep within, as stains have been absorbed by the material.

Preventing This Staining

There are several preventive measures you can take to get the bonding to keep its nice appearance for longer.
1. First, choose an expert cosmetic dentist who stocks a full inventory of esthetic bonding materials. General dentists will typically stock general purpose composites that are actually impossible to polish to the high gloss needed to resist stain and look like enamel. The surface of the bonding should be a microfill composite that is polished to a high shine.
2. Second, don’t use an abrasive toothpaste. While Supersmile toothpaste is quite a bit more expensive than your typical Crest, Colgate, or other drugstore brand, those general brands have abrasives in them that will scratch the surface of your bonding. Some of the abrasives are worse than others. I always provided my bonding patients with a first free tube of Supersmile, because it has no abrasives but rather lifts stains off by chemically dissolving the protein pellicle on the teeth.
3. Third, make sure your dental hygienist is polishing your teeth with a very fine abrasive. Pumice tooth polish is a big no-no. She or he should be using a fine aluminum oxide polish. Ask for this. (See my web page giving tips for maintenance of dental bonding.)
3. Fourth, beware of staining beverages. If you need to drink them, swallow them quickly rather than letting them sit in your mouth. And remember that hot beverages have more staining power than cold ones because they cause a slight expansion of the plastic, opening up microscopic pores that can be penetrated with the stain.

Finally, I would seriously consider switching to porcelain veneers. I don’t know how much your dentist is charging for this bonding, but dentists who do it well will charge quite a bit. Which costs more–doing composite bonding six times over 20 years, or doing porcelain veneers once for those same 20 years? Porcelain veneers done by an expert cosmetic dentist can easily look beautiful for 20 years. Porcelain is harder than tooth enamel and more stain-resistant. But go to an expert cosmetic dentist for porcelain veneers–don’t ask your family dentist to do this.

– Dr. Hall

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About David A. Hall

Dr. David 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 complete Internet marketing for dentists.

May 17, 2012

Abrasive toothpastes and porcelain veneers

Dr hall,
I messed up and didn’t know I couldn’t use abrasive toothpaste on veneers. For the past two months I have been using crest 3d vivid toothpaste on my new porcelain veneers. What are the chances they are scratched or the glaze will come off now? Will they not last as long in terms of shine now? I’m going to order Supersmile toothpaste tonight! So sad of my veneers at ruined,
– John from Florida

John,
The abrasive toothpaste will not scratch the porcelain – the porcelain surface is too hard. What it does is scratch and wear away the bonding composite that bonds the porcelain to the tooth. That bonding composite forms a very thin line around the entire veneer – it will vary a lot with the technique of the dentist and the ceramist, but it might be, say, 100-200 microns which would be about the thickness of three to five hairs. So if you have been using the abrasive toothpaste for only two months, you probably won’t notice anything yet. When that bonding composite is scratched, it might pick up stain more and what you would see would be a line of stain around the veneer. And then the other problem with the abrasive toothpaste is that it wears away that composite so that you would form a tiny, almost microscopic “ditch” around the veneer which would be an attraction for plaque and a vulnerability where decay could attack.

It’s just a prudent maintenance thing to use the Supersmile toothpaste on expensive cosmetic work – kind of like changing your oil in your car. You aren’t going to ruin your car because you went 1000 miles over the limit before changing the oil one time. Just get on the regular, sensible maintenance with the Supersmile toothpaste from here on out and you should be fine.

Now if you had direct composite bonding on your teeth, that would be a different story. The composite, like the bonding composite between the porcelain and your tooth, is a softer material and the shine can dull easily. But your expert cosmetic dentist should be able to re-polish the bonding and restore the shine.

Dr. Hall

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About David A. Hall

Dr. David 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 complete Internet marketing for dentists.

March 24, 2011

Did my toothpaste damage my porcelain veneers?

Filed under: Toothpaste — Tags: , , — mesasmiles @ 10:24 pm

Hi Dr. Hall,
I just got veneers and found out that Crest Pro Health shouldn’t be used on them. I used the toothpaste for three days (I was unaware), is there a chance I damaged them or should I be concerned? Other than Supersmile, is there another toothpaste I should use until receive the Supersmile in the mail?

Thank you,
Jason from Massachusetts

Jason,
The effect of your toothpaste on your porcelain veneers is a long-term effect. I wouldn’t worry about using a particular toothpaste a couple of times.

The problem is that most toothpastes are more abrasive than what would be ideal on cosmetic dental work. So yes, I would recommend the Supersmile toothpaste for your porcelain veneers to maximize their lifespan. Other ordinary toothpastes are a little too abrasive and if you use them consistently, they may wear away the bonding composite that is found on the margin between the porcelain and the tooth.

A good second choice toothpaste is Rembrandt, but you have to be careful about which Rembrandt you use. Rembrandt has been bought by Johnson and Johnson, and they have new formulas on the market. You want the Rembrandt Low Abrasion Whitening Toothpaste with Citroxain. It has gotten difficult to find. Don’t get the Deeply White toothpaste or the Intense Stain toothpaste, because they have new formulas that may be just as abrasive as other ordinary toothpastes.

If you can’t find the older formula Rembrandt, I would just use the Crest until the Supersmile arrives, and just brush gently. It is better to keep your teeth clean.

Dr. Hall

Links: Read all about taking care of porcelain veneers.

We thank our advertisers who help fund this site.

About David A. Hall

Dr. David 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 complete Internet marketing for dentists.

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