Care of Cosmetic Dental Work

Cosmetic dental work often involves a substantial investment. To keep it looking its best may require some extra care on your part and on the part of your dentist. Dr. Hall, as a cosmetic dentist with over twenty years experience, has some helpful information about keeping your beautiful dental work looking great for years and years.

Professional Care

Some professional maintenance procedures that are used routinely on patients, that work well for natural teeth or metal restorations, can ruin the beauty of all-ceramic or composite esthetic work. If you have extensive cosmetic work, be sure that your dental office understands these “do’s” and “don’ts”:

  • Many dental hygienists are finding that power polishing equipment, such as the Prophy-Jet®, speeds up routine cleanings and leaves teeth very clean. However, their powerful spray of sodium bicarbonate will break the glaze and cause microscopic roughness in the surface of porcelain or composite and make it stain more easily. Natural teeth aren’t affected because they smooth out this slight roughness by drawing minerals from the saliva. Porcelain crowns or porcelain veneers, however, will look great at the end of the appointment, but in a few weeks you’ll notice the rapid deterioration in appearance as they begin to pick up stains because their glaze has been broken.
  • Ultrasonic scalers need to be used skillfully. If used improperly at the margins of porcelain crowns, veneers, or composite bonding, they can chip the margins and spoil the appearance, and possibly make the tooth more susceptible to recurrent decay.
  • Regular pumice polish, used on most patients by hygienists to remove the protein pellicle layer from teeth, will scratch composite bonding. Even for durable porcelain veneers, the pumice will scratch and erode the composite that holds the veneer to the tooth and cause it to deteriorate prematurely. Hygienists should use a fine aluminum oxide polishing agent to polish this cosmetic dental work.
  • Special care is needed in providing fluoride treatments. Many hygienists and dental assistants, and even some dentists, don’t fully understand the impact of acidulated versus neutral fluoride. The acid in acidulated fluoride is hydrofluoric acid, which will etch the porcelain in crowns and veneers and the tiny glass particles in some composites. Like power polishing sprays, this breaks the glaze and roughens the surface microscopically and makes it more susceptible to staining. Also, some porcelain crowns have had custom tinting to help them match existing teeth, or they may even have all their color on the surface. Acidulated fluoride will remove any of these colors from the surface of porcelain crowns! If you have any fluoride treatment after cosmetic dental work, be sure that the fluoride used is a neutral fluoride. It isn’t as strong, but staying away from hydrofluoric acid will protect your cosmetic dental work.
  • A “do”: When you have porcelain veneers, suggests that it would be helpful to have extra maintenance polishing appointments—two extra appointments per year—to keep the shine at its maximum, especially at the critical bond area between the tooth and the veneer.
  • If a porcelain crown or bonding does lose its gloss or start staining, there are polishing tools and techniques that can bring the luster back. A dentist or hygienist who is specially trained in cosmetic dentistry will have those tools and know those techniques that can bring the shine back.

Home Care

Here’s your list of “do’s” and “don’ts” for home care:

  • The biggest “don’t” is excessive alcohol consumption. If you consume large quantities of alcohol daily, the alcohol will soften composite bonding material if you have direct bonding, and also the composite luting material that holds the porcelain to the tooth if you have porcelain veneers. Within a period of a couple of years, you could completely ruin the dental work. I saw this in a handful of patients. So, watch your alcohol consumption. Moderate amounts don’t seem to have any noticeable effect. Beware, also, of constant use of alcohol-containing mouthwashes. Read the list of ingredients on your mouthwash.
  • Don’t subject your teeth to sharp impacts or hard objects. Don’t bite pins, staples or nails. And beware of grinding your teeth. If you tend to grind at night, get a nightguard to protect your teeth. And if you engage in contact sports, wear an athletic mouthguard.
  • Floss and brush your teeth conscientiously. While your porcelain or bonding work is immune to decay, the part of your teeth not covered by the cosmetic work is still susceptible to tooth decay. The margin of the work is a particularly susceptible area. Yes, you can still get cavities with veneers or bonding or crowns. But if you keep it clean, it will stay decay-free and protect your investment.
  • Some regular toothpastes can be too abrasive for cosmetic dental work. We recommend Supersmile® toothpaste, because it is very gentle—it has powerful stain-removing properties, but it removes those stains by dissolving them rather than by physical abrasive action. See our page on this site about Supersmile toothpaste. It isn’t available from stores. Rembrandt® toothpaste has an aluminum oxide abrasive that is very gentle and is also safe for any cosmetic dental work, though it isn’t as effective at stain removal. We have some general information about whitening toothpaste that may also interest you.
  • Watch snacking! This is very important. Between-meal snacking is the single biggest factor in promoting decay. Many dental professionals don’t seem to understand this, but this has been solidly established by scientific studies. If you are a constant snacker, you feed your decay-causing bacteria all day long, even if you have excellent brushing and flossing habits. The best thing you can do to prevent decay is to limit your eating to your basic three meals a day and maybe a couple of snacks.

Links to other information about maintenance of cosmetic dental work:

Click here to ask Dr. Hall a question.

This content was written by Dr. David Hall.