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.
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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
appearance as they begin to pick up stains because their glaze has been broken.
- Ultrasonic scalers, if used at the
margins of porcelain crowns, veneers, or composite bonding, 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 and 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,
mynewsmile.com 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.
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: